by Dr. Louis Malcmacher, DDS, MAGD

Since I began practicing dentistry, now almost 30 years ago, probably the area that has changed the most is the area of infection control in dentistry. Yes we have had many technological advances such as CADCAM and lasers but on a day-to-day, in the office nuts and bolts part of the practice, infection control has changed the way that we practice dentistry and may continue to do so.

I remember in dental school we never wore gloves, except for particularly bloody extractions and even that was unusual. I remember some instructors calling people, who wanted to wear gloves during those kinds of extractions, “sissies”. We would certainly wash our hands very well before each patient and in between patients and that was considered adequate infection control. Before I sound like I am from the dark ages, we did have autoclaves even back then but most everything in the operatory was wiped down with a somewhat damp alcohol gauze. That was considered good enough. Read more

by Shannon Brinker, CDA CDD

Treatments to improve the esthetics of discolored porcelain veneers caused by improper shade selection, technique-based failures, and staining over time have caused many clinical challenges.¹ Time consuming, costly, and often requiring further removal of sound tooth structure, solutions were often limited to further polishing of the porcelain, or more commonly, removal and replacement.¹ Although effective when improper shades were selected and improper techniques used, removal and replacement is typically not the ideal treatment for restorations stained from consuming various foods and beverages.¹

Typically in these indications, restorations were merely polished further and new layers of glaze added if needed.² Although this effectively removed stains from the facial surface of the porcelain, stains at the margins and interproximal areas remained challenging and detracted from overall esthetics.² Additionally, polishing older porcelain restorations may cause excess loss of material, fracture, and debonding in some cases.² Therefore, a new solution was needed to remove stains from the surrounding dentition and improve esthetics without negatively effecting the restorative material.^{2 Read more}

by Shannon Brinker, CDA CDD and Laura Hansmann Pistoia, DA.

The role of dental restorations used for provisional and indirect restorative procedures has changed dramatically in the past several years. These restorations are no longer regarded as temporary restorations but rather as provisional restorations with distinct functions and purposes. Provisional restorations have become a vital diagnostic and assessment tool to evaluate function, color, shape, contour, occlusion, periodontal response, implant healing, and overall esthetics. An accurate fit and margination is essential to insure and maintain pulpal health.

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By Raj Upadya

There is much more to a healthy mouth than preventing and treating decay and gum disease alone. There are other factors that are critical to long-term predictability of a healthy mouth that will allow you to enjoy a better quality of life and better overall health. The well-trained eyes of a different breed of dentists that completely examine a patient are the key to determining the signs of problems before they become painful symptoms. If you wait to treat a condition until symptoms have developed, you have often missed the opportunity for conservative therapeutic options; thus treatment choices will also become much more costly and involved.

There is a scientifically based rest position for your jaw joint, called centric relation, that has been repeatedly proven to be accurate and stable through not only research, but also through patient experiences, and with trial and error of repeated dentistry. If the joints, muscles and teeth have not been working in harmony with respect to their proper positions you can find extensive damage to the teeth, the joints and muscles. This can lead to dental needs for a patient, sometimes in the absence of symptoms. Masticatory physicians are trained to see and diagnose these conditions when they are signs, before they proceed to becoming debilitating symptoms. This approach may be occasionally viewed by traditional dentists as overtreating, though in reality we are being more conservative in the overall dental life span of the patient. (Figure 1)

Figure 1

OCCLUSAL DISEASE (OD) is a common dental disorder that is usually painless in its nature and involves the development of a traumatic or pathologic bite as a result of an erosive disease process. It (OD) is now considered the highest risk factor for and cause of tooth loss. If teeth have worn through the strong outer enamel layer to the soft core, the bite has become unstable, though you may not even be aware of it. The mouth gets its stability from the back teeth supporting the front teeth, and the front teeth protecting the back teeth, working together in unison from a relaxed jaw relationship. The wear through the enamel into the softer inner tooth creates an unstable stopping position for the teeth so that they are no longer able to function adequately. Lack of enough strong teeth with intact enamel or teeth that have drifted out of their proper position overloads the system as well. Quite often, this does not cause any pain but the effects on the teeth, gum, bone and mouth are very destructive as a whole. At one point, it was thought that it was normal for the teeth to wear out and shift over time. Wear that is confined to the outer layers of enamel and has occurred slowly over time can be, in some cases, considered normal. Wear through the strong outer enamel into the soft internal core, however, is considered pathologic, as it has advanced through the entire protective layers of the tooth. (Figure 2) Read more

by Dr. Dory Stutman

We all in our careers have faced situations in which a patient walks into the office with a problem that appears to have no practical solution. The main roadblock might be do to many reasons including poor prognosis, poor health, fearor financial concerns. We would deem these cases untreatable and tell the patient its something that they have to live with.

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Husband-and-wife team Dr. Dory Stutman and Dr. Khalida Stutman combine old-world craftsmanship, the latest technologies, and top-rated materials to create beautiful, functional, long-lasting smiles. Recognized as innovators in dentistry, the team continues to build on their knowledge and expertise to bring patients the very best that the dental industry has to offer.

Dr. Dory Stutman and Dr. Khalida Stutman are two of the leading cosmetic dentists in the Long Island area. By working as a team, they combine knowledge and expertise to create beautiful, lasting smiles for patients who hail from across New York, Long Island, and Nassau County.

A Long Island native, Dr. Dory Stutman earned his dental degree from the School of Graduate Dentistry at Case Western Reserve University. He completed his general practice residency at Metrohealth Medical Center in Cleveland, Ohio and the postgraduate program in Esthetic Dentistry at the University of Buffalo.

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by Deborah Hartley, RDH

It is estimated that dental hygienists perform approximately 200 million prophylaxis procedures annually. But many states are changing their practice act allowing the expanded function dental assistant to perform some of these procedures such as coronal polishing. These assistants are working along side the hygienist as hygiene treatment coordinators helping to make this department even more functional and productive. In fact in the majority of dental offices it is the dental assistant who is in charge of ordering supplies often choosing which products the hygiene department will use.

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by Kirk Barendt from ACT Dental

Building and maintaining a dental practice is a major accomplishment for any dental professional. Growth is an important part of our mission, but without healthy growth we all can be burned out. So many practices just run through the motions of the day. Most complaints we hear from team members are they always running over, we are never on time, no time for lunch and most important no time for family where dentistry is where our life starts and stops.

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At the end of June I’ll be heading to China with my family and a team from my office to provide dental care for the nannies and children at Maria’s Big House of Hope (MBHOH). We’ll be going through Hope Smiles, my organization that delivers dentistry to people in need. I am humbled by the opportunity to help the nannies who love and care for the children in the orphanage. They are heroes in my opinion. I could not be more excited to go back to this country that I love and be apart of God’s greater story at Maria’s. I wish that we could fund trips like this with just the love and joy in our hearts for these people, but unfortunately, we can’t. The reality is there is a financial cost to get to China. What we’ve decided to do to help offset the cost of the trip is give away a day of dentistry at Kemp Dental. Friday, May 13th the proceeds from every appointment went directly to Hope Smiles. We’ll be scheduling the day just like any other regular work day, so we’ll be seeing new patients, cleaning teeth, and providing treatment to any and all who want to come.

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by Mickey Bernstein, DDS and Diane Bernstein

We, as dental professionals, have some compelling, practical reasons to build trust with our patients. As Dentists and Team members, we are there to help by changing the structure and appearance of our patient’s smile and occlusion to improve their lives and health. Change requires risk taking. Risk taking requires trust for both parties.

Patients worry about working with us. They worry about pain, cost, time, outcome and deeper subconscious anxieties. They often give us powers that are usually reserved for themselves and a few trusted others. They ask themselves whether they really want to enter this relationship, with all its uncertainties. The patients that show up in our offices want to be willing to take risks with us; they want to be able to trust us.

Consider the junior high school dance. The girls are talking along one wall and the boys along another wall. The music begins and a boy moves into that long space between the two groups to ask a girl to dance. He (the patient) holds all the power to choose. As he approaches and asks the chosen girl the balance of power has shifted. She (the doctor) can say yes or no.

In the dance between new patient and dental office, trust and risk are key elements in creating a good fit. A patient’s unwillingness to risk can be related to their degree of trust in the doctor and team based on a number of valid reasons. Some patients risk out of proportion to the early trust relationship established. No relationship has been established, but they are ready to commence a large case. This should be a warning sign.

Others show a pattern of resisting the size of the case, the costs, timing, or the details of the dentistry. This behavior could be a clue that they lack the trust necessary to take the needed risk. Some suggestions to build trust to make risking more acceptable might include:

• Be more open about yourself and your work.
• Reveal your concerns and your real self.
• Discuss other cases that you have completed with stories that made a difference in the patient’s life.
• Learn about and respect the individual. Give them hope.
• Follow through on all your commitments.
• If you want them to listen, listen more yourself. Ask compelling questions.
• Share responsibility for getting the work done. Dictating all the decision-making encourages the opposite of trusting and risking.

You will learn more about how to build trust and the willingness to risk when you approach clients knowing that your partnership must include both elements in order to work.