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I received this lovely email today:

Dear Dr. Terry Shapiro,

There’s a good possibility that I might not be back to your office. I’m adjusting to my new “Custom Dentures”. I’m writing to commend you for your patience with me and how I reacted to my new dentures. I want to tell you how pleased I am with both the comfort and aesthetics. My initial reaction was based on a distorted image of my prior dentures. My new dentures are in perfect alignment & look great. I would not hesitate to recommend you to anyone who is looking to improve their appearance. I’m 71 years old and I feel rejuvinated  because of what you did for me.

Thank you, EB

Here is my reply:

Hi Ed,

Thank you so much for your very kind words. It means a great deal to me. It is people like you who make dentistry so rewarding. It is why I love what I do. Please call us if you should need an adjustment. It is good for you to come back every year so we can check the health of your gums and check the dentures.

Would you believe that this is the same person? Carl’s teeth were decayed and broken. Many were missing.  He was also wearing an ill-fitting upper removable partial denture.  All of this was an indication for an immediate denture.  We took impressions, made some measurements and the dentures were ready for insertion. Carl made an appointment with the oral surgeon for his extractions, then I fitted his new teeth. Wow! What a difference. He looks at least 20 years younger. Carl is happy and will be even happier when we make more permanent dentures in several month’s time, after more healing takes place.

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Karen and Meg are sisters. They started out with almost identical teeth.  But Meg smoked a pack of cigarettes a day for over 20 years. Karen never smoked. Guess which teeth below belong to Meg and which teeth belong to Karen? You guessed it – Meg’s teeth are at the top; Karen’s below.  Smoking is connected to periodontal (gum) disease. The bone resorbs, leaving a long tooth.  Without support of bone, the teeth loosen and move out of position. In Meg’s case, the front teeth became more crowded and became very protrusive. The teeth were so loose that she knew that it was only a matter of time before they would fall out , and she had already lost a couple of back teeth.  By the time she came to our dental office the gum disease was so advanced and the teeth so out of position that dentures were the best option for her.  She was very unhappy about the condition of her teeth, and she was excited at the prospect of having new teeth that would make her look more like her younger self. We will fashion our custom immediate denture for her.  Photos to follow!

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A new mobile gaming app called “Toothsavers” has been launched by the Ad Council of the American Dental Association and the Partnership for Healthy Mouths.  This mobile device game asks children to rescue fairy tale characters from an evil, cavity-creating sorceress who casts a wicked, teeth rotting spell on the fairy tale kingdom.  The game was created in conjunction with the Kids’ Healthy Mouths campaign.  A spokesperson for the Ad Council of the ADA said that “Mobile technology plays a major role in influencing young people’s behavior and is a great fit for this campaign.”

 

The game is part of the ongoing effort to use technology to promote health and well-being.  The mobile game has three key features to teach parents and children about the importance of dental health.  One, in a timed, finger-swipe brushing game, players can save characters from the cavity-creating sorceress.  Two, in the two-player version of the game, kids can “brush” the teeth of their opponents when the mobile device is held up to their mouths.   Three, the app offers a toothbrushing companion so children and their parents can keep track of the child’s brushing progress.  It  is also a morning and nighttime tooth brushing reminder.  So the app is both a teaching tool and a way to monitor a child’s toothbrushing routine.  The app is geared toward children of ages three to six.  It is available free in the App Store and Google Play for Android and iOS devices.  It can also be found on the internet at 2min2x.org/PlayToothsavers.  

 

Yes – I downloaded the app and clicked around.  Cute graphics. I like the slogan “2min2x” which means brush your teeth for two minutes, two times a day.  I’ll play it for kids in the office and see how they like it and how effective it is.

Dentistry and dental hygiene both were among the top ten occupations of 2014 according to the U.S. News and World Report’s “100 Best Jobs of 2014″, published on January 23, 2014. Dentists are ranked number 3, the highest ranking health care related career.  Dental hygienists rank tenth.  The two top occupations on the list are software developer and computer systems analyst.  Other professions that make the top ten are: nurse practitioner, pharmacist, registered nurse, physical therapist, physician and web developer. Certainly computing and health care are growing industries.

The U.S. News and World Report ranks occupations based on a score combining growth volume, growth percentage, salary, job prospects, employment rate, stress level and work-life balance.

Despite fluoridation and better prevention, the need for dental professionals is increasing.  According to the article, “A comfortable salary, low unemployment rate and agreeable work-life balance boost dentist to the No. 3 position on our list of Best Jobs of 2014.”

I am proud that dentistry, so dear to my heart, ranks as one of the “Best jobs,” even though I wouldn’t call dentistry a “job.” It is so much more than a “job,” but a life choice that places a person’s health in our hands and sends us on a lifetime of learning. I am also struck that the “score” doesn’t include points for career satisfaction in devoting oneself to providing a public service. Public service, helping people achieve optimum dental health, thus improving their overall health care, is why dentistry is so satisfying a profession.

It always strikes me that people never seem to be as concerned about losing a back tooth as they are about losing a front tooth. But back teeth also count!!  You need your back teeth so you can chew properly. Back teeth also protect the front teeth, and they help to maintain your facial structure. If even one back tooth is missing, the adjacent teeth will drift to close the space; they may loosen and a pocket of infection may form. The opposing teeth may erupt into the open space. Your bite will start to collapse. The front teeth will begin to splay forward.

The following patient was missing all of her back teeth. She was putting a lot of stress on her front teeth because she didn’t have back teeth for chewing. The front teeth were beginning to splay forward. She elected to have implants placed. We placed four implants on the top and two on the bottom and gave her new front crowns – a great result and a very happy patient:

Posterior Implants Picture

 

The following patient lost her lower back teeth, and consequently the top teeth have super-erupted into the space. This weakens the top teeth and they become susceptible to loss. We did some periodontal crown lengthening and placed five crowns on the top teeth in order to restore them to their proper position. Four implants were also placed on the bottom and will soon be uncovered so implant crowns can be placed:

Posterior Implants before and after picture

Ray spent several years in the military. He was sent overseas, but before he left, the army surgeons removed all of his remaining teeth. His teeth were in poor condition but the military did not make dentures for him.  So for two years Ray had to function without any teeth at all. This means that he chewed on his gums.  This destroys the gums and resorbs the bone and makes it very difficult to make dentures that will stay in place.  But using my custom denture technique I made him dentures that are as good as they can be. We will add two implants on the top and two on the bottom for the dentures to snap into – giving him a more secure fit.  He is happy to be able to smile again.

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No teeth

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Teeth!

Carol desperately wanted to have her teeth fixed. They were crooked and discolored and chipped.  Several were decayed. She wanted white, white teeth that were straight, straight. She came to our East Setauket dental office at 9:00 this morning and by noon she had temporary crowns that were white and straight – just like she wanted. She has to have some gum recontouring done, then impressions and cementation of the permanent crowns. We will also whiten her lower back teeth.  The permanent crowns will look even better than the temporary crowns – but for now Carol is thrilled!

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Before placing crowns

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     Temporary Crowns

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I know I talk a lot about the hazards of smoking in this blog, but that is because everyday I see how cigarette smoking contributes to gum disease and loss of teeth.  Now the latest surgeon general’s report reveals that smokers today face a higher risk of chronic obstructive pulmonary disease and lung cancer than smokers in the 1960′s. This is because the design and composition of cigarettes has been changed. Even though people on average smoke fewer cigarettes, the risk of disease is higher.  Some of the cigarettes today are more addictive than those smoked in the past.  This is because the manufacturers have designed the cigarettes so the cigarettes deliver more nicotine – thus the addiction is induced and sustained.  This re-design of cigarettes is a sneaky tactic on the part of the cigarette manufacturers.   It is a practice that demands government regulation.

The journal Nicotine and Tobacco Research published an article last week with the findings that although nicotine content of cigarettes has been more or less stable for the past 10 years, the amount of that nicotine delivered to research machines as surrogates for smokers has been rising.  The researcher concluded that changes in cigarette design have increased the efficiency of nicotine delivery to a smoker’s lungs.  The effect is that people may become addicted more easily and people already smoking may find it more difficult to stop the habit.  Techniques that cigarette manufacturers use include filter design and cigarette paper that maximizes the inhalation of nicotine.  The manufacturers also add chemicals to change the taste of cigarettes so it is not as harsh and make it easier to deeply inhale.  The surgeon general’s report concludes that nicotine increases the risk for disease and affects health of the fetus.  Although the report doesn’t address dental health, just look through my blog to see how cigarette smoking destroys teeth.

old dentures

 

Smoker’s Teeth

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In August I posted a blog entry called Laurie from Coram: New Implant Crown.  I told how she had an impacted canine which had to be extracted, orthodontic treatment undertaken and an implant placed.  She wore a temporary crown while the implant integrated to the bone.  On Friday we completed the treatment. Laurie went with me to the Dental Laboratory where the ceramist applied and adjusted the shade of the porcelain so that it matched her other teeth.  Not a small thing to match one tooth to its neighboring teeth.  Once we were satisfied with the shade of the implant tooth, we returned to my dental office where I cemented the crown. Laurie looks fabulous.  She said that the wait was certainly worth it! Can you guess which is the implant tooth? (Answer at the bottom of this post.)
Julia
It’s the second from the right!