Camping

I have camped for as long as I can remember.  It’s something that is part of me.  I know that camping isn’t for everyone, but to me, there are amazing things that happen outdoors. I imagine when I say camping, most people have images that pop up in their mind about their own camping experiences.

I should explain my definition of camping. A sleeping bag under the stars, in a tent, or in a camper is camping. Camping is not sleeping under a non-mobile roof structure. Sleeping inside your house or at a hotel is not camping.  When our kids were younger we pitched a tent in the yard or on our deck, I’d call that camping. Today, my definition of camping includes be away from home. “Roughing it” has a personal definition for everyone. To me, roughing it is no running water or electricity; no bathroom, no hot water, no light bulbs.  My Sister-in-law’s “roughs it” in three star hotels.

The first camping experience I remember was camping with my Dad and older brother, Rusty.  I think my dad only took us once, he worked 7 days a week, so maybe that’s why this was so special to me.  He and his best friend Ed Holden, who had two sons our ages, went along.   We must have been about five or six, maybe younger.  We piled our stuff into a van that my dad borrowed from work.   It was painted the pale yellow and forest green of all the trucks at my dad’s business.  “Kampas Bros” was painted on the side. It was a van manufactured in the early sixties. In those days, vans were purely functional work vehicles.  This one had two bucket seats in the front, no windows in the back and a hard metal floor.

 I know the floor was hard because I recall great relief when we were finally released at the end of the journey.  Interstates 79 and 80 had not yet been built, so it was two lane roads to Cook Forest.  I actually remember very little about what we did there, but I know we cooked over a fire, we four kids crammed into a pup tent too small for us and we bathed in the stream next to our campsite.  The stream felt like it was made of liquid nitrogen. I remember the smell of fresh pine and seeing trout lazing at the bottom of the crystal river.  The fish snubbed the worms we dangled in front of them.

One of the regular things Rusty and I did was to sleep outside during the summer. While not technically camping, because we were not away from home, we had the fresh air of the outdoors and used sleeping bags.  One to five of the neighbor kids were always there too.  We didn’t have air conditioning, so on hot summer nights we’d sneak into the swimming pools of various neighbors to cool off.  We debated everything important to kids, from whether an M-80 will explode under water to what we’d do with a mountain of gumballs. It was a simpler time, before video games and M-TV.

I started camping on my own when I was sixteen.  My best friend, Eric Hoffman, and I were always doing something adventurous.  We had been exposed to rappelling through our youth group at church and became hooked.  We pooled our resources and bought a clothesline from Woolworths. We fashioned our harnesses of hemp rope wrapped into a swami belt.   Through some combination of luck and divine intervention we survived our early forays.  Later, while practicing commando rappels(upside down) with our upgraded hardware store nylon rope, we met some guys at McConnell’s Mill State Park who were starting a rock climbing school. We signed on immediately and within weeks were ‘real’ climbers on our first overnight adventure.  It didn’t take long to realize that there had to be more comfortable ways to sleep on the ground.  Our giant cotton sleeping bags would get replaced by slick, lightweight down filled mummy clouds.  The pebbles that morphed into boulders overnight were smoothed over by a thin piece of foam padding that aged into something that resembled a giant curling potato chip.  It was through rock climbing that I learned to love the smell of nylon and the joy of being lulled to sleep by the symphony of raindrops on the fly.

I climbed and camped all over the country for the following 20 years, but I’ll save those stories for another post.

I am blessed to have a great wife who loves to travel. When we met, Stephanie would have probably have preferred to stay in a nice hotel, but now she's hooked.  An opportunity to travel, even if it’s camping, is preferred to staying home.  We started out camping in a tent, just as I always had.  After our daughters moved out of baby mode, we started camping as a family. Within a few years, Steph took pity on me for all the effort it took to set up camp. It was she who suggested that we get a pop-up.  We loved that camper because it was easy to haul and the feeling of being in a tent was there.  Unfortunately, the pop-up still required a significant amount of set up time and energy.

Last Spring we broke camper protocol.  The accepted sequence of camper ownership flows like a well choreographed ballet.  We should have moved to a hybrid camper. A hybrid is a cross between pop-up and hardside camper . The hybrid has tent ends which fold out, plus they have the kitchen and bathroom of a travel trailer.   Our mistake was taking the whole family to look at campers . Instead of a hybrid, we moved from a pop-up to a 33 foot long rolling hotel suite.  Think of how the Stay Puff marshmallow man lumbered in “Ghost Busters” and you’ll know the feeling of seeing our camper chasing you in the rearview mirror.   Who wouldn’t prefer a rolling Taj Macamper.  

The kids have their own bunks and with enough beds for 9 people, each can bring a friend without feeling cramped.  The key ingredient  for a family with three daughters and wife with thimble size bladders is the bathroom.

We have had a great time this summer. The experiences that we’ve shared as a camping family will stay with us forever.  They are priceless memories.

How much do braces cost?

How much do braces cost?

How much do cars cost? Big variability huh?
 
Short answer: The fee is based on the length of time and complexity of the treatment.

What you really want to know is how much your braces will cost. Get an orthodontic exam to find out. There really is no other way. Most orthodontic offices provide evaluations at no cost (we do) or charge a small fee if x-rays or impressions are taken.
There are community and regional differences in fees. Braces in Manhattan cost more than braces in Pittsburgh.

What may be more important is "How affordable are braces?" In other words, if a treatment plan is $4000 and one office wants a lump sum and another office agrees to accept $33 for ten years, for some people this can make the a huge difference in starting treatment. Affordability matters.

Most offices have policies in place about fees. Many will ask for a down payment and spread the balance over the treatment time. Don't be afraid to ask how flexible the office can be. Some offices use third parties for financing (with interest) others will create zero interest payment plans and finance the treatment through the office.

Some offices offer discounts for family members of current patients or for church members. Insurance can lower the out of pocket costs, however some plans have elimination periods before the benefit takes effect. Most insurance will only pay their portion over the course of treatment. The effect of both of these policies is to ensure that you don't get coverage for a short period of time but max out the benefit. Last week I talked to a mom who did the calculation and the additional premium for ortho coverage was roughly equal to the benefit (Hmmmm).

Huge $ savers are the HSA or FSA's, these plans, are funded pre-tax. Orthodontics is a qualifying medical expense (check your specific plan to make sure). So if you can pay with a flex, you get your tax rate as a discount. Wow! With proper planning the orthodontic office can maximize your benefits. Please be aware that proper planning does not mean calling your orthodontist the evening before or day that you have to make your election for the following year. We've had those calls and do what we can. By the way, we can often make use of the "use it or lose it" funds towards the end of the year.

Do you have a common question about orthodontics?

When should my child see the orthodontist? PART 2

AGE 6-7

The American Association of Orthodontists recommends that all children be seen by the age of 7.
Yes, that sounds self serving, but orthodontic problems may not be obvious just by glancing.  Wouldn't you rather know if something is up? Some parents argue that they didn't see the orthodontist until they were 12 or 13.  These are the same parents who miss cassette tapes for music. Old school. We now treat early because it's more effective and we get a better long term result. Certainly every child does not need interceptive treatment.  It's just nice to know for sure.

Many parents will wait for the dentist to give them the go-ahead to schedule an orthodontic exam. Some dentists are great at screening, but some haven't thought about orthodontics since dental school.  I know a dentist who didn't send her own daughter for an evaluation until it was obvious that a tooth was completely blocked out.   She told me that she learned in dental school that the orthodontists could address problems at any age. Yes, we do treat problems at any age, but I'd rather take care of something at the right time. A dentist who fails to refer for an evaluation is not practicing to the Standard of Care.

By age seven the upper and lower incisors should have erupted. If they haven't erupted, it doesn't mean that something is wrong, but we discover teeth unable to erupt due to lack of space all the time.  Worse, we find that teeth are missing. Missing teeth are far more common than anyone believes.  I see new patients in my office every week who have missing teeth.  Most of them didn't know the teeth were absent.  The only way to properly evaluate unerupted teeth is to have a panoramic x-ray taken. Missing teeth require planning.

Indications for Early Treatment (Interceptive Orthodontics)

• Crossbites- The upper and lower teeth don't meet properly.
• Crowding- Not enough room for teeth to erupt.
• Jaw discrepancy- Poor relationship of the upper to lower jaw
• Protrusive upper teeth (Buck teeth)
• Regaining space lost by early loss of primary teeth
• Harmful oral habits
• Self conciousness or low self esteem due to smile

What doesn't need early correction?

• Extra space between teeth
• Mildly excess overjet (front to back distance of upper to lower front teeth)
• Mildly excess overbite (vertical overlap of front teeth)
• Jaw position which will improve with normal growth
• Kids who want treatment because their friends have it or they think it's coolAge

AGE 8-11

If you missed the boat on early treatment, it's not too late to get onboard. As I posted earlier, chronologic age matters less than dental age.  We can still do many of the interceptive treatments and make things easier when every tooth has emerged.  At some point is makes more sense to do one phase of treatment, comprehensive. Again, an exam can go a long way to exploring orthodontic treatment options. Keep in mind that the older the patient, the more limited the treatment options may be.

AGE 12-15
If your child hasn't been evaluated, time is running out. Get off the computer and call an orthodontic office, now.   No, I mean stop reading and come back to this later, or you'l just keep putting it off until you run into the next age range.

AGE 16-18
One of the significant treatment options is now lost, the expander.  Expanders can no longer be effectively used.  Yes, some practitioners use them this late, but the biologic basis for their use has past.  If one is used now, it hurts like heck and is very uncomfortable. Patients seeking treatment at this age are generally self motivated. They have issues with their smile and want treatment. Invisalign Teen can be used, and ceramic (clear) braces are always on option.

Summary

When is the best time to have an orthodontic evaluation? Now. Earlier is better. Even is nothing needs to be done, you'll have peace of mind. By the way, most orthodontic offices do not charge for an exam. It will only cost you some time, but you'll have invaluable information.

This post is not intended to replace the advice of your local orthodontist and is provided for informational purposes only.

 

drkampas.com

What are braces?

What are braces? and other common questions about orthodontics

Braces are fixed dental appliances designed to move the teeth.  Well, that was pretty clinical. 

Braces are used by an orthodontist to improve the smile and bite.  An orthodontist is a dental specialist who has completed a two to three year residency following dental school.  More broadly, orthodontists correct the alignment of the teeth and jaws to provide an esthetic and functional alignment of the teeth and jaws.

The orthodontists use fixed and removable appliances.  Fixed appliances are defined as those devices which stay attached to the teeth, removable appliances may be taken out by the patient (retainers are a great example). 

How can you get braces? 

The first step is to have an orthodontic exam performed by an Orthodontist. I capitalized orthodontist because some general dentists provide orthodontic treatment.  Maybe I'll rant about this later, but if you had a need for stomach surgery, would you let your family doctor do it? Some people would, but you may not be happy with the outcome.  See a real orthodontist.

Back on topic..call an Orthodontist and get an evaluation.  The orthodontist should listen to your concerns about the bite or smile. They will usually take photos of the teeth and face and may additionally get x-rays and moulds of the teeth. An full oral exam should look at the jaw alignment, musculature, jaw movement, TMJ, tooth position, eruption timing and examine the swallowing pattern.  A panoramic x-ray can determine timing and check for the presence or absence of teeth.

Once a complete exam is performed, the orthodontist will present a tentative treatment plan or plans and estimate the length of time the treatment will take.  The treatment plan should address all your concerns and correct any additional problems discovered during the exam.  The office should be able to present a fee based on the tentative treatment plan.  Payment options are also often offered.

By this point you should have the info to decide if the office is a good fit, that you are comforable with the pace of the office.  You should have confidence that your concerns have been addressed.  If you have a feeling that something doesn't make sense or unsure of what is being recommended, stop ask for clarification. If you're not satisfied, get a second opinion.

Do you have a common question about orthodontics? 

When should my child see the orthodontist?

Short answer:  Any time you have a concern about the bite or smile.

The real question should be…” What are the indications for early orthodontic treatment?’  There is no quick answer to this, but I’ll try to make break this down  by chronologic age.

 I have to tell you that this is my opinion and that you should check with your dentist or local orthodontist about any concern you have.  Individuals may vary in their dental age, sometimes significantly.  Dental age must be established by a panoramic x-ray(more about this  important x=ray later).

AGE 0-3

Unless your child has a cleft, you worry too much.  Have a glass of wine and don’t hover . It’s your first child right?  Seriously, if your child has a cleft or craniofacial anomaly you should already have contact with a team at your local medical center. You already know more than me.

Age4-5 

This age is too early for most kids, unless they have a bite issue. Have a glass of wine and don’t hover. It’s your first child, right? However, if your child has a crossbite accompanied by a functional shift he/she should be evaluated now.  A functional shift is defined as a jaw that deviates upon closure by the premature contact of the teeth which forces the jaw to slide or shift into a more lateral or anterior position. Hopefully your dentist knows what I’m talking about, sadly many don’t.  The functional shift can be responsible for abnormal jaw growth- leading either an asymmetry  of the jaw or to excessive growth forward.  This needs to be treated when it’s identified. 

The most common reason that parents seek an orthodontic evaluation at this age(4-5) is due to oral habits- finger or thumb sucking. The habit has resulted in an open bite . The child is unable to touch the front teeth together when the back teeth are touching. I don’t get too excited at this age because I know that when the habit stops, the open bite will close down.  Some kids need the extra security of having something on which to suck.  A potential consequence of finger or thumb sucking is a narrow upper jaw. By the time this becomes apparent, your child is probably taking a trip to Expanderville anyway. Don’t sweat it, but if a thumb or finger habit is a concern, have it evaluated. I’ve seen open bites close just by using an appliance which keeps the digit out of the mouth (a Habit Appliance). Other times we need braces to augment the Habit Appliance.  A child’s desire to stop goes a long way.
To be continued...

What topic concerning orthodontics is of interest to you?

A Short Bio

I was born in log cabin in the Canadian Rockies, I walked in 3 feet of snow uphill both ways to school.  We had neither food, water, plumbing nor electricity. I shot my first bear at the age of 3…

I was born into a wealthy  family from Boston. I didn’t see my parents much, but my nanny told me that they were nice…

I was born on Pittsburgh’s North Side in January of 1959.  I am considered a boomer.  I grew up in West View, PA. It’s a suburb about 6 miles north of Pittsburgh.  I attended public school.  In the 1965 I was in kindergarten and I wanted to be a Beatle.  In the 1975 I got my driver’s license and I just wanted to be cool.  In the 1985 I was in dental school, and I wanted to be an orthodontist. In 1995 was in debt and I wanted to have a successful practice.  In 2005 I opened my third office and I wanted to be a great dad.  Today, I hope I’m a good dad, have a reasonably successful practice, love being an orthodontist, am still trying to be cool and I want to be Justin Bieber.
How have your wants changed since you were 6 years old?

http://drkampas.com

When is the best time to get braces?

The short answer is now.  Anytime you feel that your bite or smile is not all that it should be is the time to get braces. 

Orthodontics can be done at any age.  My oldest patient was about 80 when we began her treatment.  She was always self-conscious of her smile and was thrilled to see her beautiful smile when we finished.  No, we did not give her full braces, but did limited treatment to address her problems.  It seemed odd to me that none of her dentists recommended orthodontic treatment prior to this time, but this goes to illustrate that many dentists won’t broach the subject, unless the patient does first.  Over the years, I have encountered this phenomenon many times.  The patient will see a new dentist who is more comfortable discussing how a person feels about his or her smile.  A good dentist may present several options to treat a dental problem, including orthodontic treatment.

Orthodontic treatment is not just about straightening the teeth, its about self esteem, self confidence.  I have another patient who is a bit older, over 6 decades. When she came into the office she instictively covered her mouth when she smiled.  In bringing out her reasons for seeking care she broke down and wept that she had always hated her smile.  She had spaces between all her front teeth.  She had raised her children and though she was of modest means, she said it was finally time to do something for herself. 

Many adults put off seeking care because of fear of the unknown.  Cost, pain, time commitment, afraid of 'brace face' are all reasons given for failing to consider orthodontic care.  The options and advances in orthodontic treatment coupled with flexible payment options, all of these objections can be overcome. 

First Blog

Ouch, I'm starring at this blank screen thinking I don't know the first think about blogging.  Once posted can I edit, or does this become a permanent legacy for my great grandchildren to read?  I always wanted to write about my experiences, but have always thought that the best was behind me. Day by day, life has proven me wrong. 
I'd like this to be an outlet of information about myself and my family, while at the same time relaying information about my profession, orthodontics, and other topics that interest me and may of interest to others.