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Re: [CORE-Discussion] TMJ/Sleep therapeutic decision tree

Comments (0) | Monday, November 24, 2014

Stephen,

Can you help me by giving me some advice on where the two or three best places are to take courses ...where I might become more familiar with reading MRIs?

Brian T Fick DDS
First Choice Dental Group
Partner / TMD Facial Pain 
621 South Park St.
Madison Wi. 
53715
608.251.3535 O
608.698.7594 C

On Nov 24, 2014, at 10:27 AM, Brian T Fick <brian_fick@me.com> wrote:

Fantastic Steven

Thx


Brian T Fick DDS
First Choice Dental Group
Partner / TMD Facial Pain 
621 South Park St.
Madison Wi. 
53715
608.251.3535 O
608.698.7594 C

On Nov 24, 2014, at 9:54 AM, Steven D Bender DDS <steve@benderdds.com> wrote:

Any physician or dentist  can order the MRI.  If you are not in network with their insurance provider, it is better from a reimbursement standpoint to have their PCP order the imaging. We send a fax to the PCP describing what image we want and most have little issue with doing it.
Steve

Steven D Bender DDS
Director: North Texas Center for
Head, Face & TMJ Pain
5068 W Plano Pkwy. Ste. 100
Plano, TX, 75093
off:214-2918063
fax: 214-291-8062

On Nov 24, 2014, at 9:38 AM, Brian T Fick <brian_fick@me.com> wrote:

Jeff,

I'm interested in taking part in your proposed study… But since I'm a newbie at these things I'm wondering if you have any advice for how I talk to patients about them needing an MRI 
 Do I just tell them that they need an MRI or what's the rationale for needing an MRI..
Do these pts end up paying out of pocket?

What's in it for them?... Since MRI is "above standard of care"

Thx

Brian T Fick DDS
First Choice Dental Group
Partner / TMD Facial Pain 
621 South Park St.
Madison Wi. 
53715
608.251.3535 O
608.698.7594 C

On Nov 22, 2014, at 12:04 PM, Pat Mc Bride <patmcb1259@gmail.com> wrote:

yes
Pat Mc Bride, BA, RDA, CCSH
650-483-4903
American Academy of Dental and Physiological Medicine
Board of Directors

patmcb1259@gmail.com
<PastedGraphic-2.tiff>

On Nov 13, 2014, at 1:58 PM, 'Jeff Rouse' via CORE Dentistry Discussion <core-dentistry-discussion@googlegroups.com> wrote:

Jack:
Let me play devils advocate for Curt...how do you know that in 40 years you have only seen one degenerative joint case if you do not image?

I do not image every case the way that Curt does. I do, however, believe that if I did I would be able to begin to be more "predictable" in my care. "The pain goes away most of the time" OR the patient goes way. Probably a little of both. All of us see the patient with a lifetime of pain episodes and a bag full of plastic that dentists have provided as a solution. Steve rightly noted that most people fix themselves if given enough time and that dentists don't fix them we simply put them in an advantageous position to heal. When I see a "typical" TMD patient, I imagine what the MRI or CBCT would show me through my examination and questioning. I treat to that problem. The minute they do not follow what I expect, I image. Routinely, the damage is worse than my vision. It changes my plan by altering the type of splint, position of the bite, wear protocol, or medical/surgical intervention. It also tells me when a person is in active degeneration, risk of further damage, and I feel more comfortable discussing future issues. In addition, if orthodontics or orthognathics is scheduled to assist with malocclusion on this patient, I want to know the risks in advance.

A simple example....there are a number of different oral appliances "validated" by highly trusted teachers. They all work a little differently (where they load, how they position the condyle, etc.) How does it make sense that they all work equally as well? Wouldn't it make more sense that some splints work better on some patients and others better on a different class. To suggest that imaging does not give us enough information to alter our care is unfair to the science. The studies are very limited. The interpretation of a normal joint is not correct as many of the "normal" images are absolutely displaced discs or posteriorly positioned condyles. In addition, the studies are routinely done in maximum intercuspation which gives a false sense of normalcy. The images should be in a fully seated position to detect the true extent of the damage. Your comment on cost and time (and I would add, availiblity and poor quality images from many centers) is for me the issue with doing it on every patient. I believe that it should be standard of care but I have not made the complete commitment.

A HUGE advantage would be if we did them on all of the OAT patients. The risk is absolute. We know that teeth, joints or both change with wear. Why???? We don't have a clue. If as a group we could gather 50-100 cases with CBCT and MRI prepop following a protocol that I would distribute. We could begin to figure out why bites change. We might even be able to predict which ones and alter the treatment strategy for those patients. Anyone have an interest????


Jeff Rouse


-----Original Message-----
From: John Stellpflug <drjackdds@gmail.com>
To: core-dentistry-discussion <core-dentistry-discussion@googlegroups.com>
Sent: Thu, Nov 13, 2014 6:40 am
Subject: Re: [CORE-Discussion] Re: TMJ/Sleep therapeutic decision tree

       Putting a patient through the time and cost of imaging may influence whether or not or how soon you start them on OAT, but does imaging substantially alter your approach to treatment of the TMD one way or the other.  I believe that most of us have a go to appliance for TMD.  How would imaging change that in most cases.  In forty years of practice I have seem one degenerative joint case that actually effected occlusion (and speech).  People do adapt (as this patient did) and pain goes away most of the time.  I think simple (but mot simple minded) is better in most cases. 
        Jack

On Wed, Nov 12, 2014 at 1:53 PM, Steven D Bender DDS <steve@benderdds.com> wrote:
1)There is a saying or thought if you will, among those of us who limit our practices to these disorders that the adapted side (the one with degenerative changes) is usually the non painful side and the one that looks normal is painful because it is not adapting (ed) as well. Most literature now refutes the notion of occlusal factors being significant in TMDs. 
2)The retrodiscal lamina is the ligament that usually occupies the place of the disc in an anterior displacement. The pseudo disc formation will ultimately depend on the patients adaptive capacity, parafunctional and functional loads, and many other factors. 
3) Since most changes in the joint happen slowly over time, the dimensions don't necessarily change that much, at least enough to create noticable occlusal changes. Now if they happen rapidly due to trauma or if the degenerative changes are a result of some systemic malady that interferes with adaptation, you will see the bite change; usually and anterior opening.
4) Sometimes you can include signs and symptoms in the term asymptomatic. Its important to note when reading a paper as they describe the study population.
When I used to do comprehensive restorative care, I liked to utilize long term provisionals for the purpose you describe. Images give us a single snapshot of the anatomy (not a diagnosis) but can not define that individuals adaptive capacity which is defined by so many factors (genetics, hormones, diet, sleep, systemic health, etc)
I like this picture for looking at adaptation:

<IMG_1070.jpeg>

Steven D Bender DDS
Director: North Texas Center for
Head, Face & TMJ Pain
5068 W Plano Pkwy. Ste. 100
Plano, TX, 75093


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On Nov 12, 2014, at 1:26 PM, curtringhofer@gmail.com wrote:


On Wednesday, November 12, 2014 9:54:57 AM UTC-6, benderdds wrote:
Curt, 
These are all excellent question that would be very difficult to cover adequately in a post. The articular surfaces of the TM joint are different than other joints. One of the main aspects is the layer of undifferentiated mesenchymal cells just waited to be signaled to do something. By altering loads via advancement, distraction etc, they will begin to proliferate and form chondrocytes and ultimately bone. This is why it can "grow" at any age.
 
I suppose I have not seen this being able to be accomplished on a predictable manner.  Although, what makes me wonder is why do other joints breakdown?  For instance when looking at the images I find more breakdown than growth.  When looking at one side compared to the other were one is normal and the other has breakdown the only difference is the position of the disk.  The one that has a normal appearence has a normal disk position.  That being said the interesting thing is the normal side may be the side that is expereincing the symptoms.  I believe this is because the occlusion has to shift toward the shorter/ stucturally altered side. 
 
The disc itself is fibrocartilage as opposed to hyaline cartilage which basically means it is more durable. When displaced, the ligamentous tissues that move into the place where the disc was tend to function as a disc.
 
When a disk is displaced the condyle is functioning on the RDT.  Is this ligamentous tissue the RDT?  In addition I believe you are descibing what I understand as a psuedodisk.  When those are seen on an MRI it is a sign the disk has been displaced at a young age and I agree it is a form of adaptation and can be treated as a normal disk.  Although, when I have seen this it is typically on the younger population. 
 
 
Normal adaptation means that the changes occur but the person remain asymptomatic (has no signs/symptoms).
 
How can changes occur in the TM joint without translating into the occlusion?  If there is a dimensional change in the joint and there will be if there is a change in disk position it will change the way the teeth meet. 
 
We teach a course at our school where we image (CBCT) cadaver heads and then dissect the joint structures. It provides amazing insight as to how different the structures can look on an image as opposed to in vivo. There is no doubt that the ideal arrangement of a tm joint would be for the intermediate zone of the disc to interposed between the condyle and the posterior slope of the anterior portion of the gleaned fossa but more than 1/3 of the asymptomatic population does not have that arrangement.
 
I believe the term assymptomatic is if we are only thinking of pain.  Although, we all need to be aware of the dimensional change because it could affect the dentistry we may be planning for these assymptomatic patients.
 
Thanks,
Curt 

Steven D Bender DDS
Director: North Texas Center for
Head, Face & TMJ Pain
5068 W Plano Pkwy. Ste. 100
Plano, TX, 75093


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On Nov 12, 2014, at 9:00 AM, curtri...@gmail.com wrote:

The question I have is if the anatomy is not normal, how could there be normal adaptation?  I would think for it to be normal the anatomy would need to be normal.  I would agree that there are times the condyle health is not altered by disk displacement.  Although, what I have observed is typically those are the cases in which the condyle is of normal dimensions (more surface area to function on).  It is the condyles in which are small either from a lack of growth or breakdown (AVN or OCD).  
 
The question I would like answered is when we see growth in the condyle with an appliance.  Are the ones that grow the condlyes that have disk displacement with reduction and the ones that do not do not reduce?  My feeling is the disk allows for better force distribution especially when it moves out of the fossa.  In the fossa it fits (for lack ofa btter way of explaining it, and I know it is not just like this, but for visual purposes work with me) like a ball and socket.  When moved down the eminence it does not function against as much area (ball on ball).  Without the disk this can put an increased load on the condyle.
 
I may be mistaken, although I believe most of those studies that were done with the Herbst were done on growing individuals in which the growth centers remained open???
 
When we talk about adaptability the whole body has the ability to adapt, and I do not agree that the TM joint is unique in its ability to do so. I also disagree that adaptation does not always come with change. If the adaptation occurs slowly it will not be castastophic events, but there will be changes.(Wear, poc. chipping etc.) Imaging has allowed me to better understand which are which, by looking at the surface area of the bone, thickness of the RDT if the condyle is functioning on it, inflammation in the marrow. We can see these signs on a ceph, pan, or clinical examinations.
 
Curt
 
 
On Wednesday, November 12, 2014 8:27:44 AM UTC-6, benderdds wrote:
If the system is adapting successfully (which most people do) there is not a price per say. Even when we see these changes in the condyle, disc, fossa assembly, in most cases they can be considered normal adaptation.There is data that would suggest that the bony changes begin to occur prior to the disc displacement so while some would argue that the disc position is important for the health of the bone, it may not be the case. 
Yes, altering the load with any type of oral appliance has the potential to alter the dimensions of the structures. In some cases we may use that to our advantage i.e., "regrow" condyles. This goes back the studies utilizing Herbst type of appliances. There has also been some more recent papers utilizing CBCT to demonstrate new cortical bone deposition with mandibular advancement. 
I agree that dentist need to become very familiar with the temporomandibular joint. I also feel strongly that the dentist become familiar with the research data pertaining to the adaptability of the structures based on it's unique histology.
Steve

Steven D Bender DDS
Director: North Texas Center for
Head, Face & TMJ Pain
5068 W Plano Pkwy. Ste. 100
Plano, TX, 75093


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On Nov 12, 2014, at 8:09 AM, curtri...@gmail.com wrote:

Maybe that is true and a lot of them will resolve over time.  Although, adaptation comes at a price in most cases.  If it is in the form of pain it may be quality of life.  If there is a dimesional change, it will affect the dentition.  The other change that can occur, besides disk displacement is osseous changes.  These changes can be up to 15 mm.  With CBCT we will notice a significant amount of condyles with some form of osseous change.  Without an MRI ther is no way of knowing for sure, but having done both for awhile, I can assure every condyle that have some form of osseous change has is a disk displacement.  So as Nadar has stated a change in dimesion of the posterior aspect of the system will always affect the front end.  
 
As I stated earlier I feel we need to be aware of the possibility of these changes and ignoring it is practicing dentistry in the 20th century.  We have the ability and technology to better understand and explain why these changes may occur.  So lets use them.  I have attached an article that discusses how the change in stress loading can affect an internally deranged joint.  That was what my intial point was.  We need to be aware of joint anatomy prior to fabricating a sleep appliance.  My feeling is it will affect the joint thus possibly leading to dimensional changes in the posterior and anterior segment of the system.
 
I realalize there will be articles that disagree with the article I have shared.  The reality is, at least for today we do not know whay we are seeing these changes in occlusion with the use of a sleep appliance, but I strongly feel we need to be open to all possibilities until proven otherwise.
 
Curt
 
 
 

On Friday, November 7, 2014 2:48:12 PM UTC-6, brian_fick wrote:
Hello all

I'm really enjoying and learning a lot from reading this blog. As a change of pace I would like to throw a question out there, not so much about the topic of therapeutic goals but more on the level of practice logistics. For some time now I've been treating TMJ patients.  I use an orthotic system that is been very successful for me and relieving patients pain. I'm wondering of the sleep doctors out there, how many of you are also treating TMJ and of those of you that are treating TMJ, how do you have the referral sent to you and I guess more importantly once the patient in the chair how do you decide whether to start orthotics/ splint therapy or whether to get them a sleep screening or do you run all your TMJ patients through a CPC or pulse ox screening before you start TMJ therapy?   What does the decision tree you look like ...for all you folks treating both sleep and TMJ

Thanks!!


Brian T Fick DDS
First Choice Dental Group
Partner
621 South Park St.
Madison Wi. 
53715

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Re: [CORE-Discussion] CPAP vs. Sleep Appliances

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I have had conversations with 3 PCPs just this past week.  All three had never heard of UARS

Brian T Fick DDS
First Choice Dental Group
Partner / TMD Facial Pain 
621 South Park St.
Madison Wi. 
53715
608.251.3535 O
608.698.7594 C

On Nov 24, 2014, at 9:59 AM, Pat Mc Bride <patmcb1259@gmail.com> wrote:

Statistics show Texas has the highest rate of PAP use in the US followed by Florida and Texas-- likely because the age demographic tilts it in those states directions. The one thing we must all understand is that the people we interact with and work with are FAR MORE sophisticated than the norm. Most physicians never even look into a patient's mouth to score Mallampatti, nor do they inquire about sleep, lack of sleep, or quality of sleep. If the patient is in an HMO model of care, the time constraints are incredible for MD's. They need to see 80 patients in a day. Taking time to even talk about sleep with them is out of the question, ergo 80+% of all SDB patients go firstly undiagnosed, and secondly untreated. However, our rates of stroke, Alzheimers and CABG surgeries continues to escalate at alarming rates as a sequale. 


Pat Mc Bride, BA, RDA, CCSH
650-483-4903
American Academy of Dental and Physiological Medicine
Board of Directors

patmcb1259@gmail.com
<PastedGraphic-2.tiff>

On Nov 19, 2014, at 3:15 PM, Mark Paschen <drmarkpaschen@gmail.com> wrote:

Hi Al,
     I hope things become a bit more progressive in Texas.  At least here in Wisconsin, my sleep physicians (4 different hospitals) look to me for an appliance if their CPAPs are not tolerated.  Every once in a while I'll get an initial referral. Unfortunately, a lot of the UARS patients are getting overlooked by the physicians and just being told that they are not severe enough for CPAP and that there is nothing that can be done for them. What a shame!  Can't they see that there's something wrong with sending those patients home sleepy, knowing the potential those patients have of falling asleep at the wheel?  We can help them with the appliances.  The trick is getting those patients into our offices.  
     Thanks for your feedback, Al.  I know appliances are not the "end all", but I hope we can educate the public and the physicians that there is an alternative out there, especially for those CPAP intolerant patients.
Paschen

On Wed, Nov 19, 2014 at 2:19 PM, toothman54 via CORE Dentistry Discussion <core-dentistry-discussion@googlegroups.com> wrote:
Hello Mark
You are right, there are a lot of sick people out there.
this is merely an observation but in my area, CPAP dominates. Here in El Paso, medical doctors are committed to CPAP, that is it end of story unless the patient complains and wants an alternative. Do you think there is monetary motivation? I calculate that each machine brings between $800 to $1000 average to the sleep clinics (I could be completely off). I have had patients complain about the CPAP and the masks and usually the reaction from treating physician is "you have got to get use to it if you want to live". The problem I see often is that other issues are not often addressed. Are the sinuses open, is the tongue free, should we consider Myofunctional therapy, would the patient benefit from Buteyko breathing, etc. I think we will find that eventually SBD will best be treated utilizing a multi-disciplinary approach.
 
CPAP cannot be considered the end all treatment. Physicians need to become more open to biPAPS AutoPaps and the various masks that are available. They need to work with the patients.  The other thing that needs to be considered is patient follow up. Things change over time. I heard Dr Beltrand da Silva speak on OSA; if you get a chance to hear him you should. He pointed out that patients who use CPAP become dependent on them as tissues tend to become more flaccid with long term use. And of course there is the issue of blowing out the ears with increased pressures.
 
I am sure that more and more appliances are being done but most likely the number of CPAPS going out the door are increasing as well. More and more patients are becoming aware of SBD. I think there is room for a lot more appliance therapy but we need to realize that as in the case of CPAP, MAA are not end all to treatment but merely one of the tools we have to attack this deadly disease. Imagine if would could reach our children early enough in growth and development.. Might be able to make OSA a rarity.
 
Al
 
-----Original Message-----
From: Mark Paschen <drmarkpaschen@gmail.com>
To: core-dentistry-discussion <core-dentistry-discussion@googlegroups.com>
Sent: Wed, Nov 19, 2014 8:13 am
Subject: [CORE-Discussion] CPAP vs. Sleep Appliances

HI All,  I was asked a question recently that I really had no idea how to answer or even give an educated guess;
What is the growth rate (usage rate) of CPAP machines in the United States vs. the growth rate (usage rate) of dental sleep appliances?
     I know that more people are becoming aware of sleep appliances, but more are also becoming aware of the dangers of sleep apnea and sleep physicians continue to use CPAP as a first line of treatment, even in mild to moderate cases.  There are a lot of sick people out there, but is the rate of usage of appliances growing compared to the usage of CPAP?
     Thanks so much.  I'd appreciate any feedback you can provide.
Paschen
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Digest for rec.food.cooking@googlegroups.com - 25 updates in 4 topics

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Dave Smith <adavid.smith@sympatico.ca>: Nov 24 10:41AM -0500

On 2014-11-24 10:03 AM, Michel Boucher wrote:
 
> local levels. I imagined that the 6th one involved tossing the
> letter outside the post office and hoping someone going towards its
> destination would pick it up and deliver it.
 
It would be nice if the were local or regional rates. Canada and the US
are both huge countries with centres of population. It makes sense to me
that local mail that only has to be transported less than 100 miles
should be cheaper than something that is shipped 3000 miles.
"Pico Rico" <PicoRico@nonospam.com>: Nov 24 08:31AM -0800

"Dave Smith" <adavid.smith@sympatico.ca> wrote in message
news:skIcw.556604$_k.297855@fx16.iad...
> are both huge countries with centres of population. It makes sense to me
> that local mail that only has to be transported less than 100 miles should
> be cheaper than something that is shipped 3000 miles.
 
Shipping is the least of the expense. Both of your example require the same
effort in collecting, sorting, and delivering. I prefer less confusion in
postage rates vs. ending up with a one cent differential, if that.
graham <gstereo@shaw.ca>: Nov 24 09:41AM -0700

On 24/11/2014 8:10 AM, Michel Boucher wrote:
>> it will despite Michels gloom and doom :)
 
> It's not doom and gloom, it's a cautionary tale about giving
> neoliberal governments too much power (or electing them at all).
 
In case you haven't noticed, we have CONservative govts in both Ottawa
and Edmonton.
Graham
"Pico Rico" <PicoRico@nonospam.com>: Nov 24 08:53AM -0800

"graham" <gstereo@shaw.ca> wrote in message
news:zcJcw.118836$ZT5.35455@fx07.iad...
 
> In case you haven't noticed, we have CONservative govts in both Ottawa and
> Edmonton.
> Graham
 
yes, but government bureaucracy does not turn on a dime. Brings to mind the
British TV show "Yes, Minister".
Michel Boucher <alsandorz@g.mail.com>: Nov 24 10:56AM -0600

"Pico Rico" <PicoRico@nonospam.com> wrote in
 
> I prefer less confusion in
> postage rates vs. ending up with a one cent differential, if
> that.
 
That would be a nickel in Canada. Our government of morons is
reclaiming the copper in pennies to build themselves an ark where
they will house all their supporters, haidressers, telephone
sanitizers, account executives and such, and launch themselves into
space to avoid being eaten by a mutant star goat.
 
I pity the planet they crash into.
 
--
 
Socialism never took root in America because the
poor there see themselves not as an exploited
proletariat but as temporarily embarassed
millionaires. - John Steinbeck
Michel Boucher <alsandorz@g.mail.com>: Nov 24 10:59AM -0600

graham <gstereo@shaw.ca> wrote in
>> all).
 
> In case you haven't noticed, we have CONservative govts in
> both Ottawa and Edmonton.
 
Of course I've noticed. I lived four years in Edmington (to quote
Mike Tyson). They masy call themselves Conservatives but they are
at their core neo-liberals. Even Harper admitted it in a document
that was on the web at one time and which has since been removed,
presumably because reptile brains cannot process such a concept.
 
--
 
Socialism never took root in America because the
poor there see themselves not as an exploited
proletariat but as temporarily embarassed
millionaires. - John Steinbeck
Michel Boucher <alsandorz@g.mail.com>: Nov 24 11:01AM -0600

"Pico Rico" <PicoRico@nonospam.com> wrote in
>> both Ottawa and Edmonton.
 
> yes, but government bureaucracy does not turn on a dime.
> Brings to mind the British TV show "Yes, Minister".
 
It's not bureaucracy that is at fault here. It's the ideologues
and demagogues in the Partei in power.
 
--
 
Socialism never took root in America because the
poor there see themselves not as an exploited
proletariat but as temporarily embarassed
millionaires. - John Steinbeck
sf <sf@geemail.com>: Nov 24 09:05AM -0800

On Mon, 24 Nov 2014 08:31:53 -0800, "Pico Rico"
 
> Shipping is the least of the expense. Both of your example require the same
> effort in collecting, sorting, and delivering. I prefer less confusion in
> postage rates vs. ending up with a one cent differential, if that.
 
Me too! They choose the fastest route to deliver mail these days and
it boils down to air. So glad special postage for air mail is a thing
of the past now.
 
 
--
Avoid cutting yourself when slicing vegetables by getting someone else to hold them.
"Kody" <dffkody@removeme.gmail.com>: Nov 24 08:34AM -0600

"sf" <sf@geemail.com> wrote in message
news:umd67a524umemddtmnjgoguc5s3tu8o4jd@4ax.com...
 
> --
> Avoid cutting yourself when slicing vegetables by getting someone else to
> hold them.
 
In the South, stuffing is made with bread, dressing is made with cornbread.
Dressing is the more popular.
sf <sf@geemail.com>: Nov 24 07:06AM -0800

On Mon, 24 Nov 2014 08:34:29 -0600, "Kody"
 
> In the South, stuffing is made with bread, dressing is made with cornbread.
> Dressing is the more popular.
 
That certainly simplifies things! I tried serving cornbread
stuffing/dressing once, but my family rebelled and I put that idea to
rest.
 
 
--
Avoid cutting yourself when slicing vegetables by getting someone else to hold them.
"Ophelia" <Ophelia@Elsinore.invalid>: Nov 24 02:57PM

"George Leppla" <george@cruisemaster.com> wrote in message
news:m4vbku02ro7@news3.newsguy.com...
> So what do you call it?
 
> When I was a kid, we "stuffed" the turkey with stuffing.
 
> I still call it that even though we bake it separately.
 
Same here!
--
http://www.helpforheroes.org.uk/shop/
"itsjoannotjoann@webtv.net" <itsjoannotjoann@webtv.net>: Nov 24 08:00AM -0800

On Monday, November 24, 2014 8:31:43 AM UTC-6, Kody wrote:
 
> So what do you call it?
 
> > In the South, stuffing is made with bread, dressing is made with cornbread.
> Dressing is the more popular.
 
YES!
"itsjoannotjoann@webtv.net" <itsjoannotjoann@webtv.net>: Nov 24 08:02AM -0800

On Monday, November 24, 2014 9:06:14 AM UTC-6, sf wrote:
 
> I tried serving cornbread
> stuffing/dressing once, but my family rebelled and I put that idea to
> rest.
 
Post your recipe and maybe we can determine what it was your family did not like about cornbread dressing.
Janet B <nospam@cableone.net>: Nov 24 09:12AM -0700


>That certainly simplifies things! I tried serving cornbread
>stuffing/dressing once, but my family rebelled and I put that idea to
>rest.
a friend does cornbread with oysters. I can't begin to tell you how
revolting that is.
Janet US
"itsjoannotjoann@webtv.net" <itsjoannotjoann@webtv.net>: Nov 24 09:00AM -0800

On Monday, November 24, 2014 10:12:37 AM UTC-6, Janet B wrote:
 
> a friend does cornbread with oysters. I can't begin to tell you how
> revolting that is.
> Janet US
 
I've read about oyster dressing and I've never eaten it but I believe I'd be hanging my head in a toilet if I ate it. NOT fond of oysters.
sf <sf@geemail.com>: Nov 24 09:00AM -0800

On Mon, 24 Nov 2014 09:12:40 -0700, Janet B <nospam@cableone.net>
wrote:
 
> >rest.
> a friend does cornbread with oysters. I can't begin to tell you how
> revolting that is.
 
I like oysters, but not in any kind of stuffing/dressing - PLEASE.
I'll take mine BBQ'd or roasted. Thank you. :)
 
 
--
Avoid cutting yourself when slicing vegetables by getting someone else to hold them.
sf <sf@geemail.com>: Nov 24 09:03AM -0800


> So, for me, it's "pass the dressing, please".
 
You're right about "Please pass the dressing", but I call it stuffing
when I make it and it doesn't matter if it's inside the bird or inside
a pan.
 
 
--
Avoid cutting yourself when slicing vegetables by getting someone else to hold them.
sf <sf@geemail.com>: Nov 24 08:27AM -0800

On Mon, 24 Nov 2014 10:08:47 -0500, jmcquown <j_mcquown@comcast.net>
wrote:
 
 
> I don't think that's what she's talking about, Gary. I remember those
> things in the foil roasting pan... ugh, the fat Mom had to drain off!
> She's thinking more of a turkey roll that combines white & dark meat.
 
I found one. Diestel brand, at Whole Foods.
http://sanjosefoodblog.blogspot.com/search/label/At%20Home
We ended up ordering a 14-16 lb turkey that will be spatchcocked and
packed inside a roasting bag, on a roasting pan, with cooking
instructions. I've never roasted anything inside a bag before! Do
they really roast or just steam? Does it get crispy and brown? I'm
going to open the bag and season the bird the way I want (butter and
herbs under the skin) anyway.
 
Unrelated question: have you ever heard of "squash dressing"?
 
 
--
Avoid cutting yourself when slicing vegetables by getting someone else to hold them.
graham <gstereo@shaw.ca>: Nov 24 09:37AM -0700

On 24/11/2014 7:58 AM, jmcquown wrote:
 
> She said she can't bear the idea of a Christmas ham, so why she should
> make one for Thanksgiving instead?
 
> Jill
 
Due to the prevalence of the disease killing piglets, pork producers are
making up for their losses by sending larger animals to slaughter.
As a result, the hams are too large for the average buyer.
(Newspaper article this morning)
Graham
"Paul M. Cook" <pmcook@gte.net>: Nov 24 08:43AM -0800

"Sqwertz" <swertz@cluemail.compost> wrote in message
news:1qphrro59741v.dlg@sqwertz.com...
 
> Figures you'd have to call a Texan to get real food. But I highly
> doubt you're getting dry-aged ribeye for $17/lb. Sucker born every
> minute.
 
It's dry aged. Which is not that hard to do in your own fridge. A sucker
is the one who pays 150 bucks for 2 ribeyes.
 
 
 
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"Paul M. Cook" <pmcook@gte.net>: Nov 24 08:54AM -0800

"Julie Bove" <juliebove@frontier.com> wrote in message
news:m4ucss$2t7$1@dont-email.me...
>> beef. Nothing compares to what I am talking about. Dry aging is the only
>> way to go.
 
> Can you buy it online?
 
Littlefield Ranch
 
I buy through a local specialty market. They buy a whole truck load at a
time so the price is unbeatable. Online it is pretty expensive and then
there is shipping. A 4 bone 10 pounder is typically 200.00. It's a once a
year treat.
 
Allen Brothers
 
 
 
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"Paul M. Cook" <pmcook@gte.net>: Nov 24 08:59AM -0800

"Julie Bove" <juliebove@frontier.com> wrote in message
news:m4ucpr$2lm$1@dont-email.me...
 
>> Drunk again, asshole? I don't but 150.00 aged Angus prime rib roasts for
>> myself like some of us do.
 
> Who does that?
 
Me. Depending on how many people I spend double that. It's a tradition
that I've done most every year for 25 years now.
 
 
 
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"itsjoannotjoann@webtv.net" <itsjoannotjoann@webtv.net>: Nov 24 08:13AM -0800

On Monday, November 24, 2014 7:03:43 AM UTC-6, Ophelia wrote:
 
> >> What exactly is, 'dressing'? Is it what we call, 'stuffing'?
 
> Thanks but do you stuff it into the turkey/chicken before you roast? When I
> looked on line they seemed to be spreading it on bread for sandwiches..
 
Yes, those that cook it inside a turkey stuff the raw stuff into it's butt cavity claiming it's more flavorful. I've had it stuffed into the bird and honestly _I_ could not discern it to be more flavorful than dressing cooked in a separate dish. There have been instances of people getting food poisoning from undercooked 'stuffing' that's been stuffed into a bird. And you don't get nearly as much to enjoy as opposed to it being cooked in a separate dish.
 
And I'm not fond of bread stuffing/dressing; too mushy and/or gummy. My preference is for cornbread dressing that has onions, celery, salt & pepper, sage and turkey drippings or chicken broth added. Also a couple of beaten eggs go into this dish to serve as a binder. (I also use melted butter and sometimes a dash or two of poultry seasoning.)
"Ophelia" <Ophelia@Elsinore.invalid>: Nov 24 04:51PM

<itsjoannotjoann@webtv.net> wrote in message
news:754cd155-181d-4a95-ac69-7f4933cdc1ae@googlegroups.com...
> pepper, sage and turkey drippings or chicken broth added. Also a couple
> of beaten eggs go into this dish to serve as a binder. (I also use melted
> butter and sometimes a dash or two of poultry seasoning.)
 
Thanks. I think it can be dangerous to stuff the cavity because there is
a chance it might not get to temp. If I want to stuff it, I put a little
in the neck flap and cook the rest apart.
 
--
http://www.helpforheroes.org.uk/shop/
Gary <g.majors@att.net>: Nov 24 12:01PM -0500

Ophelia wrote:
 
> Thanks. I think it can be dangerous to stuff the cavity because there is
> a chance it might not get to temp. If I want to stuff it, I put a little
> in the neck flap and cook the rest apart.
 
I do it all...some in neck cavity, most in main cavity and leftovers
in a casserole dish. Been doing this all my life and never any problem
with food poisoning. That's what an oven thermometer is for. :-D
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