By: Victor M. Sternberg, D.M.D.
December 6, 2021
I want to share with you good news regarding Covid-19. A patient of mine was in today and indicated that the Omicron virus was discovered at his medical school in South Africa where he had been educated. Thus far, all of the cases that have been diagnosed have been mild, barely symptomatic cases. This virus may be contagious but may not be a serious threat to human life. The story is being written as this is being written.
There is some evidence, soon to be confirmed, that previous vaccines particularly with a booster, may ameliorate some of the effects of the new variant. Let us hope this becomes a fact.
It is clear however, that what happens in Africa or doesn't happen in Africa affects us here and around the world. Until we understand that this is a worldwide problem and not just an American problem this scourge and future ones will affect us all.
There is no question that vaccines do not totally eliminate the possibility of getting Covid-19, and in some cases do not prevent serious or fatal illness.
In Vermont, where there has been an uptick in cases of the Delta virus, the chance of dying or becoming hospitalized in that state is four times greater if you are not vaccinated. Vaccines are not perfect and never were. But the issue must be discussed openly and honestly based on science and evidence, not based on opinion.
I have discussed often the need to focus on preventive medicine as opposed our sick care medical system. A couple of caveats regarding that particular opinion as it relates to patients within my practice.
Diabetes affects the progress of periodontal disease. I have treated, over the years, many diabetic patients. About 5 years ago I confronted a patient who had periodontal issues that didn't seem to resolve from the care we were providing her. I knew she was a diabetic. I knew she was obviously overweight. I confronted her about the need for a change in her diet, sharing with her a book titled Dr.
Bernstein's Diabetic Solution, a book that is available on Amazon. Dr. Bernstein has been diabetic for 77 years; he is now 88 years old and has been on insulin for his entire life after being diagnosed at age 11. He is free of all symptoms of diabetes, his vision, his kidneys, and his heart are all healthy. The book he wrote was a tribute to the diet that he adopted many years prior to becoming a physician. The book is a must read for anybody with diabetes.
In any event, I provided this patient with uncontrolled periodontal disease and diabetes with a copy of his book. Three months later she came in and her gums were pink and I could not find any evidence of periodontal disease. She confided in me that the entire time I was treating her, her A1C which measures blood sugar was 13. Normal is below 6. She then confided that she went on the diet, lost about a dozen pounds and her A1C was in the 6's. Just by changing her diet. She had already been on medication, Metformin, for her diabetes for years. Her physician was astounded that she could do this with diet. However, he had never insisted or given her a particular diet to stick to, although she obviously was capable of following one.
I have repeated this advice to a number of other diabetics with severe periodontal disease. I've watched them get healthier as they have been able to lower their blood sugar significantly by following Dr. Bernstein's diet.
The severity of diabetes, and the huge increase in the number of diabetics worldwide, and all of the medical problems that result from this condition are addressed primarily through medication. Sadly eventually medically, when heart disease develops, when limbs need to be amputated, when people lose their eyesight or their kidneys shut down.
But as I mentioned before, the medical system is set up to medicate and operate, not to prevent. A recent study revealed that the vast majority of type II diabetes can be controlled by diet and weight loss alone.
Another arena of preventive early diagnosis involves lung cancer. For a good number of years I have been aware that White Plains Hospital and other institutions are using low dose CAT scans for people who have a history of smoking. I have sent numerous patients to these clinics for scans. The radiation is minimal. A baseline is established if no nodules or suspected lesions are found, and people are followed for the next 5 to 10 years.
I have had three people in my life who have received these low dose CAT scans without any prior symptoms of lung disease. All three of these individuals underwent minor procedures to remove a malignant tumor from a small portion of the lung that was involved. They have all gone on to live healthy, cancer free lives. Early detection of lung cancer makes it curable. Late detection is often fatal.
A distressing example of the failure of not having an early diagnosis. A patient who I have known for a number of years had cardiovascular disease and a bypass surgery 6 years ago. He had been a smoker for over 30 years.
When he recently complained of shoulder pain he was diagnosed with a rotator cuff problem. This pain was treated non-surgically for almost a year, bouncing between physical therapy and orthopedics. Finally, when the operation was going to be performed to correct the shoulder pain, the anesthesiologist noticed that his oxygen level could not be maintained during the surgery. The procedure was stopped, an x-ray was taken, and a large malignant tumor of the upper lobe of his lung was detected. This was the cause of his pain, not his shoulder.
Despite having been a heavy smoker for much of his life, contributing to his heart disease, nobody bothered to do a low dose CAT scan of his lungs during his entire treatment over the last 6 years, leading to his now serious lung cancer condition.
As I have mentioned earlier, I lost my father at an early age from lung cancer, a man who smoked 4 packs a day. I have also lost many patients from the scourge of cigarette induced lung cancer. All of you who have had a long exposure to smoking should consider strongly a low dose CAT scan of your lungs.
While our country is consumed by the politics of Covid-19, an equally serious and more prolonged epidemic has infected our nation's young. Last year the number of deaths from opioid overdoses
exceeded 90,000. We are on track to exceed that number this year. This scourge has been raging in our country for over a decade with the number of lives lost exceeding all of those lost by Covid-19.
The politicalization of Covid-19, the lockdowns, the anti-vaxers, and all of the demonization of science has dominated both political parties. Meanwhile, opioid overdoses do not seem to have a constituency other than the families who lose their loved ones.
As of this writing, 7 of my patients have lost their children, one just occurring this past September. A patient and friend lost his 21 year-old daughter, his only child, to a drug overdose. Because there is no political constituency or votes to be obtained by focusing on this problem, it gets pushed to the back pages of cable news as well as newspapers, and certainly does not ring out on a daily basis in the halls of Congress.
It is taking the complicity of big pharma companies, who pushed narcotics as a safe method of pain relief, in addition to companies that have distributed these drugs to communities throughout this country where there was no need but a good market for not people needing pain relief but for people needing to sell and abuse these drugs. Equally complicit are the drug cartels that have been able to continually provide our young people with heroin and now fentanyl, a new killer roaming the streets of America. So far, only one group of individuals in the American pharmaceutical industry has gone to jail. Their company was marketing fentanyl to doctors as an excellent and safe pain reliever when it was well known that it is only to be used for terminal cancer pain. Fentanyl now is mixed with marijuana and other narcotics leading to the ongoing death of our youth. My niece, a trauma nurse, just watched a 17 year old die following vaping with marijuana laced with fentanyl.
As the right debates gun rights and downplays the carnage in our schools and in our streets, and the left about systemic racism while blood pools in our streets, the opioid epidemic goes totally unabated and more seriously, not addressed.
It is clear to this writer that issues only reach the level of the political arena when they can affect voting choices. Death by opioid has no political constituency, therefore it is essentially ignored. The war on drugs began decades ago and it's never been worse than it is now.
The origins of drug addiction are complicated. It does, however, present as an enormous healthcare issue. Whether it be suicides by gun or deaths on the streets of Chicago or the overdoses that are occurring in our community, we seem incapable of dealing with the deep psychological issues that are impacting our society.
Two books that I strongly recommend that deal extensively with the subject of the origins of our drug epidemic include, The Empire of Pain and the book Dreamland. Read them and they will inform and shock you.
One final note that is parallel to this issue of preventive medicine and human behavior. The American Highway Association just revealed statistics for first half of this year. We've had more car deaths in the first 6 months than ever before in our nation's history. This is despite having air bags and seatbelts. Interestingly enough, 90% of Americans wear seatbelts yet 50% of the deaths occur among people who have not buckled up.
Finally, an interesting dental story.
I have been treating a lovely woman for 43 years for her periodontal condition. Throughout those 43 years she has lost 2 or 3 teeth that either broke or were non-restorable, and she received 3 implants. She has 24 teeth in her mouth, all in a healthy state. She appears here every 3 months. Her oral hygiene is reviewed and her teeth are carefully cleaned. She shared with me that her identical twin sister, living in Germany where she was born, has lost all of her teeth. Here are two women, the same genetic makeup, one receiving adequate and effective instruction on how to prevent disease as well as receiving periodic and careful dental maintenance; the other with the same genetics has lost all of her teeth.
My strong interest in preventive medicine relates clearly to the experience I've had as a dentist and that people I've treated over 40 years who have shown up regularly, and adequately removed plaque from their teeth, have much better outcomes than people who just have episodic care or have dentistry without an emphasis on prevention.
The concept of preventive dentistry and medicine unfortunately are not the centerpiece of our healthcare system. Unless we adopt that preventative focus we are doomed to experience escalating medical care costs which threatens the financial survival of Medicare and increases the financial burden of private insurance costs .
Recently we received another increase in our private insurance for our practice. It is now approximately $11,000 per year for one individual to be insured and $35,000 per year for a family.
Prevention and early diagnosis can save your teeth and your life.
I hope you embrace this admonition.
As always I appreciate your feedback.
Dr. Victor M. Sternberg, D.M.D.
By Westchester Center for Periodontal & Implant Excellence
January 12, 2023