Posts

Showing posts from 2026

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...

Why do my anterior crowns keep breaking?

Image
                                                                                Often it is desirable to increase the length of a patients anterior teeth. We can have our dental laboratory make a wax up proposal and can often transfer this proposal to the mouth by utilizing a putty matrix made from the wax up. These proposals are very helpful, but they may not be representative of the most desirable shape of the final restorations. Because the finished crown need to function in the mouth and allow dental excursions and most dentists prefer cuspid guidance. Cuspid guidance means that when a patient moves their lower jaw laterally their canine tooth bears the brunt of the occlusion. Although other teeth can be used to bear the forces created by lateral jaw movements, most dentists pr...

What kind of crowns do you recommend ?

Image
  As dentistry inevitably evolves, the types of crowns our practice recommends has changed as well. It used to be that our default posterior crowns were either gold or porcelain to fused crowns... While I still recommend full gold crowns for second and third molar teeth, I am utilizing Full thickness esthetic zirconium crowns for most other posterior teeth ( first molars, first bicuspids and second bicuspids). The Esthetic zirconium crowns , when properly done are great restorations for many posterior teeth.  I believe that with proper tooth preparations and the use of more modern cements , these crowns may  last an extremely long time (10-30 years).  For anterior teeth, I use different types of crowns, depending on the individual saturation. In most situations I prefer lithium disilicate crowns with full lingual lithium disilicate but with minor porcelain layering on the facial surface to allow for superior esthetics.  For some teeth with compromised tooth...

How long have you been blogging?

 I started the Ask Dr Spindel dental blog with 3 posts in 2005... so I have been blogging for twenty years. I started it as a demonstration of my writing skills. Several of my patients were involved in a start up called Ivillage that featured article that might interest woman readers. After publishing my first posts I forwarded the link to one of my patients who worked there. Unfortunately, soon after, he left his job and I was left with the blog that I didn't need. . Since it was hosted by Blogger for free (Thank you Google) I kept it active and used it as a source of possibly relevant dental information for my patients and the public. Initially I started writing up my answers to frequently asked questions by my patients and eventually I pretty much answered all their questions (at least those that were suitable for publication) in the first three years. Now I just write about what ever I feel like discussing online or maybe an interest to dentists and the public.  At the m...