Dental Info

 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...

Silver Diamide Fluoride (SDF) is an FDA and ADA (American Dental Association) approved clear topical liquid that is used to treat cavities. It is applied to the cavity area of a tooth to control  and stop the growth of the cavity. Young children, children with special health needs, any child who has a difficult time at the dentist or who may have a lot of cavities may benefit from this type of care. It can used as an alternative cleaning out decay with a drill and placing a restorative material . For some patients, especially those who can't tolerate traditional fillings it has some advantages. It is painless and may stop cavity progression. It can help with tooth sensitivity and is an especially helpful alternative cavity treatment  for children who are very young or struggle with longer appointment times. How Does SDF Work?  SDF is composed of two main components, silver and fluoride. The silver part acts on the bacteria causing the cavity while the fluoride helps ...

  Ever since the 2020 Pandemic, commercial realestate in our neighborhood has not been doing well. There are a lot of office space available and in our midtown neighborhood there are no longer many large employers renting space. Traditionally midtown dental practices relied on these large employers for supplying many of our patients. Also a number of long time residents of Manhattan have moved elsewhere.  In our building , 30 East 40th st, most tenants arevmedical and dental practices. Traditionally, because construction costs of dental offices were high enough that it discouraged dentists from moving to other buildings when there leases were up for renewal. We renewed our least last May and signed a five year lease. It seems that some of my colleagues have chosen not to renew.  ln the last two weeks , I was able to walk through six of vacant dental offices. The dentists left for a number of reasons including retirement, joining other dental practices, selling their ...

 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...

  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...

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...

  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 - ...

  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...

  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 ...