SDNY Blog

At the request of Health Guru, the #1 website for the production of on line health videos, Drs. Paul Fletcher and Richard Smith of Specialized Dentistry of New York recently completed a series of more than 50 informational videos on various oral health topics. After only one month the videos have had over 100,000 views, a number that was way beyond expectations and demonstrates the amazing communication power of the Internet.

The subjects of our videos include, among others, proper toothbrushing techniques, anxiety control, fillings and cosmetic dentistry, root canals, adult orthodontics, dental implants, dental care during pregnancy, teeth whitening, oral cancer, eating disorders and your teeth, tongue piercing, the use of fluoride in drinking water and the significant impact tooth decay and gum disease can have on overall health.

Other health related topics covered in video on the Health Guru website are: Diet and Fitness, Sleep Issues, Dermatological Problems, High Blood Pressure-Heart Disease and Heart Medication, Diabetes, Mental Health, Sexual Health and Gynecological Issues. While oriented to an 18-35 age demographic, the information presented is pertinent for all ages.

As always, please don’t hesitate to contact us if you have any questions.

Specialized Dentistry of New York and the Columbia University College of Dental Medicine.

After more than three decades of leadership, innovation and achievement at the New York University College of Dentistry, we have established a new and exciting presence at Columbia University’s College of Dental Medicine (CDM).

Drs. Dennis Tarnow, Paul Fletcher, Jonathan Zamzok, Richard Smith and Stephen Chu have all joined the faculty of the CDM graduate departments of Prosthodontics and Periodontics and have enthusiastically taken on this new challenge.

SDNY’s Dr. Dennis Tarnow, the new Director of Implant Education at Columbia, had been the Chairman of the Department of Periodontics and Implant Dentistry at NYUCD, where he developed what was widely recognized as one of the leading dental implant fellowship programs in the world.  Students and faculty came from around the globe to study and work in his department.  Each of our seven other SDNY specialist doctors was an integral member of that faculty, contributing to the unrivaled international reputation of the department.

Dr. Stephen Chu, the former Director of Continuing Education in Advanced Aesthetic Dentistry at NYUCD has established a creative new curriculum at Columbia’s CDM and serves as the Director of Aesthetic Dentistry Education.

We are pleased to note that the administration and faculty of Columbia’s CDM have whole-heartedly welcomed and supported the efforts of the team of specialists from SDNY and that more and more students and faculty are asking to join the programs.

New and exciting research projects designed to provide significant benefits to patients are underway. And our association with Columbia University’s College of Dental Medicine can provide patients with quality, lower-cost care, under our direct supervision, at its excellent clinics.

We are proud to be part of the Columbia “family” and we appreciate this extraordinary opportunity to build, once again, something very special.

Your Specialized Dentistry of New York team

Columbia University College of Dental Medicine was established in 1916 as the School of Dental and Oral Surgery, when the School became incorporated into Columbia University. The College’s mission has evolved into a tripartite commitment to education, patient care, and research. The mission of the College of Dental Medicine is to train general dentists, dental specialists, and dental assistants in a setting that emphasizes comprehensive dental care delivery and stimulates professional growth.

New York Cosmetic Dentists with a Dental Lab in the Office.

Consistently providing the highest levels of cosmetic dentistry, aesthetic restorative dentistry and implant dentistry is a Specialized Dentistry of New York team effort and our onsite dental laboratory is an essential part of that team.

Specialized Dentistry of New York believes there is no finer facility than the world-class, full-service dental lab that is an integral part of our Manhattan office.

Most dental practices do not have a lab of any size. Our large on-premises lab serves SDNY doctors and their patients exclusively.

It is staffed by a large team of highly trained, experienced and dedicated technicians, who use state-of-the art equipment to create the crowns, veneers, implants, full and partial dentures and orthodontic appliances necessary to achieve the utmost in function, appearance and patient satisfaction.

As the American Dental Association points out, “Dental laboratory technology requires the skill of an artist. Technicians need to be creative when they make prostheses.” We are proud of our technicians’ skill, artistry and creativity. In addition to their special training with imaging equipment that helps produce more natural appearing tooth restorations, they attend yearly training courses around the country, as well as in-house seminars with our doctors and dental lab experts.

When a Manhattan cosmetic dentist and a dental technician can be in the same examining room with a patient, all three can have input on restoration fit and comfort and on “smile design” decisions, including tooth color-matching and tooth shapes that affect facial appearance.

Our doctors are there to assure that exacting specifications for restoration design, choice of materials and fabrication are always precisely followed and that quality in workmanship and materials is never compromised.

Our lab is also a major time-saving convenience for our patients. When minor adjustments are needed (and they frequently are), most practices are forced to send restorations to an outside lab, often requiring patients to come back for multiple visits. Our lab can make those adjustments during the visit. And, in the event of an emergency, such as a broken restoration, expert repairs can be made quickly.

For patients from out-of-town who may be on a tight schedule, in many instances our lab can “push” work through to completion in a very short time.

Periodontal disease is an insidious inflammatory disease caused by a bacterial infection that can destroy the gums and bone that hold your teeth in place. When the disease is neglected, teeth can be lost.

Some symptoms of periodontal (gum) disease may not appear until the disease has done some significant damage and early on there is usually no accompanying pain, which is why it is often called the silent oral disease. But when signs do appear, they should serve as a wake-up call to schedule an appointment for a periodontal evaluation with a Specialized Dentistry of New York periodontist.

The key warning signs of periodontal disease include:

• Bleeding while brushing, flossing or eating hard food

• Red, swollen or tender gums or other pain in your mouth

• Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before

• Loose or migrating teeth

• Pus between your gums and teeth

• Sores in your mouth

• Persistent bad breath

•A change in the fit of partial dentures

There two forms of periodontal disease The mildest form is gingivitis, or gum inflammation, where the initial sign is gums that bleed during brushing or flossing along with slight redness or swelling. There is usually no tissue or bone damage or even discomfort at this stage. Gingivitis, which is most often caused by poor dental hygiene, can be treated and reversed, often just by brushing and flossing more diligently.

Left untreated, gingivitis can lead to periodontitis, with serious consequences, including tooth loss. As the American Academy of Periodontology describes periodontitis: “With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that can become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.”

If you, or someone you know, is a denture wearer, you should be aware that there is new evidence that denture adhesives may be hazardous to your health and that the Food and Drug Administration is taking action.

The culprit is zinc, which is found in a number of denture creams, and the risk can be avoided with New York dental implants.

Both ABC News’ “World News with Diane Sawyer” and “Good Morning America” recently reported that long term and excessive use of zinc-containing denture adhesives could result in “serious and irreversible neurological damage.”

The FDA, which has received hundreds of complaints that long term overuse of one popular denture adhesive containing zinc caused serious nerve damage, is urging manufacturers of all denture creams with zinc to remove it from their products.

According to the FDA, consumers most at risk include people using excessive amounts of zinc-containing products over extended periods of time and people with poor fitting dentures.

1) The package labeling may not list zinc as an ingredient.
2) Users may not be aware that overexposure to zinc may lead to zinc toxicity, which may result in adverse health effects.
3) Adverse events may not manifest themselves for months to years while using the product and consumers may assume such events are caused by something other than the denture adhesive.

The Specialized Dentistry of New York implant dentists have welcome news for denture wearers who are concerned about the effects of zinc toxicity and who will appreciate no longer to have to use any adhesives: In one short visit, in most cases, we can easily add as few as two dental implants beneath a denture – providing a level of retention, security and comfort impossible to achieve with adhesives.

These dental implants, which act as anchors to which the denture is firmly attached, can truly be life altering for long-suffering denture wearers.

Millions of Americans have congenitally missing teeth, a condition almost always linked to genetics, that prevents one or more of their permanent teeth from ever forming.

When a few teeth (not including wisdom teeth) are missing, the condition is called hypodontia, The congenital lack of six or more teeth (other than wisdom teeth) is known as oligodontia.

Studies indicate that as many as six percent of the U.S. population (slightly more females than males) have some degree of hypodontia.

Missing permanent or adult teeth, especially front teeth, can have a profound effect on the self-esteem, confidence and social interaction of children and adolescents, as well adults. Once the condition is even suspected, the patient should be diagnosed and treated by a team of New York cosmetic dentists, including an orthodontist and prosthodontist.

Congenitally missing teeth in adults are a cosmetic dentistry challenge best met with dental implants placed by New York City implant dentists, generally when the individuals are in the 18 to 21 year-old age range and their jaws have stopped growing.

Implants replace the missing teeth, while eliminating the need for bridges, which require drilling down otherwise healthy teeth to support the bridges. Bridges can be uncomfortable and difficult to maintain and will, at some point, need to be replaced and updated. A removable partial denture, or “flipper,” can be used to replace congenitally missing teeth. Made of metal and acrylic, this appliance does not offer a precise and confident fit. They often press on the gums, they can break easily, they lack stability and can even cause more bone loss around the area of the missing tooth. In some cases, these partial dentures have to be removed when eating.

Implants are placed into and fuse with your jawbone, assuring stability and preventing the bone loss and atrophy that can easily result from missing teeth.

Implants are the most aesthetically pleasing and longest lasting tooth replacement option. They look and function just like natural teeth. They improve comfort and speech, as well as appearance.

“Gummy smile.” It sounds as unappealing as it looks.

When your smile is defined more by the “gummy” look of your gums than by the appearance of your teeth, it’s time to consult a NYC periodontist about the cosmetic dentistry procedures available to eliminate unattractive gummy smiles.

In many cases where the gums appear to overwhelm the teeth (usually the front teeth), the assumption may be that for some reason those teeth are too short. In fact, in almost all cases, the problem is not the size of the teeth, which are the proper length, but an excessive amount of gum tissue that covers too much tooth area, producing the illusion that there is something wrong with the size or the shape of the teeth. This condition can result in an unattractive smile, impacting self-confidence and self-esteem.

Excessive gum tissue can also make teeth look crooked.

One simple and highly effective periodontal procedure is cosmetic crown lengthening, which cosmetically reshapes the excess gums, exposing more of the natural tooth, giving teeth that appeared to be short the proper length and eliminating the gummy smile. Following this routine surgical procedure, a New York prosthodontist may be needed in some instances to place dental restorations, such as veneers or crowns, on the teeth.

And, conversely, if a Manhattan periodontal patient’s gum recession has exposed roots that make some teeth appear too long in relation to the adjacent teeth, a soft tissue graft can cover the roots. Another benefit of the procedure is that by covering the unsightly, often sensitive, exposed roots it reduces additional gum recession and helps protect the roots from decay and possible loss.

An even, symmetrical gum line and teeth that appear to be the proper length are essential for a beautiful smile.

A consultation with your Specialized Dentistry of New York periodontist will enable you to discuss your cosmetic dentistry goals and explore the best options for achieving them.

Some celebrities are known for the gaps in their front teeth (David Letterman, Lauren Hutton, Condoleeza Rice), and while there are people who consider it fashionable, many others with tooth gaps are self-conscious about their smiles. If you’re reluctant to smile because you feel that your diastema (the medical term for a space between your teeth) detracts from your appearance, our Manhattan cosmetic dentists (prosthodontists, periodontists and orthodontists) can close the gap

Treatment options include veneers, composite bonding, orthodontics or a combination of dental therapies. The size of the diastema, the positions of both the adjacent and opposing teeth (occlusion) and the condition of the teeth are all considered in determining the most desirable treatment.

When a space between teeth is relatively small, cosmetic bonding is often used to fill in the gap. To properly and effectively close larger gaps, porcelain veneers — or even dental crowns — may be required.

While cosmetic dentistry can close tooth gaps to make a smile more attractive, there may also be compelling medical reasons to treat a diastema.

When gum (periodontal) disease causes bone loss around teeth, they may drift out of position and affect the bite (occlusion), causing the teeth to move even further out of position. Our Manhattan cosmetic dentists ask our “gap” patients if they’ve always had a space between their teeth and if it has been increasing. A widening gap signals underlying problems. Treatment may include periodontal surgery, orthodontics and restorative/cosmetic procedures. There are times when a tooth — or teeth — may be lost and replaced with dental implants.

Some teeth that have migrated out of position can be easily repositioned by treating the underlying periodontal infection and adjusting the interference in the bite. Over time, this may allow the lips to push the teeth back into position.

Another reason to have diastemas treated is that they may act as food traps, which can cause both tooth decay and discomfort.

Q. What special education, training, skill, experience or certification is required for a dentist to call himself or herself a cosmetic dentist?

A. None

The fact is that the American Dental Association does not recognize cosmetic dentistry as a specialty. Actually, since standardization in training, levels of skill and extent of experience are almost nonexistent, any dentist, qualified or not, can claim to be a cosmetic dentist

As the Wall Street Journal has reported, “Cosmetic procedures, which typically are performed to improve the color and shape of teeth, are risky and can cause permanent damage to teeth, roots and gums if done incorrectly.”

The newspaper added that the latest trend in cosmetic dentistry was “fixing other dentists’ mistakes.”

So, what specialty should you look for when choosing a New York City cosmetic dentist? To begin with, you should know that the American Dental Association recognizes prosthodontists as the only genuine specialists in cosmetic or aesthetic dentistry, best able to restore optimum function and appearance to your teeth.

Prosthodontists are specialists in restoring and replacing teeth with dental implants, bridges, dentures and cosmetic/aesthetic restorations. They are required to have completed two or more years of continuous formal training beyond dental school in a university or hospital program approved by the ADA in order to receive their specialty certification.

Their “extensive training and experience provide prosthodontists with a special understanding of the dynamics of a smile, the preservation of a healthy mouth and the creation of tooth replacements,” notes the American Academy of Prosthodontists.

Specialized Dentistry of New York’s prosthodontists have earned their reputation as “the dentists who teach the dentists.” They teach at both the Columbia University College of Dental Medicine and at the New York University College of Dentistry, they deliver lectures around the world and they’ve written textbooks and dozens of journal articles on aesthetic and cosmetic dentistry.

As the American Association of Orthodontists notes, orthodontists can “improve your dental health, enhance your facial appearance and even boost your self-esteem.” Orthodontists diagnose, correct and prevent malocclusion (misaligned teeth and/or jaws). They straighten teeth and align jaws and treat other dental development irregularities.

Only a generation ago, orthodontics (in effect, controlled tooth movement) was widely perceived to be a treatment option for children, but not for adults. It was an erroneous belief then and is even more so now.

People still remember the days when unsightly stainless steel braces were cemented on to teeth and the often painful experience each month when wires had to be tightened at the dentist’s office.

The advances in orthodontics in the last few years have been revolutionary. Today, one in five orthodontic patients is an adult (and the number is rising) and orthodontists are at the forefront of cosmetic dentistry. A major reason is the development of techniques and materials that have made adult tooth movement a much more attractive and effective process than could have been imagined only a decade ago.

“Many of our New York City orthodontic patients choose the Invisalign treatment, the far superior tooth-movement alternative to yesterday’s uncomfortable and unattractive metal braces and wires,” says Specialized Dentistry of New York orthodontist Dr. Mark Hochman. These clear aligners, fabricated using 21st century three dimensional CAD-CAM imaging technology and customized for each patient, are used to treat a number of orthodontic issues, including spacing, crowding and overbite. They enable the slow and comfortable movement of teeth into positions that correct problems and enhance smiles.

Among their advantages:

• They are virtually invisible, making it highly unlikely others will realize that your teeth are in the process of being straightened.

• They offer an unprecedented comfort level. They are easily removable for eating, drinking, brushing and flossing — and their smooth edges won’t irritate gums or cheeks.

• Improved teeth alignment and a more attractive smile, are produced even before the final desired position is achieved and treatment ends.

“For many adults, straightening and aligning teeth is, truly, a life enhancing experience,” says Dr. Hochman, who, as a specialist trained in both orthodontics and periodontics (the treatment of gums and supporting bones), is eminently qualified to treat New York City orthodontic patients.