Dr. Hooman Golestani on ABC Radio

 In General Dentistry

Listen to “Dental 359 – Dr. Hooman Golestani on ABC Radio” on Spreaker.

Geoff Hutchison 0:07
Not only do I hear the noise associated with the drill, I sense that sort of cold air associated with the drill. Hooman Golestani, good morning.

Dr. Hooman Golestani 0:16
Good morning, Geoff. Pleasure to be here.

Geoff Hutchison 0:18
Lovely to have you here. We’re going to get less and less of the drill, aren’t we?

Dr. Hooman Golestani 0:22
Absolutely, absolutely. The use of the drill nowadays is literally… I use it to replace the old stuff. I rarely ever cut any new teeth with that stuff. So, yeah, less and less of it.

Geoff Hutchison 0:34
Why is it disappearing? And what’s it being replaced with?

Dr. Hooman Golestani 0:37
Well, that’s a great question and this is a topic that’s rather controversial. So I’ll make it very quick and from my experiences, simply, the fact that we’ve had fluoride in the waters in Perth for the last 30 or 40 years has certainly improved the amount of well, it’s reduced the amount of dental decay and children’s teeth. So nowadays, we’re seeing kids coming to the office with very few, if any dental decay at all.

Geoff Hutchison 0:38
Is that right?

Dr. Hooman Golestani 0:43
That is absolutely right.

Geoff Hutchison 0:46
And we as parents, thank you, my children, for, for providing the opposite. But we as parents assume that it’s going to be a life filled with fillings because of that kind of decay.

Dr. Hooman Golestani 1:13
That’s correct and in the past generations, that’s exactly what it’s been. The baby boomers nowadays, in fact, are the ones that we are treating quite extensively because they didn’t have the luxury of the fluoride in the waters and so they lost teeth when they were younger, they had big, big holes, big cavities, a lot of amalgam fillings, which are antiquated and out of date. So now we’re gonna have to replace them with the beautiful ceramics and some of the resins that we’re working on nowadays.

Geoff Hutchison 1:37
I want to talk to you about the future of dentistry today and we’d like to take some calls as well, they will be of a general nature, I think, folks, 130022720. If Dr. Hooman Golestani can assist you or maybe even encourage you to go to the dentist, that could be a good thing, but take the opportunity to give us a call now, when we talk about the future of dentistry, what will the experience be like? Do you think in two, five or ten years?

Dr. Hooman Golestani 2:05
Well, I don’t think it’ll be that much different to what it is today, other than the fact that we’re certainly blessed with better technology, better materials. For example, in my office, I can do ceramic fillings, which I can, I can scan your tooth with a camera, I can create a finished product on the screen and send it off to the mill and have a block of ceramic milled into the shape of your tooth and then I can stick it into your tooth and pretty much say that it will be there for the next 12 to 15 years without any problems. All that in 90 minutes.

Geoff Hutchison 2:35
So the technology is outstandingly good? Are we less frightened than we used to be?

Dr. Hooman Golestani 2:44
I think so. I know some of as I said earlier, the baby boomers who had the misfortune of having a lot of bad dentistry, or no dentistry for that matter, will probably think otherwise. However, the younger generation will come into my office willingly, gladly two three times a year for their regular hygiene appointments and if they need any treatment, they just close their eyes it’s pain-free.

Geoff Hutchison 3:06
Do have a television on the ceiling.

Dr. Hooman Golestani 3:08
I used to and I chose my new office not to put that in there because it distracted my nurse.

Geoff Hutchison 3:13
Yeah and I’ve got to tell you where I go and get my teeth done, and it’s a lovely experience. They always have channel 10 mid-afternoon programmes like Ready, Steady, Cook, and I find it distracting, but it’s very poor television.

Dr. Hooman Golestani 3:25
I used to always have the ABC on but now I listen to ABC Radio in the background.

Geoff Hutchison 3:30
Pop your headphones on and we’ll just take a call from Paul first 130022720 if there’s a question you’d like to put to, we’ll call you Dr. Hooman about dental matters. Let’s hear from you, Paul. Good morning.

Caller 1: Paul 3:44
Oh, good morning. How ya’ going?

Geoff Hutchison 3:45
Good thanks. What’s your question or observation, Paul?

Caller 1: Paul 3:48
I’m actually a dental technician and what we find now is a lot of dentists sending crown and bridgework and everything overseas. It is very poor quality and the only benefit to anyone is the dentist because they just get the money they put in, it used to be $40 for a crown, instead of getting it done properly here, and the dentist just pockets the excess money that they get. I was wondering is that the future of dentistry and WA?

Dr. Hooman Golestani 4:22
Thank you for calling. Thank you for asking that, and I totally agree. I hope to god it isn’t the future of dentistry and in Western Australia, I use a local lab I have been in for probably the last 12 or 15 years. I have a personal relationship with him, I can send my patients down there, he comes to my office if I have any particularly the cosmetic work that I do in my office, which is rather extensive. I would hope to god that that would end, I can tell you a story of a patient who came into my office several weeks ago or several months ago, I should say and she had a problem that just wouldn’t go away and we couldn’t work out why she was so ill. Eventually, we honed it down to a crown that she had done which had been sent to China and when we took the crown off and I had tested it, it actually tested positive for cadmium, which is, which is poisonous. Now, I can tell you right now that if I was one of my patients when I’d done that, I don’t know if I could sleep well at night. So I would hope to god that isn’t the future of dentistry and I think some regulations would have to be strengthened for that.

Geoff Hutchison 4:22
Paul, are you rather worried about your future as a dental technician?

Caller 1: Paul 5:21
I can see it going more and more that way. We actually had a dentist that told a client that we did a job for them, and it was actually sent to a really poor, low quality lab or overseas and he said that we did the job and I said, this is lying to patients to keep the faith and it’s totally wrong.

Geoff Hutchison 5:41
Yeah, I’m sure it is very frustrating Paul. Thank you for calling. Brian. Good morning.

Caller 2: Brian 5:45
Good morning Geoff

Geoff Hutchison 5:48
You’re talking to Dr. Hooman how can he help you?

Caller 2: Brian 5:52
My question is about lower dentures, I have been reading about lower denture for a long time and have tried in the past, but had a problem, lower denture she was secured by metal rings, which locked around on both sides of the lower gums and pulled the teeth away. Is there a up to date version of the lower denture available now?

Dr. Hooman Golestani 6:24
Absolutely, that’s a very good question. In our office, we love the idea of using implants, dental implants, and the particularly the system that we’re using, which is very, very, if you want to call it cutting edge is the All-On-4 implants, where we’re placing for implants to replace all of the teeth, all of your teeth will then be set on a bridge on those four implants that happens within 24 to 72 hours start to finish. You know, dentures, in my opinion, are a thing of the past, all right, they really shouldn’t be a thing of the past. We use them in our office as a transient thing. Certainly, there’s a cost-benefit for wearing dentures and if you wear them for a short period of time, you know, that’s perfectly fine and particularly in cases where you need other teeth to hold them in place, there is that added disadvantage that they may be involved. So yes, there are other options, you should certainly seek out dental implants to replace the missing teeth, they do cost a little bit more, but just like anything, if you have them done professionally and in the hands of a good dentist, they are extremely valued for money.

Geoff Hutchison 7:22
And lots of people want to speak to you, lots of questions via the text. But Mr. Burnett, the dentist will see you now, Jamie, when was the last time that you went to the dentist?

Caller 3: Jaimie 7:30
10 years ago, Geoff, I’m a little nervous about this now, it was all fun when we’re talking about it in the studio.

Geoff Hutchison 7:37
Please talk to him and his mouth is all yours. Just open up.

Dr. Hooman Golestani 7:42
Look at that. See, this is a perfect example of someone who has been under the care of a dentist really good dentist when you were younger, obviously, you had a lot of fluoride treatment, you can tell you’ve got no fillings on those teeth. But I can see from here, obviously, I need to have a closer look with some radiographs and with some of my high tech equipment to have a look really close, but from what I’m seeing there, that’s a perfect example of what happens when someone’s had good dental care as a child. Now, I have to say that unfortunately, these things will accumulate and Jamie will in the next 10 or 15 years potentially have problems that could be averted if he were to see a dentist.

Geoff Hutchison 8:18
Will they be really bad? tell the rest of us about them.

Dr. Hooman Golestani 8:20
Well, you know, we often have patients coming in of Jamie’s vintage, who will come in who have really good teeth, and then one tooth has been completely and utterly decayed right down to the core which has to be replaced and it’s a sad indictment on the fact that we do tend to become a little bit overconfident and thinking that there’s nothing wrong, nothing wrong until something happens. And then we need somebody in an emergency. And of course, by that stage, it’s too late.

Geoff Hutchison 8:46
You’re quite reassured, aren’t you?

Caller 3: Jaimie 8:47
I am. I feel like I’ve dodged the bullet a little bit, but I shouldn’t push my luck.

Geoff Hutchison 8:52
Now, this is something I wanted to ask you about. Because, again, the dentist I go to you I’ve got a mouthful of unusual teeth filled with unusual things. You can sense that can’t you?, and he said to me, do you get grinding headaches? and I go, No, not yet. I’m got your bill yet, and he said, well, have you thought about crowns? and I kind of go? No. I mean, I am one of those people who is biding my time hoping for the best knowing that at some point, I might have to have certain things done and that’s because I’m frightened of the cost.

Dr. Hooman Golestani 9:25
Okay. You know, and that is the number one thing that I hear about and if you look at anything I always say if you compare dentistry to, for example, Formula One racing, which is hard to do, okay, well think about it. If you think about Formula One racing, you know that all of the innovations in motor, in any sort of motor technology has come primarily from racing. You get your anti-locking brakes, you got your airbags, all these sorts of things come from racing. Well that eventually trickles down and you know you can buy a little $20,000 car right now, which will have the same technology as Formula One racing had, I don’t know, 20 years ago. So dentistry is not that different. You know, we are at the forefront, of dentistry and dental technology. For example, in our office, we’re working with things that are futuristic. Now in about 10 or 20 years, that stuff will trickle down to, you know, the average dentists down the road. Now, does that mean that we should avoid doing them? Because they’re expensive? Of course not. We have to, we have to always be searching for bigger and better things. So that eventually will trickle down to the average person in the average care now if you need specialist care, well, yes, it’s going to cost more of course, and you do get value for money if you are in the right hands. Now I hear all the time people saying well, it’s expensive, expensive, you know, I’m gonna go to Thailand. I’m going to go to Bali. Well, that’s a commercial decision that everyone will have to make, you know, I wish them well. But if you can’t drink the tap water in that town, I’ll tell you what, I would be very, very nervous about having their dentistry.

Geoff Hutchison 10:48
This is Neil. Good morning Neil.

Caller 4: Neil 10:51
Every morning, gentlemen.

Geoff Hutchison 10:52
Good morning. What’s your question?

Caller 4: Neil 10:54
Yeah, quick question about gum disease and look, I had very weak teeth. I grew up on a farm so we drank rainwater mostly no fluoride at all and then a mouthful of fillings and a few crowns. Now. I’ve just noticed recently that I do you have a crown put on my gum has receded away from the crown. So there’s a bit of a gap now between the tooth and the gum and the crown. But is there anything or a treatment that works on the gums as well as the teeth?

Dr. Hooman Golestani 11:28
Okay Neil, that’s that’s a fantastic question that we see this every day in our office. Gum Disease is literally the infection of the gums, a localised infection of the gum causing the bone and the gums to shrink away from the margin where they used to be. Now that’s one of the things about the future of dentistry is the idea of teams manship, and we do have a situation in our office for example, where if we have something like that we do have a hygienist that works on what is generalised gum disease, but we do have a periodontist that we refer to and periodontist are specialists in gums and they do some marvellous work. I would always consider the idea of referring anyone who has what they feel as being gum disease to a periodontist as I would if I had, for example, someone needed a root canal sends him to an endodontist, and that team approach is fantastic. But to answer your question, the reality of it is once gum disease starts, you can hold it but you can never ever get the gums to grow back. That said I’m in the future with stem cell research, you know, we certainly are looking forward to being able to grow gums and bone back but in the meanwhile, I would strongly suggest you see a dentist who has a team approach, will refer you to a periodontist and make sure that your treatment is carried out as best as can be.

Caller 4: Neil 12:39
Alright, gentlemen, thank you very much.

Geoff Hutchison 12:40
Neil. Thank you. This is Teresa. Good morning.

Caller 5: Teresa 12:43
Good morning. My query is we’re Baldivas and we’re on rainwater only with two kids with no fluoride, what should we be doing?

Dr. Hooman Golestani 12:55
Okay, now, again, this is a very controversial issue, you could certainly consider the idea of taking fluoride tablets, they used to in the past, I think that’s probably just a little bit over the top. I certainly think if you’re using good fluoride toothpaste, and you are dousing your teeth with a reasonable amount of fluoride and before I go into detail, I want to make sure that you don’t overdo it because fluoride, in fact, is a toxic product, and you should never ingest for too much of it because it will in fact cause other problems and that’s what a lot of the anti-fluoride people are leaning on. However, the idea of using fluoride toothpaste seeing a dentist regularly, having fluoride treatments, which are not ingested which are topical, you know, those things will certainly help the idea of rainwater. Well, I mean, it’s fantastic. I love rainwater, it’s just that it doesn’t have fluoride.

Geoff Hutchison 13:43
Okay, so if kids are cleaning their teeth with fluoride with a toothpaste with fluoride in it, that’s probably okay.

Dr. Hooman Golestani 13:49
That certainly helps. No question, there are fluoride rinses that you can also purchase, which you can rinse your mouth with, and they are perfectly fine.

Geoff Hutchison 13:56
Teresa, thank you very much. Max wants to take us back to some earlier days of dentistry. Hi, Max.

Caller 6: Max 14:01
Hi Geoff, Good morning, Hooman. I just wanted to say firstly, that I’m currently under a dentist who I think to be one of the best dentists in Perth, and I’ve been attending dentists now for over 60 years. The first dentist I had was in the hallway of my local school, and he decided I needed some drilling down to get rid of some infection in the teeth. Some of the teeth weren’t too good and I haven’t been for many years. So he got his machine all organised and he pedalled to drill into my teeth, add the faster he pedalled, the more I appreciated the slurry and all the problems.

Geoff Hutchison 14:46
Max thank you. Max isn’t the only one that remembers the pedal power experience. Jeff my husband at 91 remembers the drill being used whether the dentist had to use the pedal to create the drill speed and always preferred a morning visit, as the dentist tired by the afternoon.

Dr. Hooman Golestani 15:06
No comment.

Geoff Hutchison 15:08
What are we most likely to go and see you for as we get older?

Dr. Hooman Golestani 15:15
Okay, again, we are going through a little bit of a shift because the generation that is now starting to get older and requiring a lot of the treatment, the baby boomers are going to require probably a little bit more intensive treatments. As I said, ceramic fillings which we use in our office that has replaced gold. We barely ever do any crowns, frankly, we just use the CAD-CAM ceramics, that’s something that I’m using regularly. Of course, where there are teeth that are missing dental implants and titanium dental implants or a revolution in dentistry, we are replacing some amazing missing teeth. We’re amazingly I should say for people that now can chew and smile. You know that at the end of the day you want you to want your confidence, you want to be able to smile, you know, we have a patient who has never had an international trip, we did some dental implants for him. He’s got a smile back and he said I would never have travelled overseas with a denture, and I would I would have loved to have helped him years before that to hopefully saved a seat. But you know, more and more I’m going to see less and less dentistry done.

Geoff Hutchison 16:18
That’s interesting. This is Ian, and good morning Ian.

Caller 7: Ian 16:21
Good morning, Geoff. Good morning, Dr. Hooman.

Dr. Hooman Golestani 16:23
How are you?

Caller 7: Ian 16:24
Oh, my question concerns expensive dentistry gone wrong, within a year of it being done, namely a crown snapping off? Is this sort of thing covered by any kind of warranty and without any sort of redress at?

Dr. Hooman Golestani 16:38
That’s yeah, that’s a really tricky question to answer. You know, okay, so if I were to be doing that in my office, and I would do let me know, let’s not even talk about dentistry, let’s talk about if you’re, you went to, you know, you had a carpenter do something for you, and within a year broke off, you’d go back to them, and you would hope that you’d be able to negotiate some sort of a replacement or something of that nature, which would be, you know, based on the idea that perhaps some things can happen that are, you know, you’re unaware of things that could happen. The industry is not that different, you know, we take as many chances as we can to reduce risk, but sometimes, you know, there are things that will happen that are outside of our awareness. Now, is it something that is bad dentistry is, ah, you know, I mean, it’s hard.

Caller 7: Ian 17:23
You were talking earlier, about overseas, dental work, crowns, etc. I suspect I may have been a victim of one of these because this crown never felt right. You know, from the day it was put in, and I went back to the dentist and had him for a little bit offered and it improved the bite slightly, but it just never felt good. And one day, I was sitting chewing on something soft licorice. And I thought the thing was written before I knew it was in my mouth. So the dentist said that it was very unusual, the post had actually snapped. And he offered me a sort of a go, you know, putting it back again, and I didn’t feel very confident. So he’s basically just sealed the gum over.

Dr. Hooman Golestani 18:02
You know, I always recommend that you negotiate with your dentist. And if you’re not happy you seek to get a second opinion. And that’s the reality of it is and every in every industry, if you’re not happy with what you are getting, you seek another opinion. I think dentistry is not that different.

Geoff Hutchison 18:17
Dr. Hooman thank you very much. I think even if people got nothing more out of this experience, other than being told that there will be fewer dentist drills being used in the future that will be of great relief. And I guess this finally encouraged people to just go and see a dentist, don’t be terrified.

Dr. Hooman Golestani 18:33
Absolutely. Go see your dentist, spend time with them two to three times a year easily to get your hygiene up to scratch. But certainly don’t. Don’t avoid the dentist because the more you avoid them, the more painful they become

Geoff Hutchison 18:43
Glad to have you today. Could you just go out and tell Jamie a few terrible things about his mouth that will give us some degree of fun out of the experience. Thanks very much, Hooman.

Dr. Hooman Golestani 18:51
Thank you. It’s a pleasure.

Geoff Hutchison 18:52
Dr. Hooman Golestani.

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