A Good-Bye and a Hello!

Diana has been our Hygienist for several years and has deservedly won the hearts and minds of our patients with her gentle clinical style and lively earnest discussions with our patients.

We have enjoyed her laughter and camaraderie with our staff and she has been a genuine friend – not just a coworker.

Unfortunately, Diana has been battling arthritis in her fingertips and feels like continuing in her hygiene position is no longer feasible. She has “retired” from dental hygiene for medical reasons, and has left her position as our Hygienist as of the end of 2020.
She will still be at the practice from time to time as a patient and friend but will no longer be doing clinical dentistry.

We all wish her well in her new endeavors and this will be a see you a lot less than a permanent
good-bye.

Now we say Hello to Ryan as we welcome him to our practice!

Ryan will be assuming the Hygienist position in our office. Ryan has over 18 years as a dental hygienist in the Seattle area and relocated to Bellingham recently.

He enjoys rock climbing, hiking, running and playing guitar. He is looking forward to enjoying Whatcom County.
He has a gentle demeanor and is looking forward to meeting our patients and continuing to take great care of them. We wish to extend a hearty welcome to Ryan and a thank you for being part of our team!

Dr can we please have a shot today!?

Our experiences in childhood often change how we feel about dentistry years later. One interesting twist occurred some years ago in our practice.

A family of Russian immigrants with a number of children ranging from 5 to 17 had made appointments for their dental care needs. The eldest of those children spoke the best English, and acted as the translator for the family.

After some discussion amongst them, the older children decided that their five year old little girl (the youngest child) would “go first” for the treatment of her cavities.

When it came time for the first filling appt. the five year old and the 17 year old girls were the only ones in the room. The five year old was as “as good as gold” through the injections and the rubber dam placement and all-the-while, her older sister was translating. During the entire process, she was no fuss and all smiles until we were ready to drill out the decay. At this point, the eldest said something to her younger sister, and the little one became tearful and distressed. We couldn’t figure out what was wrong, and when we asked about the dam, the clamp etc. she confirmed that all was fine.

Finally, we asked what the eldest had told her and why the little one was so upset. The eldest said that she told her that no matter how badly it hurt she shouldn’t move, so the dentist could fix her teeth. Not understanding the context I asked her why something like that was said!?

She said that she wanted the little one to be polite and stay still. I stated that it wouldn’t hurt since we gave her a local anesthetic. She didn’t believe us and was quite perturbed with us when “we made her lie to her little sister” about it not hurting when we drilled.

After more discussion, we got the little one calm and starting drilling—still smiles and no tears or distress. The eldest stopped us and heavily questioned her younger sister about what was going on as she couldn’t believe that she was not in pain! She left for a minute and all of a sudden all five of the other children were in the dental operatory. They were all amazed that the little one was reporting having a filling done without any pain. Their context from going to the dentist in their country was that local anesthetic was not given for drilling and filling of a cavity. They had all experienced pain with fillings and were absolutely amazed that drilling could be done without pain. These children all politely learned to happily sit in my chair and say in broken English, “Doctor may I please have a shot today!?” Their context was that they were so happy to have no pain during excavation of decay that the injection process was a huge positive!

This was an unusual circumstance but still helps to point out that our early childhood experiences can alter the way we feel about things like dental care for a long way into the future. These experiences can create avoidance behaviors and anxiety. I (Dr. Yaremko) had bad experiences in my teenage years and it has stuck with me to this day. This is why we do not feel that our patients are defective in any way, but have been made into what they are and why we work so hard at providing anxiety managed care, be it giving a simple injection to an immigrant adolescent to general anesthesia to a traumatized adult.

We are Open

Last week, several media outlets including KING 5 News, The Seattle Times, and KUOW incorrectly reported that Gov. Inslee’s updated Proclamation 20-24.2 suspends non-urgent medical and dental procedures beginning Dec. 3. The Washington State Dental Association (WSDA) and our office would like to assure patients that these reports are incorrect; non-urgent dental procedures are NOT being suspended. WSDA is in contact with all of the media outlets that reported inaccurate information to have it removed and/or corrected.

 

We would like to announce that Dr. Eric Yaremko DMD dental facility is open and operating! We are taking full health measures to ensure your safety when it comes to cleaning guidelines between patients.

We have many systems in place to ensure your safety and comfortability during the COVID-19 Pandemic:

  • We have set up plexiglass around all of our point-of-contact stations
  • In our front lobby area, we have reduced the amount of furniture pieces so that you can sit and be physically distanced between you and other patients!
  • We are sanitizing all surfaces between patients and using our fogging solution between patient visits! We are using a fogging agent that generates a non-toxic, non-irritating fog that’s 50-80 times more effective at killing COVID than bleach.
  • Both staff and patients will get their temperature checked before entering the facility/beginning of your appointment.
  • Our Laminar air system in the office allows outside air exchange (this air system moves the airflow current from head-to-feet, always) and are wearing masks from the moment they walk into the facility.
  • Our heating and air conditioning system has an ultraviolet C cleaner installed.
  • We have separated the writing utensils you’ll be using with clean and dirty

 

You can read the full article here on the misreport, and feel free to follow us on social media for updates on closures and other covid-related news.

Exam and Treatment

At Eric Yaremko DMD PS we take the process off a thorough examination and discovery process very seriously.
Dr. Yaremko handles complex reconstruction cases and has spent countless hours training with the most knowledgeable doctors in dentistry to bring the highest level of diagnostic knowledge to you and your exam. He helps other dentists with treatment planning and was one of the founding members of the WA Creating Restorative Study Club -devoted to treatment planning advanced cases. We ask that patients be sure to set aside the appropriate time for this procedure. This is not a five minute or 30 second check-up that you may have had in the past. We are actually taking the time to talk to you and assess your current situation and what your risk is of having problems in the future.
We do not insist that you treat your condition. We do ask that you allow us time to explain to you what we see as risks to your dental health and possibly your whole health in both the present and the future. You will be asked as to how you would like us to care for you and what risks in certain categories you are willing to accept. We understand that there are times when you may not have the time, energy or finances to manage your treatment ideally. Please understand that it is our job to tell you of the problems and potential problems that we see and your job to work with us to come to a plan where you balance your concerns about your conditions and what is going on in life to come to a realistic treatment plan for you.
We have had some comments lately on the internet that we frankly find quite odd. We DO examine and check for problems regarding gum disease, cavities and weak and infected teeth, wear and jaw problems. We DO explain what future problems and risks are involved in those categories and how those may affect other conditions. We DON’T tell you that you have to manage and treat those conditions. We DO tell you what YOUR risks are if you don’t treat these conditions and how it may come to affect treatment and what potential pitfalls that you may be accepting by not managing those, including not being able to guarantee some of the work we are doing for you. Also there may be some re-do of work that we do for you if you choose to manage those problems in the future. These are after all your teeth and your risks not ours.
Some treatment planning mistakes that have walked into our office due to patients and dentists not looking past the one tooth–
Case 1 Patient came in to get an opinion on a recommendation that he had received elsewhere to have 2 crowns done. However he was unaware that he had numerous decayed and infected teeth, and moderate gum disease and also confided that he disliked the appearance of his teeth.
After looking at his problems as a whole HE DECIDED that he could not afford the time and finances to restore his teeth and that he would prefer to have an implant supported denture, which we eventually provided for him. Had he gone through with the treatment of the crowns on the 2 teeth ( which was appropriate treatment if everything else was alright ) he would have wasted his time and money having them extracted later.
Case 2 patient came in to us as he was concerned about his teeth becoming shorter. He had several crowns done in the last five years.
After consultation HE DECIDED to have those crowns re-done and several others done in order to fix the bite issues related to the shortening of the teeth. The other crowns had been done in an uncorrected bite, and had to be re-done as part of the correction of other problems.
Case 3 Patient had severely worn teeth. He had a crown done 1 year ago. He broke another tooth. In consultation he understood that he had a wear problem and that any crown restorations would be built “in the wrong place”. HE DECIDED that he couldn’t afford to treat the bite now so he accepted the risk of breakage by having us build a tooth out of filling for now and he would address the bite issue later. He would crown that tooth as part of the more comprehensive case later.
These are but a few examples of why we have some conversations about more global issues. It is our job and our moral and ethical obligation to tell you what we know and counsel and work with you to come to a mutual plan of action. This is not some conspiracy to coerce you to do more things but rather an attempt to get patients to do less elaborate immediate treatment until we and they understand the more comprehensive problems and solutions that they may have, and any potential and often expensive and incorrect treatment incompatibility issues– you can’t have 1 really nice crown in the middle of a denture! Wouldn’t it be a good thing to wait on that expensive treatment until you know that?
We think it is, and that is really what you pay me for- my education and experience at discovering it and my time in helping you figure it out and managing it.
Sincerely,
Eric Yaremko DMD