What Are Loupes And Why Must Your Dentist Wear Them?

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Dr. Nadler and Zora Circa 2003

Dental loupes are the magnifying glasses that dentists wear to enlarge everything that they see in the mouth. There are two basic reasons why these glasses are worn. First and foremost, vision is improved simply because everything in the field of view is so much bigger. Secondly, loupes are worn to allow dentists to have a more “physiologic” posture while working, and thereby minimize the slouching which dentists are historically known to develop.

 

Why is it important to have an enlarged view of the working area? The most obvious answer is that a better and enlarged view of the treatment site automatically results in more precise dental work. Dentists are better able to see the shapes that they are carving or preparing in the natural teeth as well as in the final restorations which they are providing for their patients. Perhaps even more importantly, dentists are better able to make more accurate and complete diagnoses of what is occurring in each patient’s mouth.

 

As an example, I was testing out a new product which was touted to assist in better diagnoses of oral cancer. This system required the wearing of colored lenses used in conjunction with a special light. Using this system, I would be unable to wear my loupes. I first examined a patient using this new system without magnification. And then, put on my loupes and re-examined the patient. There was no comparison between the two examinations. Without magnification, even with the special light effect, much more was visible and apparent with magnification.

 

I began wearing loupes back around 1990 while I was taking advanced classes at the L.D.  Pankey Institute in Florida. It was at this time when I truly feel that the quality of the treatment which our office provided moved to an entirely new and higher plateau. Not only was I learning some amazing skills, but also the use of the loupes alone allowed significant improvement in my ability to provide excellent treatment.  Since that time, the loupes that I use have gotten increasingly longer and provide more magnification. These glasses are simply addictive to any dentist who is serious about doing his or her absolute best work.

 

A few years after beginning to wear them, I decided to try a headlight mounted right on the  loupes. After the first patient to be seen with this light, and in spite of the discomfort of extra weight on my nose, there was no turning back. The benefits of the light are nearly as significant as those of the loupes themselves. As good as the overhead dental light is, there are still shadows as we lean in as well as from the lips and tongue, etc.  Whereas, wearing the loop-mounted headlight, the light shines exactly where I am looking.

 

I don’t see how any dentist can work without either magnification or head-mounted lights. I believe that dental schools should teach the use of this equipment as mandatory – at least in the final year of dental school. If you’ve ever seen the intraoral photographs that we take for our patients, you’ll know what it’s like to look through loupes with light. It’s just so easy to see!

 

If you have not had the opportunity to see an intraoral photo of your teeth, please ask us for a demonstration at your next appointment. It will only take a moment and can be quite eye opening. If you have any questions or concerns please visit us online at www.DesignsForDentalHealth.com or call us at 908-359-6655.

Dr. Nadler is writing a BOOK! Put your “2 Cents” in!

Have you always wanted to put your “2 cents” in on a book that was being written?  Well, Dr. Nadler would love your help!

He is writing a book for dental patients with the working title of:

Transform Your Life With A Smile, The Book on Designing Life-Changing Smiles

Please use the comment space below to:

  • What topics you would you think would be of interest in such a book?
  • Are there any specific questions which you would like to see addressed?
  • And, Finally, how do you feel that a healthy and beautiful smile can impact your life?

To thank you for your invaluable input, Dr. Nadler will give each person who puts in their “2 Cents” with an autographed copy of the book!

What is the Golden Proportion?

Two quantities a and b are said to be in the golden proportion ? if:

Golden Proportion Formula

This number and the “Golden Ratio” has had amazing significance in art and design for at least 2400 years. The Parthenon, the most well known example of Greek architecture, displays this proportion in its façade. And the statues which resided in this temple are said to embody the golden proportion as well. This ratio is found in nature everywhere, and has been used by artists, architects, and mathematicians in a variety of ways.

Golden ProportionThe principles of golden proportion apply to the parts of the face as is discussed in the attached article concerning “human attractiveness.” It so happens that the golden proportion is used when we restore teeth as well. One very important element of a beautiful smile is the relative widths of each of the front teeth. The upper front teeth (the central incisors) are 1.618 times the width of their neighbors, the lateral incisors. And the canines behind the lateral incisors are .618 the width of the laterals as viewed from the front. If the proportionality rule is broken in the display of each tooth’s relative width to its neighbor, the esthetic result is severely compromised. In addition, there is a similar appropriate proportion relating the height to the width of each tooth. Teeth are supposed to be taller than they are wide. If they are too long or too short (think squarish) relative to their width, again they are not as esthetically pleasing to the eye as they could be.

There are other proportionality rules which we use to “design” our cosmetic restorations. Using the newer porcelain materials which are both strong and strikingly life-like, we can perform amazing smile enhancements which make patients smile – beautifully!

If you have any questions about cosmetic dentistry, we invite you to contact us at (908) 359-6655 or via our website at www.DesignsForDentalHealth.com.

LEARN MORE: See a video about the effect of ratio on human attractiveness on the Huffington Post. 

NOTE: Originally posted February 14th, 2012

Cosmetic Dentist or General Dentist?

Before I begin, please forgive me if this blog entry seems a bit self-indulgent. I ran into a guy at the gym this morning with whom I have been acquainted for the past four or five years. He asked, as often happens, if I would mind talking professionally for a moment. Actually, I usually do enjoy talking shop outside the office, so I said “sure.” He proceeded to tell me that he has some cosmetic concerns about his teeth, knows some of my patients, and wondered if I would feel comfortable treating him since we know each other. He also said that he has a regular dentist who takes care of his routine dental needs. It occurred to me that I was not having a déjà vu, but had experienced this kind of interaction before. I assured him that I would not only feel comfortable seeing him, but, in fact, most of my best friends are patients. It seems that knowing a patient first, often eliminates any of the trust barriers that some new patients have.

So, “what’s the problem?” you ask. Well, I am always happy to hear that I will be seeing a new patient and was flattered that he liked the dental work of ours he had seen. But, later, on the way home, it occurred to me that I must have been sending out the wrong message somehow. That people frequently think that all I do is cosmetic dentistry, and, on top of that, that I may be too busy to accept new patients. Well, nothing could be further from the truth. Yes, I love doing cosmetic dentistry and have had the training to do very nice work. But, overwhelmingly, most of my work falls under the category of General Dentistry. I have enjoyed some patient families for twenty-five years. And, their care included the routine cleanings and exams, fillings, extractions, root canals, crowns, bridges, dentures and so on that general dentists do. In fact, there is no specialty designation of “cosmetic dentist.”

So, if you are already a patient, you probably know all this. And, if you are not, please be assured that I am a General Dentist who does accept new patients and provides a full range of dental care! As a matter of fact, the “FAGD” after my name stands for “Fellow of the Academy of General Dentistry.” I hope that this blog clears up any misconceptions and explains the initials after my name on which many have commented…

If you know anyone who will benefit from some general dentistry, we would certainly appreciate your kind referrals. Thank you for your indulgence, and, as always, please feel free to call the office at 908.359.6655 or email us at info@DesignsForDentalHealth.com.

NOTE: Originally posted February 10th, 2009

Everything You Need to Know About Tooth Whitening and Bleaching

Tooth whitening continues to be the most popular cosmetic procedure seen in most dental offices and this is especially true during the holiday season. Whiter teeth have become so popular, in fact, that a few years ago dental material manufacturers came up with a whole new range of “bleached” colors for their tooth-colored fillings, porcelains, and even denture teeth so that dentists could better match patients’ enhanced tooth colors. Compared to dental work which we placed some twenty-plus years ago, newer cases are definitely WHITE! Current patients initially requesting that their new dental work look “natural” overwhelmingly choose colors which would have seemed over-the-top only ten years ago.

Patients have two basic options when it comes to tooth whitening. First, there is “home” bleaching. This method involves wearing trays or strips for an hour or longer each day until the desired color is obtained. Some over-the-counter kits can be purchased at the grocery store or pharmacy. Other kits may be purchased from your dentist — we currently recommend TresWhite in our office. The over-the-counter kits can be very effective, but can take longer to provide an acceptable color change due to their lower concentration of the active ingredient as compared to those dispensed by a dental office. Also, the strips may not reach the back teeth as well as do the tray-type kits. When people smile the first molar can usually be seen, so coverage can be an issue.

These kits can range from about $25 for the strip-type kits up to about $100 for the dental office brands. Some offices offer a custom tray type kit into which a bleaching gel is placed. Such kits are more expensive, and our experience has been that the preformed tray kits like TresWhite are less expensive, just as effective, and more convenient.

Second, there is in-office whitening. We have been using the BriteSmile
System for many years with great success. The main difference between this technique and home bleaching is that the entire in-office process is completed in about and hour and a half. With this system, a protective barrier is first placed on the tissues surrounding the teeth. Then a whitening gel is placed on the teeth which is activated by a special light source for twenty minutes. The whitening gel is then removed, a fluoride desensitizing gel is placed, and the whitening gel and light procedure is performed for two or three additional twenty-minute sessions. Patients will see quite a marked improvement of color in one visit. The cost of this procedure is generally established by BriteSmile which frequently has “specials” in the range of $300 to $350.

Some patients have special tooth color issues. Tetracycline stains appear as bands of gray or brown along all the teeth as a result of injesting the medicine as a young child or by the mother carrying a fetus. Such stains improve with bleaching, but are not eliminated. To completely remove such stains, the teeth must be covered with porcelain or a tooth-colored filling material. Other patients display a single dark tooth as a result of root canal therapy. Such stained teeth generally respond very well to a conservative single-tooth bleaching procedure.

Finally, not all patients will benefit equally from any tooth whitening procedure. Yellowish teeth respond better than gray ones. And, excessively bleaching any teeth, especially grayish ones, will be counter- productive. Too much bleaching can actually remove too much color from the teeth causing them to look translucent. Such teeth display a dark appearance, as they no longer reflect light like normal teeth. Other patients wishing to improve their appearance would do better addressing issues other than color. Talking to a dental professional first can be enlightening regarding alternative treatments which may be more appropriate in some cases. The dentist will also determine if there are any reasons why bleaching may not be a good idea because of decay, tooth wear, tartar build-up, etc.

If you have other questions about tooth whitening or bleaching, you are welcome to call our office @ 908.359.6655 or email us at info@DesignsForDentalHealth.com.

NOTE: Originally posted on December 5th, 2008

A Truly Amazing Reconstruction

Last week, we began the last stage of a dental reconstruction which would not have been dreamed of when I was in dental school some twenty-five years ago. This patient has received the benefits of both new and old technology – i.e., implants and neuromuscular dentistry. She is a wonderful patient who has been eager to restore her worn teeth and replace her missing ones in spite of a long history of fearing dental work. My hat is off to her for her mental fortitude and willingness to do what is necessary to ensure such a great result!

This patient was originally motivated by a desire to improve the appearance of her smile. Her teeth had become so visibly worn that her front teeth were chipping and looked dark at the edges where they were so thin as to be transparent. She also had lost several back teeth long ago causing her jaws to become too close together. People with such bites develop creases at the corners of their mouth due to their being “over closed” and, in short, look older. In addition, just as the front teeth support the lips, the back teeth support the cheeks. Without the support of teeth, the lips and cheeks take on an unflattering sunken look — picture a denture wearer without his teeth.

After a thorough discussion of the alternatives for this patient, she decided to restore her worn teeth and replace her missing teeth with implants. In the process, her entire bite was reconstructed enabling the reposition of her jaw back to its proper position. The process involved her “wearing” a mock up of her finished new teeth for a period of three months before anything was done to her natural teeth. The mock-up (we call it an “orthotic”) was placed over her natural teeth and was not removable. The orthotic looks like regular teeth, and allows us to confirm that the new bite is comfortable, cosmetically pleasing, and will hold up to the forces of chewing.

After successfully wearing her orthotic for the prescribed period of time, we proceeded with the actual dental work. In this case, each arch (upper and lower) was completed in two visits, followed by carefully adjusting the bite to make sure that the “occlusion” was comfortable and stable. The implant-supported back teeth not only look natural, but allowed us to turn back the clock in amazing fashion.

Before and After

A Truly Amazing Reconstruction-Before and After

In this patient’s words:

“With having teeth which were missing and teeth that continued to chip away I knew that I needed extensive dental work.

Now that I am 90% completed, it was the best decision that I have ever made with an excellent result.

It was much easier and less painful than I imagined. I would highly recommend the dental procedure to anyone who is not pleased with their smile, or with the alignment of their teeth.”

If you have any concerns or questions about your appearance, bite or tooth wear, please feel free to call us to discuss your problem (908.359.6655) or you may email info@DesignsForDentalHealth.com. Also, you may check out the smile gallery on our website for other “before and afters.”

NOTE: Originally posted October 2nd, 2008