Dental Info

 When discussing oral health, preventing problems from worsening is the way to go.  Small fillings are better than waiting until problems worsen. A small filling can lessen the need for a root canal or an extraction in order fix the problem once it worsens.  Getting cleanings and check ups also lessons the probability of patient developing periodontal poblems. Brushing well and flossing also keep the teeth cleaner and less likely to develop smooth surface decay  (not in the pit and fissures).  Unfortunately many patients ignore the dental problems until they are hurting. By this point prevention is not an option and our fixes, sad to say, are not guaranteed to permanently fix tooth problems. Often by the time a patient "feels" significant tooth pain the situation is so advanced that the long term prognosis for their tooth is compromised even after their problem is addressed. This is why dentists advise their patients to come for checkup and cleanings every 6 months. Of

Acrylic dentures ,as a opposed to cast framework partial dentures, are used for patients whose remaining teeth have a guarded prognosis due to mobility, bone loss and /periodontal disease. Patients who are candidates for these often do not want to remove their remaining teeth and may not find implants an affordable option. Since these "transitional" dentures are made from acrylic, adding additional teeth is a relatively easy procedure that involves taking a pickup impression and sending this with the denture to the lab so that they can pour up a new model and add a replacement tooth to the denture.  These all acrylic dentures are a common choice for patients who don't wand definitive comprehensive treatment but instead just want to replace their currently missing teeth.   The other day, one of our residents filled out her Rx to the laboratory for fabrication of an acrylic partial denture. These partial appliances are all acrylic with the acception of hand bent wires t

 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 in the area can not be th

 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 allow them to pro

 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. Spindel - http://lspindeln