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Tuesday, January 22, 2013

Tiger Woods misses cut

Updated: May 4, 2012, 9:37 PM ET

By Bob Harig | ESPN.com

CHARLOTTE, N.C. -- Tiger Woods has missed the cut for just the eighth time as a professional on the PGA Tour.

Woods could manage just a 1-over 73 at the Wells Fargo Championship at Quail Hollow and didn't make a birdie over his final nine holes to finish at even-par 144. The 36-hole cut was 1 under.

Harig: Swing hurts Tiger

Tiger Woods' missed cut at Wells Fargo simply shows he's more like the rank and file PGA Tour players than many thought, writes Bob Harig. Story

• Stats & Info: Missed putts lead to cut

"I figured I needed to get to 3 under to be safe, 2 under for sure," Woods said before departing. "It's frustration. I'm not playing a weekend where I have a chance to compete for a title. I've missed my share of cuts in the past, and none of them feel good."

Woods likely will now head to South Florida for the weekend to sort out his swing and his game before next week's Players Championship -- where he's withdrawn each of the past two years.

Nick Watney shot 64 to take the early tournament lead at 12 under.

This marks just the eighth time since Woods turned pro in 1996 that he missed a 36-hole cut, and the first time he's done so twice at the same venue or tournament. Woods also missed the cut here in 2010 in just his second tournament after returning from a five-month break because of personal issues.

Woods has 72 PGA Tour victories. Phil Mickelson is next among active players with 40, and has missed 63 cuts in his career. Vijay Singh has 34 wins, and has 57 missed cuts.

Tiger's career PGA Tour missed cuts

Year	Event
2012	Wells Fargo Championship
2011	PGA Championship
2010	Wells Fargo Championship
2009	British Open
2006	U.S. Open
2005	FUNAI Classic -- Disney
2005	Byron Nelson Championship
1997	Bell Canadian Open

Woods' last missed cut came at the 2011 PGA Championship in Atlanta, where he was playing for the second time after a four-month break because of knee and Achilles injuries.

After winning the Arnold Palmer Invitational on March 25, Woods was considered a huge favorite going into the Masters. But he never broke par and finished tied for 40th, his worst performance at Augusta National as a pro.

Woods felt good about his work the past two weeks with swing coach Sean Foley, who said his client struggled with posture issues.

But Woods again lamented the inability to play properly with a new swing and lapsing into old habits.

"It all has to do with my setup," he said. "When I get over the golf ball and feel uncomfortable, I hit it great. I want to get comfortable, and I follow my old stuff and hit it awful. I just tried to get uncomfortable and feel as bad as I could and then I striped it.

"I know what I need to do. I just need more reps doing it. ... We've changed a bunch of different things, and every now and then, I fall into the old stuff. And that doesn't work, the combo platter of old and new."

All of this occurred despite a fortunate ruling for Woods at the par-5 fifth hole, where Woods hooked his second shot to the left of the green -- and nobody could find it. A lost ball would have meant a penalty stroke and going back to the original spot to hit again, but witnesses told a PGA Tour rules official that they saw the ball land and that a spectator must have picked it up. Woods got a free drop and made par.

"It was a very unusual situation, but based on all the evidence ... where else could the ball have been," PGA Tour rules official Mark Russell said. "It was like being lost on the floor right here."

None of that mattered, however, when Woods wasn't able to birdie any of the closing holes. He had a 5-footer at the par-4 eighth that might have put him on the cut line, but missed it. At the ninth, his last, he left himself a 50-footer and two-putted. Woods parred all nine holes on the front, and for the round made just two birdies.

Woods hit 14 greens in regulation but needed 33 putts and was ranked 122nd in the field in total putts.

From the 1998 AT&T Pebble Beach National Pro-am -- where he actually didn't return to play a rain-delayed round -- to the 2005 Byron Nelson Championship, Woods did not miss a cut on the PGA Tour, a record 142 straight tournaments.

Since that time, no player has gone as many as 50 straight tournaments without missing a cut -- although Steve Stricker heads into next week's Players Championship at 49 straight.

"It's a great week, this is one of my favorite tour stops," Woods said. "Unfortunately I'm just not going to be around for it."

Stoney LaRue Charity Poker & Golf Classic

Updated: May 4, 2012, 12:22 PM ET

DALLAS, TX -- Award winning singer/songwriter Stoney LaRue will host his Music & Arts Foundation charity celebrity poker & golf classic to benefit the Cook Children's Recording Studio Project on June 3 and 4 in Lewisville & Grapevine, TX.

Give Ben and Skin your full three as they broadcast live from the golf classic on June 4, and hook up with the ESPN Street Team both days for your chance to win some cool swag!

"It feels great to finally be in a position to help others find their own outlets of expression and creativity," said LaRue. "That is what the Music & Arts Foundation is all about. This inaugural year of the tournament will benefit the Cook Children's Recording Studio Project which is doing some great things for the kid's there."

The two day event kicks off with a charity celebrity poker tournament which includes dinner and post tournament concert. The charity poker tournament starts at 4PM on Sunday June 3 at Hat Tricks (101 East Corporate Dr. #300 Lewisville, TX) featuring Josh Weathers and more. The event continues the next morning Monday June 4th at 11:00A with a three-man golf scramble at the beautiful Cowboys Golf Club (1600 Fairway Drive, Grapevine, TX) followed by an acoustic concert on the course. The evening concert will be open to the public at 7PM by Stoney LaRue and friends including Jason Boland and many others to be announced soon. A full list of celebrities and musical lineup will be available soon at stoneylarue.com/foundation

Tickets and golfer registration are on sale now. Tickets to participate in the charity poker tournament, dinner and concert are $100 (concert only and spectator tickets also available). Registration for the golf tournament is $250 and includes a post golf tournament concert ticket and more. Fans interested in the post golf tournament concert only can purchase tickets for $20. For additional information on all the festivities and to purchase tickets visit stoneylarue.com/foundation.

What: Stoney LaRue Charity Poker & Golf Classic
Where: Hat Tricks and Cowboys Golf Club
When: Sunday, June 3 and Monday June 4

Friday, January 18, 2013

Dentist extols the rewards of working with elderly patients

By Laird Harrison, Senior Editor

July 21, 2008 -- Gregory Folse, D.D.S., is surfing a tsunami. The number of Americans over age 65 is likely to double in the next 50 years. As it does so, dentists may find themselves making more dentures, pulling more teeth, and perhaps -- like Dr. Folse himself -- spending a lot of their time in nursing homes.

"Nursing homes have so much disease it's overwhelming," said Dr. Folse of Lafayette, LA. "This country is going to be judged on how well we treat the elderly and disadvantaged, and we're missing the boat."

Many nursing home patients can't afford the dental care they need, and few states reimburse dentists for doing what needs to be done. Despite that, Dr. Folse argues that dentists who work in nursing homes will find more than ample rewards. "The reimbursement has never been there," he said. "But the payment is huge."

At a recent conference of the California Dental Association (CDA), Dr. Folse shared both clinical and political tips for meeting the unusual needs of nursing home residents. In a recent interview with DrBicuspid.com, Janet Yellowitz, D.M.D., M.P.H., director of geriatric dentistry at the University of Maryland Dental School and president of the Special Care Dentistry Association, confirmed much of Dr. Folse's advice.

Formerly in a growing private practice, Dr. Folse began in 1992 spending his Fridays in a nursing home. He found he loved the work. "They appreciate what we do more than anything else. I have 'girl friends' wherever I go. I have guys who can't speak but they stick out their hand to shake with me," he said.

To learn more, Dr. Folse signed up for a three-year fellowship working with geriatricians. The experience made him think dentistry should have a geriatric specialty, but then he realized about 15% of his patients weren't old, just very sick. So he is working instead to establish a special care specialty within dentistry.

The specialty is making steady progress, according to Dr. Yellowitz. Her association has formed a board, is creating an examination, and working with a new committee of the ADA.

Frequent exams critical

Dr. Folse began by working only on dentures because the Louisiana Medicaid program would not reimburse for any other dentistry service. But one day an experience changed his approach. A patient had become lethargic. Without looking in her mouth, the staff asked him to see if she had a toothache. Dr. Folse found an infected tumor the size of a golf ball. The patient died seven days later.

Now Dr. Folse emphasizes frequent examinations. He and his staff conduct 2,300 to 2,400 dental screenings a year. He has quit his private practice and become completely mobile, traveling among 21 nursing homes and serving as the facilities' dental director.

He carries all his equipment in regular vehicles and never uses a dental chair. "I find that my folks are easier to treat where they are," he said. "We set up in rooms, beauty shops, conference rooms. Anywhere there's a need, we can do dentistry." He keeps track of patients' charts through his cell phone, connecting to a software program called OnSite Dentistry.

Rather than Medicaid, he now depends on the nursing homes themselves for reimbursement. He receives $6 per bed annually. "That's how I'm able to survive, because these facilities have bought into the fact that oral health is critical."

Recently, he discovered a new dodge around the bureaucracy. Under federal law, if your state Medicaid program doesn't cover needed services -- including dental care -- those patients receiving Social Security can pay with their Social Security benefits. Money that would otherwise go to the nursing home is diverted to the dentist. The state will then reimburse the nursing home for the loss. (The success of this approach depends on the willingness of the nursing homes to cooperate, Dr. Yellowitz noted. Those she has approached have not wanted to participate.)

Dr. Folse is now lobbying for a Special Care Dentistry Act, which would provide money for the aged, blind, and disabled. He argues that it can save the U.S. government money by reducing infection. He cited research that found the same pathogens in dental plaque and pneumonia. The act has yet to be introduced in Congress.

As nursing homes have become more supportive, Dr. Folse has been able to hire help. He now works with three assistants: an office manager, an assistant who conducts preliminary exams, and a hygienist. He also consults regularly with physicians and the patient's family.

From his 16 years of experience in nursing homes, Dr. Folse offered these practical tips:

When your gut tells you something is wrong, you have to follow through because "it's life or death."
Diabetes patients should be on a three-month recall schedule.
Denture patients should be screened at least once a year for oral cancer.
"If you hear on the phone that a patient has blood on the pillow, that's serious," Dr. Folse said. He gave the example of one patient who almost died from Ludwig's angina but was saved because he responded quickly to the report of blood on the patient's pillow.
When you take impressions, don't start by seating the tray in the palate. This can cause patients to gag. Instead, take the impressions anterior to posterior. (The same can be said of x-rays.)
Set the occlusion on dentures to a flat plane (0°). A vertical plane puts pressure on the teeth. An inclined plane results in lateral pressure.
Watch for elderly patients as they arrive, and send someone to the parking lot to help them.
Patients with Alzheimer's disease may complain of dental pain they no longer feel; they remember the pain from infected teeth they had years ago.
If he suspects patients are cognitively impaired, Dr. Folse approaches slowly and indirectly, lowers his eyes, and offers his hand. He says, "I love you, I'm here to help you." It's corny, he admits, "but it works."
Dr. Folse doesn't suspend patients' anticoagulant medications before extracting teeth. "I would rather deal with bleeding problems than a stroke," he said. Instead, he tests the patient's blood for coagulation time. As long as the patient's blood tests at an international normalized ratio (INR) between 2.0 and 3.5, he will do the surgery. (This is "pretty much standard of care now," Dr. Yellowitz said.)

So how does Dr. Folse deal with bleeding? He uses CollaPlugs by Zimmer Dental -- plugs made of collagen -- which expand in a socket and stop bleeding. He also uses ActCel hemostatic gauze by Coreva Health Science. "You cut a strip off that would go a quarter of an inch past the sockets on the buccal and a quarter of an inch on the lingual and a quarter of an inch mesial and distal," he said. "This stuff acts like duct tape." The gauze resorbs in four hours. "With those two things, I've been able to control every amount of bleeding I've had," Dr. Folse said.

Dr. Folse endorsed several other specific products, including the following:

Fuji IX Extra glass ionomer for fillings by GC America
Oasis mouth spray for dry mouths by GlaxoSmithKline
Surround toothbrush with dual heads by Specialized Care: It brushes buccal, occlusal, lingual, and palatal surfaces "in one pass." "As much instruction as I give to my nursing homes, the lingual and palatal surfaces seem to get neglected all the time," Dr. Folse said.
Nomad handheld dental x-ray unit by Aribex: The system "has changed my life," he said. It's a huge improvement over the days of "loading a 200-lb unit in the back of my truck and wiping the bugs off it when I get there."
Tokuyama chairside denture reline material: It "works great," according to Dr. Folse.
Physics Forceps by GoldenMisch: Dr. Folse uses these for extractions. "This is best thing since sliced bread," he said. Typical extractions are like trying to pull nails with pliers, he noted. The Physics Forceps, by contrast, features a bumper that rests on the buccal plate to provide leverage, much in the way the claw of a hammer uses a board for leverage.

With techniques such as these, any good dentist can help nursing home patients, according to Dr. Folse. "We have to step up to the plate and treat these folks," he told the CDA audience.

And Dr. Folse lamented the number of dentists who turn elderly patients away, even after the patients and their families have struggled to get to their offices.

"I have met war veterans with no access to dental care and little old ladies and older men who have taken care of their families all their lives. That makes me so angry I want to punch someone. I'm not afraid to get out of my comfort zone, and I challenge you to do it," he said.

The secret to advertising through Google

By Richard Geller

August 26, 2008 -- Editor's note: Richard Geller's column, Marketing Madness, appears regularly on the DrBicuspid.comadvice and opinion page, Second Opinion.

In my experience, patients who find their dentist through the Internet tend to spend more on dentistry. So how can you attract these patients?

In a previous article, I discussed tricks for getting patients through your own Web site. But that's not the only way to reach out online. Google ads can also work.

In fact, you can advertise on Google and have almost no competition. Here's how:

The best known Google ad program is the one that shows ads when you do a simple search. But remember that people spend maybe 1% of their time searching. With the other 99% of their time, they hang out in other places: social media, news sites, or professional sites like this one.

So if you advertise on Google Search, you are only showing your ads a fraction of the time people are spending on the Web. And worse, you have maybe 20 competitors all screaming for your prospect from the same exact search page.

So your prospect flips to one ad, flips back, flips to a competitor, flips back. Wouldn't you do that if you were searching for a dentist? Since each doctor may pay a buck or $1.50 per click, you end up spending a lot of money on clicks that don't result in patient visits.

So how do you get a high volume of good-quality clicks? Try the Content Network. These are little bitty "text ads" that Google (or Yahoo or MSN) places on other Web sites. These big search sites act as intermediaries, buying ad space for you on sites ranging from GolfBagsAreUs.com to MySpace.com and everything in between. Content Network is mega huge -- it's the entire Internet, not just search.

Someone will be looking for golf bag information, or maybe looking for information on gums and teeth, and they will see your ad. They won't see 20 other dentists. Just yours. And they'll click.

No time to sell your dentistry. But you can collect their information and sell your dentistry to them next week, or perhaps next month. In other words, you have them in your "marketing funnel" -- a database of prospective patients.

Now with this type of advertising, you had better grab 'em quick. To do that, the ad has to bait them. So why not offer a free video or report? A book or a CD? In return, ask for their names and addresses, and get permission to market to them.

Okay, done ... they are off looking at more golf bags, but now they are in your funnel. You can then send them good e-mails or snail mail, and convert them from a good, warm lead into a smiling, live person in your chair.

I have prepared a video for you that shows you how this all works. The Content Network is quite tricky compared to Google Search and affords a lot more room for innovation -- or for error.

www.cases4dentists.com shows you exactly how you can increase your lead volume using Google advertising and the rather little-known Content Network.

The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Destination dentistry

By Sheri B. Doniger, DDS

August 23, 2011 -- Editor's note: Dr. Doniger's column, Dental Diaries, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

I recently visited my good friend Jean at her summer home in New Jersey. We had planned a total "girls weekend" that included golf, a shopping trip in New York City, and a night at the theater. We bought New Jersey corn and tomatoes (since, according to the local legend, they are the best) and barbecued salmon.

Then we returned to New York for one of the main reasons I had wanted to visit Jean: to have a Cerec restoration placed on a tooth with a failing amalgam restoration that had been placed eons ago by a dental student friend during my dental hygiene years at Loyola. I knew Jean had purchased a Cerec unit and was enjoying fabricating restorations. We had discussed the opportunity for me to experience the process, and I was very excited to participate as a patient.

I have had a few dental restorations placed over the past year. One dentist I visited in Chicago had a slightly different approach to chairside manner than Jean. First, the anesthetic was completely different. In Chicago, the dentist did not believe in a topical and, sorry to say, was not gentle in his technique. In New York, Jean used a monitored delivery system following topical placement.

I have always been a proponent of topical anesthetic. I believe the procedure does allay patients' fears and, depending on your injection technique, makes the process go a little smoother. This was a completely different experience for me. The delivery is much slower than my own very slow injection technique, but definitely as effective. Something to consider for a future purchase.

Now, the Cerec experience involves a long time in the dental chair. It is fascinating to watch the digital image of the impression and the onlay being created. It is one thing to watch a demo on the exhibit hall floor at a conference, but it is more meaningful when it is happening to you.

I watched Jean create the proper contours, then send the information off to the milling machine for the restoration to be fabricated. They don't always come out perfectly. There is a learning curve, she explained. But the ability to have a milled, porcelain restoration delivered in less than a four-hour time period is truly amazing. I was able to leave Jean's office with my newly minted porcelain onlay and make my plane back to Chicago on time.

Cerec is definitely an interesting option. It may not be for everyone, but it was pretty amazing to experience the process. Jean is an outstanding clinician, as well as an early adopter of many of the technologies that have been available to dentistry over the past several years. Personally, I would not have the return on investment for a Cerec machine in my office. But in the future, if a group of dentists got together to share the cost of the machine, I might be interested in participating. Maybe Cerec should consider mobile dental units, similar to the food trucks that tour around many big cities.

It is always good to see how other dentists practice, especially if you are a solo practitioner. Study groups, webinars, and lectures offer one aspect of learning. Being a patient is another, more practical approach. You can always pick up tips and tricks (she gave me at least six while I was in the chair). You are able to confirm what you are doing right, along with something new you may consider adding.

All things considered, even with my horrific golf game, I am very pleased with my mini summer vacation that included destination dentistry in New York. I plan to do it again. If nothing else, there is always more theater to see!

Sheri Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. Most recently, she was the editor of Woman Dentist Journal and Woman Dentist eJournal. You can reach her at donigerdental@aol.com.

Is it time to invest in digital dentistry?

By Kathy Kincade, Editor in Chief

October 12, 2011 -- LAS VEGAS - If you haven't invested in digital technologies yet, you may be undervaluing your dental practice by tens of thousands of dollars, according to Paul Feuerstein, DMD, speaking at the ADA Annual Session on October 10.

In a jam-packed, 60-minute presentation, entitled "Be a Trailblazer: Embrace the Future of Digital Dentistry," Dr. Feuerstein blazed his way through a plethora of cutting-edge products (120 in all) available at this year's ADA session, from digital diagnostic tools for caries and cancer detection to next-generation practice management software and voice-activated perio charting packages.

"I do not play golf," Dr. Feuerstein said. "I practice and work on my passion seven days a week, going to as many dental meetings as possible and looking at every product that I can."

First up was infection control. Noting growing concerns over the risks of cross-contamination from various sources in the dental operatory, he recommended several new keyboards that offer barrier protection: the Econo-Keys and Unotron washable keyboards, Advanced Input's covered keyboard, and Cleankeys' glass keyboard.

Next up was how to achieve a chartless office. Noting that all U.S. medical records have to be digital by the year 2014 under legislation enacted by former President George W. Bush, Dr. Feuerstein stressed process in addition to products.

"Pick a date, and from that date forward all new entries are digital," he said. "You do NOT have to scan the old charts -- just refer to them as needed. For the first six months you are digital, you will pull all of the charts and look at them. The next six months you will look at half, the next six months one out of ten, and beyond that, rarely."

In addition to the multitude of established practice management systems, Dr. Feuerstein pointed to a number of new players, especially those that offer cloud computing services, such as Curve Dental, Ice Dental Systems, and Planet DDS.

"The beauty here is no server is needed," he said.

Turning to patient education, Dr. Feuerstein talked for several minutes about digital cameras.

"Take a full series of photos for patients with restorative needs and use them to better communicate to them the treatment plan," he said.

And be sure to buy a camera from a camera company that knows dentistry, he emphasized. "Be clear to them what your needs are," he said.

Dr. Feuerstein also recommended using a contraster to get high-contrast images. In fact, one company -- PhotoMed International -- even has an "antinose hair" contraster.

Dr. Feuerstein, who emphasized that he receives no compensation from vendors for his product recommendations, also discussed periodontal charting products, soft-tissue lasers, digital radiography systems, intraoral cameras, and digital diagnostic tools for caries and cancer detection.

"Is the explorer the best thing we've got for finding lesions?" he said. "I don't think so."

And Dr. Feuerstein's vote for the most interesting use of technology on the ADA show floor this year? The Sonicare DiamondClean USB toothbrush by Philips.

"You can charge it on your computer!" he said.

Lesson learned

By Sheri B. Doniger, DDS

October 13, 2011 -- Editor's note: Dr. Doniger's column, Dental Diaries, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

The day started out looking like one of our better office production days in the past few months. We had a full schedule, with three new patients. It'd been a while since we had had such a good day (on paper).

We sailed through our first several patients, referred the first new lady to the surgeon for multiple extractions, and began our next new family. My business manager was attempting to contact their previous dentist to assess radiographic history. She clicked on the dentist's website and moments later, bam! We'd been hit by a virus.

And it was a nasty one. It overrode all of my attempts to install Malwarebytes or install any other antivirus programs. Our computer was shut down. Not a great ending to a good day.

All I could do was disconnect the computer and take it to my IT guru (who happens to be my son-in-law). He, too, was unable to override the virus. My choices: Discard the computer or reformat it. Since we recently installed this computer, I was not ready to toss it. So after several hours, my son-in-law had reformatted the computer, reinstalled the operating system (note to all: Never discard the discs that arrive in the box with your new systems; you never know when you may need them), installed our new antivirus software, and we were ready to go.

Yes, I did say new antivirus software. I had just purchased this software for my second computer in the office but did not have the opportunity to install it on both computers. A very costly mistake. Had my son-in-law not been able to fix the computer that contracted the virus for the cost of a few rounds of golf, it would have been a lengthy, extremely expensive endeavor to have someone else come in to repair the damage.

Seriously, this was a huge error on my part. I am almost ashamed to admit it. I am the first person to talk about background checks for employees, the sanctity of data, and the safety of personnel, but I forgot one of the biggest issues we are facing in this day and age: cybercrime.

I heard from other folks that they, too, had major computer failures that day (the day after Steve Jobs, Apple founder, passed away). Maybe all the viruses were released in his honor. But for whatever reason, the fickle finger of fate affected our cyberworld.

You never know how you get a virus. Was it because my business manager clicked on the other dentist's website? Was it attached to that? Did we open an article from the Web and something was fixed to it? Did it happen months ago, and it was set to release that day? We will never know for sure.

But lesson learned: Install your antivirus protection TODAY. My error may save you both time and money.