The Noxnoys

"Hon, are we going over to the Noxnoys' for cocktails?"

So reminiscent of that suburban middle-class vibe of my youth. But in our office, Noxnoys aren't Dry Martini-swilling neighbors with no food out on their tables but a few nuts and crackers. Some mass-produced orangy cheese spread if we're lucky. No, Noxnoys are something very special indeed. Read on and see why.

 

We see new patients, of course, some of whom have significant dental needs in order to eliminate pain or solve esthetic problems. As we work through planning and then carrying out their treatment, they experience considerable and meaningful gains as they return to the enjoyment of a beautiful smile and a healthy mouth. We have the satisfaction of performing complex and challenging procedures, of seeing them healthy for perhaps the first time in years, and yes, income for our practice is significant where needs are high.

But then we want them to get healthy and stay there, never spending on their dentistry that way again.

This brings me to another situation, that of our existing patients who are essentially healthy and decide upon some elective treatment. Perhaps they replace some old restoration that was done at a time when technology didn't allow the beauty of today's dentistry. Maybe they lighten their teeth. These days, more and more adults (like myself) are deciding to align their teeth with Invisalign or a referral to an orthodontist. These are also significant treatments and events in the life of a dental practice.

Then there are the patients who break my heart. Mostly older adults (like "myself" is rapidly becoming!), they have enjoyed fine dental health for long periods of time in our practice and perhaps in other dental offices that preceeded their time here. Suddenly, they develop some acute illness. Perhaps they have a dry mouth due to medications and the aging process itself. They soothe their throat with lozenges or cough drops that contain massive amounts of sugar; they interrupt their normal oral hygiene because of time spent in hospital and rehab; they become temporarily addicted to things like ice cream, ginger ale and other sweets. In an astonishingly short time, they can wreck their dentition. You wouldn't believe how fast cavities like these can happen in people we know and have been preventing problems in for years:

As I said, these situations break my heart. They are so preventable! I never want to have to perform major non-elective treatments that could have been prevented in the first place in patients I already know and take care of. The key to understanding this in yourself and your family is here by the way:

http://www.smilephiladelphian.com/clock/Caries.php

And then there are the Noxnoys.

You see, some years ago we went to a system where our hygienists, Annette and Maryanne, signal the need for Dr. Sukoneck or I to examine a patient by putting up a little scrap of paper on our doorway. This avoids verbal interruptions and ensures that we will go to that patient as soon as we can, since the paper scrap waves at us insouciantly, perhaps even mockingly, from our operatory door as the minutes pass.

Maryanne took to writing "nox" for "no X-rays" that visit, and "noy" for "no yellow sheet." This "yellow sheet" is our scratch sheet where both doctor and hygienist can write notes about any sort of diagnosis or treatment need.

"Noxnoy" thus means a patient who is up to date on their X-rays and has no treatment needs- a poster person for dental health. And we see many patients like this each and every day.

This makes me happy. When prevention is working, when patients avoid uneccessary and costly dental problems, when cavities and gum disease are being warded off by our mutual efforts at maintaining a clean mouth and avoiding too many bad habits, I am happy indeed to send the Noxnoys off to their careers and homes with no treatment necessary, reserving our highly refined skills for someone new who hasn't been to the dentist in too long a time.

And then watching as they, also, join the ranks of the Noxnoys who only need us twice a year. ;}

Comments

[Joel]

Powerful lesson here: when we give a name to something we like, we value it even more because it's easy to recognise and remember.

The opposite would be a bad idea, methinks: putting a name like that to those who are, shall we say, a mite needier? Before long, they're "just another yaxblad" or whatever. Not good.

[Tom Bentley]

Rick, for some reason the Noxnoys, a eminently positive affiliation, reminded me of the moniker for the drink (a potable I think I've already mentioned on Tribes) served at my old girlfriend's restaurant to any obnoxious customer who dared to counter the good graces of the waitresses.

Named after a regular customer, a fully noisome fellow named Nigel that they wanted to send to Hades, they used to mix all his cocktails with a few drops of dishwashing liquid mixed in. The unthinking drinker served such would soon feel an overwhelming urge to visit the so-called "necessary room" more often than it takes to start bothering the waitresses again. After Nigel received a few Nigels over time, he made at the least an unconscious association with the bar and intestinal distress, and began to appear less and less. Success!

What this has to do with Noxnoys is deeply tangential, but such are the workings of the mind. Thanks for a fun post, T.

[Rick Wilson DMD]

Joel, thanks for pointing out the value of naming things. Words truly do matter. They shape our reason.

Tom- thanks for the story! I recall being in college and railing against classical and operant conditioning, rather insisting that we humans are ever so much more complicated than a toaster or a sewing machine or even an automobile. Yet there are times when the ole stimulus-response schtick rocks out, and your Nigel example is certainly one of them.

And by the way, when all our various dusts have settled, what say we three chaps (and perhaps Phil and Marcos, just for the spice they'd bring) write a book entitled "The Noxnoys"? It would have to be about loyalty in both directions between people, sustainable business practices, and 1960's gin-and-whiskey-soaked American suburbia, but other than that, it's a wide open tabula rasa with an indefinite raison d'etre.

Oh. And bacon.

[Ed Hochhalter]

It's a spiffy name. Indeed, a name like that is... it's uplifting. It's a real joy to see people go to the dentist because they want to take care of their teeth and their health.

[Sydney City Dentists]

The name is actually a little catchy. Maybe it would help if clinics displayed a list of Noxnoys in plain sight to encourage more people to take proper care of their teeth.