Dental Info

                                                                                Often it is desirable to increase the length of a patients anterior teeth. We can have our dental laboratory make a wax up proposal and can often transfer this proposal to the mouth by utilizing a putty matrix made from the wax up. These proposals are very helpful, but they may not be representative of the most desirable shape of the final restorations. Because the finished crown need to function in the mouth and allow dental excursions and most dentists prefer cuspid guidance. Cuspid guidance means that when a patient moves their lower jaw laterally their canine tooth bears the brunt of the occlusion. Although other teeth can be used to bear the forces created by lateral jaw movements, most dentists pr...

  As dentistry inevitably evolves, the types of crowns our practice recommends has changed as well. It used to be that our default posterior crowns were either gold or porcelain to fused crowns... While I still recommend full gold crowns for second and third molar teeth, I am utilizing Full thickness esthetic zirconium crowns for most other posterior teeth ( first molars, first bicuspids and second bicuspids). The Esthetic zirconium crowns , when properly done are great restorations for many posterior teeth.  I believe that with proper tooth preparations and the use of more modern cements , these crowns may  last an extremely long time (10-30 years).  For anterior teeth, I use different types of crowns, depending on the individual saturation. In most situations I prefer lithium disilicate crowns with full lingual lithium disilicate but with minor porcelain layering on the facial surface to allow for superior esthetics.  For some teeth with compromised tooth...

 I started the Ask Dr Spindel dental blog with 3 posts in 2005... so I have been blogging for twenty years. I started it as a demonstration of my writing skills. Several of my patients were involved in a start up called Ivillage that featured article that might interest woman readers. After publishing my first posts I forwarded the link to one of my patients who worked there. Unfortunately, soon after, he left his job and I was left with the blog that I didn't need. . Since it was hosted by Blogger for free (Thank you Google) I kept it active and used it as a source of possibly relevant dental information for my patients and the public. Initially I started writing up my answers to frequently asked questions by my patients and eventually I pretty much answered all their questions (at least those that were suitable for publication) in the first three years. Now I just write about what ever I feel like discussing online or maybe an interest to dentists and the public.  At the m...

  First an update on our practice's new schedule for 2026 . David is seeing patients at our office on Thursdays and some Wednesdays. My schedule is Monday, Tuesday, and Thursdays as well. Friday I am an attending our Mount Sinai's general dental practice Residency. As the new year approaches and the office is closed until January 5th, I have had time to reflect on how things are going in our practice and I am looking forward to the new year and starting my 46 sixth year in dentistry. Its been a long and fascinating journey! When I started, some dentists were still taking copper band impressions for crowns, but most dentists had adopted elastomeric impression materials to accurately capture the details of their preparations. I had been trained in both techniques, but clearly taking elastomeric impressions was easier and allowed fewer steps in crown fabrication.  Now dentists coming out of school are trained in elastomeric and digital impressions. Now my son works in anoth...

 This is a situation that I encounter when I work as an attending at Mount Sinai hospital. Patients show up for emergency treatment at our dental facility. Often they have had the problem for a long time and wait until the tooth is bothering them. Many of the patient pool is dependent on their dental insurance or a possibly a sliding fee scale that they can apply for. If a patients mouth is not missing a high number of teeth, fixing the tooth is a viable option for some patients if they can afford the procedures needed... These can include multiple procedures such as root canal, post and core , crown and possibly crown lengthening. These are all feasible for many teeth, but can be time consuming and expensive. A number of the patients seen at our program opt to extract these teeth rather than to save them.  If multiple teeth are badly decayed with compromised tooth structure extraction often is the preferred option for our patients and replacement of the teeth with removable...

  Although the usual alternative options are a removable denture (partial or full) or a fixed bridge attached to natural dentition, these are not always desired or even possible. My oral surgeon and periodontist can sometimes perform grafting procedures that can miraculously add bone to make implant placement possible even for some extremely deficient ridges. Today my oral surgeon placed three guided implants for one of my patients who had extensive grafting about 4 months ago. He sent me photos of the procedure, and I was extremely impressed. This was the result of diligence for all concerned... My patient helped by not wearing a denture during the last 4 months, even though she had an important family event to go to. Our office helped by sending intraoral scans of the patients preexisting bridge and also fabricating an Essex retainer that could be placed in my patients mouth in order to aid him with his planning and execution.  My surgeons often play the biggest part in...