Dental Info

 Patients often present with dental pain and would like to get a diagnosis and appropriate dental treatment. They often complain of a tooth ache, which is not very specific, since There can be a number of causes for tooth pain and there are many differential causes.  Often my residients and students try diagnosing using the dental radiographs as their primary tool. Dental radiographs are just one of the items in our tool box. For me , the first thing I do is ask the patients a bunch of questions... When do you have pain? do you have pain on biting, pain after eating, hot or cold sensitivity  or prolonged pain. The answers to these questions have a lot to do with narrowing down why the patient is having pain.  I definitely look at the radiographs to see if their is an obvious problem in the quadrant they are feeling pain( perapical radiolucency or a large carious lesion).  If a tooth is sensitive to cold it means that it is vital and any teeth with root canals i...

 Our study club just watched a lecture on how he does examinations of his patients..It makes alot of sense. 'First he goes over problems he sees and gives a tour of the mouth to his patient. Then he explains what could happen if the problems are not addressed. Only after this initial tour does he go over possible treatment options.  I use a similar approach with my patients. I find that this allows patients to better understand their problems and why I recommend specific treatments. Also the last part of the exam is the cost of various treatment options as well as the pros and cons of each choice. I find that hearing about cost of treatments , especially if given at an earlier point of the exam can keep my patient from "hearing" my explanations, since once they hear the cost they can fixate on picking an inferior but less costly treatment plan. After all, who wants to spend thousands of dollars completing their treatment. This is especially true if they don't unders...

 Our office does take a number of different plans. I personally am a Delta Premier Provider and a Cigna Provider. My son David has joined Metlife Dental Insurance. That being said our office a fee for service dental practice that participates with a few dental insurance plans. We have plenty of patients that have plans that we are out of network for, but we bill their dental insurance and then bill them the for what is not covered. We treat all our patients the same way regardless of which insurance they have. Appointments are usually scheduled for one hour (or two for crown preparations) . This amount of time makes it possible for us to have  sufficient time to ensure a uniform high standard of care.  Since dental offices need to cover their expenses and make a profit to pay their dentist/owner, some offices have procedures engineered to be done in shorter amounts of time. By this I mean, they try to figure out techniques that are more efficient but hopefully still all...

 My son is practicing in my office on Thursdays.. We did our own version of Trading Places. He finished his Mount Sinai general practice residency in June and I started as an attending there on Thursdays and he now works in my office on Thursdays. He has joined Metlife dental plan an is a preferred provider with them and he is in the process of joining a couple of other plans.  My assistant Jennifer is helping him find where everything is and he is sharing my treatment room with me. He can work on other days as well, but he has filled up his other week days by working in other dental offices. I encouraged him to get experience in a wide variety of dental settings and he has three other part time positions.  He seems to be enjoying dentistry and he is a fine addition to our dental practice.   I have been thinking about him joining me since he started dental school and am extremely happy to have him join me and my staff in our dental practice. from Ask Dr. Sp...

  Don't get me wrong... I think having the ability to treatment plan implant restorations has added a great tool to most dentist's tool box, but sometimes salvageable teeth are extracted to facilitate implant placement and a definitive full arch fixed restoration.  I myself do this when the bone is needed to place an implant that will serve as an abutment for a multi implant treatment plan. Sometimes teeth do get in the way.  That being said, there seems to be an increasing tendency for dentists to advocate the removal of all remaining teeth to fabricate a "hybrid" full arch implant restoration. There is a nasty joke going around about all on 4 implant cases ... they are great unless one of the implants doesn't take or last long and then the entire case can be considered a failure since there is no such thing as an all on three case. Also many patients are encouraged to have expensive full arch implant treatment cases without empasizing the need for the cleans...

 Probably because I currently see patients in three settings I see a whole lot of different patients from varying socioeconomic backgrounds.  The patients who I see in my private practice and who buy into preventive maintenance and good home care do very well and even into their nineties have most of their teeth. The patients I see during my teaching tend to have less money allocated to their dentistry and have mouths that are missing more teeth. Also they are more prone to severe bone loss due to ongoing periodontal disease. It is not terribly uncommon for a patient at one of my days spent teaching to come in with a mouth full of loose teeth that probably should be removed. The other day one such young patient in her thirties came in and had been told by her dentist she needed to have her teeth removed. Sure enough they all were loose without good bone support. Sooner or later her teeth will fall out or get infected. She explained that she was very attached to her teeth and ...

In general good quality patient dental care should be about helping our patients achieve the best dental care possible. This doesn't necessarily entail getting our patients to spend maximum money. Instead it is about our ability to educate our dental patients about the factors that can undermine their dental health and lead to tooth loss. Most times tooth loss can be prevented through early intervention and patient education about the importance of home care and showing them how to achieve optimum dental health.  Most often  dentists do not get paid for the time spent on educating our patients. Instead there seems to be an increasing emphasis in health care about achieving efficiencies. and insuring our ability to generate a profits in spite of the ever increasing costs of delivering  dentistry in an optimal fashion. In my opinion our government and the insurance companies bear a certain responsibility for these developments. Both the government and the insurance...