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How are you taking impressions for crown and bridge in your dental practice?

 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...
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How to market a dental practice in 2025?

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  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...
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Will AI Replace Dentists anytime soon?

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I have been reading a lot about Artificial Intelligence impacting all sorts of professions. I found this quote byf Bill Gates on a website called Make it.  BillI Gates: Within 10 years, AI will replace many doctors and teachers—humans won’t be  needed ‘for most thing—humans won’t be needed ‘for most things’ Artificial intelligence is already making in roads in all professions and obviously will have a greater and greater impact on all health professions in the forseeable future ( the next 10 years). W hile I don't think expert health professionals will be completely replaced in immediate future, there will be greater and greater use of Artificial assist technology, probably reducing the  numbers of experts health professionals that are needed.  This week we have been using our new 3 shape scanner to take digital impressions for our patients. It uses a great deal of artificial intelligence including taking and enhancing digital tooth impressions, taking shade...
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Are you still teaching at NYU?

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  This April I will celebrate my 72nd birthday. I feel truly fortunate to still be active in my dental practice, three Spear Study Clubs and still enjoy being an attending at the Mount Sinai General Dental Practice Residency. I also have enjoyed being a clinical faculty at NYU and have found my experiences there truly rewarding.  My experiences there not only helped me further develop my clinical skills but kept me stay engaged with  helping train the next generation of dentists .  That being said ,  Given some ongoing health issues,I have recently resigned from my faculty appointment at NYU College of Dentitry, because this was one commitment too many. Teaching their was physically difficult , since I was a very active clinic instructor and worked with a large number of students every day. I loved it, but my health comes first.. so now I have moved my shcedule around and reserve Wednesday for my day off and a little R& R. from Ask Dr. Spindel - ...
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Do you take the new NY State mandated Child abuse course?

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  I took a course offered by the New York State Office of Children and Family Services  last weekend. It was supposed to take two hrs to complete and was free.  It was supposed to take about two hours, but that doesn't incluede the time it took to register for the course and the course took closer to three hours to finish. The good news was that the questions that were asked could be answered incorrectly and the person taking the course wasn't required to go back and answer the questions again and again , until the correct answer was given. Instead, if you answered incorrectly , the correct answer was given along with the explanation for why it was the proper response. According to the N.Y.State Ofice of Professions website: Updated Mandated Reporter Training Requirements.  Chapter 56 of the Laws of 2021 amended Social Services Law § 413 to require  additional training to include protocols to reduce implicit bias in decision-making processes, strategies for...
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Whats new for 2025 in the Practice?

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  I have spent limited time in my practice since June because I had a medical condition taken care of. I  have had a lengthy period of recuperation.but the good news is I am doing well and starting Jan 2, I am seeing patients in my office and have returned to being an attending at the Mount Sinai general dental practice residency program.  My son has been doing a great job holding down the fort and will continue collaborating with me as an associate dentist. We just put a deposit down on a 3 Shape cordless scanner, that will allow us to take digital impressions for restoration,s without us having to use silicone impression materials. This technology doesn't work well for every situation but it is the right time for us to start using it.  My son also works part time in other dental practices and has been using digital impressioning technology routinely and he likes it and he and his patients have been happy with the results it provides. I look forward to using it ...
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How long do crowns last?

 Nothing lasts forever, but the reason for  having a crown done is to "preserve your tooth". Often patients avoid going along with a dentists idea of making a crown for their tooth and instead ask can have a filling.  he truth is that almost any tooth can have a filling but the larger the restoration, the less predictable the result. Teeth with large fillings can me more prone to recurrent decay, food impaction( due to faulty contacts) and fracture ( since the tooth structure is compromised by not having a crown). The other day I was at my office. My son David was treating a longstanding patient of mine whose crown had come off. I peeked into his mouth and it was clear that he had experienced a fair amount of gingival recession around the tooth and he had developed recurrent furcal decay( decay between the roots).  David cleaned out the decay and filled it with a glass ionomer restoration and was able to recement the crown. I looked through my patient's old paper ...
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