Are You Missing Out on the Most Up-To-Date Procedures?

Don’t miss out on the latest state-of-the-art medical procedures.

by Meryl Davids Landau
Photograph: Illustrated by Bryan Christie

For women in their forties and fifties with severe arthritis in the hip, a total hip replacement isn’t always the best option, since new joints last only 15 to 20 years and you’ll probably live a lot longer. As a result, some doctors
are choosing a procedure known as hip resurfacing, in which the head of the femur bone is saved and capped (with a metal and plastic piece) rather than removed and replaced. Consider this procedure especially seriously if
you are a woman age 40 to 55 who is active and has large bones that aren’t thinning, says Michael Mont, MD, director of the center for joint preservation and reconstruction at Sinai Hospital of Baltimore. “Resurfacing is ideal for this woman because, in my experience, it gives her a better range of motion while leaving open the option for a replacement later on,” says Mont, who has done the procedure on hundreds of women in that age group. Bone thickness matters because one of the downsides of resurfacing is that women have a higher rate of subsequent hip fracture—two percent compared with a man’s one percent. “That seems to have more to do with size than gender; bigger women likely have a smaller risk,” Mont says.

If arthritis makes it hard to walk or function, seek out an orthopedic surgeon experienced with resurfacing. Look for someone who specializes in the procedure, Mont advises, rather than someone who does the odd case between replacements, because minor errors can lead to joint failure, especially in small-sized women.

Laser Dentistry: Drills small cavities and performs other dental work

Lasers for dentistry have been around for decades, but most dentists still don’t own them because of their high cost and the fact that they can’t be used for many common dental appli­cations. Still, where they are appropriate, they can significantly reduce a patient’s trauma. If you have a small cavity—more common after 40, due to
a decline in your bacteria-battering saliva—the laser lets you skip the annoying Novocain and high-pitched drill. The new equipment can also painlessly remove flat growths in the mouth (such as lichen planus) that are more common in women over 40 than under. And, if you plan to get veneers, lasers can zap away the prominent flap of tissue inside the upper lip (known as a frenulum) that can sometimes get in the way. “Remove it the typical way, with a steel blade, and there’s a lot of bleeding, pain and scarring, and the need for stitches. There’s none of that with the laser,” says periodontist Robert Pick, DDS, associate professor of surgery at Northwestern University Medical School and author of Lasers in Dentistry.

Still, the American Dental Association notes that lasers aren’t a panacea; they say old-fashioned methods are best for root canals, and that lasers haven’t proven their worth for treating all cavities. Pick admits some overzealous dentists “claim a laser can do many things that it really doesn’t.”

If you need specialized dental work or are in the market for a new dentist, consider looking for someone who uses this pain-free method for appropriate applications. The Academy of Laser Dentistry lists members by location at laserdentistry.org.

Old-Fashioned Back Pain Remedies: Soothe low back pain

In this case, it isn’t that you need to know more about possible high-tech remedies; what you need to know is
that they may not help much. If you have chronic low back pain, new treatments like steroid injections in the joints near the vertebrae and artificial disc replacement sound impressive, and their use is soaring. But experts say that carefully designed studies have not shown many of these invasive and expensive methods to be effective at curing the pain; the best interventions are actually the low-tech fixes you can do at home.

“We all want a magic bullet. But the evidence shows that for most low back pain, it really isn’t out there,” says Richard A. Deyo, MD, a professor of evidence-based family medicine at Oregon Health and Science University, in Portland.

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