18-27 Segment 1: The Shrinking Human Jaw

RHJ 18-27 A

 

3.5 million children get braces every year, and many adults live with obstructive sleep apnea. These two complications, along with several others, are all part of an epidemic that began when hunter-gatherers moved to an agricultural environment and lifestyle. Co-authors of the book Jaws: The Story of a Hidden Epidemic, Dr. Paul Ehrlich, Professor Emeritus of Population Studies at Stanford University, and Dr. Sandra Kahn, orthodontist, identify the cause of these problems to be a shrinking jaw.

About 75% of kids have alignment problems with their teeth by the age of 13, and many adults sleep in a CPAP machine to keep their airways free, because their tongue is too big for their jaws. The root of both of these issues is the fact that the jaw is too small and doesn’t get enough exercise. Over time, our diets have become progressively made up of softer foods, mothers don’t breastfeed for three to four years like they used to, and we wean children to soft foods. All of this adds up to a jaw that hasn’t developed well, leading to wisdom teeth, crooked teeth, and sleep apnea later on. Basically, “we’ve brought hunter-gatherer jaws and teeth into a McDonald’s environment,” Dr. Ehrlich says.

Although not many experts have explored and written on the topic of the shrinking jaw, there are some potential solutions to these problems. Dr. Kahn says we must mold our children’s teeth before the age of 10, or it will be too late. By breastfeeding longer, weaning to tougher foods, and encouraging chewing gum, we may prevent the costly and serious complications of a shrinking jaw later on.

To learn more about the shrinking jaw epidemic or to purchase a copy of our guests’ book, see the links below.

Guests:

  • Dr. Paul Ehrlich, Professor Emeritus of Population Studies at Stanford University and co-author of  Jaws: The Story of a Hidden Epidemic
  • Dr. Sandra Kahn, orthodontist and co-author of  Jaws: The Story of a Hidden Epidemic

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18-27 Segment 2: Medical Uncertainty

RHJ 18-27 B

 

Many people think that the worst thing to hear from a doctor after a test is “I don’t know.” But, hearing this could potentially save you from a false diagnosis. While all patients want a confident diagnosis, the expectation of clarity in the medical field is not consistent with the inherent uncertainty in practicing medicine and can lead to a surplus of false diagnoses. Dr. Steven Hatch, Assistant Professor of Medicine at the University of Massachusetts Medical School and author of Snowball In A Blizzard: A Physician’s Notes on Uncertainty in Medicine, discusses this issue and what can result from a fear of medical uncertainty.

While we expect our doctors to be confident in their diagnoses, Dr. Hatch says medical confidence does not necessarily mean competence.  Medical schools may not always prepare physicians for the nuances and uncertainty of real life cases. And, because patients long to hear a clear answer and doctors want to give one, the result is often a false diagnosis. Far too many patients  go through unnecessary treatment that could have been prevented if their doctor was transparent with his findings and patients didn’t always expect a clear explanation of their symptoms. Dr. Hatch pointed to mammograms and prostate cancer tests as examples of instances where many  people expect one definitive result. Doctors and patients must weigh the risks and the benefits; the risk of a false diagnosis versus the benefits of the potentially life-saving properties of medical tests.

Dr. Hatch encourages physicians to express transparency with their patients, clearly sharing their level of confidence in a test result. By doing so, doctors maintain and often gain credibility, and patients can learn more about their condition. Hatch himself practices a method of expressing uncertainty to prevent a wrong diagnosis. By doing so, doctor and patient can come to a mutual understanding, rather than have “drive-through” medical care and diagnosis. Each patient and case is nuanced, and with the freedom to express uncertainty in test results, doctors and patients can both become more confident in making the best medical choices for each specific situation.

To learn more about medical uncertainty or to purchase a copy of our guest’s book, visit the links below.

Guest:

  • Dr. Steven Hatch, Assistant Professor of Medicine at the University of Massachusetts Medical School and author of Snowball In A Blizzard: A Physician’s Notes on Uncertainty in Medicine

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Medical Notes 18-27

 

Medical Notes this week…

The number of children’s flu deaths this past season has experts concerned. Between October and May, 172 children were killed by the flu in the United States, according to a new government report. About half of the deaths occurred in otherwise healthy children, but less than one fourth of them had been fully vaccinated. The alarming H3N2 strain takes the blame for the high toll. Experts say next year’s vaccine should protect better against that form of flu.

Feel free to hit snooze this weekend, it can prolong your life…because apparently, you can catch up on the sleep you lost during the week. A study in the Journal of Sleep Research tracked more than 38,000 people in Sweden over 13 years, focusing on their weekday vs. weekend sleeping habits. The study shows that people under the age of 65 who sleep for five hours or less every single night don’t live as long as those who consistently sleep seven hours at night. But weekend snoozers, who catch up on Saturday and Sunday? They live just as long as the well-slept.

And finally, even doctors have to dress to impress. A study in the journal BMJ Open shows that a doctor’s attire can impact how patients feel toward them. According to the survey performed in clinics and hospitals of 10 major medical centers, what a doctor wears influences a patient’s satisfaction with their care. Forty-four percent of patients surveyed say they prefer their doctor to wear a white coat and tie, while 26 percent prefer scrubs with a white coat.

And that’s Medical Notes this week.

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