Your Shimbashi Number And Your Bite

I am writing this article in honor of Dr. Henry “Hank” Shimbashi, a practicing dentist and researcher from Edmonton, Alberta who passed away this week. Dr. Shimbashi was a very influential friend of comprehensive restorative dentists and his research is used every day in offices like mine where problems with the bite and TMJ’s are treated.

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As a result of his research, the Shimbashi number was established to indicate an ideal relationship between the upper and lower jaws. When there is an optimal position of the lower jaw relative to the upper jaw, the muscles which are connected to them will also be at their optimal length and can function ideally.

If the relationship between the upper and lower jaws is altered, one or more of the many muscles of the head, neck and face may be overworked causing them to go into spasm — i.e., be painful. This can happen if the lower jaw is too close to or far from the upper jaw, too far forward or back, or shifted in any direction relative to the upper jaw.

Dr. Shimbashi’s research measured muscle activity in over 500 patients. He found that there was an ideal vertical dimension at which the jaw muscles functioned at their maximum potential. In addition, at this ideal position, patients had no symptoms of muscle pain. This vertical dimension was found to be universally applicable in all age groups and all races.

This simple number which we use is the measurement from the gum line of the upper front tooth to the gum line of the lower front tooth. Dr. Shimbashi found this ideal distance to be approximately 19 mm plus or minus one mm (about three quarters of an inch) when a patient bites.  In our office, we often see patients with bite problems whose Shimbashi number is significantly less than ideal  measuring as little as 10 mm or even less. In such patients, the lower front teeth are often nearly completely covered by the upper teeth. Such patients are much more likely to develop tooth and pain problems resulting from their bad bites.

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So what is your Shimbashi number?  If you have any questions about your bite as a result of this article, please feel free to call our office at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

Designs For Dental Health VIP Plan

Starting this month, we will be offering our Designs For Dental Health VIP Plan!!
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The Designs For Dental Health VIP plan* offers new and existing patients more affordable dental care on the most common and necessary dental services. This discount plan will save patients 15% off treatment fees for most of our services at no extra cost to you! In addition, there is no yearly maximum coverage limit, no deductibles, or waiting periods

What’s included in the plan?

  • 15%* discount on fillings, periodontal deep cleanings, crowns, bridges, implant crowns, dentures, extractions and root canal therapy.
  • Two regular exams per year, regularly $122.
  • Two regular cleanings per year, regularly $230.
  • All x-rays included with your cleaning visits, regularly up to $153
  • Oral Cancer screenings
  • One Fluoride treatment per year (up to age 16), regularly $48        (15% courtesy does not apply only to in-office bleaching or bleaching products, Invisalign Orthodontics, SixMonthSmiles Orthodontics, All-on-4 procedure, TMJ therapy, Sleep Apnea appliances, Arestin treatment, and full-arch or full-mouth rehabilitation)

With Designs For Dental Health’s VIP Program there are NO worries!

  • No yearly maximum coverage limit
  • No deductibles
  • No waiting period
  • No pre-existing condition exclusions
  • No ID cards necessary
  • No Insurance consultants

What is the cost of membership?

Only $325 for one entire year beginning on your registration date. That’s an automatic savings of up to $180 on your regular exams, cleanings, and x-rays alone!

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Making high-quality dentistry even more affordable!

 Designs For Dental Health has many options to help you pay for quality dental care. We accept cash and checks. We even offer a 5% prepayment discount for all treatment prepaid in full with cash or check when scheduling a service, and when dental insurance isn’t being billed.  That means when you use the Designs For Dental Health VIP Plan and pay in full you can save 20% on treatment! 

We also honor Visa, Discover, MasterCard and American Express. And, we offer 0% financing (if paid in full over 12 months*) and flexible payment options through CareCredit and Springstone. For those with insurance, our team will file all your claims and work with you to receive the absolute maximum benefit from your dental insurance.

How do I sign up?

Come on into our office and we will be happy to sign you up ASAP! No appointment necessary, and new patients are always welcome. And if you have any questions about the Designs For Dental Health VIP Plan and would like to get more information, just ask us and we will be happy to help.

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Call us at 908-359-6655 or visit our website at www.DesignsForDentalHealth.com

*This plan is subject to change without notice

*Discounts cannot be combined with any other offers

*Fee discount is limited to 5% with any financing offer

Cracked Tooth Syndrome – What You Need To Know

We have had several patients recently who have had problems related to cracked teeth. The symptoms of which these patients complain can be difficult for both the patient and the dentist.  Both can become frustrated because the underlying cause of symptoms is frequently difficult to pinpoint.  Often, patients will complain about pain which is caused by biting pressure and sometimes temperature.  It is frustrating for both parties because the described symptoms are often difficult to duplicate in the dental office.  It’s kind of like bringing your car to the dealer with a specific problem which suddenly vanishes as soon as you arrive at the dealership.

Cracked teeth generally occur for two reasons.  First, silver or amalgam fillings expand and contract as we consume hot and cold foods and beverages. The expansion and contraction of the filling is slightly greater than the tooth itself.  So, after years of such cycling in temperature-associated expansion and contraction, cracks frequently develop in the teeth.  Second, cracks may occur while chewing foods.  Commonly patients will describe a sharp pain in a tooth while they had been chewing, and the tooth will remain sensitive to biting pressure and/or temperature.

Cracked teeth are addressed in stages depending upon symptoms.  First, a bonded filling may be placed in an attempt to prevent the cracks from propagating further.  Depending on the depth and severity of the crack, an onlay or crown may be necessary to prevent the tooth from breaking.  An onlay covers any thin walls of the tooth which may be at risk for fracture and is considered a conservative, aesthetic and long-term restoration.  If the tooth has an extensive existing restoration or a more severe crack, then a crown which covers the entire tooth will be required to prevent the tooth from breaking.

In either case, the problem needs to be addressed as quickly as possible to prevent the crack from propagating further into the tooth leading to more severe dental problems.  For example, if the crack reaches the pulp of the tooth, then root canal therapy will be required as well.  The most severe complication would be the vertical tooth fracture which includes the root thereby making the tooth non-restorable.  In such cases removal of the tooth and replacement in some fashion will be required.

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The important points to remember are as follows:

1. Determine the exact source of discomfort first

2. Address the symptoms as quickly as possible

3. Begin with the most conservative treatment and progress as needed to eliminate all symptoms

Such teeth need to be followed on a regular basis to ensure that damage to the pulp has not occurred.  Appropriate x-rays at routine intervals will be helpful for this.  Keeping your dentist apprised of precise symptoms will also go a long way to help in diagnosis.

If you have any questions about cracked tooth syndrome please do not hesitate to contact our office by calling 908.359.6655 or on the web at www.DesignsForDentalHealth.com

Expressions Of Gratitude From Members Of Our Team

 

The holiday season means different things to different people. For some, it may be that they look forward to celebrating and spending time with family and friends. For others, it may be a time for faith and devotion.

 We’re Reflecting On The Things We’re Most Grateful For…

Everyone on our team has taken some time to reflect on her (or his) life and to list some of the things we’re grateful for.  We want to share those thoughts with you!  FYI, there was no collusion amongst we participants…

 What we are thankful for:

 Dr. Nadler

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“I’m thankful for having found my wife, Elizabeth, thirty years ago!  And, for our many friends who provide our lives with so much joy and meaning.  And, finally, for my dental practice which has been my raison d’etre for three decades…”

Liz

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“I am most thankful to have found my best friend, my soul mate, my husband, Richard.”

April

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“This year I’m most thankful for my family. Having a baby changes your life and I’m so thankful to have the continuous support from my loved ones.”

Remi

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“I am thankful for my beautiful family and wonderful friends, also for our freedom, the Country that we live in and everyone that helps keep us healthy and safe.  I am thankful for my daughter Sara, she is my sunshine and she makes me smile every day!  I am grateful for learning new things every day and being able to find humor in the craziest places.  And Lastly, I am thankful for my Parents.  When I became a Mom I gained a priceless appreciation for all parents!  Wishing everyone a Great Thanksgiving!”

Maria

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“This year, I am most thankful for my family, friends and life. I’m thankful for my husband, the love of my life and my best friend. I am thankful for my beautiful daughter that I love unconditionally and am so proud of everyday.  I’m thankful for my supportive parents who sacrifice a lot in order to give me and my brother a better life.  But above all, I am most thankful to have a great job that I love, and work together with amazing colleagues that I respect and appreciate.”

Allison

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“I am thankful that I have the opportunity to spend this holiday with my loving family and reconnect with great friends that are visiting during this time of the year. I am also thankful for all of the wonderful opportunities I have had throughout my life including schooling, traveling, and being involved in my favorite sports and activities.”

We Would LOVE To Hear From You Too!

As the holiday season approaches, what are you grateful for? Please share your thoughts with us in the comments section below.

 One More Thing…

We’re so grateful for each of you—our wonderful patients and friends! Because of you, we love working here each day. We’re thankful for our relationships, and for the trust you place in us each time you visit and reach out with your health concerns and feedback.

We wish you a very happy holiday season!

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.

Free Sleep Apnea Screenings Offered in November

Again this year, we are offering free Obstructive Sleep Apnea (OSA) screenings during the month of November. This is our way of giving thanks for all the blessings which we have received during the year, and it is our hope that we may potentially save a life by providing this service.

 Sleep apnea is a serious condition with potentially life-threatening side effects. Most people are not at all aware of this condition and certainly do not think that it affects them.  People who have Obstructive Sleep Apnea are at risk for various medical conditions including:

  •  Adult onset diabetes (the #1 growing disease currently in the US!)
  • High blood pressure (especially when resistant to treatment)
  • Anxiety and depression
  •   Daytime sleepiness
  •  Heart attacks and strokes
  •   Gastro-esophageal reflux disease (GERD)

In addition, OSA patients are prone to daytime sleepiness which places them at risk when driving. Also, these patients may struggle with diet-resistant weight gain.  Such patients frequently lose significant weight when treated for their sleep apnea condition.

If you have any of the above symptoms or conditions, or have been told that you snore or stop breathing while asleep – or you just sleep poorly – perhaps finding out if sleep apnea is the problem may be the prudent thing to do. The screening is very quick and easy. It involves a history form and a brief examination, after which a preliminary diagnosis can immediately be made.

This offer is available to all of our patients as well as their friends, family, and coworkers. Please take advantage of this service! The first step is to determine if you are at risk for sleep apnea.   Once a diagnosis is established, there are various ways to control the condition, allow you to sleep better, live healthier and feel great!

Call us at 908.359.6655 or visit our website at www.DesignsForDentalHealth.com to schedule your free screening.

Have a wonderful holiday!

Richard M Nadler DMD, FAGD and the Designs For Dental Health Team

New Root Canal System Offers Major Improvements

Several months ago we began using a new root canal technique and have found it to be vastly improved compared to the methods we were taught back in dental school some 30 years ago. If you have ever undergone a root canal, you will remember that we use little files that are twisted with our fingers. This technique, when followed to completion, was a very painstaking  as well as time-consuming one. Some years ago we began using a somewhat different technique which involved using a French-made piece of equipment to clean out the canals using an electric motor and rotary files. This technique was certainly a huge improvement over the finger file techniques we previously used. But, now, our newest system which was developed by Dentsply Corporation and called WaveOne™ offers even more advanced improvements.

The major improvement as far as patients will be concerned regarding this newest system is that cleaning the canals is completed in a fraction of the time that it used to take when we were filing with our fingers. In addition, the files used with this technique are meant to be used one time only. Each pre-sterilized file assures that there will be no contamination since each patient has her own single-use file.

In addition to these improvements in instrumentation, this technique offers an activator, which may more appropriately be called a vibrator, to agitate an antimicrobial or antibiotic solution within each prepared canal. This agitation thoroughly cleans the canal and any adjacent pores in the root where bacteria may hide, thus offering more complete debridement of each canal.

Finally, this system utilizes a filler which is warmed first to allow it to be more flowable. This flowability permits the filler material to better seal not only the canal itself but also any adjacent openings or tubules in the root.

We as dental practitioners have truly enjoyed using this vastly improved system, and patients have expressed their opinions of how simple and straightforward having a root canal felt to them. This was especially true of those patients who had previously undergone root canal therapy with older techniques and systems.

If you have any questions about root canal therapy or would like more information about the system that we use, feel free to contact us @ www.DesignsForDentalHealth.com or by calling our office @ 908.359.6655.

Does Your Posture Make You Look Older?

As we discussed in an earlier blog article, many people develop poor posture for one reason or another – sleep apnea (often undiagnosed), slouching over a desk, poor physical condition, etc.  Whenever we treat patients for Temporomandibular Joint Dysfunction (TMD), their posture must be addressed.  Simply by changing the position of a person’s head, the bite will change.  Try it for yourself.  Tap your teeth together while sitting or standing with your head level.  Now, tap the same way with your head tilted back and notice how differently the teeth meet.   Since a “bad” bite is the most common cause of TMD, the posture must first be “aligned” as we address the TMJ problem, and we do this using various techniques one of which will be highlighted in this article.

The simplest way that we employ to help correct the posture involves an exercise used to correct forward head position.  You may have read our earlier article about “Upper Crossed Syndrome” in which the head and neck are angled forward giving the appearance of “hunching” over.  Not only is this posture not proper for comfort and  physiology reasons, but people who carry themselves this way look older and less attractive.

 We ask our patients to address this posture problem while we are analyzing and treating their TMD problems by having them correct their hunching in this way:  Make believe that there is a string coming out of the top of your head.  Now see this string being pulled straight up so that you are being stretched taller.  Just sit or stand straighter, not military-style with the shoulders back, but just longer.  Finally, keeping your head level, tuck your chin back bringing your ears in line with your shoulders.  This exercise may be done during the day to help correct an acquired poor posture, while, at the same time, helping you to look younger and more “conditioned.”

Here is a link to a great video which demonstrates this exercise:  http://www.posturevideos.com/posture_video/forward-head-posture-correction/

If you have any questions about posture and TMD feel free to call us at 908.359.6655 or contact us via our website at www.DesignsForDental Health.com

This Labor Day Was Truly a Special One!

You may have noticed that our regular e-newsletter did not arrive last month. That’s because we were caught up in all of the last minute arrangements for my first daughter’s wedding…very exciting!  Rest assured that we will now be getting back on track with our regular newsletters and blog articles. And, I am very happy to report that the wedding was a huge success as I’ll share with you now!

Our family began gathering at my home on the Friday before Labor Day. It was wonderful to have the entire group together for this event.  They came from Arizona, Delaware, South Carolina, Scotland and even Australia!  Talk about multi-national!  We all then loaded up and moved to a hotel in Williamsburg Brooklyn on Saturday for the rehearsal and rehearsal dinner.  I don’t know if you are familiar with Williamsburg, but it’s quite the interesting, developing and hip place to be if you are among the sub-40 demographic.

The wedding took place on Sunday, September 1 and I had the pleasure of joining all the ladies including Liz and both of my daughters as they had their hair and makeup done in their swanky wedding apartment.  We had the chance to take a bunch of pre-wedding photos, and then all climbed into a stretch limousine to be taken to the bride’s eagerly awaiting groom for the “reveal” before ending at the park overlooking Manhattan where our photographs were taken.

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A major highlight for me followed with a “second line parade” from the riverside park through Williamsburg to the wedding venue. There was a brass band which led our three-quarter mile procession through Brooklyn. It was amazing to watch all the by bystanders observe our procession with kids looking absolutely amazed and adults smiling, clapping and offering congratulatory applause. There was even a city bus driver who stopped traffic for us while he stood up behind his seat and danced to the brass band music! Wow!

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Then came the wedding ceremony which, for me, rates up to there with watching the birth of my children. What a beautiful and emotional event! Adding even more significance was the officiating by the same Rabbi who married Elizabeth and me some ten years ago.

Following this ceremony was a reception which was filled with special little moments. There was a choreographed dance performed by the new bride and groom which was over the top. There were musical tributes sung by the groom and his brother–who have performed in various musical performances– to the Irish and Russian contingents.  There was absolutely no drama, and all in attendance seemed to genuinely enjoy the evening.

So, this was no usual wedding, and I am very proud of my daughter Meredith, a former event planner, and her new husband David who arranged the entire day. It is my sincere wish that each of you may enjoy such wonderful family times in the years ahead.  All the best to you and your families for a wonderful fall season!

Hillsborough Oral Care Recycling Is a Winner

We met Tim Zavacki over twenty years ago when his parents brought him to our office as a patient.  Well, much has changed during those years, and Mr. Zavacki is now an Applied Technology Teacher at Hillsborough High School and has been since 2002!  He began working with Terracycle, a privately owned business headquartered in Trenton, New Jersey.  It is a global pioneer in the collection and recycling of otherwise difficult-to-recycle packaging and products.

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The HHS Technology program was just named a top collector in the United States for the oral care brigade through Terracycle.  Since 2010, he has collected over 1,800 units of oral care recycling which is transformed into both creative and usable products.  Money raised through this recycling program is utilized for materials and supplies for the Hillsborough High School Technology Club.  In addition, some of the money raised by this recycling program is given to seniors as scholarships.

Our office has been working with Mr. Zavacki as a collection point since 2012.  You may watch a video about the benefits of this program featuring Dr. Nadler and Liz Nadler by clicking this link: http://www.youtube.com/watch?v=Td44oQSKQu0

And you may see a description of the brigade by clicking here: http://www.terracycle.com/en-US/brigades/colgate-oral-care-brigade-r.html

Please help Hillsborough High School as well as the environment by bringing your used dental packaging and products (like used toothbrushes, toothpaste tubes, packaging, empty floss containers, make-up containers, etc.) to our office containers where they will be collected.  Mr. Zavacki and Hillsborough High School appreciate your help!