Dental Info

 Even though I work hard to do excellent work and send my dental Labs clear impressions, not every lab fabricated restoration fits well in a patient's mouth. Yes, there are times when a restoration does seem to fit without any adjustments needed, but that is not what happens in most cases. Part of a dentist job is to be methodical and check that each restoration is adequate and will actually help preserve a patient's tooth. Our patient may hope that their new crown or filling maybe perfect, but that is not always the case and while it may be true that 'perfection is the enemy of good' , we should not place inadequate restorations in our patients mouth, just because we are afraid to momentarily disappoint a patient or employer. I take a bitewing radiograph when fitting a crown or after I place a new filling. Of course I have my fingers crossed that my new crown or filling fits perfectly, and often it is the case, but sometimes it is not. When this happens, I may try...

 As I have written before I participate in three Spear Study Clubs. Each club consists of a mix of general dentists and specialists. Because we meet frequently the members get to know each other quite well. It isn't a coincidence that most of my specialists are members of one or more of these club chapters. When I refer a patient to specialist, ideally we either email or speak on the phone  before the patient sees them. This is very helpful since it ensures we are on the same page and we both have better communication with our patients as well. I know why I want my specialist to see my patient but it helps me to hear what he thinks even before the patient gets to their office. Also surely it helps my specialist as well.  My favorite periodontist has an office in my building and often I will ask him to stop down to my office for a brief consultation with a patient prior to their making an appointment. This helps me to understand what he can and cannot do for my patient a...

Silver Diamide Fluoride (SDF) is an FDA and ADA (American Dental Association) approved clear topical liquid that is used to treat cavities. It is applied to the cavity area of a tooth to control  and stop the growth of the cavity. Young children, children with special health needs, any child who has a difficult time at the dentist or who may have a lot of cavities may benefit from this type of care. It can used as an alternative cleaning out decay with a drill and placing a restorative material . For some patients, especially those who can't tolerate traditional fillings it has some advantages. It is painless and may stop cavity progression. It can help with tooth sensitivity and is an especially helpful alternative cavity treatment  for children who are very young or struggle with longer appointment times. How Does SDF Work?  SDF is composed of two main components, silver and fluoride. The silver part acts on the bacteria causing the cavity while the fluoride helps ...

  Ever since the 2020 Pandemic, commercial realestate in our neighborhood has not been doing well. There are a lot of office space available and in our midtown neighborhood there are no longer many large employers renting space. Traditionally midtown dental practices relied on these large employers for supplying many of our patients. Also a number of long time residents of Manhattan have moved elsewhere.  In our building , 30 East 40th st, most tenants arevmedical and dental practices. Traditionally, because construction costs of dental offices were high enough that it discouraged dentists from moving to other buildings when there leases were up for renewal. We renewed our least last May and signed a five year lease. It seems that some of my colleagues have chosen not to renew.  ln the last two weeks , I was able to walk through six of vacant dental offices. The dentists left for a number of reasons including retirement, joining other dental practices, selling their ...

 At the moment we are taking impressions two different ways. The traditional way is still valid and involves using elastomeric impression material, usually PVS type. Often this requires cord packing prior to taking the impression. If use properly it can take extremely accurate impressions . The models are poured up by the lab and mounted using a bite registration. The resulting dental restorations made on these models can fit extremely well. Some inaccuracies can result when the opposing models are mounted and can necessitate occlusal adjustments on the restorations before they are luted in the mouth. We recently purchased a state of the art Trios 3D Scanner and my son has been using it extensively for taking full arch impressions of the mouth and opposing arch, even for single restorations. These scans, if done with appropriate care are extremely accurate. I believe their digital mountings are even more accurate than the 'old school' techniques that I use. We ask the lab to u...

  It used to be said that word of mouth was the best way to market a dental practice. It's sort of true now as well, but a little different then it used to be. When I first started out , it was more or less true because happy patients referred patients. Yes sometimes insurance could play a part, but most of our patients had insurance that allowed them excellent coverage, even when they went to an out of network dentist.  Now, most dental insurance plans are less generous with their payments to out of network dentists. We recently had a patient who had a crown completed in our practice and their coverage only allowed 50% of their "network" fee (which wasn't very generous) so my patient had to pay a fairly high amount that was at least two times the amount that their insurance covered. Clearly this low coverage may make patients more likely to choose an in network dentist instead of a word of mouth recommended fee for service dentist. This clearly limits our marketi...