Lionsgate Leadership Blog

HELLO

2013-11-08T23:52:00.000-06:00

Hi,

I am Kate Morgan from Benin republic, I am 23 years...My Father passed away willing all his wealth and money in the bank to me worth over five million, five hundred thousand dollars $5.5m..I do not have a family, I would love to start a new family with you in your country because my uncle has threatened to kill me severally just to steal my inheritance..please get back to me if you can receive the money and invite me over to start a new life with you and your family. Please send your reply to the email below

katemrogan24@live.com

God bless you

Kate Morgan

Sad News.........(Marshall Wade)

2013-10-30T15:54:00.001-05:00

Hello,

This message may be coming to you as a surprise but I need your help.Few days back we made an unannounced vacation trip to Manila Philippines.Everything was going fine until last night when we were mugged on our way back to the hotel.They Stole all our cash,credit cards and cellphone but thank God we still have our lives and passport.Another shocking is that the hotel manager has been unhelpful to us for reasons i don't know. I'm writing you from a local library cybercafe..I've reported to the police and after writing down some statements that's the last i had from them.i contacted the consulate and all i keep hearing is they will get back to me. i need your help ..I need you to help me out with a loan to settle my bills here so we can get back home, our return flight leaves soon. I'll refund the money as soon as i get back. All i need is $1,950 ..Let me know if you can get me the money then I tell you how to get it to me.

I'm freaked out at the moment

Regards.

Marshall Wade

Easter resurrected

2012-04-04T21:48:00.001-05:00

It seems that this spring Easter has gotten kicked to the curb more than before. Holy Week is competing with the opening day of baseball season in the U.S., the NCAA National Championship game and the Master's Golf Tournament. Whatever time we have left after busy work days must be judiciously divided among these things or we might miss a crucial hit, a wicked fast break or a 40 foot put. May it never be! Instead, I will wither away my time pursuing these thrills at the expense of spending time in prayer, devotion, service or even thinking about the sacrifice Christ made for me, for us. C.S. Lewis said, "We are half-hearted creatures, fooling about with drink and sex and ambition when infinite joy is offered to us, like an ignorant child who wants to go on making mud pies in a slum because he cannot imagine what is meant by the offer of a holiday at the sea. We are far too easily pleased."

Is it any wonder that the world looks at us, the half-hearted Christians, with disdain? The resurrection of Christ is the pivotal event upon which all our hope depends for if the resurrection is a lie our hope is in vain and our faith is worthless. Wouldn't it make sense for us to focus on the one event upon which our lives are based? To consider the sacrifice that was made and what we've done with that gift? To finally live as we believe Christ has called us to live?

There are 3 days remaining to sharpen our focus before the Celebration. It is neither morbid nor depressing to think of the love that led Christ to the cross and the strength that allowed Him to finish the task. Rather it is with thankfulness that we look at that feat and child-like wonder as we strain to see the risen Christ. As the old preacher once said,"Friday's here but Sunday's comin!"
Let's act like we believe it!

A Requiem for Marty Wade

2011-11-20T21:31:00.001-06:00

A friend asked me a few days ago why I wasn't writing on my blog anymore and I began to recite a litany of involvements in various activities that precluded any quiet writing time. I paused to evaluate these activities and, while all are worthwhile endeavors, many were entered into for the wrong reasons.

To better understand what I'm going to say it is essential that the reader gain some insight into how I was raised. I was the first born of a brilliant, overachieving, highly capable mother. A winner of 2 national debate titles and valedictorian of Coe College she held advanced degrees in 2 different disciplines even in the 1950s. She instilled in me a deep desire to excel in all I did, not just to be involved but to lead whenever possible. Since one of her advanced degrees was in child psychology she knew how to make these lessons stick and I learned that notoriety was rewarded.

Somewhere in my life I lost sight of the purpose for doing notable things. Certainly there were exceptions when I knew I was doing the right thing for the right reason such as my work with Ukrainian orphans. Other times I was just the most qualified to do the job but many positions I accepted because of the associated prestige. I still worked hard to do a good job but I was always happy when the responsibilities ended. Since I began speaking publicly I have worked to constantly promote myself, to make my self noteworthy, which is an inherent part of that business. Through these efforts I have had the opportunity to present my materials at some of the finest dental meetings in the country and I have met many outstanding clinicians in groups large and small. Speaking gave rise to writing opportunities in various journals but the constant pressure to remain notable can be likened to a hamster on it's wheel. Unless you keep running the wheel will stop. Well, it's time for the wheel to stop.

Requiem is a word derived from the latin requies which means rest, especially after labor. Unfortunately it is more commonly interpreted to mean a mass for the dead but I assure the reader that any anticipation of my death is premature. For me, specifically, it means to put aside many of my present pursuits and to begin to pursue those things God has appointed for me to do. Not for my own notoriety but for a purpose beyond what I could have planned. I don't know what that looks like now but I know that I need the time to read and pray and listen for God's voice and I can't do that while I'm involved in so many different activities. It is amazing how much preparation time goes into each lecture before I ever set foot on stage and, with the clinical lectures, it is essential that all my material be current which requires constant updating. Add in travel time and the inevitable delays one encounters and it amounts to a lot of time away from the things I love the most, namely God, family and my practice.

Therefore, I am planning to end my speaking career in it's present form, as soon as I have honored my commitments in 2012. Additionally, I am resigning from the boards of which I am a member and will be limiting my writing to my blog and occasional posts on social media. I'll be posting new blog entries online and I would be honored if you, the reader, would be interested enough to return to my site. Until then I will be grateful for your prayers as I sort through this new chapter in my life.

Jim Elliott, a missionary and martyr in South America, made a statement shortly before his death that has echoed in the hearts of those deciding whether or not to give their lives over to God. Elliot said, "He is no fool who gives what he cannot keep to gain what he cannot lose." May it be so! Godspeed dear friends!

Give Your Life To Your Work, Not For It: The Death and Life of Dr. Dan Leafblad

2011-01-17T17:00:00.000-06:00

I had dinner a couple nights ago with my long time friend Dan Leafblad and his wife Barbara. Though our lives have moved apart a bit lately they are the types of friends where you can pick up right where you left off. Dan and I trained as residents together, he in OB-GYN, me in Oral Surgery. Our kids grew up together and we shared the stresses and strains of private practice though Dan's road was much, much harder. He was up delivering babies so often and having to see more and more patients in the clinic to satisfy his partners until one day his body decided it was through doing that. Dan and Barbara had been moving a big TV at Costco and, when he got into the car, he felt nauseated. Thinking this was just another bout of reflux he had his wife take him to the hospital where he so frequently spent his time. Luckily the woman at the front desk was his patient and got him directly into the ER where, while the nurse was out of the room, Dan suffered a cardiac arrest. His wife heard him thrashing against the bed while she was outside the room and immediately got help. He was in for the whole nine yards, intubation, defibrillation and chest compressions but he survived. After extensive hospitalization and rehab as well as an implantable defibrillator Dan was declared fully disabled, unable to function in the high cortisol world of surgical stress.
We reminisced about how when we were young in this business we thought we were immortal. We worked hard and there was a certain amount of pride associated with how hard we could work....for a while. Neither of us realized that one day we would be sitting across the table celebrating the fact that he was dead but now alive. Six years earlier I had developed an arrhythmia related directly to surgical stress and it gave me permission to cut back my hours and eliminate major facial reconstructive cases, for which I am thankful.
As I sit this week with 700 dentists and team members at the Seattle Study Club International Symposium I wonder, "How many of my friends here realize that how they treat their bodies now may determine whether and how well they will function in the future?" Secondly, I wonder, "How can I tell them? How can I keep them from making the same mistakes that Dan and I made?" This blog is the initial attempt at telling everyone that our bodies will eventually say, "No, I can't do that anymore!" When your body makes that decision is largely up to you and me.
Functional Strength© will be a focus for Lionsgate Leadership Coaching this year. I'll write more about the program and how to get involved soon.

An Amazing Act!

2010-12-23T15:38:00.000-06:00

We are visiting relatives in Florida this week and we were fortunate that our grandkids from Chicago could join us for a few days. I spent a lot of time with 4 year old Luke who has become Papa's (me) buddy. When he left he was in tears because it would be so long until we saw each other again and I found myself crying too. I thought to myself," I would die for this kid!" In fact, we had seen an alligator in the pond close to where we are staying and that night I had a nightmare that I was playing with the kids and the gator tried to get Luke. With no hesitation I let the gator attack me so he wouldn't get to the kids. No remorse, no misgivings just a clear sense of my duty as a grandparent in love with his kids whether Luke, Faith, Elijah or Noah.
All of us would give our lives for the ones we love. But the greater question is which of us would give our lives for the ones we don't know, let alone love. Perhaps as a hero or heroine in a plane crash we would give our lives. At least I like to think I would have the courage to do so. But would I give my life for those who hate me or want to actually harm my family? Again, maybe under the absolutely right circumstances but, honestly, it's unlikely.
Yet God sent his only son to do exactly that. I know some who are reading this are not Christ followers and I respect that but isn't it amazing that the Being that created all we have or see or are, who could choose to punish or redeem humanity however He wanted, would choose to send His son to die for those He loved, those who did not believe in Him and those who outright hated Him. That is not human-like. That is not God-like. That is God!

God bless you all!

Marty

Luke running

When Dollars Dictate Our Decisions

2010-12-15T21:44:00.000-06:00

I had an uncomfortable conversation with a clinician a couple weeks ago in which he tried to justify his inadequate treatment of Medical Assistance patients based on the fact that he is so poorly reimbursed by the state. He kept trying to tell me that he is the ONLY clinician seeing these patients and he had to see a lot of them to meet his expenses. It's no wonder he has had disciplinary action taken by the Board of Dentistry because his thinking has a terminal defect; it is just not true. One of the essential pillars of LionsGate Leadership teaching is to tell yourself the truth. Making an error at this threshold leads to multiple poor decisions moving forward.
The siren song of these difficult economic times is that each of us must somehow cut our costs or see more patients or do something to make more money. At one level these are prudent business decisions but, as with many other things, when taken to their extreme they become destructive to both the patients and the clinician. My personal feeling has always been that my patients deserve the best I can give regardless of their socioeconomic status and if it costs me a little more or my profit margin is a little less, so be it. This doesn't mean giving away the farm because the situation doesn't come up that much. But I will never allow myself to determine treatment based on my income. We'd like to think that all our colleagues behave that way as well but, after more than 3 decades in dentistry I know that is not true.
Who is the biggest loser in these situations? Interestingly it's not the patient, it's the dentist. Once their integrity has been compromised it is easier to compromise it again, and then again and then... Rather, I would prefer to pursue a level of character defined by C.S. Lewis when he said," There is a difference between doing some particular just or temperate action and being a just or temperate man. Someone who is a good tennis player may now or then make a good shot. What you mean by a good player is a man whose eye and muscles and nerves have been so trained by making innumerable good shots that they can now be relied on....In the same way a man who perseveres in doing just actions gets in the end a certain quality of character.
May we all be known as people of that kind of character!

It's All About Expectations

2010-08-22T22:18:00.000-05:00

This weekend I played in our golf club's Championship event. Don't get me wrong. I am a bad golfer. I was placed in the 6th (and last) flight. If there had been enough people for a 7th flight I would have been in that one. But I went with high expectations because I had been playing better and had taken some lessons. Each flight awards winners as well as the overall Club Champion so I thought I might be able to beat the guys in my flight and win something. At least to have the honor of being the "Best of the Worst". What I didn't count on was that since this was the club championship the course was left to be as hard as possible. The rough was long and the holes were placed in the most difficult positions and the greens were made VERY fast. The competitors played over 2 days in hot weather which was a test of everyone's stamina.
Suffice it to say that I didn't play as well as I had hoped although I finished in the top five (of the worst flight). Initially I was angry at myself but I realized that this was the first time I had played under such extraordinary circumstances. I played the best I could, kept a great demeanor and learned a lot about the Game and myself. I was only angry because I had unrealistic expectations.
Whether we are playing golf, working in the office or just trying to get along at home, life is about expectations. How many problems could be avoided if we knew what was expected of us and could communicate our expectations to others! It is unreasonable for me to be frustrated with my assistant if I haven't told her what my expectations are. And at home I need to know what my wife expects of me so I can stay in her good graces.
So I urge anyone reading this to be simple and direct in your communication about your expectations. Most people will welcome such communication and if they don't, especially in the case of an employee, a more serious conversation needs to occur. In your "self" conversations, give yourself a break, be realistic in what you can accomplish and give it all you've got!

The Best Reason to Speak!

2009-05-16T10:42:00.000-05:00

This week I had the honor of speaking to the New Jersey Dental
Forum, one of the original Seattle Study Clubs led by Drs. Tony and
Buck DiCesare. The setting was perfect and the location, the historic
Molly Pitcher Inn, lent itself well to the event, the year end dinner
for their study club. My subject was one of my favorite keynote
topics, T.O.R.C.H.E.S.; How to deal with Any Crisis, Any Time! From a
speaker's standpoint I felt the presentation went well in that people
were attentive and stayed for the entire 90 minutes in spite of the
fact that it was a beautiful evening and a Wednesday night at that.
For those who may not be acquainted with T.O.R.C.H.E.S. it stands for
tell yourself the truth, establish order in the situation, take
responsibility to deal with the situation even though it may not be
your fault, act with courage, embrace humility, empower others, and do
it all with stamina. Afterward a dentist came up to me and confided
that 7 years ago he and his wife had lost a son at 18 months to sudden
death. The depth of sadness over this was so apparent in his face
that my own heart was filled with deep compassion for him and his
wife. But rather than telling me more of his issues he said that what
I had talked about in T.O.R.C.H.E.S. had helped him to put a framework
around his life, where he'd been and where he was now. He thanked
me for helping him to look at things in a new way, we exchanged cards
and we will definitely stay in touch. I had other great conversations
with folks and several mentioned events in their lives that had rocked
them as well. Then it was time to pack up and get ready for a 6 am
trip to the airport, an all too common routine for speakers.
Sitting in my room I recalled what I always pray before I speak,
that God would make my words meaningful to at least one person in the
room that night. That's all I ask, just one person. Thankfully,
people often come up to talk about what happened to them or their
family and how the T.O.R.C.H.E.S. presentation touched them.
That is why I keep speaking! I believe in the value of
T.O.R.C.H.E.S. not as an end, the final word on crisis management, but
rather as a vehicle to open some of the doors of people's hearts that
they have vowed never to open again. The opportunity to hear me speak
about the trials our family has endured and how we have dealt with
them often brings hope to my listeners. And with hope we can
accomplish many things.
So, even though the speaking engagements make my life busier than I
want to be and pull me away from my practice more times than I desire
I wouldn't trade those opportunities for anything because
opportunities lead to relationships and that is what this is all about!

The Essentials of Leadership 1

2009-03-04T16:38:00.000-06:00

Too often I am impressed by a person who exhibits foundational
leadership talents yet goes unnoticed. My best laid plans to
reference these people in my writing many times falls victim to the
tyranny of more urgent matters and I thereby contribute to their
ongoing anonymity. Such will not be the case today.
As the medical consultant for a group of 60 high school choir kids
I fill lots of roles. Baggage handler, behavior modifier, counselor
and van driver could all be used to describe my duties. Along with
one of the teacher/chaperones, Ken Myrhe, our assignment was to
transport 60 robes and stoles to Disneyland where our students were to
perform. After a few false starts such as driving in the wrong ramp
we finally made our way to vehicle inspection and then to a charming
guard named Missy at the gate to the back lot. We were a bit
flustered but she introduced us to a marvelous gentleman, Max. He
looks for all the world like Walt Disney himself and his demeanor was
as warm and inviting as Mr. Disney used to seem when I watched him in
the '50s. All our worries abated as he welcomed us and instructed us
in where to go and where to park. In fact, he walked alongside us to
make sure we got there. Max then acted as our stage manager and we
became his responsibility.
Here is where Max's leadership talents shone, in his ability to
encourage, guide and even correct our kids while never once appearing
to be frustrated or upset. Soft spoken as he was, there was never a
question as to his authority nor did any of us doubt that, if we
disobeyed, we would be standing alone and forlorn outside the gate!
What skill it requires to balance authority and grace in our
interpersonal relationships. Max knew he would not likely see us
again and he could easily have told us that it was his way or the
highway but he chose instead to be the type of person that that we
didn't want to disappoint! Do you see the difference? Our kids
behaved because we respected him and did not want any misbehavior to
reflect poorly on Max.
Oh, that I could lead like that! The Essential to be learned
here? Balance authority and grace to inspire people to follow you.
Then hang on for your skills will be in high demand.

Getting By With A Little Help From My Friends

2008-08-03T18:56:00.001-05:00

Wow! It's been such a long time since I've written here but the
events of this weekend bear retelling. Just like returning to the joy
of writing again, I recently decided to go back to the joy of riding
my bicycle. A little history will help the reader here. I had been
deeply involved in cycling for about ten years when I was forced to
quit due to a cardiac arrhythmia. The doctors didn't want me to
create so much adrenaline and get my heart beating funny. I accepted
this since the whole episode scared me and I was confident that I
could find a more sedate sport that would fill the void, something
like golf. At 6 feet 2 inches and 195 pounds, fresh off a 300 mile
ride across Minnesota, I walked into the golf shop to buy some clubs
only to be confronted at the checkout by a nice young woman. "Your
not a very good golfer, are you?" she said. Thankfully, no one else
was around because I had to confess that she was right. " I didn't
think so." she went on. "Cause you don't have a big gut hanging over
your belt!" Such was the beginning of my golf career.
Over the next 5 years I really worked at golf. Lessons, leagues
and lager was the mantra until I did, in fact, look like a real golfer
with a paunch over my belt. With a busy speaking schedule, a busy
practice, new grandkids and some articles due at the publisher I often
found that I was not getting my aerobic exercise in. More
importantly, I was missing an important emotional component in my
life, that of getting on the bike and working my tail off to be
better. I craved the intense exertion of my cycling years as a
physical and mental health outlet. After 5 years of a stable heart I
was finally given the o.k. to go back to cycling. I didn't tell them
that I was going to race. Oops!
That brings me to the events of this weekend when I rode in a 50
mile race, the Firehouse 50, in northern Wisconsin. My friend, Dr.
Krisite O'Kane, who finished 5th overall for women, rides this race
every year and had invited me to stay at her cabin the night before.
She had a preferred start and was long gone by the time I crossed the
start line so I found myself catching on to various groups in order to
draft off other riders, the key to finishing the race. Experts
estimate that a cyclist uses 30% less energy when riding behind
another rider due to decreased wind resistance so all riders are
looking for people that are riding about at their speed to share the
drafting duties.
At about 25 miles into the race I hooked up with a group of about 7
riders, one of whom was a woman named Sarah Ostrum. As a team member
of a St.Paul bicycle racing club, Sarah is an accomplished rider. Our
group rode well until we hit the rough roads and rolling terrain of
the Namekegon forest where I began to wear out. Compounding the
tiredness were small spasms I began to have in my calves and quads on
the hills. Sarah, though, was as steady as a rock. Continuing to
struggle, I decided to "tuck in" behind her to see if I could make it
the last 10 miles. Now, what I haven't added is that Sarah is drop-
dead gorgeous, with typical Minnesota scandinavian features and, more
importantly, a no-nonsense attitude. You may be thinking that I was
just following her for the view but, listen, when every muscle in my
body ached and a very important part of my anatomy was numb from too
many hours on the bike seat and I had no breath to utter," Do you come
here often?" let me assure you that I was only thinking of one thing,
finishing the race. I can sum up those last 10 miles by telling you
that I concentrated on the back of her racing outfit. One of the team
sponsors must be a company called Sun Adventures because their logo
was prominently displayed on her back. That logo became my focus,
when it accelerated, I accelerated. I quit thinking about all my
problems and concentrated on the logo until we crossed the finish line.
When I teach the T.O.R.C.H.E.S. methodology, I discuss 7 aspects of
leadership essential for dealing with any crisis. Tell yourself the
truth, establish order, take responsibility, act with courage, remain
humble, empower others and continue with stamina. Racing this weekend
created a perfect laboratory for dealing with adversity and employing
T.O.R.C.H.E.S. helped me survive. Specifically, before I could tuck
in behind Sarah I had to make a decision that I couldn't do this on my
own, that I needed help to finish. Not dissimilar from the process we
must go through when the inevitable crises of life confront us. When
we have no resources left, it is time to tuck in and let someone else
do the work until we are able. But many times we're too proud to ask
for help even when we know our friends want to help. It's that thing
about not wanting to bother others with our problems. Even when
others offer to help we sometimes refuse. But sometimes, when we
truly have nothing left, no pride, no resources, no strength, we will
"tuck in" which allows us to heal and empowers those who help us.
The lesson is don't wait until you are totally depleted to ask for
help. There are others waiting and wanting to help if you can put
aside your pride and invite them into your life. And if you want to
start with me, I'm here for you, too.

A Star in the North West Skies

2008-01-09T14:35:00.001-06:00

Ahhhhhh, Maui! A place to relax and, more importantly, a place to write after a busy December in the office. Christmas break in an oral and maxillofacial surgery office resembles the holiday chaos at the Mall of America with college kids home and wanting wisdom teeth extracted, younger children needing cuspids uncovered or primary teeth extracted for bracesas well as an increase in trauma and orthognathic surgery. I don't remember being as tired and stressed in other years as I have been this year! When I'm stressed I tend to get cranky and it takes a conscious effort to give each patient the attention and compassion they deserve.

I was given an excellent lesson in using these skills in the service of others by a NorthWest airlines flight attendant/purser on our journey to Maui, flight 217 from Portland to Honolulu to be exact. That's a bit unusual on an NWA flight since the company reorganized. I have been in first class and have had the flight attendant refuse to hang up my coat because they "weren't paying her to do that." Not that I blame her. It was her way of saying that we, the consumer, needed to know what cutting pensions, salaries and benefits have done to the morale at NWA. Fair is fair, right?

Well, according to Denise Hall, our purser, fairness is related to what the expectations of the traveler are, not what her work conditions are. This lady has it all going for her! She's attractive, intelligent and has been in the business a long time. She's past the "stars in your eyes, look, I'm a Flight Attendant" stage." I suspect she could work wherever she wanted but she chooses to remain with NWA. Her attitude toward each passenger never exposed any animosity toward management, if any existed. Instead she made our flight one of the best NWA flights I have ever experienced!

In our practices, we are constantly faced with pressures that may draw our attention away from our most important priority, our patients. Even when we feel we are delivering the best care possible it is appropriate to make a mental check as to whether we are meeting the expectations of our patients and putting other things aside to deliver our fullest attention to their health and well being. In short, we want to treat our patients as we would want to be treated.

Virtue is not Dead in the ESPN Zone

2007-09-23T07:30:00.001-05:00

Yesterday, my family went to the ESPN Zone to watch the Chicago
Cubs play. Football seemed to be on the menu as there were only 2
T.V.s showing the baseball game. Imagine that! the Cubs haven't won
a world championship since the 1940s Yet ESPN Zone restaurant was
showing games like Syracuse and Louisville, Florida and Ole Miss. In
other parts of the country this would be fine but, hey, we are in the
deep reaches of Cubs territory here!
Still it was a "Happening" of fraternal proportions! There were a
group of Florida fans watching and one shorter stature fellow seemed
to be the self appointed information agent for the University. He
stood for a large portion of the game and screamed at both players
and refs in exhortation or correction. We asked him when he
graduated from Florida and he replied that he had "partied too much"
and had to attend another school to graduate. Yet, he and his
friends sang a stirring rendition of what I assume was the Gator
fight song at the end of the game, which was won by Florida.
Loyalty is one of the fleeting virtues of our society when it
comes to political parties or which dentist your insurance will let
you see. So, as loud and obnoxious as these guys were, they still
demonstrated loyalty to the team they had chosen in years past. They
attacked the other team as well as they could from 800 miles away
and, all in all, represented the U. of Florida in admirable
fashion. As for the Cubs, their fan base is the definition of
Loyalty and, today, their heroes did not disappoint them. Cubs
Win!! Cubs Win!!
I'll have to think through some other virtues to write about in
the future. The one that comes to mind now is Temperance which not
nearly as much in evidence in the netherworld of the ESPN Zone!

Bisphosphonate Medications and Osteonecrosis of the Jaws- 10 FAQs

2007-08-01T06:54:00.001-05:00

Bisphosphonate Medications and Osteonecrosis

10 FAQs

What is Osteonecrosis? Osteonecrosis of the Jaws is defined as a patient having exposed bone in the mouth that has persisted for more than 8 weeks and is not related to having any radiation therapy to the area.
What are bisphosphonate medications used for? There are two forms of bisphosphonate medications, intravenous and oral. The I.V. forms( Zometa® and Aredia®) are used to treat cancers that have spread to the bone. They are effective at minimizing the pain and the calcium imbalance caused when the tumor affects the bone. The oral bisphosphonates (Fosamax®, Actonel®, and Boniva® are used primarily to treat osteoporosis. Boniva® is also available in an I.V. form to minimize gastric upset.
How do these medications work? In either form, the bisphosphonate medications work by inhibiting the action of a cell known as an osteoclast. The osteoclast is the bone cell that "eats up" the old bone and stimulates new bone formation. When the osteoclast isn't working, old bone just remains and is not remodeled as it is normally. This can lead to exposure of the bone in the mouth and an inability to heal. Because the mouth is full of bacteria, the bone often becomes infected and requires extensive treatment.
How often does this happen? The best study to date comes out of Australia where they found that in patients taking the I.V. bisphosphonates the incidence of spontaneous exposure of bone was about one in every 100 cases. However, after the patient had an extraction, the incidence rose to one in every 11 cases. In those patients taking the oral form the incidence of spontaneous bone exposure was about 1 in every 10,000 patients and after extraction it rose to about 3 in every 1000 patients.
What should I do if I am taking a bisphosphonate medication and I need an extraction or other invasive procedure? Consult a knowledgeable Oral and Maxillofacial Surgeon who will work with your dentist, dental specialist and medical doctor to determine the best course of treatment for you.
Are there any tests that can be done? Yes, a test called the CTx measures your body's osteoclast function and it's capability to repair the bone after an extraction?
Is there a problem with routine dental care? No cases have been reported due to fillings or routine cleaning.
When do these problems begin to appear? It seems that there is a 3 year threshold for appearance of exposed bone from oral bisphosphonates. However, this may be accelerated by medications such as Prednisone. In I.V, bisphosphonate patients the concentration of the medication is much higher so the bone may become exposed within a few months.
Should I stop taking my bisphosphonate medication? ABSOLUTELY NOT!!!! The incidence of problems from osteoporosis and certainly from bone cancer is much higher than the incidence of osteonecrosis of the jaws. Your dentist, oral surgeon and medical doctor will work together to determine if you might benefit from a drug holiday.
What positive action can I take? If you are getting ready to begin the I.V. form of the bisphosphonate for metastatic bone disease you should alert your dentist ASAP so that they can examine your mouth carefully and correct any dental problems. If you are beginning the oral form for osteoporosis, you should also contact your dentist to advise him or her of this change in your health. They will very likely ask you to come in for an new exam to assure that no dental problems may be present that could increase the chances of developing osteonecrosis..

Level of Trust

2007-07-17T10:16:00.001-05:00

With the summer oral surgery business in full swing,I'm caring for
a lot of kids and adolescents. Many times their care requires a
general anesthetic which requires an I.V. None of us, kids or
adults, like needles being poked in us and the word "shot" conjures
up all types of images! In 20 years of practice I have yet to have a
patient ask for a "long, slow root canal" as Bill Murray did in
Little Shop of Horrors!
But there is good news! We now have the kids (and some adults)
use a topical anesthetic cream an hour before their appointment and I
promise them that they will feel nothing when the I.V. goes in! I
can say this because I have seen it work so many times that I have
total faith in the cream's efficacy. But the kids must TRUST me in
this matter. They've never seen the cream work so they have to
believe that this big, old, gray-haired guy is telling them the
truth, that the I.V. won't hurt. That trust reaches the tipping
point when the kids return to the office for the procedure and we are
just getting ready to slip in the catheter. It is at that pivotal
juncture that their trust is exercised, the catheter goes in and they
have evidence that the cream did, indeed, work!
I found myself in a similar situation as the radiologist started
putting biopsy needles in my neck to check the nodule that had
developed in my thyroid. On one side of the lump was the carotid
artery (not a good place to put a needle!) and on the other side was
the trachea. So I had to TRUST this radiologist to do his job
perfectly and get the information we needed. Thankfully, the biopsy
result was benign! And I came away with a new appreciation for what
my patients experience when they approach the "point of no return",
when one must abandon self protection and embrace trust.

A Teachable Moment

2007-06-09T12:39:00.001-05:00

This past week was truly amazing for me! I had been preparing for the national meeting of the Speaking Consulting Network for some time since I had been chosen to present my topic " It's All About You!" in the Spotlight on Speaking competition. "It's All About You" outlines how life circumstances can actually contribute to the development of a solid personal foundation. I was fortunate to be named the winner of this intense speaking competition but, more importantly, I was able to present the material about which I am PASSIONATE to an audience that I respect highly and who has the potential to impact other lives through their speaking and consulting careers. The same day my article on "Issues related to the Diagnosis and Treatment of Osteonecrosis of the Jaws", published in the fantastic interdisciplinary magazine Grand Rounds in Oral-Systemic Medicine was distributed at the conference. That night I even won the grand prize drawing at the conference and returned home to find that my picture was on the cover of The Seattle Study Club Journal. These accolades seem to have happened overnight but anyone who writes and/or speaks knows that months of preparation precedes any positive outcome. As a professional golfer once said," The more you practice, the luckier you get!". This provides a background for the following comments.

There were some health issues that I had deferred until SCN was over so, on Friday after I returned, I had a test completed that showed a mass in my thyroid gland. The majority of these tumors are benign but the issue is clouded by the fact that my daughter had thyroid cancer at age 15 and my father died of a lymphoma that started in his neck. So bumps in necks carry a degree of concern in our family! I am waiting to hear from the surgeon ( a friend of mine) now.

While I'm not looking forward to" dinking" around with this thing, I am so thankful for the opportunity to use this as a teachable moment for us all. This past week I spoke on 3 tools for withstanding the curves life throws at us; tell yourself the truth, realistically evaluate your circumstances, and then act with courage. What better time to practice what I've been preaching! And what better time to remind all of you that it just takes one test result or one phone call to change our lives forever and that we need to constantly be building a solid life foundation so that the inevitable storms won't topple us.

So a new adventure begins! I am confident that whatever occurs, I will be a better surgeon, speaker and writer because of what I will be able to experience. I'll continue to blog on this and other issues so, if you'd like to keep up with Dr. Marty in Lake Wobegon, MN you can subscribe to this blog. I'd be honored if you do!

Dr. Wade's Sure-Fire Remedies for a Bad Day

2006-10-22T17:00:00.000-05:00

View Dr. Wade's most recent article here! Published by Kodak at their Dental Systems Consultant's Corner, Dr. Wade outlines effective ways to stop a bad day in its tracks.

Welcome to the LionsGate Leadership Blog

2006-09-24T19:03:00.000-05:00

Welcome to the blog of Dr. Wade, founder of LionsGate Leadership Coaching. LionsGate is a speaking and consulting resource for dentists; this blog is your way to make frequent use of this resource. For more information on LionsGate, please visit our website: www.lionsgateleadershipcoaching.com.