Since my last blog we have done our first implant surgical for 2012 and we’re now booking up for further treatments with regards to improving people’s quality-of-life through dental implants. We have started to see some of our patients who we’d completed work for some time ago. As I’ve said before, it is always good to ask them how they’ve been since they had the dental implants done. The usual reply is that they are now using their teeth without even thinking about them any more. However when pressed on how she actually ‘feels’, one lady said “It is good to feel normal again”.

That is what I’ve always said – we are in the job of improving our patients’ quality-of-life.

In the press at the moment there is lots of talk about medical implants, particularly breast implants, which obviously we do not do! But it is reassuring to know that the company that we use for dental implants, Nobel Biocare, is one of the world’s leading manufacturers of dental implants. They have a heritage which goes back to the original dental implants and a wealth of historical evidence, as well as current research to demonstrate the safety and efficacy of their products.

Furthermore, when the implants are placed at our practice with a recommended treatment plan, our standard is to offer a four year guarantee on the work that we place in your mouth (subject to conditions). I wonder how many of the breast implant clinics could offer that?

Last week was somewhat crazy in the fact that on Monday my eldest son was playing football in an enclosed area of the school and managed to break his foot in two places. He went to kick a ball but his foot followed through and hit the base of a netball net. This meant that my wife spent most of the week running around sorting out his casts. She managed to get him a rather snazzy splinted boot which allows him to walk on the broken foot.

To really top it off, yesterday I allowed my two youngest sons to buy some toy bows and arrows with suckers on the end of the arrows and you guessed it, just after supper my eldest got shot in the eye with an arrow fired by my 9-year-old. Fortunately, despite all the shouting and moaning it did not require yet another trip to the minor injuries unit, which like in the UKand the UN Security Council, the Main family now has a permanent seat.

Thinking of strange things happening, I was in London last Wednesday attending a business meeting in an office in Mayfair. At the end of the meeting when the person being interviewed was leaving he was asked to press the red button on the door in order to let himself out. However, he somehow managed to press the wrong red button, which of course set off the fire alarm. This reminded me of something that happened this time last year. I was up in Glasgow for a dental implant conference and went out one evening to a theme pub – sponsored by Nobel Biocare – for that evening’s entertainment. At 11:30pm the fire alarm went off and we all had to be evacuated onto the streets of Glasgow and after a short wait the fire brigade turned up with two engines and the accompanying firemen. It never fails to amaze me what a fireman’s uniform does for some ladies, as one female dentist amongst a group was MORE than excited that these firemen had turned up. The bizarre thing about all this is that exactly a week later I was enjoying a meal at the Warwick Arms near Bristol and just as we were about to go and have our dessert, the fire alarm went off and we were promptly evacuated to the car park of the pub. This time the thrill of the fire engines and the firemen was enjoyed by my three boys. So when the fire alarm went off in London, I just put it down to the effect I have on fire alarms!

As I said at the start, it’s the Chinese New Year and so this time in English may I wish you Health, Wealth and Happiness in the year of the Dragon.

I contrast this with the patients for whom I have recently restored their mouths both functionally and cosmetically with dental implants, where in some cases, for the first time in 3 years they have been able to enjoy their Christmas dinner with family and friends and eat, smile and laugh in the same way that many of us take for granted. There is also the patient who for almost 20 years has had to put up with a failing tooth and always had to worry about it, and now this would have been the first Christmas that they did not have to constantly think about the tooth, and instead just get on with their lives and enjoy their time with their loved ones, and where for the first time they have been able to see themselves as being beautiful.

This is the time of year that we do the most meeting and greeting friends and family and making new relationships. I know that the people who have benefitted from the care that we have given think it is the best investment that they have ever made and those that have come and decided for whatever reason not to make that investment will never know how good their quality of life could be which is a real shame as I think life is short enough, and we often talk of the quality of life being more important than the quantity of life. I do wonder how much of a price can we place on being able to enjoy the simple pleasures of life, of being able to eat, smile and be with our friends and family without it being constantly restricted by a mouth that is handicapped.

For the Main family over the festive season we spent our time together – Jo and I and the 3 boys – and we did our usual on Christmas Eve and go to Bristol to see a Christmas show. We would normally go to the pantomime, but none of us fancied seeing the ‘Hoff’, so we went to see Coram Boy, which had moments where if our youngest two didn’t know where babies came from, they sure do now!

When we got home we tracked Santa on NORAD (North American Air Defense Command). As you can imagine, any fast moving, low flying object is of special interest to USAair defence security and Santa is no different – except they track him not to shoot him down, but to ensure the kids around the world get to bed on time before he arrives. Our lot usually get to bed when they see he has just about finished in Helsinki. What we really need instead of the High Speed Railway 2 is some of Santa’s reindeer and a very large sledge.

Thinking of Santa, we had a pretty uneventful Christmas day until we all sat down for Christmas dinner, another amazing Christmas meal (turkey with all the trimmings) from Jo that she had spent the previous week putting together. When we sat down my youngest son was looking rather miserable and when asked why, he complained that he did not receive a Lightning McQueen car from Santa despite his brother getting one. We said that as far as we knew he had not put it on his letter to Santa. Of course he did not agree and this did not placate him so we suggested he might want to go to his room until he felt happier. He did and the next thing we knew he was having a shower to go to bed.

Needless to say with all the effort that had gone into the day, my youngest was not really showing the appreciation that justified the effort! So next year Jo says they shall have one present on their list to Santa, one from us and Spaghetti Bolognese for Christmas dinner, so humbug to all that! I know we will relent but it sounded good at the time.

We saw the New Year in with some friends and their kids and on New Year’s Day we had a house full of 15 people. Jo was lucky enough to get a haunch of Exmoor venison at a knock down price and we served that up for New Year’s Day lunch.

Being that time of year I offered a little puzzle as to whether they could spot the irony in the meal. Bearing in mind our central table display was Santa on his sleigh and four of his reindeer and we had a vet sat on the table, still nobody got the irony of it all until I said – after we had all consumed the venison “Who has eaten Santa’s reindeer!?” Fortunately being in Somerset we are all made of stern country stuff and nobody felt the need to retire to the loo prematurely!

I hope the readers of my blog have a fulfilled 2012 and may it bring the happiness that you and your loved ones wish and hope for.

However it never ceases to amaze me how my wife, Jo, manages to come into work make all the Christmas cakes and puddings, decorate the tree, write all the Christmas cards, sort out the kids with their various parties and activities and ensure that we all get fed with a proper meal every evening, but still manages get Christmas presents for everyone, including me.

For my part I still go to work and ensure that I write one Christmas card to Jo and sign the ones to the boys and make sure I buy Jo her presents, even so I still somehow manage to leave buying her presents until just before Christmas Eve!

I suppose I just supported the theory of the multitask differential between sexes.

Work has been busy, I’ve been helping quite a number of very anxious patients to overcome their anxieties about dentistry and one of the patients I am treating told me that she finds it quite an experience being treated as a whole person. I am a great believer in the holistic approach and so I treat all my patients as a whole person. When patients asked me what I mean by holistic dentistry, I mean exactly that. It’s not just a matter of looking into the patient’s mouth and treating the teeth and what’s surrounding the teeth, but it’s about ensuring that I’m looking after that patient as an individual human being and doing my best to ensure that their anxieties and fears are treated – as well as me improving their quality-of-life through improving their dentition.

People do ask me whether I enjoy my job and I must say that there is no better buzz than being able to help somebody improve their quality-of-life in such a personal way. I am about to give one patient permanent teeth, the first time she would have been without a denture in 54 years so I shall be very excited to see how it will improve her life.

I had a call from the publishers for whom I write articles – some of which have been placed into various dental journals. I wrote an article a couple years ago called the Sentimental tooth and Herodontics. It was about how both dentists and patients try to do their best to hang onto some teeth which clearly in the short and medium term would ultimately fail, and during that process cause further damage and loss of bone in the jaw. The article described how one should make a decision sooner rather than later on the long-term prognosis of these teeth and maybe decide that placing a dental implant would be a better option in the long-term at a time when there still was bone available to do so. The article was published in the dental implant journal in UK about a year ago and I have now been asked by the publishers to have it published in a German dental Journal. I’m quite pleased as this will be the first time that I’ve been published in another language!

I’m still up in the mornings around 5.40am to walk my dogs Molly and Monte. I thought include a picture of my two dogs with this blog, as even for an unsentimental guy like me, I do think they are somewhat adorable.

It is always interesting walking at that time the morning as Monte (the black labrador) goes dashing off into the night and virtually disappears. Thankfully he is much better behaved than his friend Molly (the white labrador) and will come back upon calling. Molly on the other hand also dashes off but thankfully being white she can be spotted by torchlight, particularly useful when she’s found something pretty horrible in the field to try to eat. There is something nice about that time of the morning when walking the dogs under the stars in a clear sky; it certainly seems to be when the best ideas and thoughts come to your mind.

As I said earlier Christmas seems to be coming upon us pretty quickly, and I may fit in another blog before the end of the year, but just in case I don’t here is my Christmas grace which I wrote some time ago and we say at every Christmas meal that we’ve had since the birth of my eldest son, hopefully it is something which you find as a resonance for you on Christmas Day.

A Christmas Prayer

We gather here amongst family and friends

With Christmas cheer to each we extend,

Its with mirth and laughter we shall live this day

But in the quiet let us reflect and pray;

That with sumptuous food laid upon this table

Let us not forget a child in the stable.

For upon this day we do celebrate

The greatest feast of God’s grace

Amen

James Main

Christmas 1998

Since my last blog lots of interesting things have happened; not least to do with my boys, but more of that later.

We have had a busy couple of weeks at the practice. We completed a large case where a gentleman had come to us as his teeth were falling apart. At 74 years old we were able to give his mouth a new lease of life, so it’s one less thing to worry about as the years go by – and if anything he’ll be able get a lot of pleasure from both eating and smiling in the future.

I’ve also had a number of challenging cases that involve both implants and cosmetic dentistry – not to mention that the cases involve rather nervous patients.

What I always try to keep in mind is that we like to achieve the results we do by giving the patients a good experience along the journey, knowing full well that once everything is completed it is something they will benefit from for pretty much the rest of their lives. This was highlighted when I saw a patient I completed in May of this year. She said how delighted she was with the restoration of her teeth and that it was the best money that she has ever spent.

The weekend before last we went to Saunton Sands in North Devon which is our usual annual trip at this time and we went to visit the Eden Project. I must say that it is definitely worth a visit even though it is quite a trek to get there. On the Sunday before we left we went to the go-kart track in Barnstaple and my 13-year-old son was quite desperate to beat me at long last. I managed to crash into the barrier early on in the race and get myself stuck whilst my son went past me and I thought I had lost the race. However later on in the race he had done the same thing which allowed me to get well ahead of him. And in my penultimate lap I managed to skid into the barrier again whilst he, with great gusto, went past me. I did manage to catch up with him and just finished before him. However when we looked at the lap times I was actually two seconds faster than him! I have to admit it is fun moments like these that make things worthwhile.

This week seemed to revolve round my youngest son and a screw. It was recently his eighth birthday and on Sunday we bought him a Star Wars Meccano set which she spent Sunday night playing with. On Monday night he came in to see us complaining that he had a screw in his ear, at first we did not believe it and thought that he was just being silly. But just to ensure that it was not the case I took a torch to have a look and sure enough what I saw was the head of a screw.

Fortunately I had the tweezers of my old anatomy dissecting kit in my drawer which I then sterilised with hot water and had a couple of attempts at removing the screw to no avail. We then rang up the Glastonbury minor injuries unit to see whether they had some better kit to do the job, they said they had so I ended up taking my son up to the unit. They had a number of goes with a little suction pad however they could not get it out and possibly moved it further in. So at 10 o’clock on Monday night it was a trip to Musgrove A&E, but they too were unable to get it out so he had to be booked into the ENT clinic for the following day. Jo took him to the ENT clinic the following day and they too were unable to get it out and wanted him to go under GA in order to have it removed. To be fair to the ENT team they were willing to book him in the following day onto their surgical list however they were told that there were no Paediatric anaesthetists available and that he would not be seen for at least another two weeks. Unbeknownst to the Musgrove hospital bureaucracy, Jo and I know two of the consultant Paediatric anaesthetists in the hospital, who she happened to meet walking around in their scrubs, so needless to say we were somewhat annoyed at the decision of not being able to remove the screw from our son and to leave him with it in his ear for another two weeks. I was thinking what a great news story this is going to make if we could not arrange to get him in sooner. So on Tuesday evening Jo and I had worked out our next game plan with regards to getting the screw out as quickly as possible by approaching the Bristol Children’s Hospital. When I got home around nine o’clock on Tuesday night, Jo was rather excited as she had noticed that the screw in his ear appear to be much nearer the outer part of the ear hole, and I immediately got the torch to have a good look and noticed that not only had it moved nearer the outer part of the ear hole, but that it had also spun round to face the other way. Just as I was about to get my old anatomy tweezers out, our son gave his head another shake and out fell the screw!

The Recently Freed Screw

Needless to say there was much whooping and cheering and high-fiving. It turns out that our son had spent all day shaking his head and putting in more ear drops than he should have done which must have loosened the screw enough for it to start to come out. He was very pleased with himself and as we put him to bed he said that he was now double clever as not only was he the only one the family to be able to complete a puzzle (some months ago) but also he was able to get the screw out despite all the best efforts of the medical profession in Somerset. My middle son (the smarter and competitive one) feeling that he is the clever one called out from his room “I bet he doesn’t know what 7.5 and 7.5 is” at which point I just said “Who cares now that the screw is out?!”
This again shows that life is never dull in the Main household.

Take care

James

I had a fun weekend last weekend in that my youngest (7 year old) son (who has quite a voice – in a nice sort of way) went to be a chorister for the day at Wells Cathedral. It was great, we left him there for the day and I didn’t wish my son good luck, but I wished the choral master good luck with my son.

Meanwhile I bought my middle son a belated birthday present of a full desert camouflage army uniform. He already had the flak jacket so with the trousers, T-shirt and jacket he looked like a regular terror, which brings me back to my youngest son who we all went to see doing the evening song at the cathedral. He looked angelic (he wasn’t in the army fatigues) and during the rehearsal the choir master asked them all to sing ‘Aaaahhh’, just like at the dentist, then he stopped and turned round and with all the other parents sitting around me, he asked “Is there a dentist here?” I was going to keep quiet, but with my two other sons beside me in the choir pews there was no chance, so I raised my hand just above my head. He then asked if I got my patients to say ‘aaahhh’. Sadly he was right, I do (to look at the back of their throats). With me feeling vindicated in his example he returned to his choir with the polite laughter of the other parents ringing in my ears. I wonder if when he asks the choir to hum ‘mmmmm’ he asks if there are any Graham Norton impersonators in the place…

Anyway my son thoroughly enjoyed it and I must thank him for that.
The deal with the army fatigues is interesting as I had to use it as a punishment by the end of this week.

My middle (9 year old) son who is learning to write with a fountain pen, decided that the plastic Parker pen that I had bought for him was not good enough and took my wife’s silver Mont Blancpen – that I had bought for her 30th birthday – to school! He even managed to convince the teachers that the pen was bought by us for him! I am not sure whether it is a reflection of the myth that dentists earn too much or that we are stupidly generous people. Either way, when my wife found out about this at the parents evening from his teacher he was in for the high jump, hence the army fatigues are now in the boot of my car. Aaaahhh the joys of having kids.

While I was at Wells Cathedral I was inspired to write a poem, so here it is

God’s Pleasure

Magnificent, glorious and inspirational,

We become emotionally furiously creational,

In our desire to please YOU

And our eternal fire to be devotional.

We see the cathedral stone

Like an elaborate embroidery,

Rising above our city so known,

Because of the links of our common heraldry.

The cathedral’s sight and sound gives the impression

Of giving YOU pleasure through the expression

Of magnificence, splendour and innocent exultations

With the customs and rituals as is the church’s dependence.

But to all this glory and ages of love in the stone,

What pleasure is this all on its own

If it’s seen to be God’s Museum

Then it is Mankind’s Mausoleum

As God has no pleasure from all the art

If it does not impart to the heart,

A conduit of love between you and He

A constant with eternity.

And forget the creativity of mankind in stone

The glorious voices singing in tone.

As the cathedral for God is thee

To come to him in humility,

With love as your only measure

Then within you is the cathedral of God’s pleasure

James Main

16th October 2011

Jo and I went toLondon last weekend without the children, and running to a tight schedule we just made it as a train from Gillingham toLondon arrived on the platform. However by the time I managed to get the ticket for the car parking from the station’s ticket office the train had left. It was then, on returning to the car, that I noticed a poster advising me that we could have paid for the car parking using a mobile phone and quoting the station’s code. However there is a silver lining to this cloud as we had both left our mobile phones in our car in a rush to get to the train, which would have been somewhat disastrous over the weekend!

At least you now know if you’re in a rush to get on the train at Gillingham to not bother getting a parking ticket but instead to read the poster beside the parking ticket machine. The thing that we did notice a lot this time while in Londonwas the number of young people actually homeless on the streets. I have worked with homeless charities now for almost 20 years and I have seen quite an improvement in those 20 years – in particular the work that’s been done by Taunton Association for the Homeless (TAH) with whom I still work – but our visit to London this time seemed to take us back at least 10 years and that was very distressing to see.

One of the things I find interesting doing my job is that it is both technically and artistically demanding. However, when we deliver a surgical solution for patients it’s easy to forget that the patient has a journey and experience to go through in order to achieve the results that they wish for.

This is one thing, having treated so many phobic patients over the years, which I am extremely aware of and place a lot of emphasis on ensuring that the experience patients have, no matter how complex the procedure, is always a pleasant and good one. It is one reason why I always call my patients the day after surgery to see how they are doing and it is always gratifying to know that within 24 hours they are no longer taking painkillers and feeling generally good. This is very much the experience of the vast majority of our cases, although it is always difficult to get the apprehensive new patient to believe your stats. But I believe that the patient’s experience and journey through the treatment is as important as the end result itself.

Jo and I have another busy week ahead with kids and work, but hopefully we’ll get some time to ourselves.

Best wishes

James

The practice has been busy since we have been back. I have started on a number of new dental implant cases and a number of new cosmetic cases. As well as which we are reaching the end of a number of large treatment plans, and as I said before it is great to see the final result, but even better to see how delighted the patients are and what a confidence boost it gives them. I’m currently writing up a case report for a dental journal involving a patient who first came to see me because he had a very severely worn dentition and whilst he was not particularly concerned about his appearance, because he was perfectly happy within his own skin, he had been offered an opportunity to fund his treatment as he was being recruited to work in a clinic in Holland. After the treatment was done, not only was he able to eat better and it improved his digestion but he realised what a difference it made in how he interacted with other people, even with people that had known him for a long time. In particular he told me that prior to his teeth being done he was delivering a presentation to a potential sponsor with regards to a charity mission to Kathmandu. After the presentation, the sponsor said to the leader of the mission that she was very keen to sponsor such a mission however she did not feel comfortable that my patient could be trusted with the money! Months later, once his teeth had been done, he gave another presentation with regards to the same mission to Kathmandu to the same sponsor. There was no problem and the money became available. This is an incredible story of how one’s teeth, smile and overall appearance can have a major influence in how others see you even though you may present with complete confidence within yourself. I  attach some photographs of before and after to show you what can be achieved with dental implants and cosmetic dentistry. The beauty about this case is that we just added to his teeth as opposed to taking anything more away, and that is the beauty of what dental implants can do.

Finally the major worry for us this week is our eldest son had been kicked in the head whilst playing rugby so we’ve been in and out of Musgrove hospital to get him checked out. This is a strong recommendation for wearing scrum caps at all times as well as professionally made gum shields.

Take care

James

Thankfully, it is not something we do too often, but we were able to get the child’s teeth put back in a better position and reposition the bone around the teeth back to where they should have been. Fortunately for the child, the quick thinking of the people at the minor injuries unit, who placed the teeth back into the socket within thirty minutes of them coming out, gave them the best chance of them retaking. Anyway the child was fine and his father was very happy with what we had done. Hopefully I may be able to report in the future that we managed to ensure the teeth have reattached themselves back into the jaw bone.

August is always a funny month with lots of people away. We have been doing quite a lot of crown work and replacing patients’ amalgams (mercury fillings) in a safe way – by using a rubber sheet to isolate the teeth when we remove them. By doing it this way I ensure that the mercury and amalgam debris does not go down the patient’s throat but goes into our aspirator hose. This has been scientifically proven to be the best way to ensure low blood levels of mercury during removal of amalgams.

Despite it being a patchy month we have done some nice dental implant work and done some bone work, repairing some bone around the tooth that was lost due to gum disease. We also have a keyhole surgery case to look forward to at the end of the month, during which we shall give the patient instant teeth!

I have also sent numerous packs and flyers to local dentists about a course I am running on the Thursday 29th September at the Holiday Inn Express at Blackbrook,Taunton. Alongside my technicians we shall be talking about the treatment of the Difficult Denture Case.  Anyone interested in going on the course should contact us.

Our 3 boys have been out camping and also attended the Multiactivity course at Millfield School. Last Friday they had a fancy dress fete and my wife took to school a Cyberman, Manchester United footballer and Gok Wan (courtesy of my eldest son). He was disturbingly convincing and amused all during their lunch break telling the staff that what they were wearing ‘just had to go!’ – he even had the Gok Wan walk. Rory Bremner had better watch out!

We shall be off next week so will let you all know how we got on whilst the practice was closed.

Finally as all the kids are off I offer you this poem I wrote some time ago about mothers and their children.

  One for the Mums  

I know it seems that we don’t care

Except to run you ragged here and there;

I know it seems that you are in a hole

As the darkness around you enfolds.

As seem as it may seem to be,

The reality is that we love you dearly;

And what may seem a darkening hole

Is just us all hugging you close.

Best wishes

James

In contrast, I was catching up with outstanding treatment plans and I called a gentleman who suffers with his denture. He is unable to smile properly or eat properly and finds that he is tending to slur his speech as he tries to control his upper denture which is reducing his confidence to interact with other people. If only I could give him just one day to experience the quality of life that comes with an implant retained bridge. As I said to him yesterday; life is too short to suffer unnecessarily.

On another note I have had a paper published in a new dental implant journal which came out this May. It is about the sentimental tooth where a patient and the dentist hang onto a tooth that really, at some point, should have been extracted and an implant replacement fitted. Hopefully it will stimulate some thought amongst my colleagues to think of other options. Thinking of other colleagues it is always gratifying when I see patients who are no longer at the practice (as they have moved away) who have been to see another dentist. In the case of a patient who moved up to Edinburgh she has seen a dentist up there who says that she was amazed at the work that was in her mouth – a mixture of implants and cosmetic dentistry – which we did for this patient about four years ago. Good to have recognition from one’s colleagues!

On a personal note, Jo and I went toIbiza for a 50th birthday celebration over the course of a weekend. We both had an interesting time in getting a good tan and a rest from both work and the kids and Jo and I even managed to go to the famous club Pascha. We arrived there at 1am but it was completely dead – however Jo did get in for free as she did look a lot more glam than me – and it was not until around 2.30am that things started to hot up by which time us oldies were ready to cross the road and get into our hotel bed. Looks as if my days of clubbing are now long gone! We have also been away to a wedding in Berkshire of Jo’s cousin Lucy. It was a great wedding and the first time that our boys have actually been to a wedding. I have at long last invested in a kilt, which I find wearing in England, looking the way I do (that is Chinese looking) certainly raises a few eyebrows. Especially when I went to the Kebab Shack in Marlow after the wedding at around 1am. People there did ask whether I was a real Scotsman, my usual reply being, “Doesn’t it show?!”

Our boys were also all kilted up and they looked magnificent.

Hopefully this summer I will get the chance to write a couple more papers and help a few more patients improve their quality-of-life through my cosmetic dentistry and dental implants.

We all seem to be working very hard at the moment. We now have a new trainee starting with us called Emma and I am very hopeful that she should do well, she’s already seen quite a bit of surgery so at least we are confident that she is not going to be too squeamish.

On the home front it has been tough as the lady that helps us out with our boys has had to leave us due to ill-health and with half term it puts a strain on Jo’s time. The boys have been getting into their bikes and I hope that sometime this summer we should do some cycling together. My youngest, who is just about able to ride his bike, was getting somewhat ambitious and decided to go onto the main road on his own without a helmet! Needless to say we were livid, however just very glad that no harm came to him, so couldn’t really tell him off to badly.

I used some hypnotherapy recently on the medium I treated, something I have not done for a little while and that seemed to have worked really well for her, so I may get back into it again.