Innovations and Insights in future Dentistry with Dr. James Mah

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Welcome to the d'etre see you for kids. Today we're honored to have a distinguished guest, Dr. James Mah. Dr. Mah is not just the esteemed educator holding the position of Interim Dean of School of Dental Medicine at the University of Nevada, Las Vegas, but he's also shaping the future of orthodontics as the program director in orthodontics at UNLV. His groundbreaking research in three dimensional imaging and modeling has set new standards in diagnosis, treatment, planning and therapeutics, extending into the realms of anthropology and forensics. Dr. Mah's involvement in the development of cutting edge dental technologies like 3d facial imaging devices, intra oral scanners, and Cid slash cm applications reflects his commitment to advancing the field of dentistry. author of numerous publications textbooks and book chapters, Dr. Mah is a sought after speaker, both nationally and internationally. His expertise has been recognized by major media outlets like the Los Angeles Times, the National posts, and men's health and he also plays a vital role in the academic community as a reviewer for prestigious dental journals. Please join me in welcoming a true pioneer in the field of Dental Medicine and orthodontics. Dr. James Mah. We're thrilled to have him today. How are you feeling?

Dr. James Mah: Doing great. Well, thank you for that introduction. I know it's a mouthful, but yeah, you're asked to do all that stuff. But I'm happy to be here. No,

yeah. We're so excited to have you here. So Dr. molL, how did you become interested in dentistry? And what kind of led you to specialize in orthodontist?

Dr. James Mah: Well, Dentistry was a good fit for me, because throughout my childhood, I always like to tinker, I did. Arts and crafts, things I need. I like to work with my hands work on projects. And while they started as simple projects, then I went on to, you know, build things like homemade metal detector, I would do crafts items all the time. And I really liked the connection of not just knowing what's going on, but actually being able to reduce it to practice and make something to actually make something with your own hands. I'll be at some of them are very elementary, but then you advance on and you do some pretty complex things. It's a level satisfaction. That's really rewarding.

Yeah, that sounds great. So is that kind of what inspired you to go into orthodontics to that sort of artistic part? Yes.

Dr. James Mah: It's artistic. And there's element of creativity and innovation. I think you'll hear often that many of the professions, it's always about inventing a better mousetrap, if you know how it works, and then you can approach it like slightly different and keep improving it. That's how all of healthcare and society advanced forward and look no further than software or your own phone. Right. It's always a constant evolution. No,

yes, for sure. Thank you for sharing, and what kind of inspired you to take up like teaching at UNLV. And particularly in the School of Dental Medicine.

Dr. James Mah: Yeah, you know, V, I thought it was refreshing. I've been at Angel institutions, some that are over 400 years old, and some that are merely 200 years old. So I came to Nevada, Nevada in 1957. That's not old at all right compared to the institutions and we're starting a new dental school and I saw a lot of opportunity. I'm also much of a builder and architect designer, I like to start new programs and projects. And like I said, they start off at some point really small, but at some point when you get to a higher level organization, I'm starting new educational programs, and new efforts and things like that new research projects that you know, play out over a series of years, but nevertheless, it's the same concept. You design a better mousetrap. You do it again and again. You make it better and better and the project get more and more elaborate. Yes,

that's great. No, thank you for sharing. And I know UNLV is known for its cleft palate specialty team. Is that how you pronounce it? Yeah,

Dr. James Mah: there's a the only one that cleft palate, craniofacial team, the only one in Nevada, and I'll be it in the pandemic went on a bit of a hiatus. We're very much trying to resurrect that and get that going. There's funds to start At a new clinic for it, but that's an element of our of Nevada, that's very much an area of unmet need. At present, right now, a lot of the infants that are affected with cleft palate cleft lip, other cranial facial anomalies have to go elsewhere for their care, we'd like to do more for them.

No, thank you. And for some of the listeners that might not know what a cleft palate is, can you maybe like, tell them probably in simple terms, what exactly is,

Dr. James Mah: yeah, during formation of the human face very early on, actually, it's if you think at the tissue and cellular level, things come together, like building blocks, and one of the key building blocks is between the front of the lip, and the both sides, they come together embryologically And they coalesce to form one continuous lip and one contiguous us palette. But for a number of reasons for many individuals, and the incidence is, you know, about one in eight or 900. Infants, it doesn't come together quite right. I mean, everything else is normal. But that part, the cells just don't connect. And next thing, you know, you have a gap that we call a cleft in between and it causes problems for food, you know, for eating for swallowing, and speech. And it's a very correctable problem. But it takes a lot of time. It takes a team to correct because there's many aspects of it ranging from you know, ear, nose and throat, speech therapy, obviously, the Surgery Plastic Surgery, dental orthodontic, but it does take a team because it's quite a complex problem.

Mm hmm. For sure. And I know you do have some involvement in 3d imaging, do you use that for the cleft palate treatments, or? Yeah,

Dr. James Mah: 3d imaging is used now throughout dentistry. In fact, it's hard to find any aspect of dentistry that's been untouched by 3d imaging. Obviously, the the imaging that's provided gives us a lot more information regarding the severity of the problem. It allows us to evaluate progress, and also to look at continuing changes with growth and development. So it's an invaluable tool.

That's great, thank you. And then how do you use it for orthodontists?

Dr. James Mah: Orthodontics is all about sounds simple, but moving teeth. It's complex in the way that there's always almost always a challenge of trying to fit the teeth in when there's not enough space. And so the imaging allows us to define boundaries of where we can move teeth. Obviously, there's a limit, right. And for some reason that, you know, for some people, there's just not enough space, and too many teeth. And I think intuitively you know what the solution is right? It's like, somebody's got to go. And then that's why quite often people end up with extractions of teeth to be able to get the rest of the teeth in. But the 3d imaging helps us look at not only the space requirements, but look comprehensively at everything around the jaw, which includes the airway, jaw function, looking at the bony structures, and so forth. So the there's a lot of other detailed information that 3d imaging provides. Ooh,

sounds very fun. Is there any tips that kids can use to sort of, I guess, like, help their teeth, or anything like that?

Dr. James Mah: I think it's the basics right now, I think it's really important to learn about proper oral care. Another key thing is habits. There's a lot of destructive habits, people get into, you know, everything from the nail biting to using their teeth as tools, you know, to open things and so forth. Not to mention proper oral hygiene, and even doing normal things. Like I think most people play sports. It's really important. If you think about it, you're probably wearing knee pads, elbow pads and helmet. It's also important to protect your teeth, because if some of those injuries can be quite extensive, when teeth are damaged, or if they're knocked out, not to mention the soft tissue cuts. So I think that's another thing is people have to have an awareness of all the things that happen around the teeth.

Oh, I see. So you would recommend kids like when they're doing activities that might damage their head just to wear a helmet to protect kind of damage and

Dr. James Mah: mouth guard. You know, even something that you think is straightforward, like basketball. There's a lot of dental injuries in basketball. I mean, some of them are obvious like football, especially if there's any sort of contact right but lacrosse is another one. I mean, it is a lot of hockey. Those are obvious, but even some of the other sports, you wouldn't think but there are, you know, head to head collisions in say soccer, right?

Yeah. Yeah, yeah. It's fascinating how like, our everyday life and just anything wrong. That happens can just break our teeth so easily. So it's great that you're sharing this. And then I know, I was searching it up earlier, but you have some research with stem cells and tooth pulp. Could you maybe expand a little on that?

Dr. James Mah: Right, the stem cells, I think every biology student knows that this time that stem cells hold the promise for all of healthcare. Because stem cells are pluripotent, you can take a stem cell and get it to differentiate to any other type of cell, which means a nerve cell, muscle cell, and so forth. So people looking at all kinds of treatments are looking at stem cells to be able to rejuvenate, and also to treat patients with a number of human disorders and disease. But it came to us that that it's a bit of a shame that we throw out stem cells all the time when they could be saved. We throw them out. When people go for Orthodontic extractions. Almost nobody asked him, Hey, can I keep my tooth? Or anybody ever asked that? If you were well, how would you recover the stem cells? Because we know that inside a tooth, especially if you're younger person with a very healthy tooth that needs to be extracted for crowding? You might as well use it right. So if you could open it up, take the stem cells out of it. And stem cells are found there's a rich supply in the dental pulp. So there's a rich source, and yet we throw it out. So we started on this project of how do you recover? You know, stem cells from the from extracted teeth, and we develop ways because the problem is, it's also very hard to get into the middle of a tooth, because dental enamel is the hardest tissue in biology. And so you have to find a way to crack it open. And hence we developed what we call the tooth cracker 2000 Very quickly, almost like a concept of a nutcracker opened up fairly quickly. Because the stem cells have a viability their lifespan, right. As soon as they extracted, they're disconnected from oxygen and things like that. So you've got to move fast to get viable cells. And so that was that effort, and it really paid off. No,

yeah, it's great. And do you guys see yourself using it into the field of dentistry too, or just for

Dr. James Mah: Yeah, because the plural pluripotent nature of stem cells, you can help rebuild entire tooth, you can help rebuild soft tissue, bone, muscle, all that stuff,

huh? Oh, okay. So do you see this kind of going into the future of dentistry? Or do you think it's sort of this ongoing field that might not may or may not be implemented? Well, I

Dr. James Mah: think if you look at the publications, one thing, you know, to figure out if it's really a thing, or if it's a trend, just look at the number of publications on stem cells over the years, and you'll be quite surprised in the recent years, there's been a spike in it. There's no end to it, the number of research labs and researchers throughout the world focusing on stem cells because they really believe that it's the future for all of medicine for all of longevity, for a much of human disease for cancer treatment, neurologic disorders, heart disease. The secret is all gets back to the stem cell. Oh,

yeah, no, that's so interesting. Thank you for sharing. And I know throughout your career, you have so many milestones and achievements. What do you think are some of your most memorable ones?

Dr. James Mah: Oh, gosh, there's, it's a lot. I mean, throughout my education, I've worked in various areas of research. You know, I did a doctorate in biochemistry, I looked at it hang on when I describe the project, the role of a enzyme cofactor and mitochondrial electron transport in eukaryotic metabolism. That was the name of my doctoral dissertation, went through that I ended up doing research in Parkinson's toxicology and so forth. And one of the things that is predominant not so much here, but very common up east coast, but it Coming here is the effects of lead poisoning on mitochondrial electron transport. In other words, while we know that and you're too young to remember it unleaded gasoline and leaded paint, but nevertheless, there's tons of the leaded paint throughout construction, particularly in East, but lead is appearing in in common things, household products. Even in age old, if you have antique china, often the very bright colors that are on the China contain high levels of lead, if people don't know that. So we did a lot of work on toxicology, and I was the one that found a way to reverse lead poisoning. In mitochondria attacks. Mitochondria is one source. And I think it was memorable because I received a commendation from US Congress for my work on lead poisoning. That was very early success. But it was something that I see as a benchmark, it really spurred me on for other kinds of research that made a significant contribution. Ooh,

yeah, no, that's so great. And hopefully, hopefully, it's not a big problem in Vegas going forward. But what are some of the measures you'd like to give to kids to help kind of prevent lead poisoning?

Dr. James Mah: Oh, there's a lot it. Unfortunately, it's found in all kinds of household products. So the natural things is, you know, don't just chew on colored pencils, and things like that there. There are tests that people can can do. A lot of the imported products have high levels of lead. The lead is found in the brightly colored paints that are used on wood and plastic products. So if you do a search about lead poisoning, in Las Vegas, you're actually going to see a rise in lead poisoning because it's coming away, not by the traditional route of leaded gasoline and let it paint, but it's coming into environment by consumer products. Oh, okay. Yeah, this includes some known name lipsticks and cosmetic products.

Oh, I see. So you would advise kids to do their research on some of the products?

Dr. James Mah: Yes, yes. No, the brands know who you're dealing with? Yeah.

Hmm. Okay, thank you so much. And then I'm gonna recycle a little back to dentistry. But what are some of your philosophies in terms of like patient care?

Dr. James Mah: Listen, one of the first things is you got to make sure, you know, while you can do something at a very high level, the patients don't know that what patients want is they want to know that they're being heard, that somebody actually cares. I think that's the most important part is for patients to be on board with your treatment, and to be seen with respect, and be treated as an individual. I think that's the biggest number one tip. And I think, often we get into the details, right? Because I think a lot of the procedures that may because many people are very detail oriented. They focus on the detail, when they should maybe slow down and then look at everything holistically and say, okay, and explaining to people to communicate, so everybody knows what's going on. And then proceeding with the treatment.

Um, I see no, thank you so much. And you have all these different roles. So I'm just wondering, like, what's your secret to all these time management to be able to do everything at such a high level? Yeah,

Dr. James Mah: that's, I think, a really good question. I think, above all, it's about organizations. It's not necessarily a lot of people. A lot of students have the misconception. It's all about late nighters. It's not. You can't do late nighters for a whole career is not that it's not worth what you want to do is be organized and part of the organization to have schedules so you don't let things lapse. You got to just keep at certain things. If you look at things like learning to play an instrument or being a an athlete, you can't crash and cram and be an athlete. Nobody decides, well, tomorrow I'm going to run a marathon. We stay up all night. No, it's months of training. There's no other way. Right and into the same thing. I think if you organize with the schedule that you can continually dedicate and keep on things. I would say things are not necessarily really difficult. It's more about organization. When we learn when we learn Much of what we learn is an acquired skill. And I always share with students. There's no Mozart in dentistry. There is no six year old that knows how to do dentistry. It's all an acquired skill, right? So it's about practice, it's about a little bit about ego and trial and error, know that you will fail. It's trial and error. It's how you learn, right? But it's how you recover from the error, and how you learn from it. That matters.

Yes, for sure. So I guess when people do encounter failures, you would suggest them not to give up and just to keep going at it. Right. Yeah,

Dr. James Mah: that's the learning process. That's very expected. And it's not a criticism of their abilities, or what, but it's how it happens. Oh,

yes, for sure. Thank you. And I know some of these listeners that are on here, right now. They might be wondering, what are some of the steps to be a dentist? And how would you be a dentist? And what are the benefits of being a dentist? So could you maybe like briefly elaborate on that. There's

Dr. James Mah: a lot there. Obviously, the educational background, you start with the, you know, pre Dental, pre med courses. And doing well in those all the while, there's a number of organizations that you can connect with, there's pre Dental Society, so you can work with like minded people. And they talk about preparation, application strategies, how to write personal statements, and so forth to help out. And other advantage of, especially if you're within reach of dentists, and I know you are, is to go and talk to dentists go visiting their office and ask yourself, Is this the right fit for me? I do know people that said, Well, you know, dentistry, it's wet, and there's a sea blood. So I know an individual that went on to be a psychologist that nothing wrong with that, but it just wasn't a fit. So I think it's really important to have that exposure to the clinic and see what it's about. Especially the hands on part. There are some people that will just love to do things with their hands. Others don't. Key examples of people that do really well are people that have a background, doing crafts, and doing jewelry. A lot of the instruments surprisingly, for making jewelry are the same as dental instruments. Really, yes, same pliers, same wires, all that stuff. Another thing is some people don't like the some people or people you know love working with people and and others not so much. You very much. If you're gonna be dentists, you have to be a people person and have a bit of background and a little bit of hospitality experience. And I've always said the people that have worked in the food industry generally do really well in practice management. Why do you think that is because they have had exposure dealing with the public and the public? Like I said, not everybody's the same, but you have to have this aptitude for liking to work with people.

No, yes, for sure. Thank you for sharing. And if they want to learn more, are there any books that you would suggest them to read or anything like that?

Dr. James Mah: I would say the strongest connection is through these organizations where like I said, they're pre dental students that will give them the most information. There's didactic material that's found in textbooks, but not so much. I mean, there's Facebook groups on pre dental and so forth. But I think having the group around you, the people that talk to you about your schedule, you know, the ones that keep you honest, right? Those are the ones that are important. Okay,

I see no, thank you so much. And then I guess, what advice would you offer parents for maintaining their children's dental health?

Dr. James Mah: A number of things. One is the just the education on oral care, they can come by a lot of schools, school districts are great at providing, you know, the proper dental care instructions. The other one is to even if you think there is no problem, go to a dentist on a regular basis. If nothing's wrong, the visits are straightforward and easy and a nice experience. I think a lot of people love the experience when they have a perfectly good checkup and have a cleaning and their teeth feels so shiny and smooth. That's a great feeling. Rather than wait until there's a problem something hurts and that's the first encounter with a Danis. That's not necessarily the best experience to start off with.

So no yes for sure. No, thank you for sharing that and the Before we end, is there anything you would like to say? Or do you think that is important to emphasize?

Dr. James Mah: Yeah, I would say that dentistry is, has evolved and continues to evolve as very much a technology oriented profession. I mentioned a lot of the the value of hand skills. But by the same token, having computer skills and a digital acumen, we'll get a long way, much of the latest things that we talked about, we already talked about 3d imaging, but the ability to do 3d printing, the CAD CAM milling, all that is digital. So it's really important that people intraoral scanners and another example, it just as an aside, we did a study, just for background intraoral scanners are basically combat video cameras that are configured to fit inside somebody's mouth. The video camera takes a series of images that are then rendered by the computer into a 3d model. And quite often, that replaces the impression material in process. And we did a study to see if a lay person could do this themselves, right? Because you can't go wrong. If you had to, you could stop and then restart it. Video, right? And if you had to swallow or move your mouth a certain way, but there's a lot of latitude. So we ask yourself, Wait a minute, can somebody do this themselves? And we did that study. And we found out in fact, compared to train staff members, there's a group, there's a segment of the population on the first time, they scan themselves better than our trained assistants, and faster. And so you're crying, asking, Who is this person? What are they? How do they do that? Well, that demographic, was the video gamer really, could pick up an intro scanner, scan their own teeth, better than a trained professional, first time. So I found that really enlightening. I think that's a statement of the future of dentistry. There's a lot going on, and the more digital acumen that you have and capability, you're going to be a catapulted into a different level. Oh, that's

really interesting way. Actually, I actually didn't know that. Um, so would you suggest like so these kids when they're pursuing college education to take up like computer science is having

Dr. James Mah: some digital acumen. But by no means suggesting that you should play video games 24 hours a day and become a hermit and have a bad diet does not have such an adjusting. I'm suggesting that having a digital ability and acumen is going to be really important. Oh, I see.

No, thank you so much for sharing. That's actually really great. Um, but we're so glad to have you here today. And that'll be it for a podcast today. Thank

Dr. James Mah: you. All right, anytime.

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