Douglas Adams was so, so right.

A few weeks ago I posted a Douglas Adams quote on the Monday Morning Quote slot.

Like most of us I use a computer for several hours every day.

I use Skype for calls with my clients and sometimes (with permission) record them using a programme called, simply enough, “Call Recorder”.

At midnight I had an email from Ecamm – the producers of Call Recorder telling me that, “Earlier this week, Skype released version 7.1. The update introduced an incompatibility with Call Recorder, which can result in a crash when opening Skype for users running OS X 10.10 (Yosemite). We apologize for the inconvenience.”  but all is well because, “Fortunately, updating to Call Recorder v2.5.12 fixes this issue.”

I downloaded the update and installed it.

Opened Skype but Skype won’t let me in, I am attempting the wrong combination of username and / or password. (Trust me, I know that I am not). OK I accept you want me to change my password – no problem.

I click the “problem signing in button”.

Now apparently my Adobe Flash Player is out of date.

Downloaded and attempted to update – oops forgot to close my browser, sorry.

OK, no thank you Adobe I don’t want any other products, I didn’t even know I had wanted this one until I was told.

Back to Skype recovery, they want my email address which, like most people’s involves their name. My name is Alun Rees (but of course it’s “all one word”) so alunrees, nope, Skype sign in wants me to change it to ‘allures’. If my parents wanted a boy called allures they would have given me that name, I have survived for 6 decades with the 8 letters I was given, why should I change?

Third time of trying it allows me to use my own name and then permits me to change the password.

So now Skype will work with Call Recorder when I next want to record a call.

I did notice that the improved Skype 7.1 has the heavy hand of Microsoft all over it – time to move to a different VOIP provider I think.

The Adams quote was: “We are stuck with technology when what we really want is just stuff that works.” I think he had been there don’t you?

Don’t turn left, or should that be right?

Ever Notice That UPS Trucks Rarely Make Left Turns?

From The Washington Post

An estimated 90% of the turns made by UPS delivery trucks are right turns, and that’s intentional, according to the Washington Post. Left turns are seen as inefficient, because they leave trucks sitting in traffic longer. The logistics company says a policy of minimizing left turns has helped it save more than 10 million gallons of fuel over the past decade. Left turns (in countries where people drive on the right) are dangerous, too: New York City officials say left turns are 3 times more likely than right turns to cause a deadly crash involving a pedestrian.


I read this piece some months ago and have been thinking about it on and off ever since. It turns out that UPS’s policy started in 2004 after analysis ousing better tracking sysyems introduced in 2001. There’s a better piece here. Not only did they reduce the amount of fuel consumed the consequence was a reduction in emmissions equivalent to taking 5,300 cars off the road for a year. They are now rolling out propane fuelled trucks.

What has this got to do with the dental business? Well it proves the point that you need to analyse what you’re doing, everything that you’re doing and your analysis must be done to as high a standard as your dentistry.

When you do the analysis, you need to be prepared to act on what you find and make changes in your working patterns.

Or you can carry on sitting in traffic, taking roundabout routes, wasting energy and losing money.

Your choice.

Need help in analysing your business? I can help.




“My Dentist 3D Printed My Crown” – To see ourselves as others see us.

From HBR Blog Network – My Dentist 3D Printed My Crown.


As a tech junkie and geek wannabe I’ve been paying attention to 3D printing and the exploding maker movement. When I say paying attention, I mean reading about it, watching hackers and hobbyists make stuff, and wondering if there is more to the technology than the brightly colored plastic tchotchkes cluttering my desk. 3D printing really hasn’t affected me yet. That is until I recently chipped a tooth and had no choice but to visit my family dentist. It was the dentist’s chair that more than any article or demo converted me to the potential of 3D printing. Sometimes disruption has to hit you right in the mouth before you pay attention.

Now, I was no stranger to restorative dentistry. About seven years ago I had chipped another tooth that required a crown and didn’t remember the process fondly. It required multiple drawn out — not to mention expensive — visits to my dentist. He first had to make a physical mold of my damaged tooth. The mold was sent out to a local dental lab to manufacture a permanent crown. In the meantime, I was sent home with the inconvenience of a temporary crown made of a cured composite secured with temporary cement. Weeks later when the permanent mold was back from the lab I was summoned to the dentist for another lengthy visit to secure the new crown in place.

I wasn’t a happy camper, facing the same fate seven years later.. However, this time instead of a physical mold my dentist inserted a digital camera in my mouth and the next thing I knew a digital image of my damaged tooth immediately appeared on a computer screen positioned right next to my dental chair. My dentist knows I’m a tech junkie so he went out of his way to demonstrate his new high tech capability. I watched my damaged tooth rotating in all of its 3D glory when he ran the design software to quickly and magically fit a digital crown on top of my chipped digital tooth. Voila! He even made a few manual tweaks to the digital crown using the computer aided design software, a little bit off the side here and a little smoothing there.

It’s what happened next that blew me away and convinced me that 3D printing is a big deal. My dentist pushed send on his keyboard, then took me into another room in his dental office where he proudly pointed to a piece of equipment the size of a large microwave. The digital design of my new crown had been transmitted to a CNC (computer numerical control) milling machine. There are two basic approaches to 3D printing: printers that deposit layer after layer of materials to build an object from the ground up, and CNC milling machines which takes a block of material and carve out the desired object. I watched in awe as my crown was sculpted from a block of dental composite right before my eyes.

In about ten minutes, with my new crown in hand, it was back to the dental chair where it was expertly put in place permanently. I asked my dentist if this new capability put the dental lab that used to make routine crowns out of business. He told me he had just reviewed his budget and that he had actually increased his spending at the lab. It turns out the lab is busier than ever focusing on non-routine, higher value restorative work. At the same time, my dentist is busy delivering better value to his patients, and I got a new crown in a single visit and a life lesson in innovation.

Sometimes the most compelling use for a new technology isn’t the one that gets showed off in the expo hall or makes it onto YouTube. The plastic toys that can now be printed on demand may not matter much, but for the dentist, as for any number of other professions, the chance to design and manufacture products in house with 3D printing is already revolutionizing business.

The Monday Morning Quote #289

“Oh, isn’t life a terrible thing, thank God?”

Polly Garter in Under Milk Wood, a play for voices by Dylan Thomas.

(Thomas would have celebrated, in no doubt spectacular style, his 100th birthday today)

Read or recite the whole play here.


The Weekend Read – Do No Harm by Henry Marsh

UnknownThis is a wonderful book.

Henry Marsh tells stories, his own, his patients’, his profession’s and the creaking political football of the system. I regret that I waited until the paperback was available before I read it.

He writes with wonderful candour about the decisions that are needed when dealing with surgery in the most inaccesible and dangerous area of the body. Dr Marsh takes the reader through the joys of success but more importantly does not flinch from the consequences of failure.

Do No Harm, the phrase attributed to Hippokrates, is a great read on many levels. As the biography of a surgeon it is an uncompromising memoir. It is a page turner in the manner of a thriller – you feel guilty but want to know the outcomes of the operations that his patients endure. His descriptions of the diseases and their consequences that affect the brain are as good as anything I read as an undergraduate and certailnly make more sense. Finally his talents as a writer of prose make this a superior read to most novels.

I spent 35 years as a clinician, 25 of them in full time practice. My experiences and the effects that I have had on my patients’ lives are not in the same universe as the author’s, yet I can, and did, share some of his doubts, worries fears about what he was doing, the risks involved and the possible long term consequences of action. Most of medicine deals with quality of life, thank goodness, else how would most cope? What it must be like to wake up on Monday morning knowing that you could save or end a life that day very few can imagine.

It’s available from Amazon here.

Two more authors of iconic riffs passed on this week.

Firstly, Raphael Ravenscroft who played that saxophone riff on Gerry Rafferty’s Baker Street died last Sunday. He received a cheque for £27 which he said was bounced by the bank – he framed it and hung it the wall. Rafferty was reported to be earning £80K a year from the song at the time of his death.

Today was announced the death of the wonderful Jack Bruce, was there ever a more talented musician to feature on Top of the Pops? (couldn’t find a TotP clip so here’s one from Beat Club). Here he is playing with Rory Gallagher another man who gave up his liver for rock.

RIP boys, there’s a fantastic band somewhere in the great beyond.

Dentists have last laugh over sneering Keynes

From Monday’s Financial Times letters page.

Dentists have last laugh over sneering Keynes

Sir, Your editorial “A Nobel award for work of true economic value” (October 15) cites the witty and memorable line of J M Keynes about wishing that economists could be “humble, competent people, on a level with dentists”, which concludes his provocative 1930 essay on the economic future. You fail to convey, however, the irony and condescension of the original text of the arrogant, intellectual elitist Keynes, who, while superlatively competent, was assuredly not humble. With the passage of 84 years, the irony has changed directions, for modern dentistry is based on real science, and has made huge advances in scientific knowledge, applied technology and practice, to the great benefit of mankind. It is obviously far ahead of economics in these respects, and it is indeed unlikely that economics will ever be able to rise to the level of dentistry.
Alex J Pollock
Resident Fellow,
American Enterprise Institute,
Washington, DC, US

The Monday Morning Quote #288

“The question isn’t who is going to let me; it’s who is going to stop me.”

Ayn Rand


The Daily Grind – for the nth time.

An article in the London Evening Standard about the character Carrie Mathison in Homeland made me think.

Firstly. About the incidence of pain in teeth, face and head that can be related to over active muscles of mastication and bruxism.

I learnt a huge amount about occlusion during the last recession in the late 80s / early 90s. Stress was widespread, its manifestations affecting thousands. It’s greater now. A significant proportion of the patients who attended my relatively new practice were suffering. A fresh graduate of the Stockport Dental Seminars programme and full of enthusiasm with my new qualification to join the British Society for Occlusal Studies, I was looking for the signs and symptoms. I have no idea of the number of Tanner and Michigan appliances I made during that period but probably well into the hundreds. The relief I provided was fantastic, the feedback wonderful and I can honestly say that occlusion along with perio and prevention were the rocks of my successful practice.

Secondly. I recall how many of my contemporaries reckoned that what I was doing was outside the scope of a GDP and that the “occlusionists” (their term not mine) were close to being charlatans. They were the ones whose patients were smashing their restorations, going to their GPs with headaches and musculo-skeletal pain.

Finally. How many dentists are still not routinely looking for the evidence of occlusal disease, still don’t ask the question in their medical / dental examination and are therefore missing a huge opportunity to do more to help their patients and subsequently do more for their bottom line.

Hey, but what do I know?

Answer: Loads – and thanks to the web so do the patients.

Here’s the piece in its entirety:

Homeland’s Carrie provides a bit of a reality check for the average Londoner who reckons they’re stressed. Where most of us get annoyed at the screwed-up Tube and Nigel Farage, in this week’s episode Carrie was running the CIA’s Kabul office, had just sanctioned a drone strike and was super-angsty about her newborn baby daughter being thousands of miles away in the US. But when tense Carrie went to bed she popped an Ambien, slurped a large glass of white wine then slipped on an anti-grinding mouthguard to keep her teeth in one piece.

And in her mouth kit at least, Carrie’s got something in common with a lot of modern working women. Both the British Dental Association and the advisers who run the phoneline at the British Dental Health Foundation report an increase in calls about “bruxism”, or what those not sporting scrubs call “teeth-grinding”, as the stresses of City life invade people’s jaws at night. Some dentists reckon it affects as many as one in 10 Britons, whose sleeping hours are spent clenching or grinding their teeth, triggering headaches and shooting pains in the morning as, long-term, their teeth start to wear down.

“When I first went to my dentist I was certain I had a massive abscess on my back molar as the pain was so bad,” admits one high-flying executive and mother. “But my dentist found there was no decay at all. It started taking over my whole head and giving me a shattering, stomach-churning pain that meant I could hardly talk sometimes. It was affecting me all day, for months on end. Soon it became obvious that the pain got worse when work was stressy, then went away when I was on holiday. So my dentist [David Cook at Wimpole Street’s London Holistic Dental Centre] fitted me with a night brace.”

The contraption cost £1,000 “and it’s seriously not sexy — it makes you feel like an old lady putting in her false teeth,” the grinding-sufferer adds. But it’s working. “In the past few months I’ve only had one headache — after I forgot to put it in.”

Teeth-grinding is an increasingly common problem — and not just among women. “In the past 12 months we’ve treated more men with anti-grinding mouthguards than women,” says James Goolnik, who runs the Bow Lane Dental Group, near Bank, whose patients include Jimmy Carr (who’s not a grinder). “Women are better at recognising the signs of stress and dealing with it than men, who just deal with the symptoms rather than the underlying cause.”While some sufferers use a mouthguard like those of rugby players, Katie, a PR from West Hampstead, opted for the scarier sounding mandibular advancement device (MAD): two plastic plates, held together by a screw, that stop the teeth from meeting. “It’s basically another form of contraception,” she says. “It makes me dribble, smells in the morning and looks ridiculous. But anything was better than how I used to feel after a night of teeth-grinding.”

It’s not just molars that are affected. “There is a direct correlation between having a good even bite and getting neck and shoulder pain,” adds Goolnik. “If your bite is uneven it can throw off your jaw muscles and then, in turn, your neck and shoulders.”

Still, it can take grinders a long time to actually visit the dentist about their problem. “I’ve been grinding my teeth for years but recently began waking with a very painful jaw,” a thirtysomething Londoner explains. “The solution was a delightful mouth guard. My husband banned me speaking with it in because he finds it so vile.”

For some, that bedtime look is just a step too far. “Some patients do not want to wear a night guard while they sleep so the latest treatment for grinding is to inject the grinding muscles with Botox,” adds Goolnik. “It reduces their strength and lessens the grinding.”

Hypnotherapy is another option. “One study reviewed the long-term effects of hypnosis and a positive outcome was still applicable even after 36 months,” says a spokesman for the Bruxism Association. Tackling the cause of the stress is another solution — but one that Homeland’s Carrie and a lot of Londoners might find impossible.

The Monday Morning Quote #287 (twoforone)

“The Internet is the first thing that humans have built that humans do not understand.”

Eric Schmidt


“We are stuck with technology when what we really want is just stuff that works.”

Douglas Adams, The Salmon of Doubt


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