The Bottom Line is TRUST

Many of my Troy patients have been with me between 20 and 30 years. This group of patients have been among my most loyal and for the most part, they will be my patients for as long as I continue to practice dentistry.
I saw one of my 30yr patients today and the issue of Trust came up and I told my patient that having the 'trust' of my patients was very important to me. The patient responded, " Dr. Benjamin, ALL of your patients trust you."
Kinder words could not have been spoken.
Many patients do not want a relationship with their dentist and they are merely looking to have a licensed 'technician' fix a tooth for a relatively low level fee. My patients like me,like my staff and know that I have a sincere interest in maintaining their dental health. Not only do they trust me to take care of them but I return that level of trust by giving the vast majority of my patients my personal cell phone number with instructions to call me any time they need me. I TRUST my patients enough so that I never worry that I will receive a frivolous phone call.
The bottom line IS trust.

The Concept of Being a Master

It has always amazed me when patients believe that the young physician or dentist must be more knowledgeable than their older colleagues because they just graduated from professional school and therefore must have been taught the most up to date information.
What did Chesley 'Sully' Sullenberger, the pilot who saved 155 lives by landing his plane perfectly in the Hudson River, say about being a master pilot?

He wrote: "These new pilots may have exceptional training, and they may have a higher degree of ability. But it takes time, hour after hour, to master the science and art of flying a commercial jet."

I have been a dentist for 33 years, studied with the very best dentists in the world, spent millions of dollars on my professional education, won one of the most prestigious dental contests in the world sponsored by the American Academy of Cosmetic Dentistry, and strive to be the very best that I can be as a restorative dentist.

If Capt. Sullenberger were describing what it would take to be a master dentist, where do you think I would fall on the mastership path?

Please consider becoming our patients so that you can learn first hand about excellence in the profession of dentistry.

The Mistake

I read or hear about medical or dental 'mistakes' in which a patient is injured during a treatment procedure.
I ask myself how this can happen and I have come up with a few possibilities:
1. The doctor is in a rush to get to the next patient
2. The doctor is distracted by personal issues (divorce, a sick family member etc)
3. The doctor has not learned enough about the procedure to be competent or better yet, proficient.
4. The doctor schedules too many patients during the day
5. The doctor has a new business consultant who tells them to see as many patients as possible so that they can make as much money as possible.
6. The doctor has a drug or alcohol problem.
7. The doctor just doesn't care about his or her patients.

As a patient, WHY would you select someone to take care of you or your family who is described on the list above?
Excellent physicians and dentists are NOT average and are so good at what they do as not to put making money or personal issues above the care of their patients. The BEST will not rush through your treatment, will not participate with an insurance company and will not make mistakes.

Do you really want an average physician or dentist taking care of you. I DON'T.

70% of Dental Patients Are Going to the Wrong Dentist

How is this possible and why would I make that statement?
Many years ago the American Dental Association (ADA) did a survey among dentists asking the question "Would you become a dentist again if given the opportunity?"
To the surprise and dismay of the ADA, the official organization of the profession of dentistry, discovered that a whopping 70% of dentists would not be a dentist again. This means that the majority of patients are not being treated by a dentist who LOVES what they do? This is another way of saying that the person doing your dentistry doesn't want or care to treat you AND would rather be doing something else.
I LOVE being a dentist...It is my PASSION and my hobby. There is nothing more that I enjoy doing than being your dentist. I care about getting it right and I care about the sacred oath that I took when I became a dentist in 1977. That oath says that I will always do the right thing for the right reasons when I take care of another human being.
I wish the ADA asked me whether I would become a dentist again. In fact, the organization was so shocked and dismayed by the response of the dentist's survey that they have NEVER asked the question again.
So would you rather be treated by a dentist who wants to be golfing or on his boat or would you select a dentist that loves dentistry and is passionate about his life's work?
I am here to take care of those patients that seek good dentistry and know that there is a difference between dentists.

My patient's trust, appreciation and hugs

As all of my patients know, I care about you a great deal. During the last year or two, I have noted that many of my patients are thanking me and my staff for the work that we do and how well we take care of them. And recently I have received an incredible number of hugs at the end of my appointments. I think that some of my long time patients became a little nervous when I opened my new office in Saratoga Springs as they realized that perhaps I wouldn't always be around.
This also makes me think about my wife's gynecologist, the great Jonathan Schwartz, who passed away last week. Dr. Schwartz took care of my wife and thousands of other patients over the last 30 years and when the story about his death was announced on Sunday, I am sure that there were many tears from his patients. Dr. Schwartz was among the last of the BELOVED doctors who took care of his patients the exact same way despite the fact that medicine changed to a managed care environment.
As the old saying goes...you don't know what you have till you lose it. But that was not entirely true with Dr. Schwartz...He will be missed by his patients who loved him.

A Dentist's Disappointment in the Final Results

There was an article in the Magazine section of the Sunday NY Times today about an artist who said that she is frequently disappointed with her results because she knows that she could have done better. One of the dentists on the ACE forum after reading the the artist's story said that he frequently feels the same level of dissatisfaction with his patient's case outcomes.
I wrote the dentist privately and said that I was NEVER disappointed with my cases because of the 10-20 hours of study and preparation that I do BEFORE I start a big case.
Excellence is not an accident. I study and prepare endlessly before I ever touch my patient..."Proper preparation prevents poor performance." in the words of my great mentor and my personal dentist, Fred McIntyre.
You need to know that before I start one of the functional and beautiful cases that you see on this website that I have fully prepared myself to treat you...I have no choice...YOU are my PATIENT and you deserve the best.

Praise From a Colleague

I have told you that I frequently place my completed cases on the ACE Dental Forum in order to educate my colleagues and have my work critiqued by them. To my great surprise, I noted the following title in the subject line of the email:
LARGE RESIN ALA BENJAMIN--ALMOST
These are the kind words of one of my colleagues,friend and patient:
"Group, Here is yesterday mornings' project. I have admired Gerald Benjamin's work like many of you do and couple of months back I broke #18 and had him repair it. A gracious host, and outstanding educator. I laid there in the chair; mirror in hand watching. He also equilibrated me, a much needed and appreciated service."
I cannot thank my patients and colleague enough for the wonderful things that they say about me and my work.
The greatest gift from God is to have the ability,knowledge,skill,talent and compassion to help another human being.
I am truly blessed.

What Is My Job?

I saw a long time patient yesterday (25 yrs) who had a toothache and called my office. We immediately gave him an appointment on the same day that he called. I know my patients VERY WELL and I know the very significant illnesses of my patient with a toothache. I chatted with him for a while and then asked him about his toothache. I took some X-Rays and did some other tests and informed Ken that I would help set up an appointment with an endodontist (root canal specialist) near his home in Troy.
I went out to the waiting room and explained to Ken's wife the nature of his toothache and what I was going to do about it. I told her that I would have Donna call the specialist and obtain the next available appointment. "But why can't you do the root canal? Ken's wife asked. And I responded, "And what is my Job?" And all of my patients know to answer,"To take care of me!"
I have told you before that I will ALWAYS do what is my patients best interest because that it my job. Sometimes I will solve your problem and won't earn any money because I have sent you to a specialist..Ken has had serious medical problems and I know that he NEEDS an expert dentist to do his root canal so that we can avoid any medical complications.
My job is to take care of you....And that is my Life's Work.

You Have A Benjamin Smile

Several years ago I had a large billboard on Route 9 just before Siena College heading south towards Albany. The billboard only had two things: a fabulous smile of one of my patients and the my website address: www.benjaminsmile.com
One of my patients told me a story yesterday during her regular check up about her new smile which is several years old. She was riding in a car with a friend when she passed my billboard. Her friend said to my patient," You have a Benjamin Smile," indicating that her friend admired her smile. The friend then asked my patient,"Who did your BenjaminSmile?" And my patient told her, "Dr. Benjamin"
The Benjaminsmile is a one of a kind work of art requiring hours of planning and two full days of personal treatment as our office's only patient of the day.
There may be other attractive smiles created by other dentists but there is only one BENJAMIN SMILE.

What My Patient Wrote

I would be embarrassed to repeat some of the wonderful things that our patients send us in notes, cards or letters. On the other hand, folks that are considering having our office take care of them need to know what kind of office we are.
A note that we received today:
Dear Dr. Benjamin,
Thank you for being so caring to me and my family.
We are wishing you the very best for the Holiday Season and praying that your New Year is everything and more than you could ever expect.
If everyone could care like you do---what a wonderful world this would be.
See you in the Spring.
With our love and prayers.
MH

Please keep sending your kind thoughts...We read everything and we truly do care about our patients.

My Best Work is the Work that You Can't See

I restored the left front central incisor for this 27 year old female. The very large bonded filling that I replaced was very poorly done, using the wrong resin, the wrong shade and a sloppy technique.
Many dentists would just have loved to cut down the rest of this patient's front tooth and place a crown because they haven't learned the correct technique to place invisible bonded fillings that look like a real tooth.
Why would anyone be a patient of a dentist who doesn't care enough to learn how to do work correctly? What does it say about a patient? If you honestly believe that all dentists know the same techniques and are equally talented then I guess that you would keep your present dentist.
If You can't find the filling in the photograph, perhaps you need to find the dentist who did that work...I will be happy to become YOUR dentist.

I Had My Tooth Extracted

I have lost 5 permanent teeth including the one Dr. Robert Carpenter removed today. Perhaps some of you are thinking that I must not take good care of my teeth. Nothing could be further from the truth. I brush and floss at least TWICE a day, use Listerine Mouthwash between every patient and haven't eaten sweets in 30 years. And I have spent more money on my teeth than anyone that I have ever met. Then why am I losing some teeth? Some of you may be guessing the answer especially if you are a regular reader of my BLOGS. I had root canals and crowns on my back teeth while in my teens and early 20's due to a large intake of sweets and the resulting tooth decay. Cutting down beautiful, natural tooth structure for crowns is the beginning of the end for that tooth EVEN if the tooth lasts another 30 years.
None of us should go to dentists that are in a hurry to cut down our teeth and we should ask them : "How are you strengthening my tooth by cutting down the strongest part of the tooth, the enamel?"
Beautifully done, strong bonded white resin fillings placed under a rubber dam are the best restoration that you can buy to keep much of your own tooth structure.
Many dentists who accept insurance just can't wait to put crowns on your teeth because crowns are a covered benefit under your insurance coverage. If you want to have your teeth cut down then you too will have your teeth extracted in late middle age.
I wish that I had a dentist like me, with the technology that I have and the concern and ethics to always put their patient's best interest first...I would still have all of my own teeth.

Professional Criticism: ACE Forum2

Most of the dentists in the Capital District and many of my patients think of me as a 'Cosmetic Dentist.' Nothing could be further from the truth. The vast majority of my time is spent helping patients keep their back teeth with beautifully done direct composite restorations. As I have told you before...I will not destroy beautiful, healthy, natural tooth structure and place a crown when a well done bonded filling can be placed.
These photos show bonded fillings that I placed 5 years ago on all four of these back teeth. The bonded composite fillings look exactly the same as the day that I placed them.
So what do my peers have to say about my FIVE YEAR OLD WORK?

Dr. B is a periodontist in Atlanta,GA who prefers to practice as a general dentist.

"Each time I look at your work I am blown away. I realize that one can take class after class and still not achieve the same result, and this is because of the innate talent behind the individual. That doesn't come from a class at all. I like seeing Danny Melker's perio surgery and root reshaping protocol, as well as Bill Strupps cores and preparations, as well as final restorations. Theirs, like yours, is pure art. Thanks for sharing. It gives me something to shoot for."

Dr. S is a general dentist from Dallas,TX
'Mine don't look that good after 5 minutes, much less 5 years. Gerald, you are truly a master. Do you teach any courses on direct restorations?'

Dr. T practices in Las Vegas, NV. I was his instructor at a SUNY/Buffalo graduate course in 1999 or so.
'Dear Gerald they r beautiful. You r a true artist.'


Dr. L is a dentist working at a large hospital.
'Still the master!!'

Why am I posting my work and the comments of my peers? These are folks that fully recognize and appreciate clinical dentistry performed at a very high level. I truly value the comments of my patients when they thank me for being their dentist. But I have to tell you, there is nothing like having other dentists appreciate MY Work.
As I have told you before...I am NOT a cosmetic dentist. I am just a good dentist who passionately cares about taking care of his patients.

What Do Doctors Do?

I recently treated a physician who has a daughter that needs some surgery. He and I discussed the nature of the injury that required surgery in such a young person. I asked him if he was looking for the best possible orthopedic surgeon...He responded, "ABSOLUTELY." We are travelling to Denver,Colorado to see the same surgeon who treated a famous NY Yankee. When I need to have a broken tooth fixed, I get in my car and drive 5 hours to Buffalo to have one of the best dentists in the world treat me.
What is the point? Those of us in the healing professions fully recognize that many of our colleagues are not up to par and that we need to seek out the best just like you need to do when you become ill or have a significant dental problem.
Physicians and Dentists accept the fact that there is a huge difference in knowledge, skill, talent and passion among our peers and that we won't let just any physician or dentist treat us or our families.
You need to learn this and do what my colleagues and I do: seek out the best.

I Dont Take Photographs

Tis the time of the year!
I am not a party person and don't do well in party settings. This is the time of the year when dental specialists have holiday parties to meet and thank referring dentists for their trust and confidence. In a room filled with dentists, the chance of chatting with someone other than a dentist is slim.
I met a dentist who told me that they did fabulous clinical dentistry that rose to the level of art. That always perks up my interest so I asked the person if they would mind sending me photos of their work. The dentist responded that they were too busy to take photos. In the movie the famous line was, "Show Me The Money." In dentistry it is "Show Me The Photo" and if you don't have photos...it is assumed that you haven't done it.
The only thing that I could take away from the conversation is that if you are too busy to take photos, maybe they are too busy to do things the right way.
The best dentists in the world and the dentists that I study with have shown thousands of photos so that everyone knows who they are and what they have done.
As I have told you before, if your dentist doesn't take lots of photos, it is time to find a dentist that does.

Mystery Diagnosis

One of my favorite programs is 'Mystery Diagnosis.' The program shows a patient that has been having troublesome or terrific medical problems for a long time (usually two years)and despite the fact that they have gone from doctor to doctor, no one can find what is causing the problem. By the end of the half hour, the patient finally has found one of the best doctors in the world who is able to read the patients history,talk to the patient and finally examines him or her. Usually within minutes, the doctor confidently and correctly diagnoses the problem. After a commercial, the patient always asks the identical question,"Why didn't the other doctors find my problem 2 years ago?
Those of you who have kept up with my blogs easily know the answer to the poor patients question.
And for those of you who haven't read my blogs before: Some doctors should be auto mechanics while others love the status of the profession. Still others love being a physician, love to learn and are passionate and ethical about caring for their patients.
I really wish that patients would stop selecting mediocre physicians and dentists to take care of them just because they participate with an insurance company. Here is a little secret: The best physicians and dentists do not participate in any insurance program.
Please select the people that take care of you carefully because your life or the life of someone that you love may depend on it.

We Are Very Fortunate

I was speaking with a friend's parents yesterday that live in South America. They were relating problems that the middle class have with the lower classes who try to steal their money and possessions at gunpoint while in their car or just walking around the neighborhood. Very poor folks will do anything to survive.
Most of us are so very lucky to have been born in the United States and to have the things that we have...especially our safety.
I went to do my weekly banking for my office and the teller was telling me that she wasn't having a good day because it was so dreary outside. I reminded her that she hadn't been given a diagnosis of cancer today and didn't that make her feel a whole lot better.
I hope everyone that reads this takes a step back and realizes how lucky we are.

The Government Says that YOU cannot decided

I believe that companies or their insurance should pay when a worker is injured on the job. I also believe that auto insurance should pay when someone injures their mouth, jaw or teeth in a car accident.
The GOVERNMENT says the a dentist MUST accept whatever the government wants to pay to correct the injuries.
Now let's say that you fell at work and broke your three front teeth but you know that your new young dentist is not very good at fixing front teeth so that they would look as good as before they were broken.
And let's further assume that your co-worker, a patient of Dr. Benjamin, tells you to go to see him because he CAN make you look as if you hadn't taken that bad fall and he has gone to lots of extra training to know how to do what he does.
You call Dr. Benjamin and explain that you were injured on the job and Donna, the secretary extraordinaire, tells you that Dr. Benjamin does not accept Workman's Compensation fees.
You are so disappointed that you might have to go back to your new young dentist to fix your front teeth so you tell your boss that you can't go to the dentist with lots of training in repairing front teeth because he doesn't accept Workman's Compensation fees. Now your boss is a very smart man and knows that you are the best employee that he has so he personally calls Dr. Benjamin's office and tells Donna that he will pay Dr. Benjamin's usual fee or whatever Workman's Compensation does not pay.
The New York State Government says that neither you nor your employer can use YOUR OWN MONEY to get the best care that you want and deserve. This is one of the few times in all of American life that you cannot, BY LAW, buy what you want.
This is not right.

Professional Criticism: The ACE forum

Very few professionals are willing or encouraged to place their work before their peers unless they are forced to do so for State Licensing or to earn credentials in a professional organization.
I frequently post my completed cases (no faces unless my patient consents to this) on the ACE Forum. This is an open and free forum for the exchange of ideas, education,and to gain recognition by ones peers.
Why would I show close up photographs of my work for criticism by my peers?
Because it makes me a better dentist which means that you know that you are getting the best possible care that I could give to you.
Last night I posted a close up view of a case that I completed two years ago in which I told my colleagues that my goal in completing a cosmetic case is to have the work mimic beautiful natural teeth.
So what do my colleagues think of my work? More importantly, how do you, my patient feel about knowing that YOUR dentist is highly respected in his or her professional community?

Dr. H is a well known lecturer from Connecticut:
That is some beautiful work.....who did the lab work?
Just beautiful
I am proud to know you.

Dr. D is a dentist in New Mexico:
Beautiful.
One issue I really like is that you have no problem keeping the porcelain a 1/2 mm off the marginal gingival tissue. You don't bury the margins sub-gingivally. The soft tissue can't help but love this.

Dr. L is a dentist in Wisconsin:
Absolutely magnificent.
I need to come out and watch you for a few days to see exactly how you do things.
Keep up the great work.

Dr. M is a dentist in Connecticut:
Thank you for sharing this case. The dentistry is exceptional and it's nice to see that natural-looking results can be a great option for patients. This will be a great case for people to save and show their patients when having the discussion about what they want to look like.

(Truth in posting: there were NO negative comments.)
I am honored to have my work critiqued by my peers. It confirms my belief that I do wonderful dentistry for you, my patient.

Dr. Benjamin Charges Too Much for his Fillings

NO I DON'T!
Dentists repair teeth when:
1. There is tooth decay in a tooth dissolving the inside layer of a tooth
2. An existing filling which has lasted many years has finally fatigued and no long seals the inside of the tooth from saliva and bacteria.
3. A piece of natural tooth or existing filling has fractured
4. The previous dentist recently placed a new filling but it is not up to minimally acceptable standards.
5. A back tooth has had a root canal.(*Which ALWAYS means that a crown is needed)
My goal is to repair your tooth in such a way that I remove LITTLE or NO natural tooth structure. My job is to keep you from needing an expensive and tooth destroying crown for as long as possible.
Sadly to say, many professionals want to do as many crowns as they possibly can because placing crowns is where the REAL money is to be made. Well done fillings are hard to do and don't reward the dentist financially.
So let's all understand something: It is my job to preserve your beautiful, natural tooth structure for as long as I can for a fair fee. There is no dental material that is as strong as the tooth that God gave you and it is my job to help you keep that natural tooth.
The routine destruction of natural tooth structure is like cutting your finger off when you get a splinter. Don't you want to keep your finger?
So when you hear others say that I charge too much for fillings remember that I am working very hard to let you keep your own tooth for a fair fee. Few other dentists can make that statement.
My job is to take care of YOU and I will never abuse you or your teeth to increase my income.

Proficient

Many years ago when I would go to SUNY/Buffalo, I would work with Senior dental students as well as graduate dental students. I was asked to rate students at the end of the semester on the basis of whether they were competent or proficient. Competent meant that a student could perform a certain treatment at a minimally acceptable standard. Proficient meant that they could perform treatment at a high level (but obviously not the master level.)
When a dentist goes on to study an area of dentistry and attains specialty status, both the University and the New York State Board of Regents grants that dentist a Certificate of Proficiency in that area of treatment. There are nine areas of specialty dentistry recognized by the American Dental Association and there are two other areas that are University recognized which are implants and esthetic dentistry.
I am one of fewer than 40 Dentists in the United States that has attained a Certificate of Proficiency in Eshetic Dentistry. This permits me to say to my patients that I am a general dentist with a specialty in esthetic dentistry. Since there is no American Board of Esthetic Dentistry, I hold the highest degree level attainable by someone who has studied esthetic dentistry.
No other dentist within a 100 miles of the Capital District has attained Proficiency in the area of esthetic or cosmetic dentistry.NO ONE. Since esthetic dentistry is really just restorative dentistry done correctly, a highly proficient esthetic dentist is really just a fine regular dentist doing general dentistry
Proficiency + Passion= Excellence

Respect from Young Dentists

I have learned many things in my 30+ year career in dentistry and one of them is that many older dentists have stopped learning and work to maintain a standard of living. Young dentists, on the other hand, want to learn and do excellent dentistry. I went to a seminar last night with 40 other dentists and I probably got to speak with every young dentist at the course; many I met for the first time. Without fail, my young colleagues told me that they had heard of me and the superb dentistry that I do.
One young dentist,who is on the path towards excellence, followed me to my office to discuss some cases and before we parted he told me that I am the only dentist the he could discuss real dentistry with and his final words were, "You are the only dentist that I know around here who walks the walk. You do it right."
I am honored to have the respect of many of my young colleagues. Unfortunately, it also means that I have become the one of the old guys in my profession... God gave young folks strength and beauty and the old guys wisdom. Apparently, you can't have both at the same time. lol
In the olden days, excellence and respect went hand in hand. My young colleagues may not know how to do excellent dentistry but they know it when they see it. It is very gratifying to have their respect.

THE Education Place

My friends Allyson Byrne and Francisco Banchs who are root canal experts have quickly established their education center as THE PLACE to be educated in the Capital District. Last night was the third session of a series of exceptional dental learning. I gave the second lecture of the series with a lecture on how to diagnose and treatment plan so that we can obtain superb esthetic results in restoring teeth. Last night Drs. Condry and Kelling presented a live surgical case to demonstrate a successful sinus lift with implant placement.
Why is this important to our patients? I have asked you to seek out the best educated and best trained dentists to treat you. When physicians and dentists become highly educated we all win...the doctors, the professions and most of all you, our patients.
Thank you Allyson and Francisco for making all of our lives better.

It Is Not Right

Our practice in Saratoga is just starting to pick up (Thank God) and our new patients have a few common similarities. The first is that these patients are all seeking quality dentistry rather than an insurance based dentist. Another, more troublesome similarity is that the vast majority of new patients have had root canals done in the recent past and they all are failing...What is up with this?????
Root canals used to be highly successful but a few years ago, the standard of care changed from making sure that the inside of the tooth was clean to: can we treat the tooth in one hour or less so that the dentist can make the most amount of money.
I am tired of seeing patients who paid their hard earned money to a dentist and having to tell them that they need to be referred to a root canal expert so that the inside of their tooth can finally be clean and the infection resolved. WE CANNOT HAVE INFECTIONS IN OUR BODIES.
Some patients are angry with me for finding their infected tooth while others are extremely grateful for finally explaining why their tooth still hurts.
Buy excellence and you probably only have to pay once. Buy mediocrity and it may cost you more than money.

A Call from a Colleague

I received an email and a call today from a colleague (who is also my friend) who was upset about the possibility that silver mercury would no longer be taught in dental schools and therefore not used as a filling material. He felt that most of the direct posterior composites were so poorly placed by general dentists that more harm than good was being done for our patients.
I have not placed silver mercury fillings in almost 20 years and my colleagues both near and far consider me an expert in the placement of beautiful, bonded white resin fillings. I strongly believe that there is no better restoration...for the strength of the restored tooth and the conservative nature of the technique. (This means that little or no tooth structure is removed in order to fix the tooth.)
So why is my good friend and colleague so upset that mercury is being phased out???
A large percentage of dentists refuse to learn how to master the art of placing this beautiful, strong bonded white restoration and consequently the restorations fail. It is NOT the resins fault that many dentists refuse to use the material correctly. Many dentists are just too lazy to learn how to use the material correctly...and if they did, our profession and our patients would be better off.
The attached photo clearly shows 4 well done direct posterior resins that I placed for a patient. If your white fillings don't look like the photo perhaps it is time to find a new dentist

A new patient from Michigan

A new patient was in my Saratoga office today who lives in Michigan...Yes Michigan.
My patient told me that she used to live in Saratoga and that she knew one of my patients and just loved her smile. What she did not know was that I had given this person (also a Saratoga resident) a smile make over nearly 11 years ago. More importantly, my new patient was completely unaware that her friend had anything but natural teeth. What a compliment for my work!
As with many of the folks that schedule a 'cosmetic consultation,' they really need regular dentistry that is done correctly rather than just elective dentistry (or cosmetic dentistry.)
I am honored when patients make a tremendous effort to have treatment in my office.
We have treated patients from: California; Spokane, WA; Raleigh, NC; Boston, Massachusetts; Vermont, Pennsylvania, Florida and Connecticut. Our New York patients have come from: Long Island, Manhattan, Westchester, Syracuse, Buffalo, Oneonta, Binghamton and Lake Placid.
Why would anyone make the effort to be treated in our office???
BECAUSE WE ARE WORTH IT! Our patients have made a special effort to find a dentist with credentials, experience, professional accomplishments and a proven ability to provide excellent dentistry.
Why don't YOU call our office to schedule an appointment to have your dental treatment in our office...YOU ARE WORTH IT!!!!!!!!!!!

The Yankees ARE Worth It

I am NOT really a sports fan but I know that I need to remain involved so that if a patient asks me what I think about last nights World Series game, I don't give the impression that I come from another planet.
I was looking at CNN.com after the Yankees won the World Series for the 27th time (See I do pay attention) and there was a business story about the Yankees. Despite the fact that they had the highest payroll in all of baseball, that from a business standpoint, the owners of the Yankees had gotten their monies worth with the current team. The article went on to say that the owners paid the players more than 200 million dollars, but the current team was worth it and that the team actually made a big profit.
The message was that even though the Yankee players cost more, they also provided a greater value to the fans, the owners and baseball.
Once again, things that have a greater value cost more...(This can't be a new thought lol)
My patients may pay more than they might in another dental office but I promise you that I will give you and your family value for your money.

I Don't Get It

Susan and I went to the public golf course in Saratoga today and one of the men who was pared with us asked if we were local to Saratoga. I explained that I had recently opened a new dental practice in Saratoga and that we were considering moving there as well. The starter was over hearing our conversation and told me that he had a crown fall out recently and he had to go back three times to the dentist to have it recemented and did I accept GHI insurance. Oh and by the way, he was retired and needed to watch his money.
What I don't understand is the wide spread assumption that ALL dentists are the same and that the ONLY thing that separates one dentist from the other is cost. This gentleman had lived more than 6 decades and he had not learned some of the fundamentals of American society which are:
1. You get what you pay for
2. Professionals that take care of us differ vastly in their level of knowledge, skill, talent and their concern for their patients, clients or customers. Some professionals are fabulous while many are not.
3. Your body, your teeth, your car or your house do not know that you are retired and that retirement means that you need to get the BEST VALUE for the dollars that you spend.
I just don't get it...or maybe I just don't understand.

Dont' Call Me a Health Care Provider

I recently called in a prescription for a patient on the weekend who had an infection. When I called the pharmacy, the voice mail directed me to the option of "press 2" if this is a health care provider.
I must tell you that I AM OFFENDED to be called a 'health care provider.' I attended dental school and not health provider school.
Why did the insurance industry coin the phrase, 'health care provider?' A DOCTOR is expected to be knowledgeable, caring and deserving of a great deal of respect with better than average amount of compensation. Because insurance companies don't want to pay doctors, they have done everything they can to eliminate the respect that doctors deserve and used to get. The insurance companies don't have to pay 'health care providers' the same amount of compensation that they used to pay DOCTORS. (Aside: Physicians pay has been cut in HALF, in real terms, over the last 20 years.)
So what does this mean for you and me when we go to our health care provider? It means that they barely know our names, can't remember why we have the appointment and are out the door in 3 to 5 minutes.
I want to see a DOCTOR who knows who I am, remembers the important aspects of my medical history and is really happy to see ME, his or her patient.
I am offended to be called a 'health care provider' but I LOVE BEING A DOCTOR.

I Told My Financial Advisor 'NO'

A few weeks ago I blogged about the financial industry and Trust. Today I informed my financial advisor that I would rather invest my own money because I could just not TRUST anyone in the financial industry. He asked me how his company could gain my trust in the future and I told him that the industry needed more self regulation and that they needed to throw the folks who destroyed our economy in jail. Until we see those folks punished for their illegal and unethical behavior, none of us should feel comfortable in trusting the investment industry.
I feel very strongly that I must earn your trust and do my very best to keep that trust.
Unlike the financial industry, I will NEVER, EVER earn my money in an unethical or deceptive way... I don't want your money if I can't earn it honestly.
I will give you the best possible dentistry that I am capable of doing so that you can have a healthy mouth and in return, I will be paid.
Just like we did business in the old days when folks were trustworthy.
There is a reason that our office motto is "DO THE RIGHT THING."

He Does The Same Thing That You Do

I met the owner of Miss Albany Diner this morning when we went there for breakfast and he told me that he heard a local dentist advertising that he did the same kind of things that I do. (Aside: No matter what you hear...Miss Albany Diner is THE BEST diner around)
The American Dental Society and the New York State Dental Society forbid dentists from making claims of Superiority or Excellence which can make it awfully challenging for patients to select a general dentist to treat them.
Dentists often do the same kinds of treatment such as 'cosmetic dentistry' but what their advertising does not tell you, the dental patient, is HOW WELL they do it. So what should you look for in selecting a dentist?
1. Does the dentist have an advanced degree or Certification from a recognized University. (LVI is NOT a degree granting institute nor a recognized institute.)
2. Does the dentist lecture to his/her peers because of superior knowledge, expertise or clinical abilities?
3. Does the dentist have a website which presents a great number of clinical cases that they have completed?
4. Can you call Dental Specialists (Endodontist, Periodontist, Oral Surgeon etc) and ask for a list of the top 3 or 4 dentist that they would use for their own families? The best dentists will appear on most of the lists.
5. Does the dentist take a great deal of time off which indicates whether they love what they do or whether it is just a job that they want to avoid?
6. Is the dentist on the faculty of a Dental School?

What you need to know:
1.I am the only dentist that has earned a Certificate of Proficiency in Esthetic Dentistry from the State University of New York at Buffalo. There is no other dentist within a 100 miles of the Capital District of NY that has attained that Certification.
2. I have lectured to my peers in Baltimore, Buffalo, Albany,Schenectady,Troy and Saratoga. I have been asked to lecture in other places but I would rather DO dentistry than talk about it.
3. The quality of my website and the quality of the work on my website speaks for itself.
4. Call dental Specialists and find out for yourself.
5. I love what I do and want to work 5 days a week. My last vacation was in 1985. Being away from my work is NOT a priority for me.
6. I have been promoted to Associate Clinical Professor at the State University of New York at Buffalo, School of Dental Medicine. There is NO other general dentist from the Capital District on the faculty of a Dental School.

When you read,hear or watch advertising that says that a dentist does a certain kind of treatment, you must dig a little deeper and find out HOW WELL they do that kind of work. As I have told you before, when I break a tooth, I get into my car and drive 5 hours to Buffalo, NY for my treatment. Why would I do that???? Please re read this blog. lol

Associate Clinical Professor

The State University of New York at Buffalo School of Dental Medicine has promoted me to Associate Clinical Professor. I believe that I am the only restorative dentist in the Capital District who is on the faculty of a dental school and I take this appointment as a high honor. This is a recognition of and validation for my pursuit of excellence in providing dental treatment to my patients.
We all see the local dental ads by dentists who make claims about their technology, their education and their expertise. These are claims that are very subjective in nature and cannot be measured. University degrees,certificates or appointments are the recognized GOLD STANDARD of accomplishments in the field of dentistry. I am honored to have attained this level of accomplishment after 33 years as a dentist.
My Father was a high school graduate who valued education more than any one I have ever met. He didn't care very much about money but educational success was his measure of a man. My appointment at SUNY/Buffalo would have made him a very proud man.
I guess the University feels that how I take care of you,my patient, is worth recognizing.

A Disturbing Phone Call

Dental Laboratories that actually create the beautiful dentistry for the meticulous dentistry that I send to them are very much like every other industry. If we discuss cars, dentists, teachers or dental laboraties, intelligent folks recognize that there is an incredible difference in quality available and the more you demand of a product or service, the more it will cost. Valley Dental Arts is a very fine dental lab located in Minnesota; they may not be THE best dental lab in the world but they do rank as a world class lab and I use them when I have complex cases that need a high level of expertise.
I was chatting yesterday with the Vice President of the lab, my friend Rick, and he was telling me about the sad state of the economy. He said, "We are doing the very best work in the history of the lab." He was concerned that even though Vallley Dental Arts produces superb quality the economy has affected them in some degree as well. They are anxious for the economy to turn around so then they can hit the ground running.
You have heard me say the very same thing on this BLOG in the past. We have become a Walmart Society (as Tricia calls it) in which quick and cheap are in great demand by the American public.
I too am doing the very best dentistry in my long career and my skill and knowledge is not in high demand.
How can this be????????
We need to support those companies and individuals who still give us the quality and service that has made America great.

We Had Visitors

We were honored to have the Dean of SUNY/Buffal Dental School and his wife, also a dentist, visit our office the past two days. The Dean wanted to show his wife that there ARE dentists who love their work, do superb clinical dentistry and are honest and ethical in their profession. I cannot think of a better office for our guests to have visited.
Think about this: In the last WEEK,
1. A dentist travelled 5 hours for me to place a strong direct resin filling in his back tooth and for me to correct his bite (an occlusal equilibration.)
2. A young patient chipped her front tooth and travelled 3 hours from Boston where she lives for me to restore her tooth
3. Two dentists travelled 5 hours from Buffalo, NY to watch me work.
What is the message? Why would these folks travel hours for an opportunity to come to our beautiful office in Saratoga?
Those patients who really feel that their teeth and oral health are important clearly recognize that we love what we do, we do it well and we care enough so that we are honest and ethical and can be TRUSTED.
I am just doing the job that you hired me to do.
And I thank you for hiring me.

Dentist as Patient

Yesterday afternoon I treated a new patient who had travelled FIVE Hours to come to my office. Did he want veneers? Or did he have a serious dental problem that required a superior clinician? Dr L had broken a piece of natural tooth on the inside aspect of his lower left second molar (the place that cuts up your tongue until it is repaired). I asked him how he wanted me to repair his tooth. Did he want me to cut away his healthy remaining tooth for a new crown? Or did he want one of those beautiful, strong bonded white fillings that he had seen me post on the ACE Dental forum over the last 4 or 5 years? He told me that he had travelled 5 hours for me to keep as much natural tooth structure as I could and place a bonded white filling. WOW!!!!!!!!!!!!!!
And after I did that for him, would I mind balancing out his bite (by doing an occlusal equilibration) that I was always talking about on the ACE forum.
Whenever another dentist selects me as their personal dentist, I feel honored and respected. And if I am doing the same treatment for my patients on a daily basis, I must be doing something right.
It is an honor to treat another dentist but I must tell you that I receive as much personal satisfaction each time one of YOU, my regular patients, are in my chair.
Thank you for selecting me as your dentist

Even young folks can recognize quality

Last year a young man came to my office for a new patient dental checkup after he had visited my website and saw examples of beautiful dentistry. He really wanted to have veneers because he had large gaps in his front teeth. A clinical exam and a study of his new x-rays revealed that he had decay in every single one of his teeth that were fixed by a dentist just 10 months before.I successfully convinced the young man to restore all of decayed back teeth before worrying about correcting his esthetic concerns. X-rays and digital photographs DOCUMENTED the tooth decay under all of his fillings and after 16 hours in the dental chair, we had replaced the defective fillings with beautiful, new, strong and functional bonded white fillings.
Yesterday the young man's sister and mother came to my office after an hour and a half trip from Vermont. His Mother had gone to the same dentist for her dental care and she was convinced by her son that she needed to find a new dentist. His mom told me that, "she was tired of going to an average dentist because she could not trust him and it ended up costing more money." She concluded by saying that 'she wanted to go to the best like her son had.'
I am thrilled and honored to have been able to earn the trust of a young man barely out of his teens.
As I always tell you...We all need to search out good people to take care of us. Our health depends on it.

Toyota and dentistry

There is little doubt that the Toyota Car Corporation makes one of the best cars for the average car owner. Year after year, surveys confirm that Toyotas, are safe, reliable and their owners are among the most satisfied among all car owners. So why are Toyota sales declining and the company losing money and what does this have to do with dentistry and my office?
Many of us grew up with the belief (or were actually told by our parents) that the cream rises to the top and that if you were among the best at what you did, folks would beat a path to your doorway and you would be successful. One of my friends repeated an old cliche while at dinner when she said, "If you build a better mouse trap people would come."
The fact is that building great cars or doing wonderful dentistry no longer translates into how well you will do in business. I haven't put my finger on it, but there has been a fundamental change in our thinking as a country. We don't automatically look for 'the best' and that is probably due to the fact that it is hard to trust. If you can't trust car companies or dentists, you might as well buy the cheapest. Excellence costs more in the beginning but it has greater value long term. Please buy excellence.

Financial Advisors and Dentistry

I just got off of the phone with a Financial Advisor from Fidelity Investments since I didn't have any patients scheduled today. I was struck by the fact that there is so little certainty in the area of investing and even the best investing minds in the world still make decisions with other folks money with very little certainty about what they do.
Dentistry, on the other hand, when done by a really fine dentist has just about the highest degree of certainty in outcome. When I refer you to one of my specialists for an implant, a root canal or some modification to your gum tissue, I have the highest degree of certainty that the outcome is going to be in the 95% range. When I present you with a treatment plan for extensive dentistry or even how I would treat a few of your teeth, in my mind, I believe that I will be successful 99% of the time. Why? Because that is my track record. My first root canal and crown that I did for John B in 1980 is STILL IN HIS MOUTH 29 YEARS LATER.
When I invest my money for retirement (such an evil word) with Fidelity or any of the other companies, I am "hopeful" that my money will be preserved and grow for the future. When I do fine restorative dentistry for you, I am confident that we will have PREDICTABLE, long term success in permitting you to keep your teeth for many years.
Excellence in dentistry is NOT a given and you will have to search to find a dentist who is excellent in what he or she does and loves to do dentistry. You can trust me when you put your dental health in my hands. I wish I could have as much confidence in my Financial Advisor that you have in me.

What Other Dentists Say About My Work

I am so very lucky in my professional career. It seems like everyday one of my colleagues has something good to say about my work. I am in AWE of other dentists' most kind and genuine comments about the work that I place on the internet. Dentists are like folks that cut hair at a quality salon. They indignantly ask who cut your hair or who fixed your teeth because they want to offer a negative comment about the person that recently took care of you. I recently posted some photos of beautifully bonded strong resin fillings in back teeth and this is what another dentist has to say when HE posted some of his own similar work:

"With some recent posts by Gerald displaying his fantastic skills and creativity I thought it might be interesting to open the dialogue to explore the use of these materials in places that previously I only considered Indirect restorations.
I feel very strongly that when placed well these materials will last a very long time and when they begin to show signs of need, they can be repaired, replaced, or we can advance to more aggressive treatment modes if necessary."

Dr. Dennie Jenkins only knows me by the work that I have placed on the ACE dental forum. His comment on the forum is seen world wide and I am honored to have him mention MY work in his post. From a professional standpoint, it just does not get any better than this.

I thank Dr. Jenkins for his comments and I thank you for selecting me as the person that you trust to take care of you. I promise you that I will never,ever abuse your trust.

The Next Generation

It is an obligation of all of us to help prepare the next generation care for and lead the nation after we 'retire from life.' I do not believe that anyone would argue with that statement.
For the last 5 years I have made an attempt to reach out to younger dentists to help them take the path of excellence to provide great dentistry for their patients. Sometimes young dentists call me because an older dentist or specialist told them that that is what they needed to do. Other times, I call young dentists and ask them if they would like to join me for dinner so that we can get to know each other. I do this so that we help our young colleagues decide whether to go down the path of mediocrity or become a master at their craft.
I must be honest with you when I tell you that the old dentists of Troy hated when a young dentist moved into town. They wouldn't socialize with us, they would not offer help or advice in running a dental practice or how to improve our techniques.
I vowed many years ago that when I became an 'older dentist' that I would be generous with my time and knowledge so that young dentists can have the wonderful career in dentistry that I have had.
Last night I hosted four young dentists in a nice restaurant in Saratoga Springs and it was really a great experience for all of us. We are ethically and professionally obligated to support our young professionals as they move from new dentists to established clinicians.
PS. I am going to be restoring teeth for a long time to come.

"I Want You to be My Dentist"

It is always a great honor when another dentist selects me to be their dentist. It is more impressive when the dentist is from out of town, will travel 4 hours and knows me only by my work that he has seen on the internet.
I have been communicating by email with this young dentist from Pennsylvania for several years and he recently broke a back tooth and doesn't want his tooth cut down for a crown. I have become nationally recognized for my ability to place beautiful and strong bonded white fillings in back teeth with minimal removal of natural tooth structure.
I am always thrilled when a patient selects ME as their dentist because of my reputation for giving my patients fine restorative dentistry rather than because I am located down the street from their home or office.
I have many dentists as patients and I am honored to be 'the dentists dentist.' Perhaps this will give YOU food for thought and select the dentist that other dentists select as their dentist....I hope so.

Honored again

I have been mentoring a young dentist from India via the internet and emails. He asks me questions about materials or techniques that I use so that he can achieve excellence when treating his patients. I received some premier bonding resins worth about $500 but that I knew that I would never use. I mailed my young friend from India the resin along with the technique that I use to place the resin. Several weeks later, my friend sent me photos of children being fed at a local ophanage in India. He fed the children as a way of showing his appreciation for what I was doing for him. He also told the children about me and why he was doing what he was doing.
I was deeply touched by his most generous gift to me. I have NEVER received a better gift in my entire life.
I have lived a most blessed life.

I Have Been Honored

It is always an honor to be asked to give a presentation to your colleagues. Local dentists are rarely asked to give lectures locally because professionals feel a little threatened that one of their own is recognized in a particular area of study. What you also may not know is that learning is a very exhilarating yet scary process. Why is it scary? Because learning confirms our worst fears as a professional that indeed, we do not know much about what we are doing for patients on a daily basis. You can trust me when I tell you that my sole purpose in presenting a lecture is to help my young colleagues learn how to predictably achieve excellence when treating their own patients.
It is pretty amazing the Drs. Banchs and Byrnes, the endodontists at 18 Division Street, had the dream and for sight to establish a high quality and FREE learning center for Saratoga dentists so that the entire dental community can move towards excellence as a group. I would like to thank Drs. Banchs and Byrnes for the opportunity to learn.
All of us are much better off when the people that take care of us are very knowledgeable.

I Could Not Say It Better

All dentists believe that they are good clinical dentists. My office manager, Tricia believes that a dentist could not practice dentistry without thinking that they are 'good dentist.' Sadly, mediocrity is the order of the day.
I would like to quote extensively from an editorial by Dr. Harald O Haymann, the editor in chief of the Journal of Esthetic and Restorative Dentistry,one of the premier peer reviewed dental journals. Volume21,Number4, 2009
"If there is a term in dentistry that is all too frequently used in a casual and flippant manner it is "clinical excellence." It is like Mom, the flag, and apple pie: no one ever disagrees with a claim or proclamation for clinical excellence. But to what extent does it still truly exist in dentistry and how is it achieved? In an age that is becoming ever more dominated by demands for speed and profit along with declining accountability, I believe clinical excellence is all too frequently and regrettably falling by the wayside."
"...No material or technique will overcome deficiencies in the clinician, no matter who advocates it or how well it is hyped. We as individuals represent the singularly most important element in achieving clinical excellence."
"Dr. Clifford Sturdevant, an old master kept a brass plaque on his desk that was inscribed with these words: "If it's almost right, it's wrong?"
I have said these exact same thoughts to you in every single post in my blog. Dentists are like everyone else which is mostly average. Why would a patient select an average physician or dentist to take care of them? To save a few dollars???? My patients know that I will do my very best on every appointment to take care of them and it is my ETHICAL obligation not to let you down.
Clinical excellence is something that I strive for every minute of everyday for every patient. It is my honor to take care of each and every one of you and that means striving for clinical excellence because that is what you are PAYING me for.

I'm Proud

My long time patient and friend Margie was selected to be the Chairperson for the 2009 annual Gala for Saratoga Bridges, an organization that provides support for people with disabilities and their families. After I opened my office in Saratoga, she made a personal visit and requested that I make a contribution to Saratoga Bridges....You don't say 'no' to Margie. I contributed a Smile Makeover valued at up to $15,000 to be auctioned to the highest bidder.
I am proud to tell you that my smile makeover earned the most amount of money at Margie's Gala.
At the end of the bidding for the smile makeover, I went over to the highest bidder and congratulated her. More importantly, I told her that I would do my very best to make her happy despite the fact that I was not going to earn a penny for treating this patient. The mark of a Professional is that they will ALWAYS do their best whether they are being paid or not. I am proud that my contribution will help disabled folks but I am just as proud that my integrity is NEVER based on how much I am being paid. My integrity is priceless and as I have told you before...I will never do anything to hurt a patient in order to increase my bottom line; That just will not happen.

It's All About TIME

If you go to Manhattan, there are parks where folks sit and play speed chess. The games last only 5-10 minutes and the goal is to play as well as you can in a very limited amount of time. No one would confuse this type of chess play with Chess Masters who play for hours with each move diliberately thought out. Much of dentistry today is like speed chess where the dentist schedules patients in 10-15 minute 'units' and work as fast as they can to produce the greatest amount of money in a given time period. No one should confuse this type of dentistry with how master dentists work.
In our office, we schedule patients for a minimum ONE HOUR appointments with the specific goal of doing the best possible work during that hour appointment. When we are doing large cases, our patient is the ONLY patient of the DAY and whether treatment lasts 4, 5 6 or even 9 hours, our goal remains to do the best possible treatment that we are capable of doing.
If patients beleive that all dentists are the same and a filling is a filling then you might as well go to the 10 minute dentist and pay discount fees. If your intelligence tells you that not all dentists are the same and that you need to find that master dentist to treat you, then treatment will take longer and cost more.
And intelligent folks understand that as well...Nothing new about that; excellence costs more.

Am I Crazy ? (Not really)

Many of the new patients that we see who come to us specifically for "cosmetic dentistry" are told that fixing your teeth is NOT the best way to treat their appearance related dental problems. I actually turn away business because the patients have problems that really should not be corrected by cutting away beautiful,natural tooth structure. I send these patients to one of the local othrodontists who will actually move the teeth into the correct place instead of me cutting healthy tooth structure. I am not crazy for wanting to see what is best for YOU even if it means that I will not earn any income from you.
Do I need the money? Yes!!! But as I have told you before, I would never EVER hurt a patient for my personal benefit. Your best interest is my only conern.
Competence, ethics and caring is what make me,my staff and our office different than other dental practices.

How NOT to select a dentist

I like to read dental 'business magazines' just to stay in touch with the small talk of the profession. In recent courses and in the magazines, it has been stated that the Mother of the family makes the decision on selecting a dentist and one of the biggest factors is how 'technologically' advanced the dental practice appears to be and whether the dentist has the latest bells and whistles. I have to tell you that technology will slightly improve a mediocre golfer, car mechanic or dentist but it is NOT the technology that makes a great dentist. Of course, technology will make a great dentist better but the opposite is not true. Have you ever seen the old tools of a master cabinet maker or a master mason?
If you want to find a great dentist, look for skill, education and passion....One way to determine how good a dentist is to go to their website...The skill, education and passion are clear as day.
Oh yes....I was one of the first 100 dentists in the United States to convert to digital radiography, to have computer imagining and a curing laser...None of these pieces of equipment made me what I am today.

Dental Stories

Whenever I go to a party and folks find out that I am a dentist, they spontaneously tell me about their dental problems or dental horror stories. I come away thinking to myself, "And why do you continue to go to your dentist?" Do root canals fail, crowns fall out and new fillings come out of a tooth??? Not really! Root canals performed by a root canal specialist have a 95% success rate. The first crown that I ever placed in my Cropseyville office in 1979 is still in place and I have NEVER had a filling, mercury or resin, fall out.
If you are having problems with your dentistry on a regular basis...you need to find a better dentist. Dentistry placed in the modern era by a highly trained and ethical dentist is truly fabulous.
Why is it then that so many folks have problems with their dentistry and tell me their tales of woe at parties??? It tells me that there are a fair number of dentists that aren't interested in learning how to do things right or don't care to do things correctly.
The solution is for folks to look around and find a great dentist...We exist!

Value, Cost and Dentistry

In 1978, barely one year out of SUNY/Buffalo School of Dentistry, I placed a porcelain fused to gold crown on my wife's tooth. In 2008,exactly 30 years later, I saw some tooth decay starting at the margin of the crown on my wife's check up x-rays and replaced the crown.
In 1976, as a senior in dental school, I placed a gold crown in my good friend, Walter's mouth and it is still there 33 years later. (Aside: the price of gold was set at $35 by the government)
Why am I telling you this? Two reasons:
1. Pete Dawson, the godfather of dentistry once said, "All dentistry will fail. A good dentist will make dentistry fail at the slowest possible rate."
2. There is nothing that we Americans can buy that gives more value than great dentistry. Do you think my wife or Walter really cares how much their crowns cost after 30 years of use?
Everyone, including me, thinks that dentistry is costly and on the day the dentistry is placed and the check is written, dentistry is expensive. That said, after using the dentistry year after year, we all should agree that great dentistry provides a great service and exceptional value.

"Metal Free" nonsense

Patients call our office or send emails asking whether we do 'metal free' dentistry.
Our answer is that we don't use mercury in fillings and haven't for almost 20 years.
Engineering and design sciences are a major part of dentistry. Would you like your architect to use weak materials or strong materials when designing your new house?
Many dentists are advertising that they do "metal free dentistry" which is another way of telling you that they are going to use weak materials that will fracture and break much sooner than stronger materials used in traditional dentistry.
Don't be fooled by dentists who want to sell you something rather than do the right thing for you and your family.
Metals DO have a place in dentistry and ,in fact, when the beautiful pieces of (weak) porcelain broke on MY upper second molars, I went back to GOLD CROWNS.

I am NOT a cosmetic dentist

I have been a dentist for more than 1/3 of a century (geeeeez) and during that time I have probably treated close to 100,000 patients. 99% of my patients have never had,wanted or requested that I do cosmetic dentistry for them.
Most of what I do is fixing teeth. That said, I try to do it better than others can do it.
The fact of the matter is that I have treated 10 times the number of BACK teeth than Front teeth.
As I have said countless times, DENTISTRY IS A CRAFT and some folks are journeymen while others are master craftsman.
Who would you rather have fix your teeth?

My Dentist

Many of my patients are complaining that they have to drive all the way up to my beautiful new office in Saratoga.
I broke a tooth last December and one of the Capital Districts best oral surgeons, Dr. Robert Carpenter removed the tooth and then placed 2 implants where I was missing teeth.
In August, I will drive 5 hours in each direction to see one of the best restorative dentists in the world (Dr. Fred McIntyre)to have him fabricate 2 implant supported crowns so that I can eat on my right side again. Driving to Saratoga to have your teeth fixed is a piece of cake compared to driving to Buffalo, NY.
Why do I make this trip several times a year? Because I value my teeth so much that I will not let just any dentist fix my teeth. I insist on being treated by the best dentist that I can find and I would encourage you to do the same...If you have to travel to find great people to take care of you...DO IT! At a minimum, you will be very well taken care of. And just think....You won't have to waste any more time complaining to your co workers about how your new crown fell off (again) or that your filling broke for the third time.
Time and again I encourage you to find the best people to take care of you and as you now know...I follow my own recommendations and drive to Buffalo to have my teeth fixed.

Misunderstanding

Today I met one of the other business owners at 18 Division Street in Saratoga and he apologized to me for not knowing that I was a regular dentist who does fillings, cleanings and crowns. He told me that I was so highly regarded as a cosmetic dentist that he did not know that I did real dentistry.
"Cosmetic Dentistry" is the term that dental marketers developed to sell to the public to convince them to restore their front teeth.
In reality 'cosmetic dentistry' is plain old dentistry performed at a very high level. A very good 'cosmetic dentist' is really just a very good dentist. PERIOD.
Many dentists that call themselves 'cosmetic dentists' are neither good at making front teeth look beautiful nor are they very good dentists.
I don't want to seem arrogant but I am very good at fixing teeth...Front teeth and back teeth. I do not consider myself a cosmetic dentist and when people ask me what I do for a living I respond, "I do fine restorative dentistry."
If you are looking for a 'good dentist' please consider calling our office at 518 583-1116 and I will do my very best to make you happy.

Hard to Believe

I went to one of our neighbor's summer cottages this past weekend and one of the men engaged me in my favorite subject: teeth. He told me that his dentist had retired and that he was now going to a young dentist who has been out of school for 2 years. I told him that dentistry was a craft and an art and that a very young dentist would not be ideal for a 70 year old due to his lack of experience. He responded that the young dentist needed to learn on someone to which I responded that he was correct but that he didn't have to learn on you.
I continue to remind you to find good (really great) people to take care of you. It takes at least 10,000 hours to become a master according to the author of the book "Outliers."
Please buy excellence because as L'Oreal says in their ads, "You are Worth It."

FINALLY

CLEVELAND, Ohio (CNN) -- As he walks the halls of the Cleveland Clinic, Dr. Steven Nissen makes the next generation of health care in America sound quite simple.
"Everything that we do is done with the patient at the center of the picture, not the doctor at the center," Nissen says as he takes a visitor on a tour of the clinic's world-renowned cardiac center.
"Everything we do is done with the patient at the center of the picture, not the doctor at the center." (John King reported on CNN)
Where have you heard this before?
I have made this point over and over and over. Our patients are our reason for being.
I have told you time and again that I would never do anything to harm my patient nor would I ever place making money over your best interest.
In many dental practices making money IS the only thing that matters and the patient is a necessary inconvenience to that end.
WHY DO WE USE PHYSICIANS AND DENTISTS THAT NO LONGER CARE PASSIONATELY ABOUT TAKING CARE OF THEIR PATIENTS?
I am very happy to learn that the Cleveland Clinic practices the same philosophy that I have used during the past 30 yrs. It has always been about YOU, my patient.
The only difference between me and the Cleveland Clinic is that no one pays me or my staff a salary so we have to earn our keep on a daily basis.

Let's stop the destruction

The removal of beautiful healthy natural tooth structure (enamel) in order to place a crown is a procedure that IN MY OPINION is over used. The placement of a crown most definitely has its use in dentistry but in my practice it is a treatment of last resort.
As many of you know, I have been a dentist for more than 30 years and 15 years ago, I realized that we (dentists) were removing too much tooth structure too much of the time...We could not help it because that is how we were trained and technology had not progressed to the point that we had any alternatives. 15 years ago I started doing bonded onlays because when teeth were really broken down I was able to save more tooth structure with an onlay than if I placed a crown. This was a big step forward in my effort to save as much healthy tooth structure as I could.
About 6-7 years ago, dental manufacturers started producing wonderful resins called nanohybrids which which are incredibly strong materials to fix back teeth (We have had good materials for about 20 years) and with these materials and learning from the best resin dentists in the world, I have been able to restore teeth WITHOUT having to remove any significant amounts of natural tooth structure.
Let's set the record straight: I could make far more money by placing crowns instead of very strong, beautiful bonded resin fillings. Yes these fillings cost more than other dentist's fillings but they cost less than 1/3 of the cost of crowns AND you get to keep far more of your own beautiful natural tooth... (God's materials are far better than mine.) Remember: When a crown fails...you have to take out the tooth and have an implant.
Why do I place beautiful bonded resin fillings? To help you save your teeth.
If you want me to cut down your teeth and spend more money in the process...Just make that request.
I sincerely doubt that you want me to cut down your teeth unnecessarily. I took an oath in 1977 to do no harm and to ALWAYS put my patient's best interest first. Saving teeth with bonded resin fillings helps me keep my oath.

Traveling patients

I was thrilled this week to have a new patient travel to see me from Buffalo, NY. This patient was referred to me by one of my mentors and one of the finest dentists in the world. Almost everything I know, I have learned from Dr. Fred McIntyre and when he left SUNY/Buffalo and his faculty practice, he referred one of his private patients to ME. It is an absolute honor to earn the respect of a mentor and to have him trust me enough to refer his patient to me.
Another one of my long time young patients moved to Boston after she graduated from college. She called my office on Tuesday to tell me that she chipped her front tooth and that she didn't trust anyone else to repair her tooth. I am honored that one of my patients would travel 3 hours in each direction to see me because they TRUST ME.
It sure makes me wonder when some of my Troy patients tell me that Saratoga is too far to go to see a dentist.... Let me tell you...when I need a tooth fixed, I travel 4-5 hours to have Dr. McIntyre repair my tooth.

Medical Monday and Saratoga Today

I am happy to tell you that I will be the very first dentist to be a guest on Medical Monday on June 15 at 2 PM. Alan Chartock called me on Thursday and asked me to be on his show. I look forward to answering questions on dentistry...my favorite subject. Listen to the discussion

I was interviewed by Saratoga Today last week and they wrote a really great article on me and my new office. The article is the current issue and is available for the next week or online at http://www.saratoga.com/today/2009/06/business---the-art-of-dentistry.html (without photos.)

The Best in the World

I am in Cleveland, OH attending the First International Symposium on Comprehensive Dentistry. It is thrilling to see what the very best in the world are capable of doing to help patients that desperately need their help. It is always exciting to hang out with passionate masters who have devoted their lives to becoming the best...I can identify with that.
750 dentists gave up 2 days pay to learn about how WE can help our patients. The more I learn the better it is for YOU, my patient.
I am thrilled to learn on your behalf.

YES...I am a Regular Dentist

Everywhere I go people think that I just do cosmetic dentistry and they don't want to be my patient for their regular dentistry...I DO REGULAR DENTISTRY like fillings, checkups, cleanings and crowns. Most of the time, I am doing regular dentistry and in fact, most of my work is removing mercury fillings and replacing them with very strong, bonded white fillings. I am not a jack of all trades and a master of none. That means that most of what I do is fixing teeth and NOT pulling teeth, braces or root canals. But don't worry...I will send you to some of the best specialists around so that you will ALWAYS be getting GREAT DENTAL CARE.
It is true that I am the ONLY dentist within 100 miles that can say that I am a general dentist with a specialty in esthetic dentistry. However, most of my time is spent performing the kind of dentistry that most folks need...FIXING TEETH.
I do fine restorative dentistry...Dentistry that rises to the level of art.
Yes.... I am a regular dentist and I would appreciate it if you come to our office for your regular dental treatment.
Thanks!!!!!!!!!!!

"Everybody makes mistakes"

My wife and I were dining with another couple who happen to be dentists. The restaurant had many other dentists that night because the New York Dental Society was in town for its annual meeting. Dentists like to talk dental talk and one of the visiting dentists made the comment that
'everybody makes mistakes.' The dentist and I both responded with, "No! Not everyone makes mistakes." What we meant by that was that if you plan dental treatment thoroughly, if you spend a sufficient amount of time for the treatment, if you have the knowledge, training and skill and lastly if you have the ethical standards to do the right thing then the likelihood of a successful outcome for your patient is very predictable.
People (dentists included) have less than acceptable outcomes when they plan poorly, rush through treatment, take a weekend course, and really don't care about what they are doing.
Trust me when I tell you that I absolutely hate to fail and for that reason, I will always do my very best to take care of you.
Please select the people that take care of you carefully. Good and competent people exist but as I have stated before, you will have to take some time to find them.
No one is perfect but not 'everyone makes mistakes.'

"You are so good at this......."

I finally completed a very large case involving 5 root canals (by the endodontist), periodontal treatment and 3 implants (by the periodontist) and finally restoring 28 teeth that had been badly worn by time and very old dentistry. Treatment began in 2006 and was completed yesterday. I spent 20 HOURS in preparation time to plan out the case and 35-40 hours of actual treatment time with my patient in the chair... 55-60 HOURS of work.
My patient, a 57 yr old successful business man from Massachusetts, was thrilled with the results and as we were drinking coffee together when we were all finished with treatment he said to me, " You are so good at what you do. Why don't you have thousands of patients?"
I am ALWAYS thrilled when my patient is happy with the results of my work. As I have said in my previous posts here, most patients believe that all dentists are the same and 80% of the time, they are absolutely correct. It DOES NOT matter which dentist they go to because the work will be about the same. The top 10-15% of dentists do superb dentistry and patients owe it to themselves to seek out that group of dentists that are passionate about what they do and how they treat their patients.

Medical Monday Cancelled

I always like to play by the rules and when I slip occasionally, my staff keeps me on target. Several months ago, I was offered the opportunity to be a guest on Medical Monday, the WAMC interview program. I notified the radio station one day after the station sent me an email with the available dates. The station however, blocked my email with the SPAM filter and the program was filled with another doctor.
Very few things work as they are supposed to and we have become accustomed to things not going as planned. I guess I am old fashioned and still expect things to go as promised. Excellence is slipping way from us as a country and it saddens me greatly.

Medical Monday on WAMC

Dr. Alan Chartock has invited me to be a guest on Medical Monday on WAMC. The program allows listeners to call in to the radio station on any medical subject but on Monday, May 18, the topic will be dentistry. I am honored to be asked to be a guest on Dr. Chartock's program to discuss my favorite subject: TEETH
Life is getting interesting as I become a mature dentist. I recently gave a full day lecture in Maryland, I have written an article which will appear in a peer reviewed dental journal, I am re-uniting with Buffalo's School of Dental Medicine as a faculty member and I opened a new beautiful dental practice in Saratoga Springs.
I guess this is what they mean when they call it the GOLDEN YEARS.
Please listen to Medical Monday on May 18 on 90.3 on FM dial at 2 PM.

The University calls me

I have been significantly involved with the Dental School at SUNY/Buffalo for about15 years. Actually, my relationship with UB goes back 41 years when I transferred to the University as a college junior.
Most people believe that colleges and universities are cutting edge institutions but in reality they are places that hate change because when things change, the faculty becomes obsolete and must retrain to remain current.
I left the Dental School at Buffalo several years ago when the University decided that the Esthetic Center that I helped found with Dr. Fred McIntyre and Dean Louis Goldberg no longer should exist. You see, the full time faculty did not like the fact that my Esthetic Center was teaching 'modern dentistry' while they wanted to continue teaching the same material that they taught to me 35 yrs ago
Last February, the Dean called me and asked me to go to dinner with him so that he could update me on the changes that the School was making. The school has decided to introduce all the material that that I had introduced to UB Dental School more than 10 years ago at the Esthetic Center.
Next week I will return to the University to discuss the changes to be made to the curriculum for undergraduate dental students and learn what role I will play.
I am thrilled that the University has accepted my suggestions and my young colleagues will learn some of the treatment modalities that I have been using in your treatment during the last almost 20 years.

Integrity and Doing the Right Thing

I consider myself to be a person of high integrity and ethics and I would guess that most people would think of themselves to be ethical. Integrity is tested when they have to make the choice between ethics and money. I had to make that choice today between earning a significant amount of money and doing the right thing for one of my patients. I could have done the treatment which was scheduled for all day and there might have been lets say, "negative consequences" for the patient in the future OR I could sit my patient down and explain what I had learned by studying and planning her treatment.

I felt really good when I was able to convince my patient that seeing an orthodontist was in her best interest before I performed the magic that I capable of doing.

I passed the test of ethics vs money. Trust me, I would have loved to earn the money to help support my new office and my staff but I would never hurt one of my patients in the process. NEVER!!!!!!!!!!!

Patients that come to our office expect really good dentistry but they have come to recognize that they can trust me and my staff. As many of you know, I am very proud of the dentistry that I do but I have to tell you that I am more proud of the ethical standards of our office. For 30+ years our office motto has been, "Always do the right thing."

My good friend Dr Banch

After I decided to move my practice to 18 Division Street in Saratoga, one of the dental representatives told me that I needed to meet Dr. Banch and Dr. Byrne because they also were moving into the same building and she thought that I would like them.
Both dentists are bright, young, passionate and talented endodontist (root canal experts) who are also married. I know Francisco better than I know Allyson probably (as Tricia, my office manager says) because it's 'male bonding.'
Francisco reminds me a great deal of me: he is absolutely passionate about his work and doing the right thing regardless of how long it takes. Francisco and Allyson will take great care of you if you have the need (like many of us older folks) to have root canal treatment. Your treatment will be painless and extremely well done.
In every one of my blogs, I ask you to seek and buy excellence. Francisco and Allyson ARE truly excellent.

It makes me sad

A few weeks ago I met and examined a nice young man who had visited my website to help him find a new dentist. The man travelled an hour and a half to my office in Saratoga from his home in Vermont. The Air force National Guard demands that all members be in perfect health including their dental health and last year the man went to a new dentist prior to beginning Summer training. His dentist placed almost 20 white fillings in his mouth and every single one of them had failed....FAILED!!!!!!!!!!!!!
I am saddened when one of my colleagues lacks training, skill or ethical standards which results in treatment falling below the standards of acceptable (let alone excellent).
My new patient will have to travel a long distance, spend hours in my dental chair and invest a fair amount of money to have the less than ideal work redone. After a two hour appointment in which I restored several teeth, my new patient recognized that he was in the right office and was being treated by someone who actually loved being a dentist.
Once again, I encourage all of you to find the RIGHT people (physicians, lawyers, accountants and dentists) to take care of you and your family. Excellent professionals are available to take care of you but it will take some effort to find them...It COULD save your life.

My full day lecture in beautiful Maryland

It was a cold and windy day in the Capital District on April 5, 2009 but it was a glorious Spring Sunday in Maryland where I was invited to present a full day lecture to a highly motivated and educated group of dentists. My lectures were about (what else???) providing excellent dental care to you, our patients. Dr. Peter Collins, my periodontist, and I presented material on how we diagnose, plan and ultimately provide treatment to obtain the absolutely beautiful results for our patients. In the afternoon lecture and hands on portion, I taught the dentists how I place the strong, long lasting and beautiful bonded white fillings that I provide to you on a daily basis. This was the first time that any of the 23 dentists were taught the proper technique for placing these fillings although they already provide this treatment on a daily basis.
I was thrilled to receive many emails from the class thanking me and telling me how much they learned. Here is but one example:

I just wanted to thank you wholeheartedly for the superb lecture and hands on Maryland AGD lecture you gave last week. Your work is amazing, and as a new dentist, it is what I strive to emulate in the future. After listening to your lecture, I looked into the Spears program at Scottsdale and am in the process of setting money aside to take some of his courses in the future. I actually went back to work on Tuesday and tried your technique for direct posterior composites and they look great!!! I have had to do very little, if any, occlusal adjustments afterwards, and they look terrific. I feel more like an artist than i did before- the anatomy is beautiful. I have not had the opportunity to do the direct resin mock up, but will try it on my assistant soon.
Once again, thank you for being such a great speaker and teacher.
(p.s. I am also very impressed with your website!)

It is great feeling to have my patients thank me for taking care of them. It is just as wonderful to have one's peers recognize excellence. The highest honor is to be asked to TEACH your peers.
As always, I am grateful to you, my patients for permitting me to take care of you. I am humbled to have been asked to teach other dentists.

Surprised!!!

Our new office treats my long time patients as well as an entirely new group of patients that don't know very much about us. Our new patients have been to our website where they see our beautiful work or they have received or heard our marketing. When we actually start dental treatment for our new patients, they almost universally tell me or my staff that they did not know that this level of dentistry existed. They are surprised (pleasantly) by how well they are treated by my long time staff, by the gentleness of the treatment, by how I interact with Tricia and Janine, my fabulous assistants and lastly by the quality and beauty of the results.
We all know that there is a definite difference in cars (Lexus vs Kia) ,houses, general contractors and plastic surgeons. Most of us are shocked to learn that NOT all dentists are the same which surprises ME a great deal. A dentist is not a dentist is not a dentist. We all went to dental school and were granted a license by the State to practice dentistry and after that, we are all on our own to have the profession and career that we want. As most of you know, dentistry is my life, my passion, my hobby and what I do for enjoyment but because I did not come from a wealthy family, it is also how I earn my living.
Please select people to take care of you that love what they do and you also will be pleasantly surprised how well you are treated.

Lecturing in Maryland

The definition of an "expert" is a person that lectures more than 100 miles from home.
Last weekend I travelled to Baltimore, Maryland to give a full day lecture to the Maryland Academy of General Dentistry which has the reputation of providing the finest educational programs in the country. Dr. Peter Collins, my periodontist, and I lectured to 23 other dentists who have at least 1,000 hours of continuing education on how we plan and treat our patients to attain the beautiful results for our patients. In the afternoon session, I taught a 'hands on' program to teach the other dentists how to do the beautiful and strong bonded white fillings for which I have become nationally recognized.(Aside: Your dentist is teaching other dentists how to place FILLINGS, imagine that.)
I am honored that the Maryland AGD would ask an "old country dentist" to present a lecture to its members. I have certainly 'travelled' a great distance since establishing my practice in Cropseyville, NY 30 years ago. I strongly believe that my best dentistry will be performed in the years ahead in my new and beautiful Saratoga office.
Let's continue the journey together.