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Cranio- Mandibular Orthopaedics
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Mini Dental Implants
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Oral Implantologists
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Laser Dentistry
Conscious Sedation Permit,
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Member, California Dental Association
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Academy of Periodontology
Associate Member, Western Society
Academy of Periodontology
Member, American Academy of
Dental Sleep Medicine
Member, American Academy of
Implant Dentistry
Member, American Dental Society
of Anesthesiology
Member, American Academy of
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Member, American Academy of
Sleep Medicine
Member, Academy of Microscope
Enhanced Dentistry
Member, Special Care Dentistry
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San Gabriel Valley Dental
Assistants Society
San Fernando Valley Dental Society
Western Dental Society
Indian Dental Society
Chinese Dental Society
Punjabi Dental Society
Academy for Excellence in Dentistry
University of Texas, Department
of Periodontics
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Doctor of Divinity, Chinese for
Christ Theological Seminary
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USC Dentistry Associates, Dean’s
Member
Recognition for Outstanding Service,
USC School of Dentistry
Radio Transcription
Ep 63: Part 1 of Dr. Chao's interview with Dr. Charles Goodacre, Dean of the Loma Linda School of Dentistry on why the residents of Loma Linda have the longest life spans in the United States, and on Diet and Oral Health
Salvador Gaytan: It's time! SmileTalk is on the air, featuring the latest news and developments in dentistry as well as other fascinating topics that make people smile. I'm Salvador Gaytan, and I'm here with?
Dr. John Chao: Dr. John Chao, hi everybody.
Salvador Gaytan: Yeah, Dr. John, and for anyone that wants to reach Dr. John, you can reach him at AlhambraDental.com or 626-308-9104, and that's Dr. John Chao, C-H-A-O. Well, we have a fascinating interview coming up with Dr. Charles Goodacre of the Loma Linda School of Dentistry, isn't that right Dr. John?
Dr. John Chao: Yes, we are looking forward to some very interesting topics.
Salvador Gaytan: And let's get to that right now. How are you, Dr. Goodacre?
Dr. Charles Goodacre: Very good, thank you.
Salvador Gaytan: Also, with Dr. John Chao, of course.
Dr. John Chao: Yes, Dr. Goodacre, we really appreciate you taking the time to come on this show.
Dr. Charles Goodacre: Very glad to do it, thank you.
Salvador Gaytan: Now, Dr. Goodacre, you are the dean of the Loma Linda University School of Dentistry, and you've been the dean for quite a while, since 1994, isn't that right?
Dr. Charles Goodacre: That's correct; 15 years, and going on more.
Salvador Gaytan: Going on more, huh? Well, we have a lot of topics that we want to cover with you, about the school of dentistry, and also some personal topics, your personal interests and so forth.
Dr. John Chao: But before we get on, Sal, remember I told you I was going to ask you a surprise question. Because you're good at coming up with trivia and making other people stumble.
Salvador Gaytan: Oh come on now.
Dr. John Chao: So, I have a question for you. Now, this is a non-dental question, so this is a fair question. It's general knowledge and Dr. Goodacre knows the answer for sure.
Salvador Gaytan: He does?
Dr. John Chao: Now, I'll ask you the question and then we'll see whether you get the answer or not.
Salvador Gaytan: Alright, fire away.
Dr. John Chao: Now, there are three cities in the world that have the longest lifespan. Their population is at the longest lifespan. I'll give you two of them; I want you to name the third. One is Okinawa, one is Sardinia off the coast of Italy. Which is the third? Dr. Goodacre knows.
Salvador Gaytan: Well, those were the two that I knew.
Dr. John Chao: [Laughter] Yeah, now, where is the third? So, Sal, where is the third?
Salvador Gaytan: Sardinia, I'm just going to take a guess of…
Dr. John Chao: I'll give you a hint; it's in the United States.
Salvador Gaytan: In the United States, huh? Well, I wasn't even thinking…
Dr. John Chao: Don't go beyond the shores of United States.
Salvador Gaytan: I wasn't thinking of the United States.
Dr. John Chao: Yeah, that's a really good hint.
Salvador Gaytan: I will say…
Dr. John Chao: Come on, Sal.
Salvador Gaytan: I'll say…
Dr. John Chao: Wild guess.
Salvador Gaytan: Alaska; Anchorage, Alaska.
Dr. John Chao: Okay, Dr. Goodacre, what is the answer?
Dr. Charles Goodacre: Well, that's Loma Linda, California, interesting.
Dr. John Chao: There it is, Sal.
Salvador Gaytan: You know what, you guys snickerdoodled me.
[Laughter]
Dr. John Chao: Now, could you give us a little background on that, Dr. Goodacre?
Dr. Charles Goodacre: Well, it's interesting that the community of Loma Linda has a long heritage of interest in health, combined with religion and spiritual values. And there's been a number of people who've investigated this.
In fact, there's been a National Institute of Health's study on longevity of Seventh-day Adventists, which is the religious group here in Loma Linda.
And also the National Geographic did a special issue on longevity, where they identified these blue zones or areas in the world where people live longer for a variety of different reasons.
And in fact, there are different reasons in different areas, but the combination of being health conscious in terms of what you eat, and then coupling that with a spiritual experience, whatever that experience is for a particular individual, does have some obvious positive impact on longevity.
Dr. John Chao: Now, the study involved a whole bunch of people, didn't it?
Dr. Charles Goodacre: Yes.
Dr. John Chao: Was it like some 30,000 people, I understand?
Dr. Charles Goodacre: Yeah, I'm trying to remember how many -- it's extensive, there's thousands and thousands of people that they followed in this NIH study for a number of years looking at all the different factors that would play a part in this process.
Dr. John Chao: Now, I understand that those people who follow this particular regimen and lifestyle, live something like 9-10 years longer than the average American?
Dr. Charles Goodacre: That's correct.
Salvador Gaytan: So, in your dental school, the connection between dentistry, health, and I guess some of the dietary aspects of Seventh-Day Adventists, plays into it, doesn't it?
Dr. Charles Goodacre: Yeah, most Seventh-day Adventists, not all, but most will be either primarily vegetarian or totally vegetarian, and not eating a lot of meat. And that's a portion of it, and they choose not to smoke or to drink.
And I think the -- we know the effects of smoking on health, and we know the negative effects of extensive drinking on health. And people are beginning to more and more recognize the importance of not consuming large amounts of meats, and having more vegetables and other types of things in your diet, a very positive impact on health.
Salvador Gaytan: Now, Dr. Goodacre, tell us the truth, when was the last Big Mac you had?
Dr. Charles Goodacre: I am not a fast food person. I can't even remember. It would have had to have been my teenage years.
Salvador Gaytan: Teenage years, that long ago? Wow!
Dr. John Chao: Yeah, well Sal, why don't you ask me? I don't know the last time I ate a hamburger. Now, you’ve known me all these years, when was the last time you saw me eat a hamburger?
Salvador Gaytan: Dr. John, tell us, but hey, if you've had a hotdog?
Dr. John Chao: I eat other kinds of junk.
Salvador Gaytan: I saw him have a hotdog a week ago, though, Dr. Goodacre.
Dr. John Chao: Yeah, hotdog I eat at a football stadium, I'll eat one.
Dr. Charles Goodacre: I've been known to have my share of ice cream and some cake and things like that, but anyway we all have our challenges rather relative to an ideal diet, but at least I try to watch certain things clinically.
Dr. John Chao: I'm kind of a witness to the benefits of diets such as the one Loma Linda has. Every year I judge -- I'm one of the judges at the table clinics at the California Dental Association's convention, in fact it's coming up in a couple of weeks.
And in that table clinic, there are different kinds of projects being presented for the judges to vote on, and every year there will be the people selected for first, second and third place.
And a lot of times, the Loma Linda students win, but what I've noticed consistently is that when you look at Loma Linda students, and you look at other groups of students from other universities, it seems that the Loma Linda students stand out in terms of how healthy they look.
There's just something fresh and neat, and the way they conduct themselves, very, very healthy people. And I've always been impressed over the years, year after year, that Loma Linda students always look better physically as a group.
There are healthy people from other dental schools, but as a group, the majority of them look so nice. I wonder, have you heard that remark before?
Dr. Charles Goodacre: I have had people comment about that, and unfortunately not everybody follows that, but I think in general our students are very health conscious, and try to do their fair share of watching how they take care of themselves, which is important in the long run for all of us.
Dr. John Chao: Yeah, this first came to me when I met Dr. Leland House, an Otolaryngologist, a professor at Loma Linda. He was kind enough to spend time with me at my office, teaching me the inter-connection between Dentistry, TMJ and ear, nose and throat.
And I noticed from him, how healthy he looks, even when he was very advanced in age, and healthy and mentally alert. And he told me about the Loma Linda diet, and I'll always be impressed with that.
And I think this must be true that the studies have shown what is really going on. So, instead of going to Okinawa, and Sardinia, and eat their wine and drink their bread, we have an example only a few miles from where everybody lives.
Dr. Charles Goodacre: Well, my mother died last August, she was 96.
Dr. John Chao: Wow.
Dr. Charles Goodacre: And actually I thought she was going to make a 100 for sure, but she unfortunately fell and fractured a hip. And most people at that age just don't have the capacity. But she did recover from that, but just in the long run, it just sapped so much of her strength.
But she was sharp mentally and physically right up to that point. I mean she took care, she lived by herself, took care of the house, did a lot of gardening.
And even at 95, she called me one day and told me -- because my father was a sign painter and artist for a good bit of his life, also worked on the railroad, but he loved to do things in his retirement, and he took the time.
He painted the garage floor, and he painted the driveway, and striped it and everything else to make it look exotic, like a lot of these commercial companies do, but he did it himself. And it got a little bit worn, so my mother at 95, repainted the garage floor.
Dr. John Chao: Wow. That's amazing, that's amazing.
Salvador Gaytan: And for anyone just tuning, you're listening to SmileTalk with Dr. John Chao of Alhambra Dental, and we're interviewing Dr. Charles Goodacre, the dean of the Loma Linda School of Dentistry; a very fascinating interview, getting into some personal items, as well as the school itself.
Dr. John Chao: You know what, [indiscernible] context, Sal. The old saying, "The Hand that Rocks the Cradle, rules the World".
Salvador Gaytan: Yes?
Dr. John Chao: Now, this applies to dental schools, and dental schools are figuratively the hand that rocks the cradle of dentistry. From the dental schools are produced the men and women, who perform dentistry for our society.
And it is very important for us to understand dentistry to know what dental education is and what dental schools do for our country, for the world in fact and for our community.
And this is why we have taken the time to -- and impose ourselves on Dr. Goodacre to talk about dental education, and especially what happens at the University Of Loma Linda School Of Dentistry.
Salvador Gaytan: Absolutely, absolutely.
Dr. John Chao: Do you not agree with that, Dr. Goodacre, my analogy about the hand that rocks the cradle rules the world?
Dr. Charles Goodacre: Well, dentistry is a very important part of healthcare, always has been. And of course, more recently we've begun to discover a lot of things that many of us felt for many years, that is the relationship between the health of the mouth and the health of the rest of the body.
And we're seeing emerging research all the time, helping to establish that link between good oral health and good systemic health.
Dr. John Chao: And so the dental schools produce dentists who treat oral health, which has a great impact on general health. And so, from the dental schools, we're talking about the health of the entire society.
Salvador Gaytan: Now, Dr. Goodacre, what would you say is the main focus and the strength that you try to teach your students, that graduate from the Loma Linda School of Dentistry?
Dr. Charles Goodacre: Well, we've always tried to have a very strong and extensive clinical experience for the students, because patients come to dentists for a variety of reasons.
The patients want to be diagnosed properly. They want to get the highest level of care possible. They want people who care about them as a person, and who they feel comfortable with. So, that process begins with an extensive clinical education, which is the hallmark of dentistry.
You need to have exceptional manual skills to be a good dentist and provide the care for patients. And the more of the treatment that you do while you're a student, then the better are your skills.
Like any other manual skill, you don't become a great basketball player by occasionally shooting baskets. You shoot a lot of them every day, and students need to spend lots of hours doing the work that also gives them the opportunity to interface with a broad number of patients, and determine the personal characteristics that they need to develop in order to be a complete practitioner that really cares about the person and doesn't just provide great technical skill.
Dr. John Chao: So, caring and clinical skills goes hand in hand, doesn't it?
Dr. Charles Goodacre: Absolutely, compassion for the person. Most people -- well, I shouldn't say most, but a lot of people wouldn't choose to do dentistry as a pleasant experience, but it can be a very comfortable and pleasant experience in the hands of the right person.
And so, having that compassionate care for the individual and helping to allay any apprehension that they have. And some dental problems are associated with pain and discomfort.
And by having some individual that will carefully take -- that cares about you, that allays a lot of apprehension, that will take the time necessary to provide comfortable local anesthesia, so the individual is comfortable while they're having their procedures performed. That's all part of a complete package.
Dr. John Chao: Well, I'm so glad to hear that. We've been actually talking about that kind of way of delivering dentistry on the show off and on. In fact, we intend to continue to do that in the next few shows, after yours.
Salvador Gaytan: Now, Dr. Goodacre, being with the diet of the Seventh-Day Adventists, now in the care of patients as dentists, do your graduates try to influence their patients to eat better, no smoking, no drinking, and those kind of things too? Do they incorporate those in their practice?
Dr. Charles Goodacre: Well, when it's appropriate. I think once you first of all have to establish a relationship with the patient that allows them to appreciate where you're coming from, and that we understand where they're coming from.
And when things are appropriate, then absolutely, we teach our students to do some interventions relative to smoking in an appropriate manner, give them the advice; if you found somebody that was abusing drink or drugs, to try to get them into the proper place where they could get some good care about that.
As we evaluate the oral health, when you see diet and such that's not appropriate, then absolutely, I think we have a responsibility to inform people. But hopefully we'll do it in a way that doesn't turn them off, but inspires them to take up a change in their lifestyle.
Salvador Gaytan: Now, you also still practice, don't you, one day a week, isn't that right?
Dr. Charles Goodacre: Yes I do.
Salvador Gaytan: And so, why do you believe at this stage, because you're the dean, I mean you're the king around there -- so, why do you need to practice one day a week, in your viewpoint?
Dr. Charles Goodacre: Well, at age 62, I still get inspired about practicing dentistry. I love to do it, that's first of all, and then I have very strong feelings that an administrator of a dental school, somebody who is determining where the school is going, needs to be practically doing dentistry on a regular basis.
That way I understand what the issues are with patients, I understand the processes, materials, the application of science that's important to dentistry. And that helps to then mould a better curriculum, and help to drive the clinical procedures and processes that the students are learning.
Salvador Gaytan: So, do you ever get some testy patients, and you say, "You know what? I don't need to do this anymore."?
Dr. Charles Goodacre: Well, as a specialist in prosthodontics, specialists end up inheriting some of the more challenging situations, and that's what makes it fun. There's nothing more interesting than to take on some challenges.
You can't always solve everything, but it's an important part of the process, and students need to encounter that too while they're students, because not every patient is going to be easy.
Dr. John Chao: Yeah. One of my favorite sources of referral is the prosthodontist, because I do get some cases which really need the time, the skill and particularly the personality of the prosthodontist.
Salvador Gaytan: Now, tell the audience what a prosthodontist is, Dr. John.
Dr. John Chao: Well, I'm glad you asked that, prosthodontist -- well, Dr. Goodacre, why don't you tell our audience, what a prosthodontist is, since you are one?
Dr. Charles Goodacre: Well, the word prosthodontist comes from prosthesis or prostho, which means artificial replacement, and then dontist is dentist or teeth. So, we make artificial replacements for teeth that are missing, individual teeth or dentures for somebody that has no teeth at all.
And then an interesting area of prosthodontics is also what we call maxillofacial prosthetics, and that would be for individuals who would be missing part of their face or oral structures, and that could have -- that can't be reconstructed surgically.
We would of course first like to see things reconstructed with a person's own tissues, but things can happen, an ear can get traumatically removed or a nose, or somebody might have, unfortunately, cancer, and a portion of their face might have to be removed surgically to cure the cancer.
And then they have a defect that doesn't allow them to feel comfortable in public, and a prosthodontist would get involved to make an ear or a nose, and of course a lot of times then this also involves the teeth that are inside the mouth.
So, we have a broad range of activities that we do. Prosthodontists were the individuals that introduced implants to the rest of the world. Dental implants were developed by an orthopedic surgeon, the modern ones that we use today was developed by an orthopedic surgeon in Sweden.
But it was a prosthodontist from Toronto that discovered what this person was doing, visited with them, studied with Professor Branemark, the orthopedic surgeon, and then introduced that concept to the rest of the world, and it was the early prosthodontists and surgeons working together in dentistry, that really put the process on a scientific level that it is today.
Dr. John Chao: Yeah, we're going to talk more about implants, but I want to interject that I personally have worked with a maxillofacial prosthodontist in my office for a couple of years, Dr. Vincent Tso. I don’t know whether you know of him, he was trained at UCLA, and he actually needed a place to work, and we kind of practiced together independently.
And I see beautiful work, reconstructing faces and eyeballs and ears. It takes just a fascinating amount of skill to reproduce a missing part of the face and so on, and make it look exactly real. You can't tell from a reasonable distance that there was anything artificial at all.
Dr. Charles Goodacre: It's a very valuable service, and of course UCLA has one of the best maxillofacial prosthetic programs in the world. They've been doing this for lots of years. So, there wouldn't be a better place to get an education in that area of prosthodontics.
Salvador Gaytan: Are you mentioning your competitor, Dr. Goodacre?
Dr. Charles Goodacre: Absolutely.
[Laughter]
Salvador Gaytan: Alright, alright.
Dr. John Chao: But I was going to say that thank god for prosthodontists, because once in a while I'll have a patient come in. I'll give you an example; somebody comes in with actually a bag full of dentures.
This person, male or female, could have been to five, six, seven, 10 dentists, and have many, many dentures made. And those kind of patients generally I will still interview and give it a good effort to try to be of help to this patient, but in a lot of cases, I'll refer those patients to prosthodontists, because that's in your province to take care of people like that. Isn't that right?
Dr. Charles Goodacre: That's correct. Some of those can be very, very challenging, and there may be some other underlying characteristics of the patient that needs some attention too.
Salvador Gaytan: So, what's one of your most difficult cases that comes to mind?
Dr. Charles Goodacre: Well, I think most of the time it's -- and today it's individuals that have -- their entire dentition is failing, and they're going to lose all of their teeth. And that's what we all do, and I've done two or three of those in the last couple of years, and these people now realize the years of neglect and what that has caused the problems for them.
And they have such a desire to still have teeth that are fixed in their jaws and will serve them well, and they're going to lose all of their teeth.
And so the difficulty of some of these situations, because of the amount of what the dental disease has done over the years, make it extremely difficult to reconstruct those, and it takes a team of specialists to do all the necessary things.
Sometimes you have to build back the bone to the point where you could put a dental implant, which would allow them to have teeth that are more like their own than the original ones.
And I think the other difficult ones were already mentioned. Those people that have had complete dentures, they've had different sets of those, and they're still searching for something that may not even be achievable by any dentist.
And so working with those individuals, so that they begin to acquire realistic expectations as to what a complete denture can provide for them, and what it can't do. Those are both very challenging situations. Very different ones, technically different, the other one takes a lot more patient management style, and working with the individual.
Dr. John Chao: Yeah, it's wonderful that dentistry, in terms of prosthodontics can do such service for patients like that. But the moral of the lesson for our audience is that don't get there, right?
Dr. Charles Goodacre: Exactly. Keep the teeth -- there's no better implant than the natural teeth that's been retained by good care.
Dr. John Chao: Now, your expertise is not only in prosthodontics, but your expertise is also in materials that dentistry uses today. You've studied this, this is your specialty, what is your qualification in that, and what do you think has been the landmark changes over the years in terms of dental materials?
Salvador Gaytan: Well, you know, Dr. John, we're coming to the last minute or two of our show.
Dr. John Chao: Okay. So, real quickly, and then can we have you back on the next show, Dr. Goodacre?
Dr. Charles Goodacre: Well, I'd love to visit with you some more, absolutely.
Dr. John Chao: Okay, great.
Salvador Gaytan: Fantastic.
Dr. John Chao: Now, let us give the answer really quickly.
Salvador Gaytan: Go ahead.
Dr. Charles Goodacre: Well, I studied Dental Material Science. When I graduated from Loma Linda, I went to Indiana University, studied with Professor Ralph Phillips, the most widely known dental materials expert of that era, because I wanted to have a research background.
And that really instilled a great interest that's retained itself throughout my life. As far as during my career, what have been the two major changes, the most significant paradigm shift for dentistry has been the introduction of dental implants, without question, because that allowed us to do things we never could do previously.
The other thing that has always been important to dentistry is making people look better and feel better about themselves, so the aesthetic dental procedures. And we've had so many improvements in materials since I first became involved in this in the early 1970s that we can do so much more.
It looks better, it lasts longer, and we can do more conservative procedures that are less expensive to the patient than we used to be able to do many decades ago.
Salvador Gaytan: Well, that sounds fantastic, and we can touch on a little bit more of that, because I think there are some more details to that topic, Dr. Goodacre. We're coming to the last few seconds of our show.
We've been interviewing Dr. Charles Goodacre, the dean of the Loma Linda School of Dentistry. Is there a website for the School of Dentistry, Dr. Goodacre?
Dr. Charles Goodacre: Yes there is. It's lomalindauniversity.edu, llu.edu, and that takes you to the university's website, and then from there you can link into dentistry.
Salvador Gaytan: Fantastic. And we've been listening to Dr. John Chao of Alhambra Dental, interview Dr. Goodacre, and that's the last few seconds of our show, Dr. John.
Dr. John Chao: Thanks everybody for listening. We look forward to talking to you again next week.
Salvador Gaytan: Next week.
Dr. John Chao: With Dr. Goodacre as our guest.
[END OF AUDIO]
Transcribed and proofread by:
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