Dental Info

  Most people understand the difference between going to a fast food restaurant vs going to a Michellin rated food establishment.   They both provide meals, but they are really going not providing the same level of product.. The fast food establishments claim to provide a tastee meal, fast and affordable (not so much now-lol). The Michelin rated restaurants are aiming to provide  a more leisurely dinning experience, often with fresh high quality ingredients prepared using a careful technique by highly trained chefs. All consumers understand that going to a Michelin rated restaurant will be more expensive than a meal at Mcdonalds but feel that the meal is worth the extra expense. They may reserve this high end meal for a special occasion , which considering the expense is understandable. Not all people want to acknowledge  that choosing their dentist may be similar to choosing where you may dine. In some ways this analogy can be applied to dentistry today. T...

 This is a simple way of saying that dealing with things early saves a lot of trouble and effort later. I have been practicing for over 45 years and have worn many hats over the years. I have been a general dentist, a cosmetic dentist, a preventive dentist , an Invisilign provider and a dentist expert at prosthodontic restorations. It safe to say there are a lot of tools in my dental tool chest. That being said probably my most important tool is preventive dentistry. I held a teaching position for two years in the 1980's in the Preventive Dentistry department at Columbia University Dental School. It really made me aware of the importance of preventive measures in preserving dental health.    Proper daily home care very important to maintaining dental health. I continue to recommend braun oral be rechargeable tooth brushes. I feel they are the best, even the least expensive Vitality model is excellent. They require the least effort to get teeth maximally clean. After tha...

 Close to two years ago, my son David joined Aetna PPO. Almost immediately Aetna started incorrectly processing claims for my own patients as if I was an Aetna provider. My son wasn't that happy with his Aetna experience and got off the panel over 6 months ago.  Evidently Aetna isn't that quick at updating its provider network.. My secretary complains almost every week about incorrectly processed claims and each time she needs to spend time on the phone with Aetna getting them to reprocess our claims to correct them. When we speak to supervisors, we are told that neither of us  are in network and the claims were not processed correctly.  Also almost every week appointments are booked each week from our online booking application by patients with Aetna dental insurance. When we call them to explain that we are out of network, most times they cancel their appointment.  The only explanation that I can think of is that Aetna is probably not updating their list of...

Some Patients may  have shrinkage of their jaw bone(s) after the denture was inserted and experience lack of seal. While bone resorption may play a role, in my experience there are a number of other possible causes.  Uneven bite is at the top of my list. If a dentures occlusion is unbalanced, when a patient closes, their denture may loosen. Another common reason is that a patients muscle attachments are being impinged on. Muscle attachments are little bands of fibers that connect the cheeks, lips, and tongue to the jaws. Over and under extended dentures can also cause dentures to be more likely to come loose. Under extended dentures have less surface area to help develop the adhesion to help keep a denture in place. Over extended dentures tend get dislodged by patients facial muscle movement or opening and closing. A patient with a dry mouth may also find that their denture comes loose easily, since adequate saliva is needed for a denture to develop proper adhesion. De...

 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...