Mary came to our office from Patchogue – her daughter had recommended us to take care of her mother’s dental problems. Mary had been suffering with loose, infected teeth. She had already lost most of her upper teeth.  A front tooth had fallen out the day before she came to the office, and she arrived with tooth in hand. An upper denture with implants in the future and lower partial denture were indicated.  She was thrilled to learn that she would have teeth in a matter of weeks. She would be out of pain and would be able to smile and eat comfortably once again. Mary was anxious to get started so we took out the remaining teeth and scheduled impressions for the following week. Then the week after that we took some measurements, the week after that we had a dress rehearsal of the new teeth. One more week passed and she had her new teeth. Four weeks all told!

Her daughter flew up from Tampa to be here for the big day.  Her entire family loved Mary’s new smile and so did we. This is the start of a new life for Mary. She can go out in confidence.





Rick was born without his permanent lateral incisors (the teeth just to the side of his two front teeth). His other teeth moved over and everything was crooked. When he was nine, it was time for the orthodontist. He wore braces for several years so his teeth could be moved into the proper spaces. Space was left where the missing teeth should have erupted. Rick is now 15 but when his jaw is no longer growing at about age 19 he will have implants placed. Crowns will be placed over the implants in order to fill in the spaces.

In the meantime he needs a temporary solution so he has replacement teeth for the two missing teeth and also to hold the spaces so the teeth don’t drift again. The orthodontist made him a removable retainer, but Rick didn’t like that the retainer was removable. It didn’t look great and it was not comfortable.  Rick asked me what to do.  I recommended a bonded, or Maryland, bridge. This is a fixed bridge that is bonded to the adjacent teeth. It doesn’t require cutting the adjacent teeth and the esthetics can be excellent. It is easily removed when Rick is ready for implants.



Missing teeth.

X0103013Replaced with a bonded or Maryland bridge.

Are you among the one-third or the two-thirds?


More than a third of the American public did not visit the dentist once during the past year, says a new Gallup poll.  Two-thirds of Americans said they visited the dentist in 2013 at least once in the past 12 month. This is is the same percentage as visited the dentist in 2008. Women are more likely than men to report that they visit the dentist on an annual basis. The report was released on April 28. It gives details of findings based on interviewing over 178,000 American adults in 2013. The report is part of the Gallup-Healthways Well-Being Index.  Further findings: 55% of African-Americans and Hispanics report visiting the dentist in 2013. Whites and Asians report at 70%.  Adults of ages 18-29 are the least likely to have visited the dentist. Adults who earn $120,000 or more per year are twice as likely to say they visited the dentist in the past year as those whose income was less than $12,000.  This is 82% visiting the dentist as opposed to 43% visiting.


“Dental visit rates have held steady since 2008 for top earners,” the Gallup report indicates, “while they have declined for all other groups, particularly for low- and middle-income households with incomes between $24,000 and $60,000 per year.” Dental visits are lowest in the South at 60% and highest in the East at 69%.  Married people are more likely to visit the dentist than single adults.


The ADA website lists 15 signs to prompt people to visit the dentist:  So join the two-thirds and pay us a visit today!

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The family doctor may be a thing of the past, but the family dentist has not gone the way of the dial phone. So what is a family dentist? A family dentist is typically a solo practitioner whom you and your entire family can see for your dental needs. A family dentist does not work for a large practice where the dentist you saw at your last visit is no longer working or where you see a different dentist for each appointment, and where there is a large and chaotic staff that only knows you as a number. A family dentist is part of the community and supports community activities. He/she is a fixture in the community and can be relied upon year after year to take good care of you and your family through good times and bad.


I’ve had the good fortune to have practiced at the same location in our beautiful Three Village area (East Setauket, Setauket, Stony Brook) for over 25 years. I have seen my young patients grow up, marry, and become parents themselves, as other patients have aged and become grandparents. I have shared holidays, celebrations and some difficult moments with my dental family. My patients know they can always reach me, and my door is always open to take care of any dental emergency. My staff is equally committed to excellent patient care. We have all worked together as a team for seven years.


I also act as an advocate for my patients. I may refer them to a specialist for particular procedures, such as periodontal or oral surgery, and I communicate directly with the referral doctor to be sure that my patients are well taken care of. I discuss recommended treatment with the patient and help them to make a decision that’s right for them. I call my patients after each visit to my office to see if they have any concerns. I am always available to speak to them on the phone or on email. I am responsible for the quality of the work that comes out of my office, and for the quality of the supplies and the cleanliness of the office. My office is a reflection of me. That’s why one goes to a family dentist!


An image from 1300s (A.D.) England depicting a...

An image from 1300s (A.D.) England depicting a dentist extracting a tooth with forceps. (Photo credit: Wikipedia)

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Remember Meg from my March 25 blog post? Well, here we are just one month later and look at her now! Hard to believe that this is the same person. Meg looks just wonderful. Her failing teeth stuck out too far and were far too long, but once they were gone, her face looked so much more attractive.  She is wearing immediate dentures that we will monitor for fit while healing continues over the next several months. We will then make her permanent dentures and she will have the immediate dentures as a spare set. She may also add implants at that time for increased confidence.



Have you ever tried brushing your teeth without toothpaste? Studies show that this is a very effective technique. Most people apply a long swirl of toothpaste to their toothbrush instead of just a pea size drop. The excess toothpaste creates so many bubbles that people tend to lean over the sink and drool and daydream while they brush. What seems like two minutes or more is really closer to thirty seconds which is not enough time to effectively remove dental plaque from all parts of the teeth.  The wetting and flavoring agents in toothpaste actually numb the tongue so people think their teeth are clean although the plaque is not removed.


So try brushing without toothpaste.  This will result in a longer brushing time and more effective removal of plaque.  Begin on the inside of the bottom teeth first and brush until your teeth feel and taste clean before you add toothpaste. One study showed that this technique has resulted in a 63 percent reduction in calculus in the lower front teeth and a 55 percent reduction in bleeding. Toothpaste ingredients may have many benefits but toothpaste can also get in the way of effective plaque removal.


Toothpaste and toothbrush

Toothpaste and toothbrush (Photo credit: Wikipedia)


                        The swirl – don’t do it. Save your teeth and save money too!Enhanced by Zemanta

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.





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!



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  


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.