Tuesday, December 24, 2013

Trust

In the past two days, I treated a patient from Washington, DC, San Hosea, CA and Grand Rapids, MI.
Why would these relatively young patients (less than 40) schedule appointments with me when they returned 'home' for the Holidays to see their family?

The answer is simple:

They trust me to treat them right,  have the skill and knowledge and be proficient in my areas of treatment and lastly to have high ethical standards to place their best interest above my own financial concerns.

Patients that select their dentist because they accept their insurance, have low fees and are close to home or work are truly missing out because they will never be able to trust that dentist.

I value my patient's trust more than anything.

I received this email today (December 24) and I thought that I would share it with you.

"Just wanted to say thank you for the gift of the best advice.  I am so happy
with my emerging new smile.
Happy holidays!"

This older patient trusted me sufficiently that when I told her that cutting down her teeth for crowns was not in her best interest and that Invisilign (invisible braces) would be a far better option. My fee would have been $14,000 , earned in less than a month….AND SHE WAS READY TO START TREATMENT. I sat down with this patient and explained that moving her teeth for a beautiful smile was far superior (in this case) to over cutting her teeth for crowns. She trusted me to help her make the right decision even though I would not make a penny treating her.

Monday, December 16, 2013

Why I Use the Rubber Dam

Some of my patients LOVE the rubber dam and a few patients HATE the rubber dam. Every dental student in the United States was trained and required to use a rubber dam in dental school.  95% of practicing dentist give up using the rubber dam once they leave school.

So why do 5% of dentists use a rubber dam?
1. So that they can see what they need to see without  interference from the tongue, lips, cheeks or
    saliva.
2. To place all materials completely dry as required by manufacturers of materials.
3. To prevent injuring the tongue, lips or cheeks
4. To provide a sufficient amount of time to place materials without contamination.

This is a tooth that I fixed today. The reddish/brown mush is tooth decay under a resin (white) filling.
How did the decay get under a new resin filling?
1. Either the dentist could not see the tooth adequately to remove all of the tooth decay or
2. The dentist could not keep the tooth dry enough to adequately bond the new filling to the tooth.

The middle photo shows all the tooth decay removed and the bottom photo shows my completed bonded resin filling.



The more important question is: Why do 95% of dentist refuse to use a rubber dam? There is only one reason:

LAZINESS

Why would anyone select a lazy dentist to take care of them?

Why don't you ask the dentist and THEIR PATIENTS?

My Greatest Accomplishment As A Dentist

I have had many clinical successes and accomplishments during my almost 40 years of practicing dentistry. Last week, Trish, my hygienist saw 10 patients in one day  who had been with me 25-30 years and ranged in age from late 60s to early 80s. Not one of those patients had lost a single tooth while they were under my care.

Our Practiceworks software program has been used in our office for 18 years and it permits me to see every tooth that I have fixed during that time period at a quick glance. A visual survey of each patient showed that I had restored 15- 20 teeth while they have been my patient. A quick look at Practiceworks  
showed that over the last 18 years, I had only restored a few teeth  for this patient group during that time period.

In summary:
1. for most of my long term patients, they have lost very few teeth in the last 25-30 years
2. during the last 18 years, I have fixed very few teeth in this group of patients even though I have fixed almost every tooth in their mouth during the 25-30 year time period.
3. the cost to maintain their teeth for my long term patient has been extremely low considering the length of time that they have been my patient.

Do you understand why I consider this my greatest accomplishment?

Sunday, December 1, 2013

Notes of Thanks

Dr. Banchs and I each received a thank you note from the young lady who was kicked in the mouth by a horse on her 19th birthday. It is incredible that the only injury was a severely fractured front tooth.

Dr. Banchs and I worked several hours past our normal hours to do everything possible to  help our young patient keep her front tooth.

It is an honor to be able to treat another human being.

Why I Want to Replace ALL Old Mercury Fillings

Dentists pick and choose which old silver mercury fillings look the worst and need replacing. The fact of the matter is that ALL 20 + year old mercury fillings should be removed and replaced  as conservatively as possible, hopefully with a bonded resin (white) filling using a rubber dam.  Every single old mercury filling has either tooth decay or leakage under the old filling….EVERY SINGLE ONE.

Dentists fool themselves into thinking that ONLY the fillings that they remove have decay underneath.
This is incorrect…ALL of them have tooth decay under the filling.

And if you look very closely at the bottom tooth, you will see a crack in the natural tooth. How does this happen? All metals expand when heated by hot coffee, hot tea or a hot baked potato. Teeth are made of glass and do not want to expand at the same rate as the mercury filling. The result is that the natural tooth develops cracks which cause the tooth to break even when we are only eating a soft egg or soft pasta.

Think about this and ask your dentist to be PROACTIVE and replace all your old mercury fillings. It is a lot cheaper to replace old fillings than to have a mouthful of crowns or porcelain ONLAYS.





Saturday, November 30, 2013

"I Go To a Very Good Dentist"


At Thanksgiving dinner my friend's daughter in law told me that 'she goes to a very good dentist in Manhattan and that it only cost her $10.'

You can probably guess my immediate and shall we say 'indelicate' response to this very bright young lady who lacks the ability to judge excellence. I told this young lady that she did not go to a very good dentist who participated with her insurance and where she had to pay $10.

Let's think of this in terms of houses or cars which are things that we buy and can relatively understand. 
If someone pays $11,000 for a new car do you think that they have a right to expect that they have purchased a Lexus? Or if someone buys a fixer upper for $25,000 does anyone think that have purchased a magnificent home in Beverly Hills?

About every 18-24 months I review the finances of operating a private dental practice and I guess this is as good a time to repeat this:

The average dental office has an overhead of 70% which means that some overhead (rent, staff, supplies, lab fees, insurance, office taxes, donations  and utilities) are slightly below or above 70%. The government: federal, state, local, medicare, social security and school taxes amount to 50% of the remaining 30%. If you have done your math up to this point, it means that I get to take home and spend 15 cents out of every dollar that I produce. Is this a lot???? I don't think so.

Many dentists who participate with insurance companies give the insurance company a 20-30% discount from their usual fees.

Uh Oh….How does a dentist 'give away' 30% when overhead is 70% and they would make no income.

Easy:

…cleaning appointments will be 15-30 minutes instead of 45-60 minutes
…instead of using resin that is fabulous and costs $100 to fix front teeth, dentists will use a $50 resin
…instead of using a quality American laboratory to make crowns, they will use a Chinese lab that charges very little but may 'accidentally' use a little lead in the crown
…spend 10-15 minutes fixing a tooth instead of an hour
…constantly hire and fire staff so that no one knows your name when you enter the office.

Does this make sense? 

It is very challenging to participate with insurance companies and try to pursue excellence.

In the final analysis, if you pay a little for something, then your wisdom and intelligence  must tell you that you are not buying the best but rather the best at the (low) price that you are paying.

I hate talking about this .

Young Dentists Looking to Find Happiness in Excellence

A few weeks ago a young dentist sent me an email through the www.benjaminsmile.com website asking if I gave CE courses (continuing education). I responded to her that I didn't but asked her what she wanted to learn and how did she find me. The young dentist told me that she was Googling cosmetic dentists and my website was among many that came up. She went to many websites and decided that she liked the photos of my patients and she particularly liked my blogs.

At her request, I agreed to meet her on Thanksgiving morning as she was traveling from her home in New Jersey and was going to visit friends in Saranac Lake. She was a delightful young dentist who emigrated from Bangalore, India and went to dental school at NYU dental school. She is hungry to learn more and move to her next level of excellence.

(Aside: It truly amazes me that young dentists are looking for what the dental schools were unable to offer them despite spending four grueling years in school. )

I have agreed to help my friend in the same way that I have helped many young dentists. I offer complete access to me via email or texting very much the same way my mentor Dr. Fred McIntyre did for me. We must give our knowledge and experience  to the next generation of dentists so that they can better take care of you.

Unlike Susan's Aunt Sophie who refused to tell anyone her recipe for Pierogies and thus denied her family and others  the pleasure of eating her delicious food, many older dentists give freely of themselves to our young colleagues….Just the way it is supposed to happen.



Wednesday, November 27, 2013

In One Day

Today I saw patients who live in Dallas, Texas ; Brooklyn, NY; Manhattan and the state of Virginia.

My Dallas patient finally agreed with my recommendation that I find her an accomplished clinician closer to home because she travels too far to see me after moving from Troy, NY.

The Brooklyn patient was my regular patient until she was 22 years old and moved away after college 12 years ago. She has had the same fillings done and redone several times and finally decided that it was time to return to my office and have treatment when she visits her parents who are long time patients. She commented that it was time to return to the dentist that she can trust.

The Manhattan patient is the daughter of one my colleagues and he was tired of seeing new decay around her recently placed dental work when he took her check up x-rays.

My Virginia patient is a retired Troy detective  and he insists that I continue to be his dentist just as I have been for the past 20 years.

I am always so honored when patients endure great hardships in order to  have treatment in my office.

Think about what people see in our office that they are willing to drive hundreds of miles for their dental care. I must be doing something right after almost 40 years as a dentist.

The Old Guys…This is How We Do It Because This Is How We Have Always Done It #2

A few days ago I informed you about how old guys refuse to change their thinking, techniques or materials and preferring to do things the way we always did them.

The American Board of Obstetrics and Gynecology refused to let OB/GYN specialists see men because that is how we have done things since 1935.

Yesterday, the American Board of OB/GYN reversed itself because of the uproar created by its narrow thinking.

Old men need to get out of the way and let younger generations make decisions that affect their professional lives.

The average age of the leadership of the American Dental Association is between 60 and 70 years old while the average age of a dentist is 46.

This makes no sense.

Sunday, November 24, 2013

Thank You

"Wow, can I just tell you again.... THANK YOU!! What a world of difference.  I
feel like my old self. Thank you so much.  I forgot I need to schedule for
you to fix my filling so you will have to put up w me again soon."

                                                                         AND

"I just wanted to say thank you for staying so late to work on me yesterday and for doing such a wonderful job. Sadly, there are few professionals who would have done that. I feel blessed to have found you.
Happy Thanksgiving."

                                                                                                   AND 

"Dr. B. well, you certainly know how to care for your patients! Many
thanks. We'll see you at 11:45."    

It seems like a daily event to receive emails and cards of thanks from grateful patients. Every dentist can drag out 'thank you' cards from their patients so receiving these messages is NOT unusual. What is unusual is the number of messages that I receive and the fact that the comments of appreciation are for the things that I have done for the last almost 4 decades.  I have always seen emergency patients on the day that they call or within 24 hours. And I have always gone to my office after hours or in the middle of the night. 

The reality is that I should be sending my PATIENTS  the 'thank you' notes for traveling 40 miles each way or just for being our patient. It is truly a pleasure to take care of my patients.

Saturday, November 23, 2013

Crowns: How to Destroy a Tooth


Those of you who have been my patient for more than 20 years know that I have made every effort to enable you to keep every millimeter of beautiful, healthy tooth structure that I can. Another way of saying this is:

 I will not destroy tooth structure for MY personal, financial gain.

I have been perfecting my techniques to maintain and protect your tooth structure for more than two DECADES and I will challenge any dentist or dental school faculty who says that my techniques do not work or that they put YOU at risk.

The top photograph shows a tooth that had a relatively new porcelain onlay that failed when leakage caused massive tooth decay under the onlay. The nerve of this tooth will probably start to die and will require root canal therapy (Hopefully done by Root Canal Experts) in the relatively near future. My goal in treating this tooth at 6 PM on Wednesday evening was to restore this tooth as conservatively as possible and not further traumatize the nerve by removing additional tooth structure for a crown.

The bottom photo shows my completed direct bonded resin restoration…which your insurance company would call, " just a filling."  (And yes I left some extra bonding agent between my new restoration and the tooth to the left of it…UGGGG…I will remove it on the patient's next visit.)

My restoration is the BEST way to restore this incredibly traumatized tooth regardless of the cost or what other dentists will tell you.

DO NOT let dentists tell you that a crown will strengthen your tooth (unless it is a root canal treated tooth). Crowns WEAKEN teeth by removing the strongest part of a tooth (enamel) and should be treatment  of last resort.

I can tell you that my 401K plan really hates the fact that I do so few crowns on healthy teeth…but that is not YOUR problem.  You hire me to take care of you and place your best interest above my own.

(Note: I did not place the direct bonded fillings on either side of the tooth that I restored.)

The Old Guys…This is How We Do It Because This Is How We Have Always Done It

There is an interesting article in today's New York Times about a board certified OB/GYN in Manhattan who treats men with pre-cancerous anal lesions.The American Board of OB/GYN believes that their members should only treat women even though the EXPERTS in cancer research and treatment of pre-cancerous lesions may be OB/GYN physicians.

The Times contacted the Executive Director of the American Board of OB/GYN, Dr. Larry C. Gilstrap  for his comment and he said:

The specialty of obstetrics and gynecology …was restricted to taking care of women …AND THAT'S THE WAY IT'S BEEN SINCE 1935." (My emphasis added)

My first response to Dr. Gilstrap's comment was : another old guy who wants to keep things the way they were because that's the way we have always done it. I decided to find out how old Dr. Gilstrap is and sure enough he is an old (70+) guy from Texas.

Old guys…politicians, physicians, dentists, lawyers want to keep things the way they were because they are EXPERTS in the way things were and unwilling to learn new things or do things in a new way.

The Dental School at SUNY/Buffalo is another example of the old guys not wanted to learn new things  (i.e. techniques that are more than TEN YEARS OLD)  because they will have to re-educate themselves to become experts and doing things in a new and better way FOR THE BENEFIT OF OUR PATIENTS.

Trust me…I fight with myself everyday so that I don't become an OLD, old guy. I constantly am looking for and studying to find ways so that I can provide the best methods, techniques or materials   to take care of YOU.

I graduated dental school in 1977 and with the exception of using a rubber dam…there is NOTHING that I do today  that I was doing in 1977. You will never hear me say,"because that is the way we did it in 1977."

Saturday, November 9, 2013

The Most Common Questions

I have been asked the same questions throughout my career:

1. What are you doing HERE?  (Especially when I was in Cropseyville, NY)
2. Does my insurance cover this?
3. What am I going too when you retire?

No one has asked me about my location since I moved to Saratoga Springs. My move has been good for both me and my patients. Very few of my patients ask me about insurance today because everyone knows that I want to do the best clinical dentistry that I can and insurance usually covers the minimally acceptable treatment.

The third question is the most interesting to me because patients would ask me that question starting when I was a relatively young dentist. Even more interesting is that the majority of patients who asked me that question when I was younger have long ago FIRED me. As my current patients have watched me get older, they have become realistically concerned that they would need to find a new dentist in the near future and I would like to address that.

I am doing the BEST clinical dentistry of my career at this moment and I want to continue to do this level of dentistry for many years. That said, I am very concerned that my patients continue to receive the level of care that they are receiving now and I will do everything possible to make sure that they will receive great care in the future. I have started to meet with many younger (40+) dentists to determine which dentists might be interested in developing their passion, skill and education so that they will be capable of delivering fine dental care to my current patients. The dentist that assumes my practice will join me In the near future (3-4 years)  to begin  their intense education in the area of fixing teeth and restoring implants at a very high level.

I do not want you to worry about who will care for you when it is time for me to retire. I promise you that I will do everything possible to make sure that you are will have a talented, caring and ethical person to care of you in the future.

You know how much I care for my patients.

Wednesday, November 6, 2013

Made My Day

I have a patient who travels 3 hours from Potsdam to have me redo some old and unattractive crowns. The case was exceptionally hard and the patient should have had orthodontics (braces) rather than having her previous dentist cut down her beautiful tooth structure for crowns.

Yesterday, I spent 5 hours bonding in her new restorations and I believe that her new smile was pretty spectacular. Last night I received the following text from my patient:

"Home safe-and everyone loves my smile. My kids said it is perfect and my mother said,'now that's a million dollar smile!' I could not be happier or more grateful."

I am honored when a an individual  travels a great distance to become my patient. I am thrilled when I can meet my patient's expectations so that they feel that it is worth making the trip.

My job never becomes boring….I love being a dentist.

Validation

In 1992 I realized that cutting down healthy, beautiful tooth structure (called enamel) made no sense and should be avoided when possible. 1992 was the year that dental researchers discovered bonding agents which allowed dentists to bond porcelain or resin to the inside of a tooth. This  meant that both the enamel and the dentin could be bonded which was a major advancement.  I no longer had to remove ALL of the enamel for a crown and I could simply bond a piece of porcelain or resin in the exact shape of the missing, broken or decayed tooth.

At the same time, I stopped placing mercury fillings and exclusively used resin to repair my patient's cavities. I must admit that neither I nor any of my colleagues had very good resins or protocols for placing bonded resin (white fillings) but we were on our way.

About 10 years ago, a new patient came to my office with root canals having been done in ALL of his upper right teeth and few of them looked very well done. My treatment plan was to place some very large bonded white fillings in all of upper left teeth and place some crowns on the teeth that had recently done root canals. I don't see this patient very often but today I saw him because he was  complaining of pain in his upper right jaw. Sure enough, some of the poorly done root canals were re-infected and I referred the patient to Dr. Banchs, a fabulous root canal expert.

Before the patient left my office I examined the exceptionally large bonded white fillings in his upper left jaw and I was pleased to note that ALL of my restorations were still perfect  and the teeth were strong and healthy.

I strongly believe that dentists should place as few crowns as possible AND learn how to do very well done bonded white (resin) fillings using the proper protocol. When I examined my patient today, I felt that my approach to treating patients which is to keep as much natural tooth structure as possible is absolutely the best way to treat patients. My patients pay me to let them walk out of my office with as much healthy enamel as possible which, by the way, costs 1/4 of the cost of placing a crown.

I feel both validated and vindicated after seeing my bonded white fillings still going strong after 20+ years of service in my patient's mouths.

Saturday, October 19, 2013

Meeting Young Dentists

Since moving to Saratoga, I have made every effort to meet many of the younger dentists in the area. Troy had no younger dentists and the older dentists never really liked me even if they did not know me.
I help younger dentists work out some of their complex treatment plans and have given many lectures to them through the Root Canal Experts Education Center.

Now I am meeting young dentists for a different reason. My goal is to work another 10 years provided that I remain healthy and at the top of my game. In 3-4 years, I will find a younger dentist who will work with me for 4-5 years so that I can transfer all the knowledge that I know to them before I leave the profession.

I have been asked, "What are we going to do when you retire?" to which I have always answered, "You have more important things to worry about in your life than that but when I do retire, I will have found someone who is fabulous to take care of you."

Last Thursday evening I met a young dentist who joined Dr. Banchs and I for dinner. I wanted to know  a little about his future plans and to let him know that I had informally began a preliminary search for the person that will continue my legacy. During the course of a very warm and social dinner the young dentist said, "You realize that there will never be another Gerald Benjamin."

I told the young dentist that I did not share his view and that it was my job that the person that I work with in the future WILL have the same work ethic, knowledge, talent and concern for our patients that I do.

I come from a different generation of physicians and dentists than the current group. I was taught by my previous generation of dentists that you ALWAYS put your patient's best interest about my own needs.
I truly believed that all I would have to do is to find a young dentist who loves dentistry, is passionate about his or her  profession, is willing to pursue excellence and finally have the clinical skills to do the job right.  I now think that my job will be a lot harder than I originally thought.

I promise you that I will have a fabulous person and dentist to take care of you when I no longer can.

Trust by Someone Who Understands the Meaning of Trust

I have a patient who recently returned to my practice after a five year hiatus from dental treatment. He recently retired as a psychiatrist and is a friendly, affable and interesting patient and he wants his mouth to be healthy again. The one request that he made was that he complete all of his treatment before the end of the year and so we schedule 2-3 hour appointments with a few breaks in between treatment.

On one of the breaks I showed him the tooth decay (in a photograph) that was under his 25 year old mercury filling. Everyone who is my patient knows that I take photographs of almost all the teeth that I treat so that I can show my patient WHY I am treating a tooth and provides assurance to them that I am honest, have integrity and worthy of their trust. When my patient looked at the photo of his tooth he said, " I trust you because it you didn't do an excellent job it would eat you up and you couldn't sleep at night."

I could not believe that in the very short time that my patient, the psychiatrist, was able to understand and determine who I am and what my concerns and values are.

I hope that it does not take someone who analyzes people for a living to know how important it is to me and my staff that we take care of you the best that we can...not because you pay us to do  that but because it is OUR NEED to do so. It would not be an overstatement to say that it ruins my day when treatment does not meet MY expectations for the treatment that YOU deserve.e

Just When You Thought That You Heard It All

The folks that run Government must think that the rest of us are idiots.

Greg Collett is a Tea Party candidate running for the United States Senate. He hates government and he will tell you so. He hates Medicaid but 10 of his children are ON MEDICAID.

Please read his own words:

A graduate of the University of Idaho and son of a U.S. Forest Service employee, Collett opposes a wide array of government services and mandates, including public schools, national forests, national parks, public transit, libraries, marriage licenses, the Uniform Commercial Code and the direct election of U.S. senators.
He writes, in part:
“Let me set the record straight. Yes, I participate in government programs of which I adamantly oppose. Many of them, actually. Am I a hypocrite for participating in programs that I oppose? If it was that simple, and if participation demonstrated support, then of course. But, my reason for participation in government programs often is not directly related to that issue in and of itself, and it certainly does not demonstrate support. For instance, I participate in government programs in order to stay out of the courts, or jail, so that I can take care of my family; other things I do to avoid fines or for other financial reasons; and some are simply because it is the only practical choice. With each situation, I have to evaluate the consequences of participating or not participating.
“By way of example, here are a few government programs and policies that I oppose because they do not conform to the proper role of government, yet I participate in them: I am against marriage licenses, but I still got one to get married; I am against the foster care program, but I became a foster parent; I am against property taxes, but I own property and pay the tax; I am against federal ownership of land by the Forest Service and BLM, but I use the land for hiking, backpacking, camping, and fishing; I am against national parks, but I visit them; I am against driver’s licenses, vehicle registration, license plates, and mandated liability insurance, but I comply with all of them to drive; I am against public funding of transportation systems, but I still use them; I am against building permits, fees, and inspections, but I get them as needed; I am against public libraries, but my family uses them; I am against public schools, but I occasionally use their facilities; I am against occupational licensing, but I use the services of individuals and companies that comply with those requirements; I am against USDA inspections, but I still use products that carry their label; I am against the Uniform Commercial Code and designated legal business entities such as corporations, but I use the services of such entities and have set up several of them for myself; I am against the current structure of our judicial system and courts, but I still use them; I am against the 17th Amendment, but I still cast my vote for Senators; and the list could go on and on.”
I don't care if you support the Republican Party or the Democrat Party. Don't you think we need a party of reasonability to govern our great country?

Sunday, October 13, 2013

Thoughts I Agree With

There is an interesting article in today's New York Times about women at the top of organizations.
I copied one question and answer that I found interesting.


Amy Schulman
Executive vice president and general counsel; business unit lead, consumer health care, Pfizer
Fred R. Conrad/The New York Times
Amy Schulman, named president of Pfizer Nutrition in 2010, increased revenue 15 percent, to $2.1 billion, over the following year, when the division was sold to Nestl for $11.85 billion.
Q.
What are some patterns you’ve noticed over the years about women at work, and things they could be doing better to advance their careers?
A.
One thing that happens at work is that women tend to hoard favors as if they were airline miles — you know, the hundreds of thousands of airplane miles that we’re saving for when we really need them. But “when we really need them” may never come. The trips are not going to happen, and we’ll be left with 800,000 airline miles.
There’s a parallel at work. You need to spend political capital — be unafraid to introduce people, compliment somebody when it’s deserved and stand up for something you really believe in, rather than just go with the flow. I don’t mean being a perennial troublemaker, but it’s about having conviction and courage. Spend that political capital you earn by being intellectually credible, by being a fighter for the people on your team when appropriate, and by arguing for principles that matter. Those are qualities that give you credit. If you’re waiting for the perfect moment to spend that capital, you’re going to be sidelined your whole career waiting to just kind of enter the ring.
Women can and should do a better job of helping one another to be in that transactional forum, and to get over the anxiety that we’re going to be found wanting on the wrong side of that equation. We’re undervaluing the role that we can play in the success of other people and the organization. So don’t be afraid to spend some of that political capital. You have to be well prepared, you have to be smart, you have to be on time, you have to be responsive, you have to be respectful, you have to have principles. But once you have all those things and you’ve built a track record, don’t wait for the perfect day.
What Ms. Schulman is saying is that you must do the right thing and say the right thing despite the fact that there will ALWAYS be a price to be paid for doing so. In our office, 'Doing the right thing,' usually will cost us money...BUT SO BE IT. If that is the price that I have to pay, then so be it.

Saturday, October 12, 2013

Simply Amazing

I spoke with my patient who I will use on my website and in my HerLife Ads about the photographs that she recently had done at my request. I hired one of the best photographers in the Capital District, Dan Cooper, to shoot photos of my beautiful patient.  When I spoke with Kristen, she told me that, "You have changed my life. The last 3 months have been just amazing."

Can you imagine the affect that having a fabulous smile and feeling great about yourself is?

95% of people believe that having a beautiful smile is both personally and professionally important but only .0001% (my guess) of people are willing to actually have the work done.

Interesting don't you think?

Doing the Right Thing

No one forces us to the right thing or pays us extra to do the right thing. It is the right thing to do and most us us know this.

Last Saturday afternoon at 4:50 pm I received a call from one of my long time patients telling me that she broke a tooth. She put her broken tooth in context by telling me that her husband died a week ago, she had to euthanize her pet and now the broken tooth all while talking through her tears.

I asked her when she would like me to fix her tooth and she responded 'NOW.'  I told her that she could come right in knowing that it would take her about 75 minutes to arrive.  I restored her tooth with great difficulty since I was working by myself and it was one of the more difficult teeth to restore.

At the end of the appointment she asked me if it would be ok to make payments over time to which I responded, " There is no charge. You need a favor and not a filling.  She fell into my arms, her knees buckled and she started to cry. This person has been my patient for almost 30 years and I was not about to make her life any more difficult than it already was.

Everyone knows the right thing to do but making money gets in the way much of the time.

I did what I did because it is what needed to be done.

More of us need to do the right thing....Are you listening Congress?

Saturday, October 5, 2013

Doing the 'Impossible' is Sometimes Possible




I was working on a large case Friday morning when one of Dr. Banchs staff members called to ask me to see a 19 year old patient who was kicked in the mouth by a horse. He wanted me to see what we would be up against so that we could determine if we could treat or refer the patient for an extraction and an implant.

 When I examined our young patient my initial reaction was that the tooth had been hopelessly damaged and needed removal. On the other hand, if this was my daughter, the absolute gold standard of treatment, I would want someone to do their very best to preserve this tooth even if it was only for 10 years.

Dr. Banchs called me and informed me that he would do the root canal for this patient at 4 PM and that I would then 'step up' and restore and restore the tooth at 5 PM..."Are you kidding" was my first response but, hey, maybe Dr. Banchs thinks that I am more skilled than I think I am.

This sequence of photos shows the incredible damage to the tooth, following root canal treatment and my final restoration of the tooth. We completed treatment at 7 PM and we all left knowing that we had done the very best that we could do to permit this young lady to keep her tooth.

Education, skill, talent, passion and the relentless pursuit of excellence enabled Dr. Banchs and I to pull off this miracle.

I encourage all of you to find people to take care of you that possess all of the above qualities. Sometimes more than just the survival of a tooth is at stake.

Monday, September 30, 2013

Sorry, I Don't Hate

Susan and I were brought up in families where our parents completed high school and we lived paycheck to paycheck. Our parents brought us up to value education, work hard and to be respectful of others regardless of their ethnic or religious backgrounds. Regardless of the faults or short comings of our parents, they taught us not to hate.

Recently someone asked the CEO of Barilla Pasta, one of the largest pasta companies in America whether we would be seeing any gay couples in their advertising. The CEO responded that (I am paraphrasing) that there would never be gay couples in Barilla ads and that if that was unacceptable, they could buy their pasta from another company.

Needless to say, Barilla was bombarded with negative feedback which forced an apology. In response to my email, Barilla sent the following email:


Dear Dr. Gerald,

At Barilla, we consider it our mission to treat our consumers and partners as our neighbors – with love and respect – and to deliver the very best products possible. We take this responsibility seriously and consider it a core part of who we are as a family-owned company.

We are working hard to learn from this experience, and appreciate you taking the time to share your comments and valuable feedback.

Sincerely,

Barilla

Case # 163841

Sorry, I will buy my pasta from another company. If the CEO was a class act, he would resign.If we don't stand up against hate, someday the haters will  come after us.

Thursday, September 26, 2013

Changing Our Website

Most of our new patients learn about our office from the internet and specifically by visiting our website.  We have had a website for more than 10 years and we have always used the wedding photo of one of our patients on our homepage. The bride's teeth were restored in 1999 and I have always loved the results. I entered her case in the American Academy of Cosmetic Dentistry Smile Contest in 2000 in Boston but I did not win unlike the previous year in San Antonio when I did earn a first place for my work. When I complained to my West Coast Mentor, Dr. Frank Spear that I was not able to pull off a 'repeat'  in Boston he consoled me by saying, "The judges wanted to see lots of porcelain and you just showed them a beautiful smile."

I live in fear that my best cases are behind me an that I may not do any fabulous cases ever again. Fortunately, another great case always seems to come along and my latest case is being considered as the replacement for the Bride on our homepage. I just love Black and White photography and we are considering the unusual step of using a Black and White photo on our homepage.

What do you think?
double click on the image 

Sunday, September 22, 2013

Dr. Benjamin Why Do I Need a New Crown?

Patients sometimes cannot understand how a crown that they paid $850 TWENTY FIVE YEARS AGO has worn out and needs to be replaced. People fully understand that their 15 year old $2500 refrigerator has 'died' but a crown should last forever.  This photo is a picture of a tooth that had an old crown that had started to leak. This means that the metal in the crown had fatigued,became slightly bent and permitted saliva to get under the crown.  You don't have to be a dentist to see the black part of the tooth near the bottom of the photo. That is what tooth decay looks like.  Yes you could wait until the crown falls off when the decay becomes advanced but why would you?  Patients usually understand when I ask them when was the last time that they had purchased only one set of tires in their lifetime?  Everything a dentist does...including me...will fail. The definition of a 'good dentist'  is a dentist that makes things fail at the slowest possible rate.
Now do you see why I take so many photographs? Trust but verify.

Friday, September 13, 2013

Care and Concern

I would be highly upset if one of my patients expressed an opinion that I did not care about my patients.    I would never tell anyone that I was 'the best' clinical dentist in the world because I know that there are dentists who are better at restoring teeth than I am.  No one can ever say "You Don't Care About Me." because that would be completely false.

I saw a young patient  (30 years old) on Tuesday that was seeing me for a consultation about two recently placed front crowns and about a burning mouth ; she was regretting the day that she let her dentist cut down her front teeth for crowns. She showed me photos of herself when she was in her early 20s so that I could see her teeth before the crowns. To be honest, I was not even looking at her teeth but was looking at how much weight she had lost sometime over the last 7 or 8 years and how she had gone from a beautiful young woman to person with no fat whatsoever in her face (or elsewhere) to the point of being emaciated.

The longer I spoke with this patient, the more I understood that her displeasure with her teeth was only a small part of why she was unhappy. As you can imagine, it is very difficult to speak to a patient about matters of privacy especially when they do not involve teeth. That said, I have a professional obligation to help my patients because I care about them and I am concerned about their general well-being.

I am not a father but  I can only imagine how this patient's father feels about how unhappy is daughter is and how concerned he probably is.

It was my impression that this patient was suffering from post- partum depression and I strongly suggested that she contact both her physician and her ob/gyn physician  to manage the fungal infection and her lack of happiness.

I received the following email today:

Dr. Benjamin, 
The burning from thrush is lessening slightly, not much, but the doctor told me it could take some time. I saw my primary care doctor yesterday and she prescribed a very low dose escitalopram 5 Mg for anxiety. I was lectured on my weight loss, it was a little more than I realized. I'm still having an ache in one tooth that travels upward and a lot of sinus pressure. Thank you for giving me the push to see the doctor and for your concern and follow up, I appreciate it.

Later in the day, I saw a long time patient (25 + years) who appeared to have lost a considerable amount of weight although she was always thin. I immediate addressed her loss of weight even before I sat down to look at her teeth. She told me that she had been seeing a doctor who told her that she had an absorption problem but with was  little success with the treatment. I strongly suggested to my patient that she needed to go to The Cleveland Clinic, The Mayo Clinic or NY Presbyterian Hospital in NYC for an evaluation. Unexplained significant weight loss is an indication of a serious problem that must be explored and a diagnosis determined.

I was not sure how my patient would accept my suggestions but all she could say was, "Thank you so much for your recommendation. I will call them when I get home."

No one can ever say that I lack concern for my patients.

Friday, August 23, 2013

I Can't Say It Any Better

Sometimes I read something online or in the newspaper that stops me in my tracks. Somethings I agree with and others appear outrageous like the older woman who was a member of  a Church for decades and when the Congregation found out that her child (a police officer) was gay, they threw her out of the Church.

The following column appeared on the CNN website and is verbatim:


Editor's note: LZ Granderson is a CNN contributor who writes a weekly column for CNN.com. The former Hechinger Institute Fellow has had his commentary recognized by the Online News Association, the National Association of Black Journalists and the National Lesbian and Gay Journalists Association. He is also a senior writer for ESPN. Follow him on Twitter @locs_n_laughs.
(CNN) -- A detail in the fatal shooting of 14-year-old Shaaliver Douse by a New York Police Department officer earlier this month has been stopping me from grieving his death.
The tragedy happened around 3 a.m.
Why was a 14-year-old boy out that late without his mother, Shanise Farrar, who called the shooting an assassination? Or his aunt, Quwana Barcene, who said the bloody gun police say was found near his body was part of a coverup? Where was the supervising adult who should have been with a 14-year-old boy walking the streets of New York at 3 o'clock in the morning?
LZ Granderson
LZ Granderson
"I'm not saying that he's the best one, but he's my angel," his grieving mother said.
Her "angel" was a suspected gang member who police say was chasing and shooting at an unidentified man when they encountered him. Her "angel" was arrested last month for attempted murder of a 15-year-old. Her "angel" left their apartment around 8 p.m. and she had no idea where he was until the next morning when detectives informed her that her son was dead.
I want to mourn for her loss, I really do.
But as callous and as heartless as this sounds, I just can't get past what awful parents she and the boy's father were. Children may be born angels, but with all the temptations out there in the world, it takes work to try to keep them that way.
I'm sure the three teenagers suspected in the death of 23-year-old Christopher Lane -- killed because they allegedly were bored -- started off as angels. But who, besides their parents, would call them angels now?
Australian student shot dead in U.S.
As a newspaper reporter, I covered and was around a fair number of crime scenes involving juvenile delinquents and few things bothered me more than listening to their parents. Crying, ranting, proclaiming how great their children were despite being kicked out of school or previous run-ins with the law.
That's not to say kids won't be kids. Of course they will be.
Which is why it is vitally important that parents be parents.
So when kids get bored, they don't think they should go "f**k with some n**gers," as then-18-year-old Deryl Dedmon Jr. suggested before he and his buddies ran over and killed 49-year-old auto worker James Craig Anderson, the first black person he saw, with his pickup truck back in 2011. Or randomly shoot a college student jogging down the street as entertainment -- though it seems the shooting may not have been as random as previously thought considering one of the suspects, who is black, tweeted that he hated white people back in April.
Parents are supposed to instill a sense of right and wrong in their children and then keep up the due diligence necessary to make sure they don't veer off that path. When parents don't do that, we end up with three 15-year-olds assaulting and breaking the arm of a 13-year-old on a school bus in Florida.
"This is life. I am sorry what happened to the victim," Julian McKnight Sr., whose son Julian was one of the boys accused in the attack, said after a court appearance. A second appearance is scheduled later this month.
"It's just the way it is. My son ain't never been no bad person, he just got mixed with bad people, that's all ... he sorry."
I am not a perfect parent with all the answers. But I do know that it was the father, and not the son, who was apologizing -- and that, my friends, is our problem in a nutshell.
We don't teach accountability, we don't expect accountability and I'm not even sure we even know what accountability looks like anymore. Some of us have become so addicted to pointing fingers at others for all the wrong that happens in our lives that self-assessment has become synonymous with blaming the victim.
Yes, there are cultural factors that make parenting difficult. And sometimes a bad seed is just that. But none of this excuses us from taking personal responsibility where we can.
I am tired of seeing "sorry" being used to cloak negligent parents.
Sorry won't bring back Christopher Lane or James Craig Anderson.
And they, too, were each somebody's "angel."
If sorry is not good enough to protect a bartender who serves alcohol to a visibly intoxicated person who drives and kills someone, why is sorry good enough for parents who, through negligence, are culpable for the crimes their undisciplined children commit?
If my son goes out and breaks the neighbor's window, I have to pay for it. Why is a window more sacred than another human life?
We need to hold parents more accountable, both culturally and legally, for the actions of their children. Maybe then more parents will be more engaged in the lives of their children on the front end, rather than the back end, in front of a judge. Society has avenues for juveniles who refuse to obey their parents. But where are the safeguards for society when parents decide not to use those avenues?
I'm tired of hearing how good the kids who commit heinous crimes are. Maybe we should start putting parents on the witness stand so they can tell us exactly what they did to raise such perfect children.

Thursday, August 22, 2013

Trust and Integrity

My NEED is to have all my patients trust me with regards to my diagnosis, treatment planning and recommendations. President Reagan once said, "Trust but verify" and I could not agree more.

The best way for patients to trust their dentist is with photography. I usually take a series of photos of the tooth with the old filling, the decay under the filling and the final results of what the tooth looks like once the new bonded resin filling is placed.

This past Tuesday, I treated a young college student who had never had a cavity before and I felt that it would be best to send treatment photos to her parents via email.

Looking the photos you can clearly see the brown/black stain of tooth decay and the beautiful final results.

The unrelenting pursuit of excellence.d


Wednesday, August 14, 2013

Improving Lives

The original function and purpose of medical professionals was to help our fellow human beings to have a a better and happier life. Insurance companies have completely changed the medical professions and I am not sure whether my premise  ie to help people has any validity.

That said, in my office I maintain the same life purpose that I entered the dental profession. My role is to improve the lives of my patients by maintaining their oral health, eliminating infection and creating dental beauty that improves self worth.

These photos visually demonstrate how changing a patient's smile can dramatically change how the world views her and how she will interact with her world. I truly LOVE her beautiful smile.

I am honored that she selected my office for her dental care. My passion for my work and helping my patients has never been greater. After almost 40 years as a dentist, my love for my work remains the same as my first day that I graduated from Dental School.





Sunday, August 11, 2013

Just When You Thought That You Saw It All

As you know, Susan and I go to Compton's on Broadway in Saratoga for  breakfast on Friday and Saturday mornings. This is a basic restaurant/diner that moves people in and out and no one would confuse this with Fine Dining.

Yesterday, as we were getting ready to leave Compton's, a man came in carrying 3 large coffee type drinks from Starbucks down the street. So the man sits down with his two friends to have their drinks without considering that it is impolite to bring food or drinks into a restaurant establishment. What was this man thinking and how did he think that Compton's was going to pay its rent, electricity, insurance, food bill and staff?

I often receive email from prospective patients asking if they can come in to my office for a consultation for FREE? I never want to be rude but I have to ask myself if the bank will forgive one hour of my mortgage or if my staff will forgo an hours pay.

Do people who work for the State work for free?
Do teachers work for free? Policeman?

Why would I want to work for nothing and what would happen if 20 people a month wanted free one hour consultations?

In a Capitalist Society, this makes no sense.  People must be paid for their time, their talent,  and their expertise just like in the old days.

Thursday, August 8, 2013

Even Children Know

I have taken care of Abby since she was 3 or 4 years old. She is now 15 and I recently had to fix a cavity in one of her teeth for her. Since she has never had treatment to repair tooth decay in her tooth, she was someone apprehensive and I explained  all the steps that I would follow in order to complete her filling including the use of a rubber dam. Her treatment was uneventful except for the fact that having a numb lip and chin was astonishing for her. I hadn't hurt her while giving her Novocaine so it really was a mystery for her how her lip could feel sooooo different.

Yesterday, I fixed her second and last tooth that had a cavity and as I was taking my final look at the tooth prior to beginning treatment, she looked at me slightly alarmed and said:

"Aren't you going to use the rubber thing in my mouth?"

Her first experience was so positive, comfortable and safe when I used the rubber dam that she was nervous about having treatment without one. Even young children can tell when something is right and makes sense.

I have used a rubber dam since my second year in dental school and have never practiced a day without using one.

Why?

The rubber dam does all of the following:
1. Allows me to clearly see the tooth or teeth that I am about to repair
2. Keeps your tongue from being injured  by the drill as it explores what I am doing.
3. Prevents you from swallowing mercury and tooth decay which is really bacteria
4. Keeps your lips and cheeks out of my way for complete visualization.
5. Keeps the area that I am working on clean and dry so that my bonded fillings are not contaminated by saliva which lead to premature failure.

If a patient knew nothing about a dentist other than that dentist routinely used rubber dam, the dentist would be a clear choice to be his or her dentist. Only 5% of dentists use rubber dam and it is an indisputable fact that the best dentistry is done using  one.

So why wouldn't a dentist use rubber dam?

Either they are plain LAZY or they don't care about doing the best possible clinical dentistry.
Why don't you ask your dentist why he or she doesn't use one? Even children can see the benefits of using a dam.

Tuesday, July 30, 2013

In Appreciation

I am not a big fan of FACEBOOK but  occasionally stop by to see if there is anything interesting going on. I posted a cosmetic case on FACEBOOK  for the very first time and received very positive reviews of my work from dentists that I used to be on dental forums with.

Then I received the following comment from a good friend and great colleague who taught with me at SUNY/Buffalo Esthetic Education Center at the Dental School?

A.j. Monacelli commented on your post.
A.j. wrote: "Great work, Gerald, You are still the best. You set a standard all of dentistry should strive for."

AJ was an excellent dentist before he retired because of back and neck pain. He was also a highly educated dentist who cared greatly for his patients. Unfortunately, his patients did not return the love  and were mostly interested in the cheapest possible dentistry.

It is a great honor to to receive AJ's message today. Striving to be the best while pursuing excellence is what I have dedicated my  38 year career to. It is wonderful to be recognized by a fine clinician such as AJ.

Saturday, July 27, 2013

Not Just a Pretty Smile


Most patients and (sadly) most dentists, believe that 'cosmetic dentistry' is about placing porcelain or resin onto teeth to create a beautiful smile.

Sorry, that is completely WRONG!!!!!

The vast majority of patients that want a new and beautiful smile have very worn and chipped teeth.
My question to myself is:

 And how the hell did these teeth get to look so worn?

This means that I must play the role of a tooth detective and find out how and why the teeth look like they do. What is it in the bite and/or the position of the teeth that caused collisions between teeth and caused them to wear?

After I learn what happened to the teeth I must ask myself:

And how the hell am I going to change something in the bite to correct the problem that I discovered?

It is only through the process of discovery that we can come up with a diagnosis and treatment plan.

I have to be honest with you...the physical aspect of treating teeth, after 38 years, has become pretty easy for me.  I have the education, skills, and eye/brain/hand coordination to do beautiful dentistry.

The diagnosis and treatment planning  area of dentistry remains a challenge for everyone who cares about excellence.

This case involved orthodontics (we won't go there) extraordinarily beautiful bone reshaping by the very talented Dr. Perter  Collins (Troy, NY), fabulous porcelain work by Sherill at Northwest Esthetics Dental Lab in Bellevue, WA, and my diagnostic and clinical skills.

So you thought that beautiful dentistry was just placing porcelain on teeth?

(Aside: I posted these photos on Facebook and within minutes a dentist across the country wrote:

David wrote: "Never seen a case from you I didn't like, Gerald Benjamin! Good to see from you again."

It is always a great honor to receive positive critiques from a colleague)

Perfectly Stated: Defining a Path for a Successful Life

This is a recent post from a recent  SPEAR EDUCATION blog post by Imatiaz Manji

The quality of your life depends a lot on the choices you make each day. And I’m not just talking about the “should I take this course or that course?” kind of choice—the kind of decisions we make in the context of our daily lives.
These can have important implications, but the biggest impact on our lives comes from what I call our “state of mind choices.” These are the kinds of things we sometimes forget are choices. For instance …

1. Choose to be a great clinician. That’s a choice that ultimately determines how successful you and your practice will be. If it’s one you’re committed to making, there should be no half-measures about pursuing the upper reaches of excellence. Once you have made the choice to be great, you have to be all-in, all the time.
2. Choose to be a great leader. It’s not enough to have a great vision in mind, you have to be able to get that vision into the minds of others and give them the tools and inspiration they need to join you on the journey. Make the sincere choice to do it and you will start looking at team leadership in a new way.
3. Choose to be profitable. Running a dental practice is not just about dentistry. If you aren’t seeing the right return on investment, you’ll never get to achieve greatness in the profession. Make the choice to be a complete dental entrepreneur.
4. Choose to be giving. A sense of abundance and gratitude is part of any fulfilling life. Don’t just get tied down in day-to-day obligations. Enlarge your life by giving and growing. Choose to be a part of something greater than yourself.
5. Choose to be healthy. It’s something we all understand at some level, but it is a lesson that too many people learn only when it is too late; nothing else really matters. Don’t wait for issues to develop. Choose to be healthy now and embrace everything that entails. Make time to make health the priority you know in your heart it is. And finally, on a related note…
6. Choose to be happy. And yes, it is a choice. Smiling makes you feel better and, more than that it makes the world smile back. Happiness is a mode of living that brings its own rewards and it is an approach to life that helps you conquer obstacles. Look at it this way: You can choose to let yourself get frustrated or discouraged by the inevitable disturbances of life. Or you can put on a smile and say, “It’s all good! Bring it on!” I know the choice I want to make.

My Comment was:

1. This is a great list for laying out a life plan. Numbers 2-6 are relatively easy especially if you are born with the ‘happiness gene.’
The decision to be a great clinician which means an absolute, relentless pursuit of excellence (especially for an entire career) is the most challenging. Doing a fabulous case is rewarding, wonderful and profitable. Now do 1000 more fabulous cases with each one as good or better than the first.
The commitment to clinical excellence is daunting and for many, unsustainable. 10,000 Hours is merely a good start. The book “Talent is Overrated” provides a good understanding of why brilliant, extremely talented and dedicated people fail to achieve and/or sustain greatness.