D e n t a l    F o l l i c l e               

             The        Monthly     E- Journal Of  Dentistry                  Vol - I V    Number-  X I I   May 2010

In this Issue:

  • Editorial

  • News

  • DentistryUnited  Ranks  2   on GOOGLE

  • Video Of The Month - CT Applications in Dentistry

  • Halitosis -Breath Malodor - A review (Aug 2009) - Dr.Gazala Danish

  • The Overwhelmed Practice (December 2009) - Dr.Bhavana Doshi

  • Cure for the tooth ache - Royal Gazatte & NewFoundland Adverise - Feb 14 1811                                     


Editorial :


Dental Follicle Volume 4 Number 12 --- This is the end of 5th Year Of Dental Follicle. In this issue you have two of the best papers published in the last year. In the next 2 months will publish papers , which were some of the best in the last 5 years.

Have nothing to say more than " thankyou" everyone for making Dental Follicle a success story.

Click here to join DentistryUnited
Click to join DentistryUnited

Yours truly

Dr. Syed  Nabeel

Editor of Dental Follicle & WebMaster


DentistryUnited @  Ranks 2 on GOOGLE

Laughter - The Best Medicine :

Patient: Doctor, what does the X-ray of my head show?

Doctor: Absolutely nothing!






Halitosis -Breath Malodor - A review


(Aug 2009)

By Dr.Ghazala Danish MDS

Oral Diagnostitian & Radiologist



Breath malodor means an unpleasant odor of the expired air, whatever the origin may be. Oral malodor specifically refers to such odor originating from the oral cavity itself. A term like halitosis is synonymous with breath malodor. There are references to it in the Bible and in the Koran. Surprisingly enough, until recently breath malodor has not been a matter of much interest in periodontology, although its most frequent causes are plaque-related gingivitis and periodontitis.

Breath malodor should not be confused with the momentarily disturbing odor caused by food intake (e.g., garlic) or smoking because these odors do not reveal a health problem. The same is true for morning bad breath: as habitually experienced on awakening.

A persistent breath malodor, by definition, does reflect some pathology.

Imaginary breath odor or halitophobia, well-established personality disorder questionnaires allow the clinician to assess the patient's tendency for illusional breath malodor.


Morning bad breath

Transient breath malodor is noticed when waking up in the morning in more man half the adult population. It does not deserve special attention since it is due to the xerostomia developed during sleep, i.e. when salivary flow is reduced to a minimum. This with the ongoing intra-oral putrefaction explains the malodor when waking up. Morning breath odor disappears soon after the intake of food or fluid. The intra-oral placement of a toothpaste containing zinc salts and triclosan has the capacity to reduce the odor for several hours, even in the absence of toothbrushing.


Socio-economic aspects

The real concern of the population is the breath malodor which remains during the day and which can cause social and/or relational problems. Subjects who believe they produce malodor can adopt avoidance patterns such as keeping a distance when speaking to others or holding their hand in front of the mouth while speaking. There is also a tendency to constantly use rinses, sprays, chewing gums or pills to mask the breath odor, although many such items have no effect whatsoever or at least no lasting effect.

Even more disturbing is the fact that a number of subjects imagine they have breath malodor when they may not have. This imaginary breath odor, also called halitophobia, has been associated with obsessive-compulsive disorders or hypochondria. It has even led to suicide. For such patients, the presence of a psychologist/psychiatrist at the multidisciplinary malodor consultation is essential.


Etiology and pathophysiology

Causes of halitosis

I Physiologic

  Lack of flow of saliva during sleep




II Pathologic

A.    Disorders of oral cavity

  Poor oral hygiene

  Dental plaque




  Hairy tongue

  Oral carcinoma

B.     Disorders of upper respiratory tract

  Mouth breathing

  Chronic sinusitis

  Foreign bodies

  Atrophic rhinitis (ozena)

  Wegeners granulomatosis (Midline granuloma)





  Nasopharyngeal abscess

  Carcinoma of larynx


C.     Disorders of lower respiratory tract

  Pulmonary abscess

  Carcinoma of the lung



Necrotizing pneumonitis


D.    Gastrointestinal conditions

  Salivary gland dysfunctions


                  Anticholenergic drugs


                  Sjogrens syndrome

  Peritonsillar abscess

  Retropharyngeal abscess

  Cryptic tonsillopathy

  Vincents angina

  Carcinoma of the tonsil or pharynx

  Pharyngitis sicca

  Gangrenous angina

  Zenkers diverticulum

  Postcricoid carcinoma

  Congenital bronchoesophageal fistula

E.     Disorders of lower gastrointestinal tract

  Gastric carcinoma

  Hiatus hernia

  Pyloric stenosis

  Enteric infections

F.      Neurologic disorders



  Zinc deficiency

G.    Systemic diseases



  Febrile illness with dehydration


  Hepatic failure


H.    Drugs

  Lithium salts




  Dimethyl sulfoxide

I.       Functional


  depression be continued in next issue




VIDEO OF THE MONTH - CT Applications in Dentistry







The Overwhelmed Practice (December 2009)

Author: Dr. Bhavna Doshi  B.D.S Lon.

Dr Bhavna Doshi is an international lecturer, who has worked extensively with the National Media including Extreme Makeover UK.  She is the CEO of Dental WEALTH Builder, which primarily focuses on Practice Productivity, Cost-Effective Marketing and Growth Strategies

Too much to do, Too little time 

The most common form of stress that practice owners experience is the feeling of being overwhelmed with far too much to do and having little time to do it. In fact TIME POVERTY is the biggest single problem facing our profession today! 

We simply do not have enough time to fulfil our responsibilities. Because of budget limitations, staff motivation and training, downsizing, patient care and time needed with treatment planning, and then competitive pressures, individual practice managers and principals are forced to take on more and more work, all of which appears to be indispensable to the smooth functioning of the dental practice.


Unproductive Behaviours 

These pressures in turn often lead to unproductive behaviours by both dentists and dental teams. Unproductive behaviours include: procrastination, blaming anyone other than yourself, poor standards, waiting for a better time to do the work and generally never feeling that you are progressing in any way. These behaviours lead to unfulfilling work and lower profits, not to mention lower standards of care. 

This cannot be good for any business, especially in a business like ours where a service with a smile is so important to our ultimate practice growth.

Ask yourself the following questions:

How genuine is your smile when you are under stress?!!!

How effective and productive are you when you are pushed for time?

How much do you dislike your job when you are under pressure?

In this mind set are you taking your business forward or are you stagnant?


This tends to come to us in all forms and manner; and is definitely not beneficial to our long term health. When we are not achieving our goals in life we often tend to procrastinate or just settle ourselves in our comfort zones that are familiar and bearable. Going outside this zone often leads to undesirable stress. 

Stress often comes in three forms the good, the bad and the ugly

The ugly stress is the one which leads to verbal tension and complete uncooperative behaviour. This is damaging to the entire infrastructure of the business. You will instantly recognise this because it will be the only thing playing on your mind. Get rid of it now! 

We then come to the bad stress, this is often the one we do not realise is creeping in on us. This is the stress leading to job dissatisfaction, where we no longer enjoy the practice of dentistry, yet dont even stop to even think about the cause of it. We often blame our patients and unmotivated staff. We tend to end up feeling there is no way out and this is the way it will remain. We go into an if only mode. 

What we need is the good stress, this is the one we need, to keep us alert and motivated and is the one which allows us to achieve goals. Good stress is created as a result of reorganising the elements which give us the bad stress. 

As a business owner we need to take a step back and re- evaluate our situations. We need to ask ourselves What are we trying to achieve? We then need to figure out the steps that will take us there.  

We need to take a good look at the bigger picture-of where we are heading.

The most common time wasters:


         Telephone interruptions

         Drop-in visitors e.g. sales reps

         Ineffective delegation

         Lack of clear  and definite purpose, vision and goals

         Crises management

         Attempting to do too much at once

         Lack of prioritisation

         Personal disorganisation

         Lack of practice systems

         No definite system to monitor progress


         Lacking the ability to say No

         Having poor team members

Becoming an expert 

Then all we need is to create solutions. One such solution to the problem of work overload is for you to become an expert in time management. There is probably no other skill you can learn that will give you more value per pound spent than to become extremely knowledgeable and experienced in using time management practices. 

It is a case of giving more value to your time than your money. In order for you to do this you need to take an inventory of yourself and your practice needs. Then you need to prioritize the steps which will lead to your bigger picture. You need to develop sound leadership qualities in order to redirect the team and their operative functions within the practice. 

The art of leadership and delegation is what will eventually save the day. As a business owner you need to be more visionary in your role in order for you to take your practice forward. 

Time management is about doing your job in the most efficient way possible to maximise profits and enjoyment.  

The two indispensable keys to the practice of time organisation are:

-          the ability to set priorities

-          the ability to concentrate single- minded on one thing at a time

TWELVE Tips For Effective Productivity 

1.    Write down a plan of key objectives for the following week.

2.    Focus on results not activities.

3.    Prioritise the daily objectives by giving each activity a 1-5 star priority.

4.    Plan your daily activities the day before. Your day will begin on a higher note.

5.    Include personal time for yourself daily, to reflect on your day ahead.

6.    Good planners consistently get better results than non-planners.

7.    Give start times and finish times per activity for effective planning.

8.    Make sure delegation is done effectively by ensuring the job is explained clearly with help given when required and more importantly a deadline for completion decided.

9.    Do not put off high productivity activities. Follow the Pareto principle that 20% of your actions will lead to 80% of your results and vice versa.

10. Regular, planned, and prepared meetings to increase practice communication

11. Provide complete and effective training to the team.

12. Do not succumb to interruptions during a planned activity e.g. telephone interruptions, internet use, emails, etc

Since there is never enough time to do everything that needs to be done, you must be continually setting priorities on your activities. Perhaps the very best question that you can memorize and repeat, over and over, is, What is the most valuable use of my time right now? 

This question will do more to keep you on track, hour by hour, than any other single question in the list of time management strategies. 

Often we are so busy doing the LITTLE things that all we achieve is LITTLE results!!!! The natural tendency for all of us is to major in minors and to give in to the temptation to clear up small things first. After all, small things are easier and they are often more fun than the big, important things that represent the most valuable use of your time. 

However, the self discipline of organizing your work and focusing on your highest value tasks is the starting point of getting your time under control and lowering your stress levels. 

This principal not only applies the dental business management but also to your time allocation with your patients and their treatment planning. Schedule your patient diary to maximise income yet at the same time to lower your stress levels by deploying the correct time allocation per patient. There is nothing more stressful than a waiting room full of WAITING patients!!!! 

There are various techniques to scheduling your patients with better efficiency. One such technique is to book long higher income earning procedures in the morning (when you are your at your optimum level of energy) and to book lower income earning procedures in the afternoon. This way you still have sufficient productivity each day yet you are not stressing yourself all at one time. 

One other action point you can make use of is to create definite practice systems for various jobs, then create a check list for that system. Soon the systems within the practice will become auto-run by the team as norm, hence freeing you up for creative ventures to grow the business.  

Creative Procrastination 

Set clear priorities each day, week, month and year and soon you will be realising your potential for further growth and productivity. This we can only do if we have taken the TIME to work out where we want to steer our ship. We need to understand the most valuable use of our time deciding what to eliminate, what to delegate and what to outsource. We need to be creative in our procrastination of our responsibilities.  What should do we do now and what we can leave for later are very important productive decisions.  We will ultimately have peak performance and enjoy the benefits, if we manage our very valuable time to its ultimate potential. 




Practice Essentials

Correct and efficient time management skills are an essential to any practice owner. Especially if you are ambitious enough to want to enjoy the fruits of your labour, and obtain enjoyment and fulfilment in the practice of dentistry; not to mention increased productivity!




Cure .For The Tooth, .Ache.

Royal Gazette And Newfoundland Advertise... - Feb 14, 1811

The Above is from the archieves of dentistry. Do read above what was the treatment for tooth pain. Was it something that we advise to our patients not to have!!! Science takes "U" turns!