So it’s 7:45 Saturday morning and I’m awakened from a deep sleep by the sound of my cell phone ringing. “ Expletive!” I forgot to turn off my alarm clock feature, or so I thought. Stumbling out of bed, I reached for the dreaded dream destroying droid only to discover that I had an incoming call. After groggily greeting the caller, I heard a woman respond, “Oh, I wasn’t expecting to get a real person on the line, I broke my tooth and need help before Monday…..I have an important meeting…..leaving for Pennsylvania…” Not knowing who I was talking to, with cobwebs lingering in my head, night-guard still in my mouth, I took the caller’s name and number and told her I’d call her back in 15 minutes. Before hanging up, I realized that this lady was not a regular patient of mine and found out that she learned of me through a Google search!

I jumped into the shower, pondering the predicament: a total stranger calls me out of the blue in the wee hours of a Saturday morning after finding me on the Internet. She’s not in pain, but is clearly distressed. I have no available staff. Do I open the office to see a female stranger alone without supervision? Do I try to locate another dentist with Saturday hours? Is this a true emergency or a terrible inconvenience? Awashed, awake and alert, I finish showering and call “her back. After ascertaining that she does indeed need immediate care, I agree to see her as long she comes in with another adult.

9:30 am: Jackie (not her real name) arrives at the office with her sister, Jamie (also, not her real name). Jackie had broken her four front teeth in a fall. Additionally, two of her other teeth were knocked loose. Having calmed her down, (to say she was nervous is an understatement) we proceeded to the operatory where her sister Jamie sat in my assistant’s chair and held her hand throughout the 2+ hour “appointment”. I don’t know who was squeezing whose hand harder, but before long I had them both smiling and laughing. Jackie was unaware of the injection I was giving her and kept asking Jamie if the needle was in. And both started giggling while the Lidocaine was being administered. The more I bantered with them, the more they laughed. The anxiety and distress of the situation was but a memory. As strange as it may seem, there was a backdrop of levity and humor amidst an otherwise serious situation.

In the end, I bonded and stabilized Jackie’s battered teeth. Her smile was beautifully restored (if I do say so myself). Actually, Jackie thought they looked better than before and Jamie had been regularly updating concerned family members on her iPhone during the procedure proclaiming how wonderful and natural Jackie’s teeth looked. (One might say that she had chair-side seating giving bond-by-bond analysis to her listening audience.)

When we left the office, I was bolstered by the feeling of a job well done and a good deed done for someone deserving and in need. Nothing is more rewarding than being the recipient of a grateful smile. I will be seeing Jackie again soon for follow-up care.

The curious thing is that she did call her regular dentist and spoke to his service. She just never heard back from him.

Many people (including yours truly) who are at least old enough to have college-age children are walking around with “medals of valor” in their mouths, reflective of a dental age gone by. These “medals” or actually “metals” that I playfully refer to are of course silver-mercury amalgam fillings.

Silver-mercury amalgam was the mainstay  of restorative dentistry for generations long before the advent of dental bonding and protective occlusal sealants. Amalgam fillings predate water fluoridation, which began in earnest in the 1950′s (and no, fluoridation was not some Communist plot to poison Americans as some had theorized!).

In those days, was not uncommon for a child to come from the dentist’s office with the news of five or six cavities, each of which would subsequently be treated and restored with silver-mercury amalgam. While I don’t mean this in a pejorative way, “drill-and-fill” was a common moniker for that process of treating cavities. Quite a few of us baby boomers are walking around with veritable mouthfuls of silver-mercury amalgam fillings.

But times have changed. Thanks to preventive dentistry, healthier diets, and the aforementioned fluoride and sealants, numerous teenagers and young adults have never had a single cavity! But there have been recent reports, such as the one cited in this New York Times article, A Closer Look at Teeth May Mean More Fillings, that heretofore pristine mouths are being diagnosed and treated for a condition (I use the term loosely) called “microcavities”. “Microcavities” are not a new phenomenon. In fact, they are essentially a very early stage of the tooth decay process that may or may not develop into a full-blown cavity. Today’s “microcavities” are what dentists have for decades referred to as incipient caries, or to put it more simply, “surface cavities”.

What Causes Cavities Anyway?

A cavity begins with a bacteria-induced acid attack of the enamel surface of a tooth (enamel is the hardest substance in the body). If this acid attack persists, pitting and softening of the tooth structure occurs and renders it susceptible to breakdown. Thus a cavity is born. But incipient caries affect only the enamel of the tooth. They are superficial and do not penetrate beyond the outer half of the tooth’s protective enamel. Incipient caries can be treated with fluoride to re-mineralize the tooth structure and reverse the destruction, thus eliminating the need for a filling.

As mentioned before, not all incipient caries will progress to true cavities. Good clinical judgment is required to make the right decision. “To treat or not to treat, that is the question! Sometimes watchful waiting (along with dietary counseling and fluoride application) is the most prudent course of action. New technologies can help with monitoring and aid in treatment decisions and one such development is Diagnodent, a diagnostic laser that can measure the relative depth and progression of a cavity.

Unfortunately, many of the so-called “microcavities” are being rushed into treatment with fillings. What’s important is this: once a filling is placed into a tooth, the greater the likelihood that the filling will need to be replaced someday.

So, remember, all cavities are not the same. If you are diagnosed with an uncharacteristically large number of cavities, ask questions! While it is not uncommon to see your kids go off to college with perfect teeth and come back with their first cavities (blame it on increased sugar and junk food intake accompanied by a slackening in oral home care) I fear that the “discovery” of “microcavities” has led to over-treatment of what is often a reversible condition.

Though I’m not usually one to be at a loss for words, I often experience a uniquely gratifying feeling that I find difficult to describe while interacting with many of my patients. There is a special bond, born of familiarity, comfort and ease that transcends the typical doctor/patient relationship. Perhaps it’s best portrayed as a unique type of friendship that invites a warm exchange of feelings, stories and ideas. My spirits soar when I think about how practicing dentistry has expanded my world by enabling me to be involved (dare I say be“ intimate”) with so many wonderful people. One person at a time over a course of many appointments spanning many years, being a dentist has led to some amazing relationships.

So, one of the highlights of my week was seeing Jennifer Bahme in my office. Jen has been a patient of mine for more than ten years and what made her visit especially heart-warming is that she now lives in Spain. This wasn’t the first occasion that I’ve seen her since she decided to pull up stakes and move to Madrid. This time she came to New York on a 4-day whirlwind trip to attend to some matters that needed tending to including a dental appointment with me. Now how good do you think that makes me feel? I’ve heard of the guy who would “walk a mile for a Camel” (I know I’m dating myself citing old cigarette ads not seen on TV for at least 20 years), but Jen flew 6,000 miles to see moi. (I choose to downplay the other things she had to do.) We had such a warm reunion prior, during and after her dental visit with the hygienist. “Unfortunately”, Jen had broken a tooth and I had the “pleasure” of seeing her again later in the day to remedy the problem and to commiserate further.

Jen is a fantastic person simultaneously interesting and interested in our banter. I remember some time ago how she moved to Costa Rica for a year before she returned to the big apple. This time her relocation seems more permanent for reasons I won’t share, except to say that I look forward to visiting her and her Spanish boyfriend when my wife and I go to Madrid. For the record, Jennifer has not been reading my blog but promised to do so if I wrote about her.

So Jen, this one’s for you.

So it was the first Monday of the New Year and one of my most beloved patients, having just learned that my office was closed for the holiday, called me on my cell phone to report a dental mishap. As odd as this may sound, I was thrilled to hear from her and to be speaking  with her. (And no, I’m not some sadistic dentist of the Little Shop of Horrors variety reveling at someone’s dental emergency) as  she was very quick to point out that she was not in distress and could wait until tomorrow to see me. Having known each other since 1984, she knows I would have opened the office to see her if need be.

Bernice called me to make sure I would be in the office this week to see her before she jetted off to Israel to attend a Hadassah conference. I was excited to speak to Bernice because she is a most dynamic, compassionate inspirational individual. To be speaking with her at the onset of the New Year was, well it was… inspirational.

You see, Bernice is 98+ years young with the optimism and “can do” spirit that inspires me to embrace 2012 with vigor and optimism. But there is more to this than being “pumped up” for the adventure of a new year; it’s being reminded that to be fully engaged in life is not to look at the calendar and push the restart button with the arrival of January 1^st.  Rather, it’s to take each day as the gift it is (whether it’s Monday January 2^nd or Thursday October 12^th) and to make it count.

As the saying goes, Carpe Diem – Seize the Day…everyday! And before you know it, 35,770 days will pass by (that’s 98 years) and you will still look forward to tomorrow. That’s what I call living a fulfilling life and that’s the lesson Bernice has taught me by example.

While I have already wished you all a Happy New Year, maybe what I really wish for you is fulfillment of a life fully lived.

Michael

Boxes, boxes everywhere. The movers just left and I’m sitting in our NYC living room for the first time (amen)! Our 15-month period of displacement is drawing to a close with the delivery of our worldly possessions not seen since they were put into storage in September 2010. I’m not going to rehash the exasperating details of our odyssey from Ardsley to the Upper West Side via a 51-week layover in Yonkers, but in the words of the Grateful Dead, “what long strange trip it’s been.”

So here I am on December 30th staring at all of these boxes filled with stuff that we accumulated over the decades and realize that if I never saw half of it again, I wouldn’t miss it. I honestly don’t remember everything that we decided to pack up and deemed important enough to pay $400/month to keep in storage. But as I delved into the first cartons, I was struck with a certain curiosity as to what our mind-set was when we were deciding what was worth keeping. Interestingly, the first three things I randomly unpacked were a beer stein, our wedding picture, and a book about dental esthetics (all very important). Then came the plastic potted plants, LEGO’s, old college text books, decorative ornaments of all types including an assortment of soap dishes, countless chargers that don’t match our current phones….I mean what were we thinking?

So I stepped back from the columns of corrugated containers and began to ponder (metaphorically) about the baggage we all carry. Much if not most of it is volitional; that is, we have what we have because we have worked hard to get it. But some of this baggage that we schlep around is not wanted at all-we’re just too busy to notice. The baggage I am referring to is stress and the burden of carrying this extra load does take its toll both physically and mentally. These past few years have been extremely difficult for many of us. Some are working harder than ever just to keep their heads above water. Being bogged down and pulled under by the “extra weight” of stress only makes for tougher going. While as individuals we can’t change the reality of a poor economy, we can unburden ourselves by taking better care of ourselves. Being more health conscious when eating, exercising more, perhaps joining a yoga class or taking a time out for a walk are just a few suggestions to help reduce stress.

I know that aside from a lot of useless stuff that I have boxed up and carried to New York at no small expense, I have put on 25 unwanted pounds (talk about extra baggage) over the past 15 months because of stress. Comfort food can be so soothing after battling with contractors. But when it’s all said and done, I’m the one stuck holding the bag (actually it’s more of a roll and a belly.)

So, as we are about to embark on a new year, I wish you all a happy, healthy and prosperous 2012. And if I may be so bold, take a moment to take stock of your stuff, perhaps there is some baggage you can shed to lighten your load.

HAPPY NEW YEAR!!!!

Over the course of my nearly 30 years of dental practice, I have referred many patients to the orthodontist to correct their misaligned, crowded, or widely spaced teeth. These patients used to be predominantly teenagers, horrified at the thought of how unsightly metal braces would affect their fragile social lives. In the past decade however, more adults are seeking orthodontic care to set their smiles straight. The reason that there is such an avalanche of interest in adults straightening their “crooked teeth” can be summed up in one word—Invisalign.

In the past, orthodontic treatment was synonymous with metal braces, and even with the advent of the more esthetic ceramic brackets and lingual braces (attached on the tongue side of the teeth), metal wires and elastic bands remain an integral part of traditional orthodontic care. Invisalign has changed all of that.

So what exactly is Invisalign?

Invisalign is a minimally visible method of moving teeth without band, wire or bracket. Therapy consists of a series of clear aligners that are worn to gradually move teeth to a more desired position. The Invisalign aligner is a removable and comfortable dental retainer that is fabricated on virtual models that are created using CAD/CAM (computer-aided design/computer-assisted manufacture).

Each aligner is worn approximately 22 hours a day over a two week period. (Simple math leaves one 2 hours a day for eating, tooth brushing and flossing). Obviously because they are removable, an important social occasion or business meeting need not pose a problem, but compliance is critical to treatment success. Generally, aligners are replaced every two weeks to allow for gentle tooth movement over time. Treatment duration varies according to the individual situation, but uncomplicated treatment for crowded overlapping teeth can span 6-12 months. (Richard Bouchez, DDS, Clinical Success in Invisalign Orthodontic Treatment)

I’m a Certified Invisalign Provider in New York

As more of my patients were being treated for their orthodontic problems with Invisalign, I began to study the technique. I became so intrigued with Invisaign methodology that I completed certification requirements and am now an Invisalign provider, and am offering Invisalign treatment to any interested patients.

While I am very excited to broaden the scope of my practice (those of you who know me also know how passionate I am about being a dentist!), I will still refer to my orthodontist colleagues when appropriate. Invisalign is not the solution for all dental crowding problems or misaligned teeth, and for that traditional orthodontic care is very much alive. Schedule a consultation or ask me about Invisalign care at your next visit.

A fast, invisible solution to crooked teeth? Yes please!

A Dental Smile Makeover Will Help You Shine on your Special Day

Planning your wedding? You know you need something old, something new, something borrowed, and something blue…but what about white? As your big day approaches, don’t forget your most important accessory—a dazzling white smile.

If you’ve ever been unhappy with your smile and couldn’t justify cosmetic dental work, your upcoming wedding is the perfect excuse to finally do it! There are three procedures that are the most popular in my practice for wedding smile makeovers:

1. If your teeth are relatively straight and you have no bite problems or broken, cracked teeth, then a simple One-Visit Teeth-Whitening Procedure may be all you need to ensure that those pearly whites stay white. This procedure is usually completed in just one appointment and is fast, effective and long-lasting.

2. If your teeth are badly stained or damaged, a Dental Bonding Procedure may be required to achieve that cosmetic dental makeover look and feel. Bonding involves a special tooth-colored composite material that is placed over the affected tooth or teeth and then buffed, shaped and polished to look like your own natural teeth. It is very effective if you have just one or two teeth that need treatment. Bonding is a durable and long-lasting way to get a more beautiful smile, fast.

3. If you have more severe staining or damage caused by injury, medication or inadequate dental care, dental Porcelain Veneers may be the answer to your wedding smile worries. A porcelain veneer is a permanent, ultra-thin shell that is permanently adhered to your natural tooth. Each one is custom-made to look as good (if not better) than your own natural teeth.

Having perfect teeth will give you one more reason to smile brightly on your big day, so be sure to fit a visit to the dentist in before you head down the aisle. A wedding smile makeover will last long after your honeymoon is over—just don’t get mad at me if your dazzling teeth get more compliments than your dress!

Dr. Michael Sinkin has been practicing dentistry in NYC 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. Find out more about Dr. Sinkin here

For some reason, the phrase “dental crown” evokes a frightened response from many patients, especially if it’s the first time they ever faced the proposition that they may need one. This sense of alarm is based on a common misconception that getting a dental crown means that you are loosing your beloved tooth. Au contraire. We are actually saving your little pearly white. It fact, most often when one needs a crown, their tooth is no longer such a pearl.

When the first wave of panic subsides, the question I usually get is: “What exactly is a dental crown?”

What is a Dental Crown?

A dental crown is a tooth-shaped cover that is placed over a broken, cracked, or otherwise damaged tooth to restore it to its original shape and appearance. It is one of the most common dental procedures and has evolved (thanks to modern technology) into a practically painless procedure that serves to protect the tooth for many years.

In the past, teeth that were damaged usually had to be removed. So, in essence, dental crowns allow patients to keep their own teeth, even damaged ones, often for the rest of their lives.

The 9 Most Common Reasons that You May Need a Dental Crown Are:

• To cover and protect a tooth that has been weakened, usually due to decay.
• To stabilize sections of a cracked tooth.
• For broken tooth repair.
• To repair a tooth that has been severely worn down.
• To cover and strengthen a tooth where there is a large filling and very little tooth structure remaining.
• To reinforce a tooth that has had a root canal.
• To anchor a dental bridge in place.
• To repair misshaped or severely discolored teeth.
• To encase a dental implant.

Will it Hurt?

It is my number one goal to make sure that every patient is relaxed, comfortable, and pain free. I use local anesthesia throughout the process. When patients ask, I administer nitrous oxide (laughing gas), which usually helps to make the entire procedure go by very quickly.

Between the caring ministrations of my staff, and the multimedia entertainment we offer (TV’s in every room, headphones with your choice of music), many of my patients are not only surprised when I tell them, “You’re finished!” but they also say “Wow, that was easy!”.

And that’s why I love my job!

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. Find out more about Dr. Sinkin here

So on this day before Thanksgiving, a windy, wet Wednesday (its not really that windy, I just like the alliteration), I am sitting at Lenny’s Bagels on the Upper West Side cogitating my feelings of thankfulness.

I am grateful for so many things, not the least of which is that I’m at Lenny’s Bagels just around the corner from our new home. I am thankful that my son Jonathan is home from college sleeping in his new bedroom, albeit on an Aero Bed. I am thankful for the five pieces of furniture we now have in our home including our most important bed. (After sleeping on a Murphy bed for three months and then a box spring and mattress plopped on the floor, you can’t imagine the joy and gratitude I feel swinging my feet on the floor and standing up, instead of crawling out of bed on all fours until I could arise from the “ground”. Ah, the simple pleasures in life we so often take for granted.

As you know, these are not easy times. Many are still struggling with the aftermath of the financial meltdown and ensuing recession which (despite what the spin doctors might say) shows scant signs of letting up. Everyone has been affected, some far worse than others. I believe better times are ahead, but in the meantime, many are missing what they once had, like a good job and the self-esteem that comes with it.

Until things “return to normal” perhaps we should make a conscious decision to focus upon what is good in our lives: loving family, friends, and good health; and be grateful for what is right in our lives. I have observed the power of positive thinking and how a grateful outlook can put a bounce in one’s step.

On a different note, yesterday our office enjoyed our annual potluck Thanksgiving luncheon. DELICIOUS. I am so thankful for my wonderful staff that has helped me to create a warm and compassionate office ambiance and provide our patients with the best care possible.

Finally, I am eternally grateful for you, my wonderful patients. Thank you for the privilege and honor to be your dentist.

-Michael