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Cranio- Mandibular Orthopaedics
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Mini Dental Implants
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Laser Dentistry
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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
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Member, American Academy of
Implant Dentistry
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of Anesthesiology
Member, American Academy of
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Academy for Excellence in Dentistry
University of Texas, Department
of Periodontics
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Member
Recognition for Outstanding Service,
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Radio Transcription
Ep 68: Part 2 of Dr. Chao's interview with Esmeralda and how her new smile has changed her life
Salvador Gaytan: It's time! SmileTalk is on the air, featuring the latest news and developments in dentistry, as well as other interesting topics that make people smile. I'm Salvador Gaytan, and I'm here with…?
Dr. John Chao: Dr. John Chao, and I'm with somebody who has a wonderful smile, Esmeralda. This is her second appearance on our show. We talked about her, with her at the last show.
Salvador Gaytan: When you said a wonderful smile, I thought you talk about me, Dr. John. You never give me any compliments. I'm just kidding.
Dr. John Chao: Well, I'm kind of prejudiced.
Salvador Gaytan: I know, I'm just kidding.
Dr. John Chao: Somehow I don't notice your smile, even though it's not really bad, right? He doesn't have a bad smile.
Esmeralda: He has a really nice smile.
Salvador Gaytan: He's just always throwing me under the bus, he's never giving me -- I'm just teasing him.
Dr. John Chao: When have you complimented me on my smile? Esmeralda, look at my smile, it's not too bad, right?
Esmeralda: You have a great smile.
Salvador Gaytan: Absolutely, a great smile.
Dr. John Chao: Yeah, so when is the last time you complimented…
Salvador Gaytan: Well, you're wearing a very nice tie today too actually.
Dr. John Chao: Now you're talking.
Dr. John Chao: Okay, so Esmeralda was talking at the last show about how we fixed her up, and in one session, about three or four hours, and then she has this new smile. Tell us how you felt.
Salvador Gaytan: Well, before we get to that Dr. John, we tie it in, let's just give the audience a little detail about where Esmeralda works, because this is very important, her smile is very important. Tell the audience where you work Esmeralda.
Esmeralda: I work for the Department of Public Social Services, meaning I deal with the public every single day.
Salvador Gaytan: Face to face.
Esmeralda: Face to face.
Salvador Gaytan: So, your smile is very important to you.
Esmeralda: Yes, now it is, now it is. I didn't realize how important it was, not just from the outside, but from the inside, because not taking care of your teeth can bring many other problems, health wise, I didn't know that.
Dr. John Chao: Yes, we talked about that with you, didn't we? We connected gum disease with systemic diseases, with not feeling well, with being tired, with not being able to sleep well. Did you notice any physical improvements after you were treated for gum disease?
Esmeralda: Yes. It's funny that you say with the sleeping, because I didn't sleep very well. Now I do, I sleep all night.
Dr. John Chao: Now, we haven't even discussed that, have we, before this?
Esmeralda: No.
Dr. John Chao: Because I noticed our patients to actually sleep better, with the infection gone. There is as much gum in your mouth and tissue in your mouth to be equal to about the skin on your forehead.
Imagine if that's all infected, seriously, and with that infection going through your system all the time. Now, imagine that that's all gone one day, and how much better your body would feel.
Salvador Gaytan: So, when you say that you didn't sleep well before your treatments, how did that translate? I mean did you wake up or did you just toss and turn or what do you mean by that?
Esmeralda: No, I would literally be up all the time for hours, and I'd end up falling -- I would actually wake up about maybe 2:00, 2:30, and I would stay awake all the way till 5:00, and then I'd have to force myself to sleep, because I'd have to get up at 6:30. So, now I sleep all the way through.
Salvador Gaytan: Now, Dr. John, why do you think that is? Why was she waking up?
Dr. John Chao: Well, if you have that much infection, it's a strain on your body. It has a negative impact on your immune system that impacts every organ of your body. It's like you have a very mild infection all the time, it drains you. You're drained every moment, you're just not aware of how serious it is.
All of a sudden when that's gone, every organ in your body begins to react better and better. So, there's more energy, there's more a sense of wellbeing. I've seen women's complexion get better once that's gone. So, there's a tremendous amount of impact that gum disease has on the body.
When that's gone, we just continuously see different positive reactions. One of which we always seem to see a lot of, not every single case, but a lot of patients sleep better. It's just so common. Esmeralda and I have not even talked about her sleeping better, have we?
Esmeralda: No, no.
Dr. John Chao: We just mentioned it and there you are. So, it's just one of those side benefits. So, now in case you've just tuned it, we're talking to Esmeralda, one of my patients, who has had gum disease treatment, in fact a very advanced gum treatment where her teeth…
Salvador Gaytan: Were waving goodbye.
Dr. John Chao: Were loosening out, we were kidding, waving goodbye, but we were able to…
Salvador Gaytan: You saved them.
Dr. John Chao: Snatch it back from the jaws of defeat.
Salvador Gaytan: That's right.
Dr. John Chao: We made her smile really, really pretty and she's just sitting there beaming, and we're talking about her working with the public. Now, isn't that kind of nice to be able to smile and treat people who are coming to you for services?
Esmeralda: It feels great. I really hated seeing my people, because I take over 600 participants for every month.
Dr. John Chao: Wow.
Esmeralda: So, having them come in and having to speak to them was terrible for me. I hated that. I hated yelling, and so I was having to use the PA to call them. But when I take them in, I have to -- I mean they're as far apart as we are.
So, I kind of avoided all the time turning and looking at them, because I didn't want them to just stare at my mouth. But now, I can actually look at them, and they won't be looking -- they're not staring at my mouth, they're looking at my eyes, and I like that.
Dr. John Chao: And you're able to smile at them?
Esmeralda: Yes, I am.
Dr. John Chao: Have you noticed that they smile back at you?
Esmeralda: Oh yes, it's easier. I'm not feeling embarrassed by it anymore.
Dr. John Chao: So, do you feel like you bring more to the table, you're able to enhance their lives to a certain extent by being so friendly?
Esmeralda: Yes, yes, because I feel better about myself, so I don't have to hush or hurry up and move on. I can take my time now, look at them and speak to them, so I'm happy.
Dr. John Chao: Having been just to the DMV, I noticed that certain ones are just a lot friendlier than others. How nice it is, you go to a window and there's somebody smiling at you. It's really, really nice. I had my eyes tested. Did I tell you the story, Sal?
Salvador Gaytan: Tell me you can see, Dr. John.
Dr. John Chao: Yeah, I told you the story, I haven't told you on the air. I had to wear glasses for driving, and it's been about at least 15 years now. I don't know what happened, because they notified me to go in for an eye test, so I went to the optometrist and had my eyes tested. It turned out I needed the glasses, but my eyesight was actually getting better.
So, it must be the exercise that you've been recommending or the vitamins I've been taking. So, I said -- when I go to the test, go there, I'm going to do it without my glasses.
So, these guys were -- he was pleasant. He didn't have me read the stuff on the wall, he took me to the machine and was really going to test me. So, I squinted and I squinted and I looked really hard, but I called the letters and he passed me. So, I was beaming from ear to ear. Nobody else is beaming, except when I got to the place where they were taking pictures.
I went to this camera lady. She was very nice. This other gentleman had given me the slip that says V/P. So, I said to the lady, I said, "You must be the VIP lady I have to see." She smiled, and I don't know what that V/P means, but she was happy.
So, we were complimenting each other, and I thought that was very nice. That made the whole experience so much better, when one person smiled. So, I can't imagine what you were doing for your 600 clients, that you smiled at them and made them feel good.
Esmeralda: Yes, it's more pleasant. I have better days, I'm happier. I can actually flirt now, which is something I…
Salvador Gaytan: You're doing what? Are you grooming flirters, is that what she said?
[Laughter]
Dr. John Chao: She's actually flirting, I heard the word flirt.
Salvador Gaytan: Oh my God.
Dr. John Chao: She's actually enjoying flirting.
Salvador Gaytan: What kind of patients are you producing now Dr. John?
Dr. John Chao: I noticed you were flirting with her when she walked in.
Salvador Gaytan: Well, she is a very beautiful lady, of course.
Dr. John Chao: Well, you can't blame her for flirting, when…
Salvador Gaytan: But she's doing it -- she says she's doing it every day Dr. John. Is that true, Esmeralda?
Dr. John Chao: Well, she has 600 people to pick from.
Esmeralda: Now I look for like, "Okay, where can I flirt?" I am dead serious.
Dr. John Chao: Isn't that nice? Wouldn't you like to be flirted with, when you go to a place, where everybody is serious, and get flirted? It could make my day.
Salvador Gaytan: Well, you know what's interesting, how it's a snowball, is if you just start from the sleep, you had the treatments done, you sleep better. Now you have more energy, now you have more energy on the job, to do your job and flirt, you have a smile that you're proud of, so it's like a snowball, isn't it?
Esmeralda: Yes, I also wanted to mention, you said something about the skin. My skin is better, it is.
Dr. John Chao: You know what, I do believe -- I almost forgot what you looked like, but looking at you right now, your complexion is great.
Salvador Gaytan: Your complexion looks fantastic.
Esmeralda: I'm surprised because I don't have to use anymore -- just the one day, last week I -- actually not last week, but the week before, and I have not used my moisturizer every day, so I'm in shock.
Dr. John Chao: Wow. Okay, well here, you started the treatment you said -- what day did you start? It was this month, right?
Esmeralda: Yeah, the 7th of this month.
Dr. John Chao: It was the 7th of June. So, you started treatment some time in early part of June, didn't you?
Esmeralda: Yes.
Dr. John Chao: So, this is about a month later, and you say you're not using moisturizers anymore.
Esmeralda: Exactly.
Dr. John Chao: And because you feel all your skin is what?
Esmeralda: It's better. It's not dry, it's not oily, I love it, it's perfect, I'm in shock.
Dr. John Chao: Have you done anything different?
Esmeralda: No, no, except my mouth.
Dr. John Chao: Except you got your gums treated.
Esmeralda: Yes.
Dr. John Chao: Isn't that amazing?
Salvador Gaytan: It is incredible. I think what Esmeralda said, what we've talked about on numerous other shows is how so many other ailments are associated with the mouth, the mouth not being clean.
Dr. John Chao: We have scientific studies on the relationship between periodontitis or gum disease, gum infection and cardiovascular diseases. We have established connection between diabetes and gum disease.
We have established that there maybe some link between rheumatoid arthritis and periodontitis. Do you remember when Dr. Sadan, dean of USC Dental School came in to our studio and told us that according to what he has read, actually it's connected to rheumatoid arthritis.
But there has been no study that I'm aware of, that studies the impact of infection in the gums on skin. I think there definitely should be something done for that, because I've seen it too often. We haven't even talked about this, have we, about the impact on skin?
Esmeralda: No.
Dr. John Chao: You just picked it up, because I was talking about it in general, and now you saw it. So, in case you just tuned in, we're talking to Esmeralda, my patient. We just happened to talk about the impact of gum disease, sometimes on complexion.
I mentioned that some of my patients actually reported having a better complexion, and sometimes I have noticed it myself. But Esmeralda having listened to that, has come up with her own experience that her skin actually has gotten better. That's amazing.
Salvador Gaytan: Now, Dr. John, let's get to the meat and potatoes of this procedure, because it's very interesting, of how you handled the problems of her loose tooth, how you anchored it in a special situation, and then did a little something extra to make it all come together into a nice smile.
Dr. John Chao: Yes. Actually it's a very interesting case, because Esmeralda, you came in, you had various complaints, right, you have a loose tooth, you have decay between the front teeth, and you realized that you have gum disease. Now, in treating your gum disease, we also took care of the smile problem, didn't we?
Esmeralda: Yes, correct.
Dr. John Chao: So, let me kind of describe the procedure. Now, we told you your teeth needed to be bonded together, because they were loose. If the loose ones were anchored or bonded to the firm ones, then we can save the loose ones, and this is the principle.
Now, normally what we do Esmeralda, is we put a wire or a fiber behind the teeth, and basically bond it or glue them together. There are problems with that, because it's kind of bulky, and we have to work it around, so that when you bite down, you're not biting into those fibers or those wires.
In your particular case, fortunately or unfortunately you have decay between the teeth. So, instead of using a wire, I wonder if the audience can imagine that this cavity is [indiscernible], instead of using a wire to glue all the teeth together or tie the teeth together, we actually put fillings between the teeth.
Since we have to fill the size of the teeth anyway, then what we did was, we had those fillings bonded together. So, now all the teeth are glued together, the cavities are taken care of, and we are able to sculpt what we put on there, to make them look like natural teeth.
In the process, the gaps between the teeth were also gone. So, in one appointment, we glued the teeth together, we got rid of the gaps, and we resurfaced all her front teeth, and now she has firm teeth, and we treated her for a gum disease, and she has a beautiful smile in one day.
Esmeralda: Yes.
Salvador Gaytan: You are Houdini, Dr. John!
[Laughter]
Dr. John Chao: It's a pleasure to do. We did it also painlessly, didn't we?
Esmeralda: Yes, yes he did.
Salvador Gaytan: Now, on a scale of one to 10, when you came in, I'm sure you had certain expectations of you hope you can get certain things done. On a scale of one to 10, 10 being your highest, how did it meet your expectations?
Esmeralda: A 10, honestly. I honestly thought this would be a long process. I never, ever thought that I would have this. I didn't. Well, I'm getting a little emotional.
Dr. John Chao: Well, how nice.
Salvador Gaytan: It's understandable.
Dr. John Chao: How nice that as a dentist, that I can do this for my patients week after week. This is why I will never quit dentistry. We can do so much for people. People just don't sometimes realize how taking care of their smile, taking care of their gums and their teeth can so change their lives.
Esmeralda: Oh yes.
Dr. John Chao: And Esmeralda is just a lovely person to begin with. There's so much happiness and joy that's within her. What we were able to do, what I was able to do is help bring it out, so that she can have the vehicle, with which to become the person that she's always been, as a happy, energetic…
Salvador Gaytan: That's right.
Esmeralda: That is true.
Dr. John Chao: A vivacious person that wants to touch people, and get joy in touching them or making them happy. It makes you happy when other people are happy, and you've always wanted it that way. But it just somehow didn't come up for a while now, right?
Esmeralda: Yes.
Salvador Gaytan: And for anyone just tuning in, you're listening to SmileTalk. I'm Salvador Gaytan here with Dr. John Chao, and he's interviewing one of his excellent lovely patients, Esmeralda.
For anyone wanting to get in contact with Dr. John Chao, spelled C-H-A-O. You can call him at 626-308-9104 or AlhambraDental.com.
Dr. John Chao: if you don't remember how to spell my name, C-H-A-O, just remember Alhambra Dental, that's good enough. You can get in touch with us and tell us your concerns, your questions. You can email us and we'll be happy to respond to you that way.
Salvador Gaytan: The main thing is we have one case here, but for anyone listening, that has -- if you have a difficult problem, Dr. John Chao is a specialist in handling difficult problems, and especially people who just don't want to go to the dentist, they have apprehensions. So, if you need someone like that, Dr. Chao is the man.
Dr. John Chao: Well, thank you very much Sal, you are being very generous. We do want to make sure that we define our terms. I know that what you meant to say when you say I'm a specialist, because of my emphasis in my practice is towards a certain thing, such as gum disease, such as trying to make things as painless as possible for my patients, but there's no specialty as to what I do.
Formally speaking, there are specialties for gum disease, the periodontist is the specialist for that. There's the endodontist, who does root canals. There are general practitioners like myself. We do the treatment that are the province of the specialists, but also in the province of the general practitioner.
So, we do everything, and I'm one of those who had the opportunity to learn and gain the knowledge and experience in taking care of my patients, whether their needs fall into any specialty or not. So, generally I'm able to take care of all of them together and put everything together.
Esmeralda's case is a very, very interesting example of a situation where you cannot have various specialists together under one roof, and do what we did for her. It's cosmetic dentistry, it's gum disease treatment, and so things are all wrapped up together, but we were able to do it under one roof, because one doctor can do all of it.
So, we were able to do fillings, certain niches. And for our audience who has special problems like that, although you certainly should have the choice of going to the specialist, but don't forget your own general practitioner.
A lot of times they can do things for you, in certain situations do it better, and there are certain situations where your dentist feels like you'll get better care if you're referred to the specialist. Be assertive, and if you drop into a situation where you cannot get the specialist be sure to assert yourself. Be sure to call up your general dentist and say, "Listen, you got to find me somebody else."
This has got to be done. So, I don't think it's a general rule for us to say, for referrals to be that long. I think in most cases it happens pretty quickly, but unfortunately some cases do slip through the cracks.
Salvador Gaytan: Excellent. Well, Dr. John, we're coming to the last few minutes, but I know you want to touch on -- now, Esmeralda, you have follow-up treatments, so tell the audience what you understand, what are your follow-up treatments? Now, you've got a clean bill of health, but you still have to do things to keep it that way, isn't that right?
Esmeralda: Yes. At home, of course, every morning now it's brushing my teeth and doing the gum massaging. Of course, flossing, that's during the day, of course, right before I brush for the second time, and at night is a follow-up with the flossing again, and the use of Waterpik and after that is brushing my teeth.
Dr. John Chao: That's a great question, Sal, because gum disease is not something that can be cured. It's not a curable disease, and this is something that most people don't understand. My analogy is that gum disease is very much like termite infestation.
Salvador Gaytan: No, not the ugly termites.
Dr. John Chao: Termite, ugly termites eating away at the foundation of your house, and the bacteria that we find in the mouth, certain ones literally cause the eating away of the bone and gum around the teeth.
Actually, the real process is, certain bacteria, the toxic bacteria causes the body to actually turn on itself. It's a glitch in the immune system that's genetic, and the bacteria you have, that cause the problem is something that you also get from your family, especially your parents when you're one or two years old as a baby.
So, once you have that bacteria in your mouth when you're a baby, it stays with you. At certain point in time the genetic defect and the bacteria combine to produce a slow erosion of the bone and gum around the teeth. it can never be cured,
Salvador Gaytan: So, what does Esmeralda need to do then on a regular basis? She just described her homecare, but there's other care too, isn't there?
Dr. John Chao: I'm not sure we have you on the system yet Esmeralda. I think in the future we will. It's a system where we have the patient come back in every three weeks, and then we retreat those areas, where infection has recurred, with scaling, with antibiotics, with lasers and different things.
Then, we also give the patients certain kinds of specialized mouth guards, with which you can apply medicines such as peroxide to the gums, and these trays or these mouth guards can generate hydraulic pressure, so that the medicine actually goes into the gums and gets rid of the infection on a daily basis.
Over time, the infection is such that it will not recur, and then we would keep seeing the patient every three months, and if it does occur, we can treat it at that time. So, long term wise, it's a continual thing, it's something that the patient has to follow through.
Esmeralda: Yes.
Dr. John Chao: Day after day, month after month.
Esmeralda: Yes, my next appointment is within three months, so you're right.
Dr. John Chao: Yes. So, if it does occur, we can catch it at the three month level, rather than try to fix it a year or two later again.
Salvador Gaytan: So, we're coming to the last few seconds, but Esmeralda, you went from not going to the dentist at all, now you have a clean bill of health, and you’re going to be going every three months to have your teeth cleaned. You have a great daily regiment. Before you were only brushing in the morning, you said, right?
Esmeralda: Yes.
Salvador Gaytan: Bad girl, Esmeralda, bad, but you're going to be good now, right?
Esmeralda: I am.
Dr. John Chao: Yeah, well, that was before.
Salvador Gaytan: That was before, but now you're going to be one of Dr. Chao's prized patients, isn't that right?
Esmeralda: Yes.
Dr. John Chao: Well, she doesn't want to lose her great complexion. That's enough motivation already.
Salvador Gaytan: Well, that's amazing, great smile, you got great complexion, you got more energy, you sleep better. So, it was quite a lot that you gained from fixing the problem.
Dr. John Chao: Well, I almost wish everybody has gum disease, then you can get better.
Salvador Gaytan: Then you get better, it's right. Well, we got to wrap it up Dr. John, it's been a great show. You can contact Dr. John Chao, C-H-A-O, at AlhambraDental.com or 626-308-9104. It's been a great interview with his prized patient Esmeralda, it's been a pleasure having you Esmeralda.
Esmeralda: It's been a pleasure being here.
Dr. John Chao: Feel free to contact us at our phone number or address, or email address. Thanks, Esmeralda.
Esmeralda: Thank you.
Salvador Gaytan: Goodbye everybody.
Dr. John Chao: Goodbye.
[END OF AUDIO]
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