Dental Info

 Lately I have been utilizing tibased screw retained implant crowns, using original tibased prefab parts from the manufacturers. These are OK, but may sometimes be a problem. They only come in certain lengths and configurations for the titanium components. Sometimes the metal sleeve is too short to be retentive and sometimes the base of the part can be too close to the bone housing the implant, especially when the bone around the implant is at uneven levels. This can make torquing the implants down difficult since they are not passively fitting. I have become aware of an alternative to use in these situations which involve having a custom titanium abutment designed and milled to fit passively and then the lab cements on a milled zirconium crown with a hole in it. Voila, the resulting "screwmentable" restoration is better designed and more likely to fit passively.  I know my labs have been using Atlantis to mill these , but they may also be available by milling centers that ...

Dentistry can be expensive, especially when the dentist has to handle problems on an emergency basis. Many patients wait until something hurts them and often their pain is due to an infection that will necessitate a root canal or an extraction. Either way this scenario can easily become expensive since most teeth will need a post and/or core and a crown afterwards or in the case of an extraction, replacement teeth can cost more. Many of our patients have dental insurance that covers a high percentage of their dental work, especially for treatment plans that are less than $3000.  Most plans run on a yearly basis, ending on December 31. Since our patients often have long term, staged treatment plans. This allows them to do some of their planned work each year, in a way that maximizes the amount their dental insurance will contribute. Often they have "large interim fillings" that will function like "dental duct tape" to keep their teeth from becoming decayed, until...

  Many denture wearers are excited to get their new dentures completed but often become frustrated when they have discomfort after they start to wear them. Some just take them out and give up on wearing them. This can be especially true of patients with new partial dentures that are replacing posterior teeth. It is unfortunate when this happens since most dentures can be made more comfortable by their dentists performing appropriate denture adjustments. There are a number of reasons that dentures need adjusting. Sometimes the bite is uneven and causes some pain and unintended loosening of the denture. Sometimes a denture border can be over extended, causing sores where the perifery contacts the mucosa. Other times the internal border is pressing on part of the patients maxilla or mandible that has an under cut and this can cause a sore to form from the excessive pressure.  Additional dentures sometimes need relieving because a part of the patient's ridge can't tolerate an...

  Don't it always seem to go  that you don't know what you got 'til it's gone . These words from the Joni Mitchell song "big yellow taxi" may prove prophetic if Congress passes the new proposed expansion of the new Medicare bill to include dental. If this bill is passed and not carefully thought out it could cause a problem for my elderly patients, who may expect a continued high standard of dental care. Many dentists may choose not to participate, retire or sell their practices to more business oriented corporate entities.  Many private dental office have significant fixed overhead expenses that are often exceeding 70% of their collections and if dentistry is added to our medicare benefits, the deeply discounted fees that medicare may allow will discourage many dentists from participating.  If they choose to participate, they may change their operating procedures, in order to greatly increase the number of patients seen. Either way this may not be the type o...

  My son David and his Best friend Maria are both fourth year dental students and NYU College of Dentistry. They have recently started their own dental blog- Aires and Caries  . He recently sent me a link to it and I am impressed. It's a great looking site.  They are certainly off to a good start with great photography and eight well written initial posts. I have been writing this blog since 2005 and have more than 1000 original posts. It hasn't always been easy coming up with ideas, and creating readable posts, but it has been both enjoyable and a worthwhile use of my time.  I feel proud that my son and his best friend are picking up the gauntlet and choosing to write their own dental blog. I am proud of their effort and and I wish them great success! from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2021/09/aires-and-caries.html - http://lspindelnycdds.blogspot.com/