What Are My Choices If I Don't Want a Crown?

Some patients just don't want crowns. They or someone they know may have had a bad experience or the may just not want to reduce their entire tooth to receive a crown. This is totally understandable. The good news is that there are very often alternatives to full crowns. These choices may include one type of inlay or onlay.

Inlays (or onlays) are basically laboratory fabricated restorations made of porcelain or a very hard resin, that can be used to replace missing tooth structure while saving as much of the natural tooth as possible. Onlays usually replace the cusps of teeth while inlays lie within the center of the tooth. For the most part, inlays and onlays for the lay person are basically the same.

These restorations are tooth colored and are typically bonded to the tooth restoring it back to normal function while at the same time strengthening it as well.

Years ago, and still being done today, many teeth were restored with gold inlays or onlays. These restorations, although done less and less, are excellent but have the cosmetic issues of gold metal display.

Inlays and onlays, where possible are great ways to restore teeth. The choice is up to your dentist as to whether inlays and/or onlays will be appropriate.

Don't Take It Personally But I Hate Dentists

Every dentist has heard these words...probably often. The reality is that most patients really don't hate dentists, they hate the inconvenience, discomfort and fears associated with the dental office. As a dentist, I can tell you I hate the medical doctor. Well, not really my physician but going there, having things done to me and not knowing what will occur just drives me nuts.

We, as dentists, can do a great deal to make this type of patient a better patient in the future. By using care and concern rather than drill and fill, we can provide a dental experience that makes a change in the patient's life that is far more important than replacing an old amalgam filling. By creating a better, less fearful patient we can provide that patient with a life long change that will make them healthier and happier.

Just think of the patients that have stayed away from the dental office because of the fears mentioned above that now have significant dental disabilities. People who have lost teeth, are in pain or can't face others because of a dentition that they are ashamed of. If we can make the dental experience more enjoyable by providing a wide variety of patient oriented services, listen to the patient's concerns and address their needs we can move a patient from "I hate all dentists" to " I just love going to the dentist". Well, maybe a dream but we can all hope.

I Just Hate Silver Fillings

It was kind of amazing to me when a patient asked the other day if there was an alternative to silver fillings. In reality, we haven't placed an amalgam (silver filling) in over ten years. White composite fillings are nicer to look at and have many advantages over the older silver fillings. There is no need to remove silver fillings unless they are inadequate or present a cosmetic issue that is important to the patient. The concerns some people have about the mercury contained within amalgam fillings has been proven to be of no real concern.

Most of the time we remove old silver fillings it is because they have outlived their usefulness and replacing them with white, composite fillings or porcelain restorations looks and feels better.

What is the Difference between a Crown and a Cap

Well, in reality, there is no difference. Patients have been asking this question for as long as I have been in practice and it just happened again. Over the years dentists have been using these two terms, caps and crowns, synonymously. At one time a cap was a term used just for front teeth to denote usually an all porcelain restoration. At the present time there is no real difference between the two terms.

A cap or crown is a full tooth covering. It is usually used when there is not enough tooth structure left to place either a filling (silver or tooth colored composite) or an inlay (a porcelain or similar material restoration made at the laboratory). A crown (cap) can be made of all metal, metal covered by porcelain, all porcelain or out of one of a number of new porcelain type materials such as Procera or Empress. In all cases, crowns (caps) cover the entire tooth and need to be either cemented or bonded in place.

Hope this helps to resolve the confusion.

The Tooth Fairy and Stem Cells Have Something In Common

I just read a very interesting article that may be of interest to many of you. Here it is:

"Baby and wisdom teeth, along with jawbone and periodontal ligament, are noncontroversial sources of stem cells that could be "banked" for future health needs, according to a National Institutes of Health researcher who spoke today at the American Dental Association’s national media conference.
Harvested from the pulp layer inside the teeth, jawbone and periodontal ligament, these stem cells may one day correct periodontal defects and cleft palate, and may help restore nerve cells lost in diseases such as Parkinson’s, according to Pamela Gehron Robey, Ph.D., Chief, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research of the National Institutes of Health, Department of Health and Human Services.
The stem cells have the potential to save injured teeth and grow jawbone. Regenerating an entire tooth is on the horizon, and years from now, Dr. Robey said stem cells from teeth and jawbone might be used to correct cleft palate, one of the most common birth defects, sparing children multiple surgeries."

We now have the ability to actually salvage naturally lost baby teeth and save them for use in ways we currently cannot fathom. A company called BioEden has a protocol that can be used in the dental office for banking your child's baby teeth. If interested please give us a call.

It's All About Timing

I've just been listening to some real good information presented by Dr. Paul Homoly. He suggests, and I totally agree, that dentists need to think more about the lifestyles of our patients and a bit less about "drilling and filling". Dentistry is mostly elective. Now I understand that there are many situations where in the case of pain and infection that elective may be not quite accurate. But, if we take this to the nth degree, we really don't need teeth at all to function. Lots of people out there have no teeth, don't or can't wear dentures, and are functioning just fine.

Now that would not be my lifestyle choice but it is reality. Dentistry, especially cosmetics and implant dentistry, is elective. In order for most people to fit this into their complex lives they need to find a way to prioritize it so that there is time and financial resources to make it work. This is no small task.

Helping our patients fit the dentistry they need or want into their lives should be something we truly think about when formulating our treatment plans.

Thanks Dr. Homoly for a great idea.

How Often Do You Need X-rays

One of the things that drives me a bit nuts is the way insurance and toothpaste companies have been allowed to dictate dental treatment. We see the dentist twice a year because way back when one of the toothpaste manufacturers used that as a tag line in their marketing campaigns. We take x-rays (full mouth x-rays) maybe once every three years because an insurance company has decided to pay for them in that manner.

This is totally crazy. When it comes to deciding how often you, as a patient, need to see your dentist, it should be the dentists decision in line with your best interest. How often do you need x-rays? Well, once again that is a treatment decision best left to your dentist and not to some insurance clerk.

The higher your dental disease index (how really bad your teeth may be) the more often you need to see your dentist and probably the more often you will need x-rays to check for decay, infections and the like. This makes a bit more sense than allowing non-professionals to dictate dental treatment.

Just the thought for the day....

More on My Presidential Platform

More on my platform:

4. Taxes - No more new taxes. Well, if that sounds familiar it should. It has been the rhetoric we have heard year after year but somehow I just don't have more money to spend even with "no more taxes. Our taxes should be spent on projects that move our country forward. This money should not be politically spent but rather put where it needs to be and taken away from where it is doing no good. Pork barrel legislation, ear marks etc. must become a thing of the past. Congress has wasted the last dollar of our money should I decide to decide to run possibly, maybe for the Presidency.

Since I will not be beholding to anyone I will make sure that these goof balls in Congress stop playing games with our money as if it was found in a Monopoly box. If I am going to struggle to pay my bills on time, so should the government. If I can't buy something because I don't have the money, neither should these guys we voted into office. One of the questions we should ask someone running for Congress, or any other elected office, is are they running their household on a negative budget. If the answer is yes, they don't get my vote. If they can't balance their household budget, how can they balance the budget of the U.S.?

I also think it is totally unreasonable to tax Estate taxes a second time. If this money was taxed during the individual's lifetime, then why should it be taxed upon their death just to add some money to the government's coffers. This is crazy. If someone can give me another reason to double tax this money, I'm willing to listen. Otherwise no more Estate Tax.

Now there is something else you need to understand before voting for me, should I decide to decide to think about possibly running for President. I am neither a Republican, a Democrat or an Independent. I believe in certain Liberal policies and on the other hand, I believe in some of Conservative ideas as well. I guess I am a political mutt....

5. Abortion - When men can have babies, I'll let them decide who or who cannot have an abortion. How can these clowns in Congress decide whether a woman can or cannot have an abortion. This should and must stay a woman's right to choose.

Summertime – A Great Time for Dentistry

OK. Summertime, to be totally honest, is probably an even better time for vacations, boating and barbeques but even with all of these terrific events, the summer months are also a great time to take care of some of those forgotten dental issues.

During the winter, even in some of our more temperate climates, most people are involved in other, sometimes more pressing, matters such as getting the kids to and from school, soccer and after school activities etc. In some of the areas of the country getting to and from the dental office can be a real challenge because of weather such as snow storms and chilling cold.

The summer provides a great opportunity to take care of some of those dental problems that had to be stalled during the winter. Kids are in camp and parents have some free time to take care of themselves. Now is a great time to not only correct problems that affect your dental health such as fixing broken teeth, periodontal issues and the like but also a great time to just make yourself feel better by allowing time to create the smile you have always wanted.

Just imagine how great you can look with a summer tan and a whiter, brighter smile. Tooth whitening takes only an hour or so in the office and can make a summer smile really shine. Cosmetic veneers and other forms of esthetic dentistry, also taking only a few visits, can make the summer something to really smile about and also take you into the winter looking and feeling great.

Take a moment to give our office a call today and we will be happy to schedule some time to talk about your new summer smile. We promise not to interfere with your barbeques and trips to the beach.

Ganz Presidency - Platform Continues

Yesterday I announced my decision to think about deciding to run for President. (I already sound like a politician). As I stated in yesterday's blog I think anyone reading this should have some idea where I stand on the issues (now I don't sound like a politician. They never take a stand on anything except possibly on trying to keep their jobs.)

3. Healthcare - Now I have to disclose that there are lots of medical/dental people in my life and therefore I am totally biased in my opinion on healthcare. (Now isn't that refreshing, someone admitting they are actually biased) I really believe that our medical professionals are underpaid. If we can pay football and basketball players ridiculous salaries because they can try to hit a ball or sink a basket (understand that I used the word "try") then shouldn't we be paying our medical life savers the same millions to take care of our health and the health of our children? Shouldn't we make sure that our hospitals are the best they can be and are always available for us when we need medical care? Shouldn't medical care be available to everyone, everywhere and at anytime. Well, someone has to pay for this and I guess it's us. If I have to raise taxes to do this, I will. (Kind of crazy I know, raising taxes but someone will figure out how to avoid these taxes anyway so it's really no big deal.) Universal health care is a right not a privilege. If we can find money for all of the other nonsense that becomes part of the federal budget, then certainly we can find the money to pay for the lives of the people that make up our country.

We should make sure that there is oversight of the insurance industry so that profits are reasonable and the return on their investor's money is reasonable as well. There should be no windfall for these companies at the expense of our health. Spending $20,000 per year for a family of 3 for health insurance is nuts.

Our pharmaceutical industry also needs help. Not with making money, they do real well with that. Too well. What they need is for us to invest in new drugs and keep old drugs cheap enough for everyone to what they need when they need it. If this costs money, so be it. What better way to spend our tax dollars then on healthcare? If we get out of Iraq, stop waste in government, stop pork barrel legislation, shrink the government (how many attorneys do you really need in the justice department? Nobody is really doing anything I can see other than watching each others back so they don't get caught themselves in something illegal), allow imports from countries like Canada where we are probably getting most of our drugs anyway, allow competitive bidding by all agencies etc. we can pay for this and have money left over for lunch.

When it comes to healthcare we need to stop thinking politically and start thinking personally. It's amazing to me that we want to limit the amount of money a physician can make (everyone thinks they are so rich) until their own life is on the line, then of course the doctor and hospital are Gods. This is crazy. Unless those NBA ballplayers have someway to save my life, let's get our priorities straight. A great example of taking from the rich and giving to the poor. Think of the as the Robin Hood Healthcare Program. (RHHP - government loves acronyms)

Research - Another area where sanity needs to take hold. Stop cancer, provide funds for Stem cell research and let's get our population healthy. We've sent men to the moon, created IPods but we can't find a cure for cancer. We throw embryos in the garbage instead of using them for valid research because some nut thinks we one way of killing embryos is better than another. Let's try to make these nuts understand that using unwanted embryos for research with the possibility of saving lives is far better that having them taken away by our waste disposal personnel (aka Garbage men).

When I'm President you can be sure that healthcare will be my major priority. Afterall, I have my physician kids to think of....just like a politician.

Cary H. Ganz DDS for President

Sounds crazy I know but after watching the democratic and republican debates I just have to run. These yahoos just have no idea what they are doing. One is more scary than the next. There is no common sense, no honesty of purpose and no thought whatsoever to their constituents. They are purely political animals attempting to survive. In doing so, they look like buffoons and to some extent, lunatics. Creationism versus evolution. Give me a break.

OK. Since there may be one or two people reading this blog I need to give you my platform. So here it goes:

1. Iraq - We get out immediately. No nonsense. No fuss no muss. If the Iraqis want to continue killing each other who are we to stop them. In our civil war we killed each other until a time came when killing just wasn't fun anymore so we stopped and a country was formed. Let's give Iraq the same chance. Now some will say, what about the oil. Now there is the crux of the matter. Oil ! The U.S. is great at forming companies. Let's form a company where the U.S. manages the oil production, maintains our supply line until we can devoid ourselves of the need for fossil fuel, divides the profits up into three portions. One portion each for the three states to be formed; Shia, Sunni and Kurd. The monies from the oil can only be used for infrastructure and to support the governments. The distribution is based upon population size. More later on how the government of Iraq will be constituted but for now it will be formed in a manner similar to our government with representation based upon population in the three separate states.
2. Immigration - This one is easy. If someone is here, for the time being even illegally, but have learned our language, have stayed out of jail, paid their taxes (how they do that and be illegal is still totally mind boggling to me. We allow illegal aliens to pay taxes?), have a job and raised a family then they can stay. They have to become citizens, register to vote etc. All others go home. Then we spend whatever is necessary (money will be available since the war is over) to tighten the borders etc. The idea that we are going to create another state of slavery is just unacceptable. If we need to raise the price of goods then so be it. Slavery was abolished years ago and should not be brought back just to assist landscapers and pizza parlors in obtaining cheap help.

More to come...stay tuned.

It's Not Only About Teeth

When deciding what to do to improve your smile there is something more to look at then teeth. Make sure to have your dentist evaluate your gum tissue during smiling. Mother Nature and most viewers, want to see a geometric, even flow of gum tissue when viewing someone's smile. This means that the gum tissue that is in view during your broadest smile should be even throughout your mouth. The image to the left is a good example of uneven gingival (gum) architecture. Your eye is just drawn to the disparity in the heights of teeth etc.

There should be a symmetry between the length of the teeth and the height of the gum tissue. The gum tissue should not be higher on some teeth and then lower on other teeth. This tends to draw too much attention to one area of the mouth and can detract from a beautiful smile. A simple periodontal procedure, crown lengthening, can correct this problem by recontouring your gum tissue. If longer teeth are a prerequisite to a more natural smile, this should be done prior to having any cosmetic dental procedures such as veneers or porcelain crowns.

A beautiful smile is, as you can see, much more than just teeth.

No Prep vs Traditional Veneers

There has been a lot of discussion in my office over the last couple of months thanks to advertising by the company marketing Lumineers. Today there are a variety of laboratories providing no or little prep veneers. Lumineers is a brand name for just one of these laboratories.

This increases awareness has been both good and bad for dentistry. The good part is the interest it is creating in patients who may have thought that there was no way to fix their smiles without extensive drilling. The bad part has been the confusion it has created in the marketplace. Let's try to fix that by explaining the difference between traditional veneers and the new no or little prep veneers.

No or little prep veneers, are basically used in certain circumstances where little or no preparation of the teeth are required in order to accomplish the patient's goals. They cannot be used in every case especially those where the teeth are exceptionally crooked and may require a great deal of preparation in order to realign the teeth into a more natural look. Additionally, in certain patients with severely stained teeth, such a tetracycline staining, No Prep veneers may just not be the correct treatment option. In order to make major color changes in these types of cases sometimes these no prep veneers may become very opaque looking and lose their natural appearance.

Additionally, it is important to understand that when Lumineers, or no-prep veneers are used, the teeth by necessity will be thicker. Normally this is not a problem but the patient should be aware of this before treatment is begun.

The benefits of no or little prep veneers are 1) as the name implies there is little if any preparation of the teeth, 2) no temporaries are needed and 3) very often no anesthesia is required. For many patients these benefits outweigh the disadvantage of a bit thicker veneers.

It is important to understand that both treatment options, prep and no prep veneers, are just tools in the hands of a dentist. There is no panacea and both treatment options should be evaluated before a final treatment decision is made.

Distinction Magazine | elegant living on long island

This article about the Dental Spa at Garden City appeared in Distinction Magazine in April 2007. It briefly describes what we feel is a new and unique way to provide dental care. The Spa concept in Dentistry was introduced many years ago by us as a means of comforting our patients while we provided the kind of dentistry they wanted and needed. Atmosphere does play a major role in reducing the stresses of dental care and it has always been our goal to treat our patients the same way we would hope to be treated.

Distinction Magazine elegant living on long island