We Now Offer A Solution For Dental Anxiety

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First, let me say that much has happened since our last newsletter back in August. We have welcomed Dr. Sagar Lunagaria to our practice, and as a result, we are offering new services and additional hours. In particular, Dr. Lunagaria provides sedation for those who have dental anxiety, he is experienced in placing dental implants and he performs gum procedures which previously required our patients to seek the care of a periodontist. For many minor surgical procedures our patients can now remain in our office. In addition, in the event that you need care for a dental emergency, you will find it much easier to be seen very promptly to have your problem addressed.

It has been an absolute pleasure working with Dr. Lunagaria, and he has been well received by not only our team but by the many patients who have met him during September. Dr. Lunagaria will be available in our office every day that we are open except Tuesdays. Please make sure that you have an opportunity to meet him the next time that you are in the office.

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You can now truly relax in the dental chair while having your treatment. Nitrous oxide – commonly known as laughing gas is a mild sedative. It is one of the safest ways to relieve fear and anxiety related to dental appointments. This form of relaxation is also very helpful in eliminating or minimizing severe gagging. It does wonders for individuals who are highly fearful of needles or who have real difficulty getting numbed.

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Is severe gagging preventing you from seeing a dentist?

Nitrous oxide is administered through the nose by simple inhalation while your dentist works on your teeth. The amount of gas is regulated by the dentist so he has full control over the amount of anxiety control which is needed for each individual patient.

Fear of needles?

Inhalation sedation is very safe and there is almost no side effect of it. The effects of the laughing gas wear off quickly as so that you can drive yourself home after finishing your procedure without the need of an escort.

Do you ever dread going to a dentist?

Depending on the severity of fear and anxiety, nitrous oxide (laughing gas) can be combined with oral medication which is taken before your treatment to help you relax even further. It is a great choice for people who fear needles. You will be awake and aware of your surroundings but relaxed and free of anxiety. It also helps create short term partial memory loss, so most patients do remember discomfort, smells or noises associated with the dental procedures performed.

Do you have difficulty getting numbed?

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Again, our goal is for you to be comfortable and anxiety-free during your dental treatment. We are proud to offer this service in our office now. Call our office at 908-659-6655 to find out more or visit us online at www.DesignsForDentalHealth.com to book a complimentary consultation today!!

Top Five Dental Problems For People 50 +

Many of our patients have been visiting us for well over 20 years. As these patients reach 50 years of age and above, we see a significant shift in the risk factors whichj affect them from a dental standpoint.  There have been several instances of patients who have suddenly developed rather severe decay, gum disease, and general tooth attrition resulting from bite problems. These are patients who for years required only minimal and basic preventive and restorative care.

As a result, I decided to list and describe the top five dental problems which those of us who have reached age 50 and beyond are experiencing. In our next blog article, we will present the top treatments which have been successful at addressing these issues. As always, the best treatment and care which every dental patient needs is preventive care. Preventive care includes proper homecare and routine dental exams and cleanings. Those who are seen regularly in our office are much less likely to develop the major problems which some 50+ year olds experience.

The top five dental concerns are:

1. Dental decay especially around the gumline.

features-teeth-1Often, as we get older, our gums recede leaving root surfaces exposed and gaps between the teeth.   As the root surface is less smooth and softer than enamel, decay in these areas is quite common here. And between the teeth where spaces have developed, food and plaque become trapped and lead to decay as well.

 

 2. Dry mouth, also known as xerostomia.

The amount of saliva in our mouths can decrease as we age. In addition, many medications can cause a reduction in saliva production leading to dry mouth. The importance of saliva in protecting our teeth and gums cannot be overstated. Saliva acts as a buffer to help neutralize the acids which are the main cause of dental decay and gum disease. Acids are formed in our mouths when the bacteria in plaque ingest carbohydrates like sugars which we eat.

3.   Gum disease (periodontal disease)

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It is not uncommon to see patients who have had mild to moderate cases of gingivitis in the past begin to develop more serious periodontal disease. Gingivitis is inflammation which is limited to the gums and results in redness, swelling and bleeding gums. If this problem progresses, the underlying bone may become involved and the attachments of the teeth becomes increasingly jeopardized. In its most severe form, teeth will become loosened and may eventually literally fall out.

4. Oral cancer

Traditionally, the use of tobacco and alcohol has been associated with oral cancer.   Today HPV  (Human papilloma virus) which is sexually transmitted has become the number one cause of oral cancer. In this case, the best offense is a good defense meaning regular dental checkups which include a proper oral cancer screening.

5. Crowded teeth

We have seen numerous examples of patients whose teeth have been slowly shifting over the years resulting in marked overlapping of especially the upper and lower front teeth. Teeth which are crowded tend to collect more debris and plaque than those which are straight. In addition, overlapping teeth are more difficult to keep clean. As a result, such teeth are more prone to both dental decay and gum disease. In addition, because crowded teeth do not meet the teeth in the opposing arch evenly, such teeth exhibit increased wear and chipping as they become more and more thin.

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We will address possible solutions to each of these problems in our next blog. In the meantime, if you have any questions about any of these issues please feel free to contact us by telephone at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

 

Which Is Worse –Bad Gums Or Teeth?

This may sound like a trick question, but really it’s not. The “correct” answer, of course, is that both are equally important. But, I have a different view and will share it later in this article.

Both gums and teeth require good to excellent daily hygiene to remain healthy.   Prevention of both periodontal disease and dental decay is accomplished using the same techniques and products.  Both gum disease and dental decay are caused by the attack of bacteria which produce acid.  This acid causes damage to both hard and soft oral tissues including gums, enamel, dentin and bone. Both conditions if not properly and promptly addressed will result in the eventual loss of teeth as well as the inability to properly chew food.   And, both problems are a source of embarrassment and self consciousness due to missing teeth, bad breath, swollen and red gums, black holes, etc., etc.

Both teeth and gums are checked at every dental re-care appointment.   Commonly, both june3of these dental diseases go unnoticed by patients until more involved and expensive treatments are required. In the case of cavities, decay which has advanced to the point when a patient feels pain will generally require root canal therapy. And, in the case of gum disease, by the time a patient realizes that there is a problem, the solution often involves the services of a periodontist, possible gum surgery and / or loss of teeth.   Unrecognized and untreated periodontal disease will eventually lead to loose teeth as a result of the loss of bone and the attachment of the teeth.

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Finally, both gum disease and tooth decay result in the existence of chronic infection and inflammation which has detrimental affects on the overall health of the body. A chronic infection which becomes acute, can result in serious illness which may require hospitalization. The hidden impact of such diseases, however, is that these chronic inflammations increase the risk of other health issues including heart disease, cancer, complicated births, etc.

As promised, my view whenever planning the treatment for patients and explaining its need is that once acute infection and pain are under control, the health of the gums is the number one priority.  Consider the gums and bone to be the foundation which supports the teeth.   Without a solid foundation, even the healthiest teeth can be lost. Once the periodontal condition is stable and healthy, then the teeth can be addressed as needed.

If you have any questions about gum disease or dental decay, please feel free to contact us by telephone @ 908.359.6655 or via our website www.DesignsForDentalHealth.com

Our 30th Anniversary Hillsborough High School Scholarship

The artwork which you see displayed in our office has been created by six Hillsborough High School Seniors who have applied for the Richard M. Nadler DMD, PA 30th Anniversary Scholarship.  One student will be selected to receive this scholarship based on their artwork submitted for display as well as letters of recommendation from two people who were influential in the selection of fine arts as their college path.  

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This scholarship is our way of expressing thanks to the Township as well as the people of Hillsborough for having been hosts for our dental practice for the past 30 plus years.  You may ask why would a dentist sponsor a Fine Art scholarship? Wouldn’t a career in science or medicine make more sense? Well, you may already know that I originally began my working career as an architect. I actually practiced that profession for a period of some ten years before returning to school to become a dentist.  One of the reasons that I chose architecture as my original career was because of my love of drawing and art. I have always had tremendous respect and admiration for those creative individuals who have the ability to express their imagination through the visual arts – whether it is on paper, canvas, film or in three-dimensional sculpture. So, I decided to also encourage a potential, local, up-and-coming young artist to pursue his or her career in the arts.

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I hope that in some small way this scholarship expresses the gratitude that our entire team has for the people of Hillsborough.   It is you wonderful people who have made coming to work each day our life’s fulfillment.

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Back to Normal Sooner with Oraverse

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With today’s busy schedules, sometimes it’s difficult to make time for a dental appointment. The last thing you want is to have to spend several more hours after your appointment recovering from the numbing effects of the anesthetic.

Here at Designs for Dental Health, we believe that providing the best possible care also means minimizing your downtime! So, we use a “numbness reversal” product called OraVerse to get you back to your normal life, faster.

Resume Your Life In Half The Time

OraVerse brings patients who have received anesthesia back to normal sensation in half the time. Oraverse is a rather new product which we felt would offer a real benefit to some of our patients who really do not like that “numb” feeling or who need to be ready to get back to work fast. As always, feel free to let us know if you have any questions about this product.

Say Goodbye To Slurred Speech And Drooling!

After your appointment here, we know you may be headed back to work or school. We want to help get your sensations and speech back to normal as soon as possible.

In addition to helping you avoid embarrassment caused by slurred speech or drooling, OraVerse helps reduce the risk of injury caused by biting the inside of your cheek while you’re still numb.

Has Anything Funny Happened To YOU While Numb?

We feel like our relationship with you doesn’t end when you walk out our door.  Has anything funny happened to you when your mouth was numb? If so, share your story in our comments section below. We’d love to hear from you!

This article was originally featured on our secondary blog site.  You can find it by clicking on this link: http://designsfordentalhealthblog.com

Is Invisalign a Reasonable Option to Straighten Adult Teeth?

Invisalign is a system for straightening teeth and improving the bite which is an alternative to conventional metal orthodontic “braces”.  This system utilizes a series of clear plastic aligners, each of which is worn 22 hours per day for a period of 2 weeks. The company began in 1997 and has gone through a series of improvements which have made this method increasingly utilized and accepted by the dental community as well as patients.

There is no question that our practice is seeing more and more adult patients who  request Invisalign to improve their bite and appearance, as well as to help turn back the clock.

There are a number of conditions which can be addressed using this system:

  1. Those who had orthodontics as a child but have seen significant relapse over the years.
  2. Patients who are concerned about the shifting or increasing misalignment of their teeth.
  3. Those who have teeth which are wearing down unevenly.
  4. Patients with teeth that appear crowded or misaligned.
  5. Those who have an underbite, overbite or open bite.
  6. In some cases, those who have gaps between their teeth.
  7. Increasingly, those who desire to improve their appearance and look younger.
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Click this image for a concise video on Invisalign.

There are significant benefits of Invisalign as compared to conventional metal orthodontics:

  1. InvisalignThere are no dietary restrictions because the aligners are removed before eating.
  2. There are no special dental hygiene requirements because the liners can be removed to brush and floss the teeth.
  3. Because the aligners are made from a clear plastic material, they are practically invisible.

As the system begins with a virtual treatment plan called a “ClinCheck”, both the dentist and the patient are provided a digital preview of the treatment.   This preview, if used properly, helps to determine how well the treatment will result.  In our experience, patients truly enjoy this preview and its use to track the progress of their case.  It’s important to note that In some severe cases, the use of Invisalign may not offer the best solution. Some cases may still require either surgical intervention, conventional metal braces or a combination of the two.

There are several long-term benefits of having straight teeth and a good bite:

  1. Straight teeth are easier to keep clean and food particles and plaque are not trapped in uneven spaces.  The result is a decreased likelihood of both dental decay and gum disease.
  2. Healthier teeth and gums contribute to a person’s overall systematic well-being and health.
  3. Uneven wear due to misaligned teeth is alleviated.
  4. Patients enjoy a more confident smile and an improved, more youthful appearance.

 If you have any questions about Invisalign, please feel free to call us at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

Invisalign

The Best Way To Fill Your Tooth

Can You Just Fill It?

One question that dentists are asked all the time is: “Can you just fill it?” My goal with this particular article is to answer just that question.   And the answer is: That depends on several factors. First and foremost are the needs and desires of the particular patient.  Equally important is the condition of the tooth or teeth in question.

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First, let me begin by explaining that nearly all of today’s tooth restorations are made of ceramic. Ceramic encompasses the materials most commonly used to restore teeth today. This includes porcelain in various forms as well as composite, commonly known as “plastic” fillings.  In our practice, metal is rarely used except in specific cases where achieving a quality bond is impossible (deep under the gum) or the strength of metal is mandatory.  Ceramic materials offer a beautiful, lifelike appearance and can be bonded to tooth structure for strength and longevity.

The choice of whether to use a composite filling or some type of porcelain restoration is dependent upon the following five conditions:

1. The size of the cavity

Composite fillings makes sense when the cavity – whether caused by decay or fracture – is less than one third the width of the tooth and takes up less than 50% of the biting surface. Larger cavities with inadequate tooth to support a filling are best restored using porcelain.

2. A cracked tooth

If the tooth is cracked, a porcelain restoration is needed to protect the tooth from fracturing.  We commonly see cracked teeth when silver fillings, especially large ones, have been in place for many years.

3. Worn teeth

Teeth which are worn can be restored with either material depending upon the extent and location of wear.   Surfaces which receive heavy biting forces require the strength of porcelain to last a reasonable length of time.

4. Root canal

Teeth which have had root canal therapy generally require porcelain crowns to protect them from breakage, as these teeth are brittle and somewhat hollow as a result of the root canal.

5. Tooth Modifications

Sometimes teeth are restored to alter their shape and or appearance. Examples are gaps between teeth, poorly aligned teeth and teeth which are restored to improve the bite.  Larger modifications require the use of porcelain.

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Today’s porcelains are much different from those that were used only 10 to 15 years ago. Newer technology has produced ceramic materials with exceptional strength as well as a lifelike appearance.  In addition, these materials can be used to make crowns, commonly known as  “caps”, which cover the entire tooth.

fillThey can also be used as onlays or “partial caps” to preserve solid healthy tooth structure. These onlays are beautiful and long-lasting restorations which can be less costly than full crowns.

If you have any questions about which fillings are appropriate for you, please do not hesitate to call our office at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

Celebrating 30 Years- Thank You, Mentors!

I had wanted to complete all of our anniversary “Thank You’s” in November, but that was not meant to be.  Liz and I enjoyed a wonderful long Thanksgiving weekend with our family and I decided not to rush through the final couple of articles as the people to whom they are directed have been important mentors in our lives.

With that being said, I feel extremely fortunate during my career for having found the perfect mentors who I needed at the exact time when I needed them. Each of these mentors helped our office and me personally to grow and focus on what is important and point out and help eliminate our weaknesses. I firmly believe in the value that mentoring provides for people in every situation and in every decade of life. It is my sincere hope that at some point in the future, I may give back to younger dentists some of that which I took away from my mentors over the years.

mentorsI have already mentioned in an earlier thank you article the first mentor who had a significant impact on my career – Dr. Peter Dawson. Shortly after dental school, I knew that I did not want to be an “ordinary” dentist who filled teeth all day, every day. I had also come to believe that a thorough understanding of occlusion was mandatory if I was to be an excellent dentist. The reason is because occlusion has an impact on just about every condition in the mouth including gum disease, TMD, appearance and everything having to do with the longevity of dental health. Since Dr. Dawson wrote the most important modern book on the subject, I decided to take his course and began to learn about this most complex subject. As I mentioned in the previous article, I had the amazing luck to run into Dr. Dawson in the airport as I was coming home after his class. It was at that meeting when he recommended that I begin studying at the L. D. Pankey Institute which I did.

It was on a gorgeous day in the summer of 1987 or thereabouts that I sat in my lounge chair with an occlusion textbook (which had been recommended as adjunct reading) on the beach at Spring Lake. That day was a turning point in my life as that was the day when occlusion began to make sense to me. To this day, whenever I choose to improve my understanding of any subject, I find no better place to do it than in a chaise lounge on a beach.  Now, some 25 years later, I am still studying occlusion and have attended the Las Vegas Institute for Advanced Dental Studies where I learned another philosophy on the same subject.  Thank you very much Dr. Dawson for helping me to begin on the right path.

Then, a few years later, as the office was getting busier, it became apparent that our lack of business management savvy was becoming an issue. My experience and reading had taught me that most businesses go through a progression of plateaus and the best businesses do what is necessary to face and address challenges as they arise. Common challenges include time management, team building, financial controls and the myriad of systems which make a business work.

mentorsTo that end, I was extremely fortunate to have met Dr. Michael Schuster. He and I shared a similar practice philosophy as he, too, practiced Pankey style dentistry and had a school called the Center for Professional Development (now called the Schuster Center) where a philosophy of practice management and the tools necessary to run a dental practice were taught. My team and I studied in this center in Scottsdale, Arizona for two years; and, during that time, traveled there on several occasions to learn how to better manage our office. In addition to the meetings in Arizona, there were monthly phone conferences, many books to be read and book reports to write. This course of study was like an MBA for dentists. After the first year, I clearly remember feeling so positive that I had recurring dreams about being able to fly –  seriously!

This course of study helped me to organize my entire life as well as our dental practice that eventually began to run like a well-oiled machine. Unfortunately, along with the process of self-discovery and success with the dental practice came the end of my marriage. I believe that if it were not for Dr. Schuster I would not be as successful as I feel today both professionally and personally. There, I was taught the value of setting goals and looking inward to take control of my life in a positive way. Thank you Dr. Schuster. I owe a huge debt of gratitude to you for providing exactly what I needed at that time in my life.

mentorsFinally, I’d like to thank Dr. Charlie Martin who is a dentist in Richmond Virginia and who ran conferences four times each year and facilitated a “mastermind” of like-minded dentists. Charlie is a passionate and hard-working dentist who has the ability to engage others with his point of view and extensive knowledge on various subjects. He was most helpful to me in helping to decide the most current direction in our dental practice. He provided what I needed to know,  and, as a result moved to the next level of my career. Unfortunately, Charlie has retired, but the effects of his efforts on all of our mastermind members will be felt for years to come.   Thank you Dr. Martin! This course of study helped me to organize my entire life, as well as our dental practice, which eventually began to run like a well-oiled machine. Unfortunately, along with the process of self-discovery and success with the dental practice, came the end of my marriage.

I am also grateful to Dr. Charlie Martin for having introduced me to a wonderful group of dentists who are equally passionate, hard working, intelligent and an absolute pleasure to share time with. I miss them and the conferences in Richmond, and I wish each of these friends much health, happiness and success for years to come!

Celebrating 30 Years- Thank You, Maria and Our Hygienists

In today’s installment of our Thirty Days of Thanks, I have the pleasure of expressing my gratitude to Maria Slavinsky and all of our dental hygienists. Maria has been an important member of our team for the last eleven years! During that time, anyone who has been a “regular” in our office knows that Maria was married, had a baby and has become a most caring and involved mother. One reason that patients like her so much is that she begins every visit by “catching up” on the past six months and sharing the most recent pictures of her family. She has that natural gift of being able to bond with people and show her true interest in everyone for whom she provides care, not to mention her coworkers, friends and family.

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Patients also appreciate the fact that she is gentle and yet very thorough in her treatment. She provides a complete explanation of what is happening in each patient’s mouth, and has the knowledge to offer solutions for patients’ various issues and concerns.

As a team member, all of us appreciate Maria’s dependability, enthusiasm and cooperation. She has only missed being in the office on two extended occasions.  One of those occurred six years ago just after one of our office holiday parties. Apparently, Italian food jump started Maria’s contractions and she gave birth to her daughter Veronica within a day or so. The other occasion followed an incident in Maria’s kitchen when she was attempting to remove an avocado pit.   Without getting into too much detail, that incident resulted in surgery to properly reattach one of Maria’s fingers. She is no longer allowed to carve up avocados! I guess the only other time she regularly places herself in jeopardy is when she and her husband Dmitri and daughter Veronica go skiing, which I believe is as often as possible.

There is one trait which Maria has that you may not be aware of. It is a trait which I have come to share with her. We have both become rather germophobic over the years, so none of our patients needs to be too concerned about cleanliness around Maria. She and I wash our hands constantly after any questionable contact, and she is always cleaning up to get rid of any potential hazard.

I would be remiss if I didn’t mention Karen Cummins  I have known Karen for as long as I have been in Hillsborough, as her son Marty and my daughter Meredith were an item at one time. More importantly, Karen has been a part time hygienist in our office for many, many years; and, has a very loyal following of patients who want to be seen only by her. She has been a good friend to us over the years and we truly appreciate all her help.

Similarly, there have been other hygienists in our first two decades who were wonderful members of our team and provided excellent care for our patients. The work that hygienists do is not easy and requires dedication and skill to be done with proficiency.

Thank you to Maria, Karen and all the hygienists for your professionalism and friendship over the past thirty years.

Celebrating 30 Years- Thank You, Our IT Partners

Thirty years ago, a dentist would not have had any idea that he or she would need IT partners to insure that his or her practice runs smoothly. So, in today’s installment, I would like to thank those companies who help to make our office run like a well-oiled machine while giving us more time to spend on patient care and less on managing our non-clinical affairs.

First there is Dentrix, our dental software company.   It is this company which provides all the software to make appointments, set up individual digital charts for patients, manage each patient’s account, submit insurance claims, and basically keep track of just about everything that goes on in our dental office. I vaguely remember managing all these details by hand until the late 1980s. It was very time consuming and not fun!   Dentrix is our second software company, and we have been with them for about 20 years. It is easy to take for granted everything that this software allows us to accomplish, but I believe that this company offers a wonderful product, keeps it current, and allows us to be so much more efficient.

Second, there is Dexis, our digital imaging company, which provides both the hardware and software for digital radiography (x-rays).  As I mentioned in our previous article, these digital x-rays are a huge improvement over the photographic system that we had used for over 20 years. So now, when we open the patient’s digital chart, all of his or her x-rays and photographs are visible and easily enlarged on our computer screens. The system has improved our ability to make proper diagnoses, explain what we see to patients, and keepg ongoing photographic record of patients’ conditions, which we have found to be so helpful in developing appropriate treatment plans for any given patient.

Third, I’d like to thank the Smilereminder Company (now called Solutionreach).    We have been with this company for close to ten years and they are responsible for the reminders which you receive before your appointments. They also allow us to stay in touch with you via our Digital newsletters, birthday cards, and holiday wishes. We have found that this company is very well managed and provides a great service for us as a dental office and for you as patients.

Finally, I’d like to thank Gilleard Marketing for producing our newest website and maintaining it in a professional manner. We feel that this website reflects a true image of our office and we appreciate Keith Gileard’s photographic and creative skills to produce such a fine website. I consider Gilleard to be a very important IT partner in the day-to-day management of our dental practice and I would recommend his work to anyone who seeks such service.

IT Partners

I hope that this brief view of our dental management technology has offered you some insight. We always encourage and welcome your comments about this and any other technology. Feel free to ask us about it or offer your opinions the next time that you are in the office.