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How are you making nightguards in 2026?

 We have always made our hard guards without tissue contact and most times we use full maxillary coverage. Most times we specify two metal ball clasps between the first molar and second bicuspid. These clasps can be adjusted if needed to tighten the fit of a loose night guard (night guards tend to wear and get   looser with time. We still use a lab that knows how to fabricate these guards using an analog manner  but are using digital impressions to capture both arches and the bite. Our lab uses a 3D printed model and then applys the metal ball clasps and applies cold cure acrylic. These 'hybrid' nightguards seem to combine the 'old' tried and true lab techniques with newer digital techniques for taking the impression and fabricating a 3D printed model.  These guards require less effort to fit to patients mouths and patients seem to be very satisfied with their fit. They seem to fit more passively with less discomfort due to the tightness that many patients compl...

What days are you in the office?

 Most weeks I am working a full schedule on Monday and Tuesday. David is seeing patients on Thursday. Some Thursdays I am in the office, but mostly I am not seeing patients. Fridays I spend time as an Attending Dentist at the Mount Sinai Dental Residency. Occasionally if I am performing a lengthy procedure I see a patient or two on Wednesday. My assistant Jennifer is answering our office phone on Wednesdays. My goal is to come into the office no more than three days each week.  As a recovering Liver Transplant patient, my doctors have advised me to limit my work to 4 days per week. Having Wednesdays off seems to agree with me and Thursdays I spend time on clerical office matters for the most part. I understand that my 'limited' schedule may frustrate some people, but for now its what I can do. from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2026/04/what-days-are-you-in-office.html - http://lspindelnycdds.blogspot.com/

Should a dentist do their own hygiene?

 It really depends on the dentist and his practice. I personally enjoy doing some of our patients cleanings. Historically  I have always been open to accepting hygiene appointments and find it a good way of connecting with our patients.  That being the case, many dentists choose to employ hygienist to do their patients recare appointments in order to free up time for them to do their restorative dental or other more challenging and lucrative procedures. For most of my career I have employed hygienists to perform some of the cleanings for my patients. This was an efficient way to handle recare and most paitents like having a hygienist clean their teeth. Still some patients seemed to prefer my cleanings and the time I would spend with them. When my son David has joined our practice, He also accepted hygiene appointments. As a matter of fact, recently when my long time hygienist left, we decided not to  replace her and My son and I have been able to absorb her patient...

Whats new in dentistry?

 In the last 10 years or so , it has never been easier to deliver both excellent and time efficent dentistry for my patients. New technologies and materials have made this true. At this point, for most crowns I utilize either Zirconium or lithium dislicate materials to fabricate monolithic crowns , that are easier to fit and more durable than the older pfms that I utilized. While I still schedule one hr for fitting my crowns, truth be told, they now rarely require the full hr and often are completed and my patient dismissed in about 35-45 mins. Also digital radiographs, 3d scanning and AI , when used properly, are terrific tools that make a dentists easier. All of our technologies still require skill and judgment to provide optimal outcomes, but I am convinced that when properly utilized these tools make dentists better at achieving great results for our patients. Our office doesn't do single visit permanent crowns since the labs I use probably provide a higher quality result the...

Midtown dental Operatory for Rent?

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Many dentists are in at least two businesses. First and formost is their dental practice. This should be by far our most important endeavor.  This is in my opinion our most rewarding business, since it usually provides the most financial and professional satisfaction. That being said , I and many other dentists maintain dental offices that are larger than we need for our own personal needs. In fact our dental supply houses strongly encourage us to build offices with extra operatories for other dentists to use.These operatories give us the opportunity to obtain sublet rental income or facilitate our hiring another dentist(s) to see patients.  In my case, for most of my career, I have sublet one of the operatories in my office and this allows me rent a more spacious office .  I have dabbled with hiring a dentist using my extrao peratory  but truth be told , this hasn't worked out so well for me. Employee dentists seem to come and go and place additional stress on m...

What's wrong with cook book dentistry?

 When dental students are studying to become dentists, often their schools focus on teaching a 'core curiculum'. The logic is that dental schools want to make sure their graduates achieve a level of basic skills and can perform procedures to a level of competency. Often there is a conscious decision made to not 'confuse' our students. That being said there are many ways to do dentistry and students of dentistry need to be open to learning new ideas and new ways of doing their dentistry Unfortunately many dentists fall into a complacency trap , where they develop a routine way of doing procedures and aren't always open to learning different ways of doing things. They probably believe that doing things the same will provide consistent acceptable results. This is what I mean by cookbook dentistry since they probably find it easy to follow their recipe over and over again. The problem is that dentistry (and all professions) is constantly changing and improving and we ...

Why don't you retire and enjoy yourself?

 I am asked this question almost every week by someone. The answer is obvious.... I am doing what I enjoy. I am seeing patients in my office 4 days per week (with some help from my son David) and teaching at the Mount Sinai General Practice Residency on my day off (Friday). The truth is that being able to do what I am good at , helping my patients and my residents every week is very satisfying. It keeps my mind and body active and healthy.  I still participate in three Spear Study Clubs and enjoy interacting with my study club collegues This  activity allows me to earn over 90 hrs of continuing ed each year and almost every week I learn something new about dentistry I plan on continuing as long as my mind and body allow me to maintain the high level of service that I am accustomed to offering in my clinical practice and my teaching position.  Being at service and having a purpose makes my life more worthwhile and I feel truly blessed to have been given the opportuni...