Dr. Sinkin's Blog: The Dental And The Incidental

A HELLUVA RIDE – THE DENTAL IMPLANT PROGRAM AT NYU

July 6th, 2016 by | No Comments »

michael sinkin, nyc dentist
Never mind Memorial Day Weekend. For me, the commencement of summer fun is heralded in by a Fourth of July celebration replete with family barbecues, beach getaways, and of course, the cacophonous fanfare of fireworks.

But a few short weeks ago another type of commencement took place. This one was at The NYU College of Dentistry. It was a graduation ceremony that marked the completion of my three-year course of study in Comprehensive Implant Treatment henceforth referred to as The Dental Implant Program.

I attended classes every Wednesday (that be, all day, every Wednesday), participated in 600 hours of lectures, on-site patient care, not to mention multitudes of time spent on assigned reading and case presentations. And of course, the weekly homework assignments (that had to be handed-in.)

Three years! Where did the time go?

It seems like it was just yesterday that I started The Dental Implant Program. I was among other dentists that were half my age. I wondered if I’d be able to brush off the neural cobwebs and seriously hit the books. In fact, the books included a thousand-plus page textbook and a myriad of published articles. I would also have to learn new technology and become proficient at reading and interpreting CT scans of the jaws and sinuses, to master computer software to treatment plan and virtually place implants, to design CAD-CAM surgical guides, and more.

Then, of course, there was the mastery of implant surgery itself. But that didn’t concern me at all. In fact, I was pretty pumped about acquiring new surgical skills and adding to my repertoire.

So the time whisked by. Time does fly when you’re having fun and as cliché as this may sound, this oft-quoted adage proved very much to be a truism.

I had a blast!

My experience at NYU was simultaneously stimulating, electrifying and energizing. Learning can be quite intoxicating. The more I learned, the more I wanted to learn.  I hadn’t anticipated the inspiration and enthusiasm that my return to the classroom would engender. Nor could I predict my renewed vigor in the practice of dentistry.  When I first enrolled in The Dental Implant Program, Assistant Dean Ken Beacham predicted that it would be a life-changing experience for me. “That’s a little bit too much hyperbole,” I thought at the time. But truth be told, he was right.

From the very beginning, this academic adventure was as if an internal fire had been ignited. Without realizing it, my commitment to the Implant Program morphed into a full-fledged quest to become a skilled implant surgeon and, by extension, to become a superior dental clinician. I set out on a path to professional self-actualization. This was despite the fact that I was already in a very good place in terms as how I viewed my accomplishments and myself.

I have always loved being a dentist and I am proud of my clinical acumen. Yet from the onset of my new status as student, I felt compelled to excel even more. To be all that I could be (without having to join the Marines – besides I’m too old for Boot Camp!)

Every morning my wife Ann cast a smile upon me as she left me sitting in my study hall (the kitchen). I was armed with coffee, multicolored highlighters and Carl Misch’s textbook Contemporary Implant Dentistry. Such was my early morning ritual before I headed off to my office.

It is possible that I had an advantage over my younger colleagues. I have already established a successful practice, I have no small children to attend to (one benefit of empty nesthood) and I have 32 years of clinical experience under my belt. Whatever the reason, I excelled in The Dental Implant Program. I was an anomaly of sorts being older than everyone save two faculty members. But I exuded the enthusiasm and wonder of a kid in a candy store. Always smiling (so I was repeatedly told) and always on the move (I maximized the time I spent at the school). I was quite productive in my clinical endeavors and amassed perhaps unprecedented experience in placing implants and performing advanced bone-grafting procedures.

I have another advantage. My dental practice is close to NYU and I am blessed with trusting patients. Many jumped at the opportunity to be my guinea pigs. So I had no shortage of patients to treat and implants to place.

While in The Dental Implant Program I was no stranger to the speaker’s podium in the lecture hall, either. I had to present each patient’s surgical treatment plan and case work-up in a PowerPoint presentation to the class and faculty. Inconspicuous I was not. But I was ever thoughtful, respectful and appreciative of my fellow students and, of course, my teachers.

The Dental Implant Program Was A Life-Changer

Dean Beacham was right. The Implant Program at NYU was a life-changer for me.  It was one helluva ride. In addition to receiving not one, but two certificates (suitable for framing) I have acquired superior clinical skills, developed what I hope will be lasting friendships with some truly outstanding people, and got an intense infusion of mojo which only enhances my passion and desire to practice dentistry for many years to come.

Having said all that, perhaps the single greatest gift I’ve received is a sense of pride. I am so proud of myself for the effort put forth and the achievement attained.

One Final Note: An hour after I officially graduated from The Dental Implant Program I received formal notification from NYU of my appointment as Adjunct Clinical Associate Professor. I will be teaching in the very program that I just completed. Therefore, my Wednesday odyssey will continue. But not to worry my dear patients, I will not give up my practice for a life in academia.

One Absolutely Final Note: I am indebted to the faculty who so unselfishly give both their time and effort to youngsters like me who thirst for knowledge. I want to especially recognize and express my gratitude to two individuals who were (and still are) my surgical mentors: Dr. Ehab Shahid and Dr. John Como. I am happy to count you as friends.

And of course, I can’t forget to mention Dr. Donald Spitzer, whose prosthetic skills are as much appreciated as is his friendship. And, a huge hug to Ken Beacham. Were it not for you and your wife Lillian, I would never have learned of this program.

And most of all, thank you to my wife Ann. Without your encouragement and love I would not have been able to achieve even a fraction of what I have. Thank You.

I am deeply honored and humbled by the past three years.

Michael

Michael Sinkin practices in New York. He loves being a dentist and is known throughout the city for taking wonderful care of his patients and for his wicked sense of humor. To contact Dr. Sinkin, link here.

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PATIENTS & FRIENDS

June 2nd, 2016 by | No Comments »

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As it is often the case with busy people, I sometimes find myself so caught up in what I’m doing and so busy being busy (running a busy practice, going to school (yes, I am still a fully engaged and enthusiastic student), as well as attending to all the other responsibilities and the stuff that keeps the fabric of my personal and professional life from unraveling and my family happy) that I lose sight of the bigger picture; namely the perspective one gains by taking a step back from it all and taking stock.

I’m not necessarily referring to a stop and smell the roses moment, but rather having the need and the discipline to allow for the occasional time-out as a means of taking a personal reality check.  Such moments often result in an exercise of conscious introspection that offers someone like me (who ponders the why as much as the how and what) the opportunity to maintain balance, motivation and focus.

Vacations often prompt such trains of thought. Nothing is more inspiring than standing ski-a foot atop a mountain covered in knee-deep snow peering out into an endless sea of azure blue sky and beholding breathtaking vistas of snow-capped mountains. Magnificent sunsets and the astronomical wonders of a clear star-filled summer’s night (hey, did anyone behold Mars, Saturn and Jupiter this weekend? – very beautiful and quite thought provoking).

But sometimes these moments, call them what you will: time-outs, reality checks etc., can happen spontaneously and unexpectedly during the course of a typical day in the office.

I had such a mini-epiphany just a few short days ago.

As it turns out, last week was particularly awesome week. Winding down my third and final year as a student at NYU’s Implant program, I had just presented my final power point presentation to my fellow participants and faculty. It was a 118-page slide show of interesting surgical and restorative implant cases that I completed during time of study. I was told later that I had more slides than the other five presentations given that day, combined. Perhaps (ok…. definitely) I can be a bit verbose, but I always loved show-and-tell. Give me a microphone, an audience and a platform – well, let’s just say I was in the zone.

I was simultaneously bringing to fruition another NYU surgical case (after a year of planning) in which I will place 15 implants in one single appointment using a sophisticated, minimally invasive technique called guided surgery. No incisions and no sutures. It’s very cool and very exciting. All the while, I have been busy in my office treating many new (thank you for all of your kind referrals) and veteran patients. And of course “luxuriating” in my more recently acquired expertise in the field of implant surgery.

As I was saying, I was having a very fulfilling week when into my office arrived quite independently Arlene D. and Judy L. who are patients of mine dating back to 1984 and my early formative years as a dentist. Then I was the “new kid” in a Forest Hills practice and at age 27 was the youngest dentist in our four-doctor partnership (my other partners at the time were 38, 46, 60 and 67 years old). I remember how somewhat less than enthusiastically both ladies had agreed to be seen by the youngster (that be me). And the rest is history.

Arlene and Judy watched me grow personally and professionally. They witnessed my becoming a father, mature into a family man, and over the years observed my evolution as a skilled doctor and compassionate human being (their words, not mine). They “followed” me to Manhattan when I started anew in 1995 and provided me with the emotional support I needed when I was going through a difficult professional do-over.

So here they were, Judy and Arlene. Beloved patients and friends for more than 32 years in my office on the same day, just hours apart. And so we visited. We caught up with each other and I shared with them the latest update of the most incredible professional and personal odyssey at NYU that was now coming to its fruition (graduation is June 15th).

Coincidentally, independently, and quite remarkably, Judy and Arlen provided me with an unexpected, unsolicited and overwhelming sense of accomplishment and fulfillment.  They have watched me “grow-up”. They saw my character develop and my skills grow. They are not surprised by my accomplishments and I feel as if they have been cheering me on not so much as fans (though it did have that feel), but as friends whose trust, respect and fondness I have earned over the years.

What Arlene and Judy gave me was historical perspective. They’ve witnessed my development and shared with me their perspective. And it was a most special gift.  The three of us shared an all-important time-out and they took stock for me about me. They didn’t just give me the chance to smell the roses they smelled them with me.

And while I embarked on this educational journey for what I thought were personal reasons, in the end, it is also for my patients like Arlene and Judy for whom I aspire to be the best I can be.

Thanks for reading,

Dr. Sinkin

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DENTAL PHOBIA – WHY ARE YOU AFRAID TO GO TO THE DENTIST?

May 12th, 2016 by | 5 Comments »

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In the words of President Franklin D. Roosevelt, “The only thing to fear is fear itself.”  But he was merely talking about the Japanese invasion of Pearl Harbor and not the crippling fear that many people experience when faced with the going to the dentist.

Dental Phobia is an actual clinical term that means THE FEAR OF DENTISTS. If you are one of the millions of people who suffer from this common phobia, you are likely shaking your head “YES” right now.

There’s a paradox about Dental Phobia that is fascinating. Studies show that dentists are consistently ranked as among the most trusted professionals. Yet, fear of actually visiting the dentist is so much a reality for so many people, that it can’t be ignored.

To avoid feeling the fear, thousands of people (even when in pain) can’t pick up the phone to schedule that long overdue dental appointment. Dental Phobia can be so overwhelming that it can lead to years of procrastination. Procrastination is often why a small problem, such as a tiny cavity, can becomes a very BIG and COSTLY problem (which only helps to reinforce one’s anxiety-a real dental “Catch-22”).

Thanks to the entertainment media, fear of the dentist is deeply woven into our collective consciousness. Just think of films such as Marathon Man, Little Shop of Horrors, The Dentist, etc. and you know what I’m referring to. Modern folklore, too, can reinforce some common myths that are associated with dental treatment. For some, just the phrase root canal is enough to bring on images of pain and suffering.

(Check out Painless Root Canal: An Oxymoron? In this post I demystify the procedure. Find the link the end of this this article]

LET’S BREAK DOWN DENTAL PHOBIA AND SEE WHAT’S REALLY GOING ON

Here’s some good news: Dental Phobia is so commonplace that most dentists address it as one of the most essential parts of their daily practice.

I’ve been a dentist for over 30 years. I have discovered that my most anxious and fearful patients are singularly scared of one specific thing: THE NEEDLE.

Whether it is a carry-over from childhood or the impact of an unpleasant adult experience, fear of getting a shot, especially in the mouth, is an almost universally shared emotion. But here’s what is crucially important for you to understand: nearly every needle-phobic patient who has ever sat in my chair has been able to overcome their fearful angst simply by receiving calming and reassuring words of encouragement, having a the comforting hand of an empathetic assistant to hold, and the application of lots and lots of topical (on the gum) anesthetic before the deed is done.

For dental phobic patients the next hurdle happens at the point when the feeling of numbness has spread and treatment commences. Many people experience unease that the injection has fully deadened the area to be treated. This feeling of angst is palpable and can be described as a disquieting ANTICIPATION OF PAIN that could rear its head at any moment. Add to that the THE SHRILL OF THE DRILL, THE STEADY SPRAY OF WATER (images of waterboarding), and THE SMELL of burning tooth.

(FYI, that telltale smell is not because a tooth is incinerated. The odor is actually from pulverized tooth (and sometimes old filling material) that is being dispersed by in a combination of air and water from the dental hand piece.)

If you have ever experienced an unexpected jolt of pain during a dental procedure, the memory is both long lasting and visceral. The fearful patient will wait with apprehension for that jolt to come. Even if it happened only once and it was years and years in the past, the feelings of dread can readily surface. Again, reassuring words, a compassionate hand to hold, plenty of anesthetic and allowing enough time for complete numbness to set in has proven to be the magic combination that gets patients to calm down a bit. A set of headphones with music is also a pleasant distraction.

Dentistry has come a long way in the past few decades. Great advances have been made in the delivery of care, especially in management of anxiety, fear and pain control. Comfortable and nearly painless care is not just a reality today. It is an essential reality. My staff and I are proud to have built a practice known to deliver care in a trusting and caring environment.

 

dental phobia, michael sinkin, root canal

IF YOUR DENTAL PHOBIA IS SEVERE, HERE’S A SUGGESTION:

Is this you? If you’ve avoided making a dental appointment because the thought of the treatment paralyzes you, may I make this suggestion: call and ask for a CONSULTATION VISIT ONLY. Go and meet the dentist with the knowledge that NOTHING will be done to you on that day. Then decide for yourself if this dentist, this office staff, and you, are a comfortable fit.

If you approach the consultation is if you were conducting a job interview…to hire someone…you will feel more in control. You’re in the driver’s seat. Don’t be afraid to ask questions. Don’t be afraid to say you’re afraid. And make sure all your concerns are addressed before you leave. If one practice isn’t a good fit, try another.

A consultation is the first step in overcoming your fears.

Do you suffer from Dental Phobia? Have you found ways to overcome it? I’d love to hear your feedback.

Read: Painless Root Canal: An Oxymoron?

(Michael Sinkin is a dentist in New York City. He loves being a dentist and is known throughout the city for taking wonderful care of his patients and for his wicked sense of humor. To contact Dr. Sinkin, link here.)

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Get New Teeth In A Day? No Joke!

April 10th, 2016 by | No Comments »

 

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Wouldn’t it be truly remarkable if you could go to a special kind of dentist and in a ONE SINGLE DAY regain lost self-esteem and improve the quality of your life? Wouldn’t it be incredible if, at the conclusion of this transformative day, you would be sporting a truly bodacious, spontaneous smile (accompanied by a few tears of joy)?

Can you really get new teeth in a day?

That’s a pretty dramatic description for a truly dramatic and often life-altering TRANSFORMATION experienced by many people who had lost all, some or even just one of their teeth. You see, tooth loss doesn’t simply affect a person’s smile, it can affect the ability to eat comfortably and to speak clearly. Because without the support of your natural teeth, even your facial features can collapse. This leaves many people without self-confidence and with plenty of self-consciousness.

Unbelievably, more than 30 million Americans are missing all of their upper teeth and another 20 million are missing all of their lower teeth (not counting wisdom teeth.) Furthermore, among people over 60 years of age, most have lost an average of 10 teeth during their lifetimes. The lucky adult who still has a complete dentition (none lost) has 28 teeth. That means that the average 60+ year-old is missing 35% of his or her natural teeth!

If we set aside the obvious physical impact that complete or partial edentulism (lost teeth) can cause, we also see psychological impacts of tooth loss. When you have missing teeth you can experience anxiety and concern about romantic situations (especially if you’re in a new relationship), fear of ending up as an oral invalid (especially if you don’t tolerate dentures well), difficulty speaking clearly, and unhappiness with your appearance. This can all can lead to social avoidance and low self-esteem. In fact, Americans spend more than 200 million dollars each year just on adhesives to keep dentures in place.

Take Heart…You Can Get Your Confidence Back

Because of amazing advances in implant dentistry, including improved surgical techniques, computer imaging, and other innovations, we can now offer many thousands of people hope that they never had before. Even a temporary state of toothless-ness can now be avoided.

This treatment approach has been popularized by a very catchy moniker: Teeth In A Day.

Simply put, Teeth In A Day is a treatment approach in which you can have dental implants surgically placed and then capped (restored) with attractive, comfortable and functional replacement teeth…all in just one visit!

This type of treatment requires careful and thorough planning. While the actual implant surgery and prosthetics (the actual crowns or bridges) can be done in one visit, you must visit you dentist for preliminary and preparatory appointments. This is because teeth are not one-size-fits-all. The design, appearance and function must be individually planned and fabricated prior to the day of delivery (that was not a reference to childbirth!).

Some Clarification About Teeth In A Day:

The Teeth In A Day process is actually a temporary (provisional) restoration.

Modern dental implants are most frequently made of commercially pure titanium or titanium alloy whose unique properties allow the implants to fuse to bone in a process called osseointegration. Certain biologic principles are accepted as scientific facts – implants require 4 to 6 months of healing before osseointegration occurs. This means that with the rare exception, the final crowns and bridges that will be supported by implants cannot be made before this time frame.

Thankfully, temporary “teeth” can be quite exquisite in appearance and comfort. But, they are a merely a means to an end. Once the implants have integrated to the bone, permanent restorations can be fabricated which in beauty, form, function, and natural luminescence, can be extraordinary and dazzling.

Losing your teeth can be a devastating and even haunting personal crisis. Dental implants make possible what was once inconceivable. They offer the means and the opportunity to bridge the gap between being toothless and whole.

Teeth In A Day is an innovative approach, which when executed thoughtfully and using proper technique, elicits spontaneous and very genuine smiles

 

Dr. Michael Sinkin has been practicing dentistry for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. To find out more about Dr. Sinkin, please click here. Thanks for reading!

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All On 4 Dental Implants: Are They Right For You?

February 5th, 2016 by | No Comments »

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A technique that’s being heavily advertised on TV, radio, print and on the web is All On 4 dental implants. Promoted as a fast and economical way to escape the discomfort and embarrassment of wearing dentures, All On 4 refers to a very specific dental implant treatment plan that can replace all or most of a patient’s missing teeth in the upper or lower dental arch.

The appeal of All On 4 is that is involves only 4 strategically placed implants, as opposed to 5 or even 6. In essence, the patient gets a nearly full complement of teeth, but needs only four implants. ALL the missing teeth are replaced by restorations that are supported by only 4 implants: All. On. 4.

It’s pretty obvious why All On 4 dental implants could be popular. The treatment plan:

  • Involves Less Surgery: Only four implants need to be placed and bone grafting procedures such as sinus lifts are often not needed.
  • Is More Economical: Only four implants are placed, thus reducing the cost of the surgery as well as that of the final restoration.
  • Takes Less Time: Because advanced surgical procedures are often avoided and the time and number of visits required to fabricate the final restoration is reduced, the entire procedure requires fewer hours in the chair.

When a patient fulfills most of the clinical requisites for a successful outcome and with careful planning on the part of the dentist All On Four can be a very viable and economical choice for patients who are either wearing (or facing the prospect) of full dentures.

In fact, success with this technique can be a real game-changer in the quality of life of the person who pursues such care. To be able to smile, to eat, and to live in comfort without being concerned that one’s teeth may fall out, is something that was unheard of for denture wearers just a few years ago.

All On 4 Dental Implants Are Not For Everyone

Before embarking on the All On 4 treatment course many considerations (clinical, anatomical, and above all bio-mechanical) must be taken into account. Failure to do so will most assuredly, in my personal and professional opinion, lead to dramatic disappointment for both the patient and his or her dentist.

While it is the dentist’s (or team of dentists’) responsibility to determine whether All On 4 is a viable treatment option, it is the patient’s prerogative to ask a lot of questions about the pros and cons of such treatment. And the most important question of all is this:

What Happens if One of the Implants Fails?

With thorough and thoughtful diagnosis, carefully planned and proper surgical techniques, well fabricated restorations, and the appropriate follow-up care, the majority of implants are highly successful. In fact, some literature indicates a greater than 95% success rate.

But the reality is this: some of the implants will fail. Aside from surgical failure, the most common reason for an implant to fail is overload. In other words, after an implant is restored with a crown or as part of a bridge, it is then put into what we call function. This implant works hard: it bites, chews, and it grinds.

When an implant is part of a bridge, one of its jobs is to help support and carry the load that normally would have been carried by natural teeth. When the load becomes excessive, it’s common for the patient to lose some of his or her supporting bone. That is what leads to implant failure.

Management of these forces is one of the most crucial aspects of long-term implant success. Here are two of the many considerations that must be taken into account when deciding if All On Four is a good choice:

  • The more missing teeth that are replaced, the greater stress and strain is placed on the implants and the supporting bone around them.
  • If the opposite dentition is overly strong, the implants will be subjected to incredible forces. Imagine a large man with powerful jaw muscles and the force his implants will endure. The greater the force, the more support (number of implants) will be needed to help share or distribute the load.

Getting back to All On 4. Remember, there are just four implants to support the functional load of an entire dental arch. If the force factors are relatively low and there is an abundance of bone to support properly sized and angled implants, the All On 4 treatment can offer years of service to a very satisfied patient. But should just one implant fail, there will be trouble. First, the entire restoration must be removed. Next, additional implants must be placed. Finally, a new restoration must be made. This is costly in time and money.

If you lose one implant on All On 4 you are left with None On 3

As a highly trained implant dentist, it is my goal to properly address the clinical and bio-mechanical demands that will be placed on my patients’ teeth and implants in the future. It’s not my goal to over-engineer a planned dental implant restoration, but it’s prudent to provide some built-in fail safes.

Okay, so maybe I do lean towards being a bit conservative. But when I design All On 5 or All On 6 restorations, my patients are confident that one single implant failure will not necessarily doom the entire restoration. Most often, a simple chair side modification is made and the patient endures not even one full day without teeth.

Thanks to both dental ingenuity and a lot of publicity, All On 4 has become a very popular and sought-after treatment option. It can be a valuable service to the edentulous (a nice way to say “toothless”) person seeking better function, esthetics and comfort, less time in the dental chair, and a lower overall investment. But it is only a good In the appropriate circumstances.

Therefore, All On 4 is not for everyone and I fear it is being overused. In the long run, the cheapest route is not necessarily the most economical one.

Stay tuned (and subscribe) for more of my thoughts on the All On Four dental implants procedure and something else that concerns me: Teeth In A Day.

 

 

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Timely Reflections: Looking Back On 2015 & Looking Forward To 2016

December 31st, 2015 by | No Comments »

michael sinkin

It’s that time of year again. After the festivities of the holidays just past, and before the celebration of the New Year to begin, that I indulge in my now thoroughly ingrained ritual of taking personal stock.

2015 was HISTORIC. It was unlike any year I have experienced since 1995 when I left Forest Hills after a long partnership and opened my practice in Manhattan. 2015 was simultaneously stimulating, thrilling, challenging, mind expanding, gratifying and…exhausting!

It also marked the beginning of a crescendo that has been building over these past two plus years during which time I went back to school in the NYU College of Dentistry’s Implant Program. I graduated from the two-year program in June (with great fanfare thanks to my wonderful staff) and in September I enrolled in the more advanced Third Year of study in Implant Dentistry and Advanced Bone Grafting techniques (SO COOL!!!)

Every Wednesday, I marched into school with an action packed schedule: lecture at 7:30am; clinic 8:30-11:30; lecture 12-1:30, lab session 1:30-4:00. Did I mention reading assignments and homework?

nyu dental school implant program graduate, michael sinkin

It’s been nothing short of EXHILARATING! So much so that when I’m in school I’m anything but inconspicuous. I know most of the answers to the lecturer’s questions and I don’t hide the fact. (Brown-noser? Show off? A little of both?) But hey, I’m 25 years older than most of my classmates!

Michael Sinkin, Dentist, Blog
All the while I have been in the office four FULL days each week doing what I’ve always loved: practicing dentistry. And somehow I appreciate it more than ever while simultaneously developing an implant practice (as in surgical placement – I’ve been restoring implants for over 25 years.)

2015 also heralded many innovative changes in my office IN ADDITION TO my continuing professional education and development.

My office manager, Sandra Rolon (who has been with us since mid-2014), spearheaded implementation of a new office computer system (despite my kicking and screaming) that has brought new technology into the treatment room and facilitated our record-keeping and insurance claim processes.

We have also instituted regular patient blood pressure screening and have even encouraged some of our unsuspecting, but otherwise healthy, patients to get their long overdue physicals.

And because I now need the additional treatment room, my longtime tenant Dr. Alter has relocated to another office in the building.

On top of it all, the entire staff has been working with a professional dental consultant to help us do what we do, but even better. We are all learning how to harness our individual and collective skills to better serve our growing “clientele” and maintain a low-stress environment.

In March I was invited to deliver a TED-style talk at the annual meeting of the American Academy of Dental Practice Administration, of which I have been a member since 1990. “How I Rediscovered The Bounce in My Step” is the story of how I rediscovered my passion for clinical practice by going back to school at age 57. It was amazingly well received.

And with all of this activity going on, I have still tried to maintain my stream of postings on The Dental & Incidental Blog. Some years ago, when I first started dispensing helpful dental pearls of wisdom along with my incidental observations, my friend Jeff asked me if it was hubris to think that anyone would deem my writing exercise worthy of the time it took to read. Well, Jeff, as it turns out many people have visited my website and found the information useful. In fact, my blog posts on average attract between 6,000 and 9,000 new visitors to my website every month.

This past July, Google used my blog post “7 Ways To Stop Brain Freeze” as part of their TV ad campaign. That post alone received 75,000 visits in three weeks and the You Tube video of the ad was watched nearly three million times.

My dental “newsletter” has evolved into a platform for readers to ask specific questions about common dental problems. It’s a kind of Ask Dr. Sinkin advice column.

Yes, I have been very busy and engaged this past year but I just never stopped to think about how busy and engaged I’ve been until I noticed how much I was looking forward to the school vacation and some time off for the holidays. This operating in overdrive has been fueled by excitement.

michael sinkin

Now that 2015 is coming to a close, I am taking my foot off the gas pedal and coasting across the finish line. I look forward to 2016 with great anticipation, but for the next week or so I’m just going to chill out in California and a long overdue visit with my mom.

A happy and healthy new year to all and a most heartfelt THANK YOU to all of you who allowed me into your lives: Dentally or Incidentally.

Michael

PS: The one New Year’s resolution that I don’t have to make (as I’ve had to for the past 20 years) is to lose weight. I joined Weight Watchers last January in 2015 I lost 40lbs.!

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This Letter From A Patient Made Me Cry

November 13th, 2015 by | 1 Comment »

It’s hard for me to believe, but as of today I’ve been blogging for six years! Back in 2009 when Betsy Kent (who is my marketing consultant) made the suggestion that I start blogging, I really thought she had lost her mind! I couldn’t imagine what I’d write blogs about or that anyone would want to read them.

But over the years my blog has proven to be a wonderfully satisfying way for me to connect with patients when they’re not sitting in my dental chair. And it’s become a great way to introduce the practice to new patients, as well.

While reading some of my older blog posts I came upon this one. It’s really special to me, so I decided to re-post it. I hope you enjoy….


from April 2014…

I received this letter from a patient the other day. I was so touched that I just had to share it with you. This is why I love being a dentist:

“Dear Dr. Sinkin,

I have been your patient for many years. Your office is so friendly and your staff so attentive and wonderful. I have expressed my gratitude over and over for how you helped me overcome my dental phobia. As a matter of fact, when I needed a filling last month, I didn’t even have one bit of nervousness!

But this time I want to thank you for the incredible transformation that my husband has had because of you.

As you know, my husband has had dental problems his entire life. He has been to many dentists and prosthodontists, but in spite of that, his suffering just got worse. It has broken my heart to observe the pain he has had to deal with, not to mention his inability to eat normally and his embarrassment about the change in his appearance. We felt that there was no hope, and that he would have to live this way for the rest of his life.

But when I met him the other night after his appointment with you, his smile was the first thing I saw. Then I noticed that the pained expression he always has on his face was gone. His mouth was back to its beautiful former shape. And his self-confidence was apparent just by the way he was walking down the street. He was truly a sight for sore eyes. We celebrated by going out for a steak dinner and he actually was able to eat the steak (for the first time in years)!

Words cannot describe how grateful we are that you didn’t give up and kept trying until you found the right solution. You are truly a miracle worker. Thank you, thank you, thank you!”


Have a great day,

Dr. Sinkin

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Don’t Flush Your Dentures Down The Toilet

October 16th, 2015 by | No Comments »

Gert #1

 

Especially Before A Holiday!
 
Dental emergencies are as varied as the people who have the misfortune to experience them. From the sudden toothache to the lost crown, from the acute abscess to the broken tooth, dental “urgencies” come in a variety of manifestations and when they do present themselves, it often happens at a most inopportune and inconvenient time (weekends, holidays, vacations…)

I have written a number of self-help blogs that have been “googled” by the dental misfortunate seeking first aid tips for the unexpected crisis. And as a way of underscoring the commonplace nature of the dental emergency, two blogs in particular (5 Home Remedies For A Toothache and What To Do If You Break A Tooth Or Lose A Crown) have had over 200,000 visits.

Suffice it to say that dental mishaps are a fact of life and dealing with dental emergencies are very much a part of a dentist’s day-to-day duties.
As I alluded to, dental emergencies come in all shapes and sizes and by their very nature are indifferent to the time of day or day of the week. So it should not come as surprise when I recount the circumstances of a recent (and rather unique) dental crisis upon which I was called to act.

  • Time Of Distress Call: Sunday of Labor Day weekend
  • Location: On the beach at Fire Island, New York
  • Nature Of Crisis: My dear friend Lenny’s 92-year old mother, Gertrude, had just flushed her lower denture down the toilet!

So what’s a mother to do? Call her son! What’s the son to do? Turn to his friend who was sunning himself right next to him – that be me!) and say, “Michael, can you help?” I said “Of course!”

  • Complicating Factor: The Jewish New Year and a family gathering to celebrate was less than a week away. The prospect of not having teeth (to smile, to speak let alone to be able to enjoy the traditional holiday meal) was mortifying. The dental lab requires three days to manufacture a denture and we had only three days to deliver the finished product (including the several intermediate steps that needed to be performed in my office.

[Important sidebar]: Comfortable complete lower dentures are perhaps the single most challenging and disappointing dental prosthesis in clinical dentistry for both dentist and patient. (Thank goodness for dental implants, amen!)

  • The Story: I saw Gert in my office three times during the already shortened week between Labor Day and the Jewish holiday. On her final visit, which was a Friday, I delivered her the finished denture. I did warn that she still would need a few adjustments and the brisket might be a challenge. Also that she would most likely experience the predictable development of denture sores. (Warm saltwater rinses and analgesic denture cream would be her friends during this time).
  • The Coincidence: We were both headed to Fire Island for the holiday; Gert with her son Lenny and me with my wife, Ann. Our homes are four houses away from each other.

gert #2

On Saturday, I made a house call. I examined Gert’s mouth on the backyard deck under bright sunlight. I adjusted and relieved any areas of irritation and polished the denture. All documented by the photojournalist-on-hand: her son, Lenny. She got a real kick out of a dentist making a house call, let alone a beach house call.

I received a hug and a kiss from a most appreciative and humored patient. And a wonderful festive meal was enjoyed by all.

Oh, I forgot to mention, that our families were welcoming the New Year together with what could only be described as a festive feast. We spent a joyous evening together thankful for all that we have. And Gertrude looked MARRVELLLOUS! The belle of the ball!
With a kiss farewell, I told her loved breaking bread with special emphasis of the soft center of the challah.

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Do Wisdom Teeth HAVE To Be Extracted? New Research:

September 22nd, 2015 by | No Comments »

do wisdom teeth have to be extracted, college

“To treat or not to treat?” That is the question.

As another August came to an end, thousands of recent high school graduates were making ready to begin the next phase of their formal education: college. And while students and proud parents alike were preparing for this milestone with shopping sprees to department stores, electronics stores (for the requisite laptop, printer and other accoutrements), Bed, Bath and Beyond (don’t forget bedsheets, towels, laundry bag and shower caddy); another errand that is part of this coming of age ritual is a trip to the dentist and an evaluation of the soon-to-be-freshman’s wisdom teeth.

Wisdom teeth generally begin to erupt around the age of seventeen, but the process of eruption can be very gradual over several years. In fact, for many people the wisdom teeth don’t develop at all. They happen to be the most frequently missing teeth in the human dentition.

The college years, ages 18-22, are primetime for wisdom teeth problems and hence, the pre-baccalaureate conversation about Dick or Jane’s wisdom teeth (and no, there isn’t dog named Spot in this tale or if you prefer: tail).

Recent trends in both clinical practice and research over the past decade suggest that wisdom teeth need not be, and perhaps should not be, extracted merely because they are impacted or poorly aligned. This is a dramatic departure from routine removal for some 20-30 years when malposed or partially erupted wisdom teeth were viewed almost as if they were “white tumors” and they had to come out. In fact, a recent study in the British Dental Journal as well as the UK National Institute for Health and Care Excellence question the heretofore-unquestioned practice of extracting asymptomatic wisdom teeth.

Certainly, there are potential problems associated with aberrant wisdom teeth such as infection, cysts, damage to the adjacent teeth, pain, and even the rare neoplasm or tumor. But, third molar surgery is not without the risks associated with any surgical intervention (pain, swelling and infection to name a few). Plus, in rare occasions nerve damage is possible (lower wisdom teeth) or sinus damage (upper wisdom teeth).

As a general dentist I am usually the first go-to person with regards to wisdom teeth evaluation. More frequently than not I am able to make my treatment recommendation based upon clinical examination and evaluation of diagnostic x-rays. When appropriate, I will make a referral to my oral surgeon colleagues for their input and expertise as often two heads are better than one when making a proper diagnosis and treatment plan. Sometimes more advanced diagnostic imaging such as a CT-scan is warranted. This helps to me to visualize the tooth, its position in three dimensions and its proximity to vital structures such as the mandibular nerve.

Each patient must be carefully evaluated on an individual basis. While younger people tolerate wisdom tooth extractions more easily, this fact alone does not warrant automatic removal.

Sometimes, however, it makes sense to remove the tooth before the roots are fully formed which makes for both a simpler surgical procedure while also avoiding nearby vital structures like nerves and sinuses.

Coronoectomy or the removal of just the crown portion of the tooth while leaving the deeply impacted roots alone is a somewhat novel surgical approach that involves thinking “out of the box” treatment planning. It eliminates the “problem” of a malposed wisdom tooth and its threat to the adjacent second molar while minimizing the potential morbidity of more complicated and invasive surgery. My close working relationships with talented specialists is an essential resource for optimal patient care; even when the extent of that care may be the decision not to care at all.

Proper evaluation of wisdom teeth is essential to maintaining and safeguarding optimal oral health. Diagnostic imaging, be it x-rays or cone beam scans (dental cat scans) are a crucial part of thorough work-up.

I will never forget my patient Tim. When I first met Tim he was a healthy 40-year old with a full complement of completely erupted and properly-aligned wisdom teeth. One day he arrived at the office with swelling in his jaw. Conventional dental x-rays could not “reach” far enough back in his jaw to see the source of his problem. (By the way, this is a common problem when taking X-rays of wisdom teeth in a small mouth because the X-ray sensor can cause a gag reflex and even dig into the delicate tissues of the mouth.)

I referred Tim to an oral surgeon, who upon taking a panoramic x-ray and a C-T Scan, discovered an impacted wisdom tooth with what turned out to be an associated dental tumor (Odotontogenic Keratocyst, if you must know). Not only did the wisdom tooth, extra tooth and tumor need to be removed, the procedure needed to be done in a hospital (in this case, Sloan-Kettering in NYC).

Tim is fine now, but i shudder to think what might have been if his condition was not discovered. The tumor was literally eating his jaw bone. While his situation is indeed rare, it underscores the importance of a thorough evaluation of your wisdom teeth, even if they are not bothering you.

Remember, an ounce of prevention…

To all of you college students: Good Luck! Remember to brush your teeth and don’t let your books get in the way of your education. For those of you not pursuing a college education, remember that college may not be the be all and end all to a successful happy life, and it won’t spare you from those potentially pesky wisdom teeth.

 

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Adding Milk To Tea Prevents Teeth Staining – Here’s Why:

September 1st, 2015 by | 2 Comments »

girl drinking tea

 

Tea is the cause of more teeth staining than any other beverage, including coffee. And black tea, the most widely consumed type in the world, is the worst offender of all!

It’s no sin to need that cuppa first thing in the morning, but the downside is the residual dark staining that it can leave behind. Tea (and coffee) contains chromagens. Chromagens are intensely pigmented molecules and are the reason that these seemingly indispensable beverages have their beautiful dark color. Because chromagens have a particular affinity for tooth enamel it makes them prime smile-tainters and teeth-stainers.

Why Adding Milk To Tea Prevents Teeth Staining – The Facts:

A recent study reported in the International Journal of Dental Hygiene found that that by adding milk to tea you can reduce its staining impact. That’s great news for tea lovers. But why is tea such a culprit?

If you thought chromagens were bad, meet tannins!

Tea, unlike coffee, also contains tannins. Tannins are a kind of chromagen and are largely responsible for tea’s distinct flavor and lovely color. However, tannins make teeth enamel much more susceptible to staining. In effect, tea presents a double-whammy to your pearly whites!

But don’t freak out. You can still enjoy your cups of soothing tea without ruining your smile. Here are my recommendations:
The Tea Drinker’s Guide To Teeth-Friendly Tea Consumption:

    1. Add Some Milk to your Tea. Milk contains a protein called casein, which binds with tannins and decreases dental discoloration. (I guess the Brits knew what they were doing all along!)
    2. Be mindful of the Tannin Levels. Most teas contain some tannin including green tea, white tea and herbal tea (decaffeinated, too!). But it is black tea that has the highest levels.
    3. Swish With Plain Water: When you finish sipping your tea it’s a good idea to swish your mouth with plain water. This washes away much of the residual tannins lingering on your tooth enamel.
    4. Be Scientific: When steeping your tea, keep this piece of scientific trivia in mind:During the first two minutes of immersion in boiling water tea leaves release the majority of their caffeine. Between 2 and 5 minutes the tannins are drawn out of the leaves.So, if you are looking for a pick-me-up, drink your tea after two minutes for maximum stimulation and minimum tannins. If you are looking to relax, empty your cup after two minutes, and then re-steep your tea bag. But beware of the tannins (see helpful hints 2. and 3.)
    5. Beware of Herbal Teas: Many herbal teas are derived from fruit. Most popular are lemons, raspberries, and black currants, which are delicious but tend to be very acidic. These teas can actually dissolve tooth enamel and weaken your teeth them, too. Rinsing with water after consuming can help neutralize this “acid attack”.Note: Don’t brush your teeth for at least 30 minutes after drinking an acidic beverage, lest you abrade away the softened tooth structure. (Also, when you add a slice of lemon to any tea you are also increasing its acidity.)
    6. Don’t Swish Your Tea! Avoid swishing tea in your mouth. Try to minimize the tannin-to-tooth contact as much as possible. When drinking iced tea, use a straw.
    7.  Switch: If you are an avid tea drinker here’s one last caveat to keep in mind: the trifecta of rich color, high tannin content, and high acidity maximizes tea’s staining potential. Alternatives, such as chamomile, are a tooth-friendly choice.

As you can see, while tea is one of the most widely consumed beverages in the world, it’s not the most conducive to a white, bright smile. If you drink tea all day, try to cut down or replace a few cups with an alternative.

And as the study indicates, when you do sit down to enjoy that cozy cup of tea, splash in a little milk to protect your smile. And if your teeth are already stained, think about an in-office teeth whitening treatment. We do tons of these every week and our patients are in love with the results: The Best Teeth Whitening In New York City.

Here are some other articles about this new information about tea with milk and your teeth: http://greatideas.people.com/2015/08/20/milk-tea-teeth-whitener-study/

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© 2008 Dr. Michael Sinkin, D.D.S.