Another Beautiful Smile Created on Long Island

Ryan suffers from amelogenesis imperfecta, a hereditary disease in which there is imperfect formation of enamel, resulting in a brownish coloration and fragile teeth. These teeth are weak and tend to decay easily. Unfortunately, Ryan and other members of his family have this condition. All of his teeth were decayed; some were too decayed to be saved, others needed root canal treatment, and also periodontal treatment before we could create a fabulous smile for him with porcelain veneers.  Ryan is thrilled and is getting ready to have his lower arch restored.

 

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Before

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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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Sheri first came into the office several months ago with broken and decayed teeth and worn out crowns (see below).  She travels to us from Sayville and even made the trip while a blizzard was on its way. She required full reconstruction due to the amount of lost tooth substance. She also needed periodontal treatment to improve the health of her gums and she needed several root canals and extractions.  She had already had two implants placed that we were able to utilize.

We talked about adding several more implants instead of a bridge and removable partial dentures  – but finances were a factor. To stay within her budget, we made her a porcelain bridge and removable partial dentures for the upper and lower arches.

The dental work is now complete and she is very happy with the result.  She will come back at three month intervals for her dental examination and teeth cleaning. We want to make sure that everything stays healthy and bright.

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Before and after photos of Mike’s old and new smile.  During his first visit two weeks ago I removed the decay in Mike’s front teeth and placed temporary crowns. During his second visit today, I bonded in place these sparkling new crowns and veneers.  He is one happy patient!

Today’s knowledgeable dental patients often know that excellent cosmetic dentistry is a partnership between the dentist and the dental ceramist.  The ceramist who fabricates my porcelain tooth veneers and crowns is Peter Kouvaris.  Peter has been a ceramic artist for more than 20 years.  He was the Cosmetic Designer at the JK Dental Laboratory and recently opened his own dental studio in New York City: Peter Kouvaris Dental Studio.

Peter is a member of the prestigious Oral Design International, a group of dental ceramists who have studied under Master Willi Geller.  Willi Geller resides in Switzerland and is considered to be the world’s leading dental ceramist.  He was one of the first ceramists who realized that teeth reflect and refract light like prisms because of layers of tooth dentin and enamel.  He invented a buildup technique which involves layering different density of porcelain in different colors and degrees of translucence. His method is used by a highly trained and talented group of 80 ceramists and is used to create beautiful, life-like veneers, crowns and implant crowns.  Peter Kouvaris is one of Willi Geller’s proteges.

Not every dentist can or will work with an oral design ceramist.  The dentist needs to have advanced training and needs to work at a higher level and with increased attention to detail.  Excellent cosmetic dentistry is a collaboration between the cosmetic dentist and the dental ceramist.

This week the Huntington Hilton hosted the Greater Long Island Dental Meeting. I spent all day Tuesday at the meeting, talking to dental suppliers about materials we use in my Suffolk County dental office and learning about new dental materials available. Talking to the suppliers is a great learning opportunity for interested dentists. I also attended one of the many courses offered. I take many days of continuing dental education each year so I can keep up with current techniques, materials and technologies.

I am very excited that I will be taking a year-long course on advanced dental restoration next year at the New York University School of Dental Medicine. I will be treating patients at the school’s clinic under supervision of top dental clinicians, and I will be attending lectures on advanced dental restoration and cosmetic dentistry, including implants, veneers, crowns, bridges and dentures. The course meets one day a week for 28 weeks. This will better enable me to offer dental treatment options for the increasing numbers of patients who come to my office with severely broken-down dentitions.

Go for the second opinion. Don’t be embarrassed. People often call our Long Island dental office to ask for a second opinion. I am happy to talk to them, find out what their needs are and make suggestions. It’s your dental health and your pocketbook so you need to get as much information as you can, and you need to find a dental practitioner you can trust. Too many times people come to the office and have been told things that I think would not be in their best interest.

For example, a young woman came into my dental office last week and said that her front tooth had chipped and she was told she needed a crown. She was upset at the thought of putting a crown on her front tooth. I looked at the chip and told her that it should be repaired with a simple and undetectable tooth-colored composite bonding procedure. We took care of the chip and she was thrilled!

Another woman came into the office this week with a temporary bridge that had fallen out. She was told that one of the abutment teeth would have to be extracted and two implants placed. She was upset at losing another tooth. I took a look and recommended some gum work to save the tooth and placement of a permanent bridge. She was thrilled!

In both of these cases my recommendation was an alternative to what the patient didn’t want – the crown in the first case and extraction and implants in the second case. And my recommendation was considerably less expensive and a better service than what had been suggested at another dental office. So go for that second opinion. I’ll be happy to speak to you and recommend the treatment that’s right for you.madagascar free

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You may have heard recent news reports about lead in dental crowns made in overseas Chinese laboratories. Previously most Americans had given little thought to where their dental restorations were being made – but now patients are asking questions.

The new global economy is changing everything, and that includes the dental profession… or SOME of the dental profession. Cheap overseas labor and shrinking profit margins have forced some dentists to outsource their laboratory work to foreign laboratories. These dentists are typically those who participate in low-fee “managed care” insurance programs such as HMOs. When a dentist signs a contract with these plans, he or she must agree to the insurance company’s fee schedule, which is typically 50% or even LESS than their normal fees. But to remain in business, corners MUST be cut if these dentists are reducing their fees by 50% or more. One way to lower expenses is by sending laboratory work to China.

Always check where your dental restorations are being made. Remember that, “The bitterness of poor quality is remembered long after the sweetness of low price has faded from memory.” In the case of lead-contaminated dental crowns, poor quality may have negative effects on your health.

In my Long Island dental office I use only American laboratories that do not outsource and which follow strict quality standards. We use certified, high-quality materials and laboratories – only the best for our dental patients!

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I was at a barbeque last weekend (the first of the summer) and was intrigued by a young man – a nice looking fellow who never smiled, not even once. Of course I wanted to check out his smile but he never gave me a chance. Then after he had a few beers he got up the courage to take me aside so he could confide that he was missing his upper left bicuspid. He was so embarrassed by this hole in his mouth that he refused to smile. He knew that he needed an implant but he said that he couldn’t afford one. He also said that he didn’t want to cut down the two teeth on either side to make a bridge and that would be too expensive in any event. He didn’t know what to do. And on top of this, he was getting married. I suggested that he come to my Suffolk County dental office so we could determine if a Maryland Bridge would be an appropriate treatment for him.

 

A Maryland Bridge is a bonded bridge that consists of a replacement tooth with two metal connectors that bond to the teeth on either side. The teeth don’t have to be cut down and the cost is minimal. The procedure is totally reversible so if his financial situation changes in the future, the bridge can be removed without damage to his teeth and an implant placed. You have to be careful with a Maryland Bridge; it isn’t as strong as the more expensive options and it may not last as long. But with careful diagnosis and placement on the part of the dentist and proper home care on the part of the patient, the Maryland Bridge can be a great choice!

 

I did make a Maryland Bridge for Alex and – all smiles – he sent me a wedding photo.

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