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

Is the “Clean” Program for You?

On January 2, as has been the case for many years, I began a nutritional program in order to rid my body of all the excesses which have been inevitable during the holidays. In the office, we truly appreciate the many gifts we receive during December, and are always amazed that 95% of them are either sugar–laden delectables or adult beverages. In addition, there are the holiday parties and family celebrations all of which involve lots of wonderful food and wine. Couple the opportunity for all this overindulgence with under–performing self-control and I face the usual weight gain coupled with some minor gastric distress and a subtle feeling of malaise.

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So, this January 2nd I began the twenty-one day cleanse known as “Clean”. This is the same program that I wrote to you about last year. It’s a program designed by Dr. Alejandro Junger which is rather strict yet uncomplicated. Basically, I have given up all gluten, dairy, alcohol, and specific other foods as outlined in the book. During this three-week period, there is one solid meal at lunchtime. Breakfast is a smoothie and dinner is a soup. All foods are organic whenever possible.

I had forgotten much about the experience during last year’s cleanse. I can truly say that the results are amazing. I am sleeping so much better and perhaps that is the main reason why I have so much energy. Even my mood is different. I feel much more optimistic and upbeat than in the recent past. I have already lost six pounds and my osteo-arthritic knees are feeling better.

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I had first heard about this program from a fellow dentist who had been battling cancer. In addition to his regular cancer treatment, this man also began the Clean program. He too shared his feelings about how wonderful he felt after the initial three-week cleanse. And, I am happy to report that he is totally healthy with his cancer in remission. I am not saying that this program is the single cause of his current health, but his impassioned description of his experience while on the program had convinced me to give it a try.

Anecdotally, I had been rather ill during December with the upper respiratory infection which was being passed around at that time. Since beginning the Clean program my health has continued to improve and I now feel one hundred percent. Around me, however, are people who had similar illnesses which continue to linger or even seem to resurface. I wonder if this program might be helping my body to better fight disease.

If you have put on some weight, just feel a bit sluggish, or have any interest in getting a body tune-up, perhaps this program is for you. You can find the book entitled CLEAN with the subtitle The Revolutionary Program To Restore the Body’s Natural Ability to Heal Itself written by Alejandro Junger, M. D. You may also Google this program to get a better sense of what it’s about. A series of products are offered online but not necessary. For what it’s worth, I only use foods and beverages which are easily available in your grocery store.

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If you have any questions about this program, feel free to contact me in the office at 908.359.6655 or via our website at  www.DesignsForDentalHealth.com   .

Is It Really A Migraine??

Last week in the course of a routine examination, I asked a standard question of our young woman patient: “Do you have any problem with headaches?” She replied that she does have “migraines”. So I asked a few relevant questions about the headaches, and as is often the case, this patient’s answers led me to believe that her headaches are, in fact, not migraines.

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In our office, we often treat patients with head and neck pain who have been diagnosed by their doctors as having temporomandibular joint dysfunction. Oftentimes, such patients visit their doctors because they assume that the headaches from which they suffer must be migraines.

What are the typical signs and symptoms of a migraine headache? A typical migraine may last several hours to as many as three days. The pain is moderate to severe, pulsating, and usually on one side of the head. Typical associated signs of migraines include nausea and/or vomiting, as well as sensitivity to light and noise. Many migraine patients describe an “aura” just before the migraine begins. Auras are exhibited as a change in vision or hearing. Episodic migraines occur fewer than fifteen times per month with only some of these headaches being actual migraines. Such headaches occurring more than fifteen days per month with pain lasting four hours or more over a three-month period are considered to be “chronic migraines”.

Migraines may be triggered by various factors, and three out of four migraine sufferers describe specific triggers. Common examples of these triggers are physical exertion, stress, hormonal changes, weather changes, and others.

Tension headaches are the most common primary headaches. Such headaches may be misdiagnosed as migraines and vice versa.

Cluster headaches are severe attacks of pain on one side of the head lasting between fifteen minutes and three hours. These headaches may occur every other day or as often as eight times each day. Cluster headaches may be associated with facial sweating, restlessness, agitation or nasal congestion.

Other types of headaches include those brought on by exertion or coughing.  They may be described as feeling like stabbing pain or other equally unpleasant feelings.

If you or someone that you know suffers from headaches, we can generally help determine whether or not migraine headache is a proper diagnosis. The determination is made based upon the patient’s history and description of the pain as well as a screening examination to rule out the possibility of TMJ-type pain. We even have a computerized evaluation system to diagnose which muscle or muscles may be causing the problem. Patients often find it hard to believe that their headaches may be related to their jaw joints or their bite. The truth is, the connection between head and neck pain and the muscles involved in moving the jaw as well as those holding the head erect are commonly the source of such pain.

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If you have a question about headaches or would like additional information please feel free to contact us via our website www.DesignsForDentalHealth.com or by calling our office at 908.359.6655.

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!

I Learned First Hand What Being a TMD Patient Feels Like! AND, It’s All About the Bite!

First, I believe that this is one of the most important articles that I’ll write.  For the past twenty plus years, the study of occlusion (how the teeth meet plus A LOT more) has been my passion.  It is very difficult to explain to patients how the bite can be responsible for so many dental issues.  And, it is even more difficult for patients to understand that fixing the bite does not generally mean just getting braces (orthodontics).

richardtensTENS To Relax Muscles

Having just returned from a three-day advanced TMD (Temporomandibular Disorder or TMJ disorder) program, I learned updated techniques to assist in the establishing of proper bites for patients –  especially those who suffer form head, neck and facial pain.  We were able to see objectively with the help of computer analysis how getting the jaw position right results in muscles which RELAX, and, therefore, STOP HURTING!

 And that is the big paradigm shift that is difficult for patients to understand.  Occlusion involves a system which includes the teeth, the upper and lower jaws, muscles, ligaments, nerves, etc.  And, when this system is out of balance, there may be a variety of signs (what the dentist sees) and symptoms (what the patient experiences) which develop.

If a person’s occlusion is out of balance, he or she may develop loose teeth, sensitive or painful teeth, worn and broken teeth, headaches, neck and shoulder pain, facial pain, dizziness, clicking or popping jaw, ringing in the ears, tingling fingers, and much more.  Most people, if told that they have problems due to their bite, assume that the only way to fix it is by having orthodontics or braces on their teeth. 

Orthodontics is a dental specialty which addresses how to straighten teeth and how to make the upper and lower teeth fit together.  It does not address the position of the jaw nor the muscles and other “soft” tissues which support the jaw.  And it is the jaw position and the muscles which need treatment to solve most bite-related problems.   Picture the jaw just hanging from the skull by muscles and ligaments.  As we close our mouths, we bite to bring our teeth together as best we can.  If our ideal “physiologic” jaw position and the tooth biting position do not match, the jaw is forced into a ”bad” position requiring muscles to work overtime.  Muscles which are over-worked build up lactic acid and begin to hurt.  Most people experience such pain when they begin a new exercise program.   So, just straightening the teeth without regard for jaw position nor muscle relaxation will not solve most problems of occlusion.

 Please do not misunderstand the value of orthodontics.  Due to various hereditary and environmental conditions, children develop crooked teeth which require straightening.  Such “malocclusions” are best treated early and after a thorough analysis of how the problem developed.  Orthodontists provide an excellent service and help both children and adults to look great and function well.  Having dabbled in orthodontics, I have a real appreciation for the amazing work that they perform.

richardk7Establishing a Correct Bite

But this article is intended for those who have true “occlusal” issues which tooth straightening alone will not resolve.  A thorough examination including a complete history, comprehensive examination, necessary xray evaluations, and diagnosis by a doctor or dentist who is well-versed with occlusal issues is the first step to successful  treatment.

 I am very excited about the wonderful advances that are being made in this field, and I welcome your comments and questions.  I plan to continue addressing this subject in upcoming blog articles.  Please let me know if you have specific questions which you will find interesting and pertinent.  You may contact me by calling the office at 908.359.6655 or through our website at www.DesignsForDentalHealth.com .

Improve Your Workouts And Lessen TMJ Pain With Six Exercises

Mariano Rocabado, DPT is a physical therapist who specializes in problems with the head, neck and spines. His work with Temporomandibular Joint Disorders (TMJ or TMD) is very extensive, and he developed an exercise program that is taught to all over the world to address postural relationships with the head to neck, neck to shoulders and lower jaw to upper jaw. The objective of this home exercise program is for patients to learn a new postural position, fight the soft tissue memory of the old position, restore the original muscle length-tension relationships, restore normal joint mobility and restore normal body balance.

Temporomandibular joint (TMJ) disorder is a term which encompasses inflammatory disorders of the jaw. Symptoms of TMJ may include headache, earache, neck pain, jaw tenderness and clicking or aching facial muscles. TMJ usually occurs when the muscles used for chewing and your jaw joint are out of balance.  The cause of TMJ is most commonly improper alignment of your teeth, and is exacerbated by stress and tooth grinding.

What is most interesting is that when the body’s posture is corrected, amazing things happen with regard to strength, flexibility and balance.  Similarly, there are bite appliances which place the jaw in its “physiologic” neuromuscular position.  Such appliances are used not only to treat TMJ but are also worn by athletes of all kinds to improve their performance – golfers, basketball players, football players, etc.  I have seen demonstrations of such “instant” improvements and they are amazing.  Feel free to ask me for a demonstration the next time that you visit the office.

I began using one of these exercises during my workouts in cycle classes which I have grown to love.  These spin classes have been the core of my cardiovascular exercise for many years now.  Proper posture improves performance while exercising and playing sports, and I find that that there is a simple maneuver to help ensure good body position to allow me to get the most of my workouts.  It’s the last exercise in the series described below.

Rocabado advocates that the program be performed by the patient at home, and it consists of six different exercises and six repetitions of each exercise, performed six times per day until symptoms subside. The Rocabado exercises emphasize correct postural position and help to combat the soft tissue memory of your old posture. Perform the exercises one after the other until your session is complete. It will take about one minute.

The six exercises:

  1. Place your tongue on the roof of your mouth. Position the tip just behind your teeth and take six deep breaths.
  2. Keep your tongue on the roof of your mouth and open and close your mouth six times.
  3. Your tongue remains on the roof of your mouth and two fingers are placed on the chin to open your mouth against gentle resistance. Following that, place your fingers on both sides of your jaw and move the jaw sideways six times.
  4. Place your hands behind your neck and bend your chin down as if nodding your head.
  5. Move your chin down and back as if making a double chin.
  6. Finally, correct your posture by lifting your ribs and chest upward while squeezing your shoulder blades together.

Perform six repetitions of these exercises six times a day.

Give these exercises a try.  If you feel pain while performing these exercises, stop doing them and consider calling us to arrange a TMJ screening or consultation about your symptoms.  If you have questions, feel free to call us at 908.359.6655 or send us an email via our website at www.DesignsForDentalHealth.com

BREAKING NEWS! It’s official!

BREAKING NEWS! It’s official! We received the call this morning that Dr. Nadler has won the title of BEST Dentist in Central New Jersey! Our entire team Thanks You for voting and showing your support. We are committed to continuing our hard work to bring all of our patients the BEST that modern dental care has to offer:
*Personalized attention and a wonderful and friendly team
*State-of-the-art technology, techniques, and materials
*The best American Dental Labs
*A beautiful and clean office
THANK YOU , AGAIN!