Why Must You Replace My Crown...It Doesn't Hurt?

Patients can get very upset when you advise them that their 25 year old crown (or amalgam [mercury filling] needs  replacement. Everyone KNOWS that you don't buy one car or one pair of shoes in your lifetime and expect it to last forever. Unreasonably, they DO expect dental treatment to last forever. The bad news is that nothing a dentist...even the BEST dentist ....does, will last forever. Since I photograph all of my work, I can easily prove this to my patients which avoids any misunderstandings.

The red dye only stains tooth decay RED. The entire inside of the tooth had leakage and/or decay.

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This is what the tooth looks like when the old post was removed

This is what I found under the crown

This is what was on the inner aspect of a 25 year old crown.
 

"You Are Not Going to Retire, are you?"

 Every day of my career, I have been asked if I was going to retire. And every day, I have responded that I have no plans to retire and besides, you have more important things to be worried about.

I do not look forward to retirement. I LOVE what I do and I still have my talents intact.

What would force me to retire is not having a sufficient number of patients who want/demand excellence in dental care.

What does this mean?

It means that if you like and value the care that we provide for you, You must tell your friends and family about our  office. We are NOT for every dental patient. Our office is for those patients that want good care.

Please refer  your friends and family to our office. We will take good care of them.

Mini Implants

 Everyday patients ask me, "Do mini implants 'work?'

And everyday, I respond, "Depends."

If you are 40 years old, the chance of a mini implant lasting the patient's entire life is ZERO.

If you are 83 years old, frail, and have an ill fitting lower denture, mini implants might be a good thing.

Are mini implants the BEST dental implants? NO!!!! It is almost impossible to make the gum tissue around a mini implant look like a natural tooth and trust me...The gum tissue shape and contour is critical to make implants look like natural teeth.

But I see advertisements on TV for MINI IMPLANTS.

Doesn't make them the best option.

So Well Cared For In This Office

 Twice this past week patients said to me, "I feel so well cared for in this office."

When a physician, surgeon or dentist says that they will take care of YOU, the Patient should FEEL taken care of. 

What  has gone wrong?

Back in the day, the  old guys repeatedly told me, "You ALWAYS put your patient's best  interest above  your own." ie Don't let making money take precedence over taking care of your patient.

Being an honest, ethical and religious person (in the BEST sense of the word), I took those words to heart and have NEVER put making money for myself over providing the best care for YOU.

So what has changed?

Two things: 

1.Insurance companies and government programs (MEDICARE) do not allow physicians or dentists to earn a living honestly.

2. The cost of attaining a dental school education is too high (NYU Dental School charges #125,000 a year for dental school.

Insurance companies reimburse dentist 37% of the usual dentist's fee to place a filling when overhead is 70% and MEDICARE pays 10% of a physican's/surgeon's fee.

Would YOU work for 37% of  your daily paycheck at work?

And THAT is why I won't participate with insurance companies. Insurance companies don't care about YOU and I do.

Welcome

 As Trish exists our office, we take great pleasure in announcing her replacement, Amy.

Amy has been a hygienist for 21 years and was personally selected by Trish as her replacement. 

When we met Amy she told us that she loved being a hygienist which is exactly what an employer wants to hear.

We are very excited to have  Amy join our team. It is my job to make this the best job that Amy has ever had.

With Sincere Appreciation

 Many know when it is time to end our Professional Careers and our hygienist of 12 years, Trish has decided that it is time to take life easy. Trish has been an excellent  fit for our  practice which is dedicated to excellence and she will be missed.

I was hoping that we would all retire together as an office but that will not be the case.

We wish Trish great enjoyment in her retirement. 

Recognized Again

 About 25 years ago, one of my patients had misshapen and discolored teeth. The teenager was very embarrassed about her smile and her parents asked me to bond her teeth which I was happy to do. When my patient became a Senior at Brunswick High School she was nominated for having the BEST SMILE by a graduating senior. She and I were both thrilled by her being voted as having the best smile.

Well today, another young patient was in for a cleaning and told me that she was voted as having the best smile for a graduating Senior. I placed veneers for this  young lady when she was about 16 years old and her smile is SPECTACULAR.

I am so happy that my young beautiful patient is thrill  to have a Benjamin Smile.

Times Union "Best Dentist"

 As you may remember, I have never been a fan of Social Media 'Reviews' because I feel that they are not valid. Some dentists that I don't respect have some of the best reviews because some dentists put pressure on their patients to write reviews before they leave the office. 

I do not engage in pressuring patients for reviews.

Every year the Times Union does a 'contest' to determine "The Best Of" in the Capital District and again, I don't pay any attention to that Contest.

In our office we all know the quality of dentistry offered so it is not necessary to win a popularity contest.

21 YEARS ago, I won the American Academy of Cosmetic Dentistry Smile Contest which was the most prestigious clinical contest in the world...

So I am competitive  and I do love to win......Just not in meaningless contests.

Taking Care of My Patients

 The Pandemic and politics have made our lives miserable and are the reasons that I don't blog much.

I told you that I used to post my work on several dental forums over the years and had a reputation as a significant clinician. I rarely post my work any more because very few dentists on these forums are interested in pursuing excellence.

An older dentist posted the following recently:

Very impressive, Gerald. Thank you for the brilliant skill you employ while caring fir your patients. Thanks for inspiring us to think differently about what we do. 

The post concerned the influence of dental insurance on the quality of care and the ability to deliver excellence to your patient IF the dentist participates with insurance.

The discussion yielded the following:

Participation with insurance does not permit the patient to have access to the BEST POSSIBLE DENTAL CARE.

Insurance limits the materials the a dentist can use.

Insurance precludes dentists from hiring and paying for the BEST staff members.

Insurance prevents a dentist from using the BEST dental laboratories.

I will not have the stockholders of the insurance companies preventing me from deliver excellence in clinical dentistry  because they want to make more money.

YOU are MY PATIENT and no one will dictate the quality (or lack of)  of your  treatment.

No Rumors!!!

 Rumors are impossible to deny once they create a life of their own.

THREE WEEKS AGO, the wife of one of my patients developed symptoms of  Covid and tested positive. My patient called me a week ago to report the results of the test and I immediately called my physician to ask for a prescription for a Covid test. My test and Jeanine's test both came back NEGATIVE. The last time we saw our patient was 20 or so days ago.

Before I received my test, I CLOSED our office for Monday and Tuesday out of an abundance of caution so that everyone associated with our practice would be safe. I would never put my staff or my patients at risk so we did the right thing by closing.

We have no illness in our office or our families.

Rest assured that we will always do the right thing to keep you healthy and safe including the installation of FOUR UV AIR FILTERS and an even greater attention to our sterilization of our rooms between patients.

What do we know?

MASKS PREVENT DISEASES LIKE COVID.

WEAR YOUR MASKS.

No Way to Select a Physician or a Dentist

It is quite common to select a physician or dentist by checking reviews.

In MY OPINION that is an unwise way to select people to take care of you.

Why??????

Many Doctors and Dentists hire a service to write good reviews for them. Or many put their patients on the spot and request  positive review prior to leaving the office.

More commonly, a 'good dentist' is a dentist that accepts your insurance and doesn't hurt giving Novocain.

The BEST WAY to select a dentist is to use OBJECT MEANS to your evaluation such as the following:

1. The BEST clinical dentists are those that use a rubber dam when they place a bonded posterior resin. Unfortunately only 5% of dentists use a dam ....the BEST 5 %.

2. The best clinical dentists have thousands and thousands of world class continuing education

3. The Best dentists will have many examples of their work to show other patients.

4. Better dentists post cases on dental forums for constructive criticism.

5. Better dentists TEACH at a dental school or to local dentists.

It is a good idea to use Yelp or Google to find a great restaurant. It doesn't work so well to find great people to take care of you.

Do No Harm

The most traumatic treatment that can be performed on a live tooth is the preparation of the tooth for a crown;  Preparing a tooth for a crown in a young patient 20-40 is the most detrimental. I have not placed a crown on a live tooth for a 20,20 or 40 year old in almost 25 YEARS.

If a crown is placed on a vital tooth in a young patient, the chance that the tooth lasts an entire life is very low while the probability of an implant is high. In my practice, the placement of a crown is the dental treatment of last resort, regardless of the age of the patient.

Notice what happened to the tooth when the mercury amalgam was removed. The entire cusp fell off because of expansion and contraction of the metal.

No healthy  tooth structure was removed to restore either tooth. One or both of these teeth would have been crowns or onlays in other dental practices.

Do no harm.

My Ibuprofen is Made in China

I don't know about you but I am very concerned that the majority of our generic drugs are made in China.

20 years ago, China was making baby cribs for Americans. Shortly after we started importing the cribs, we found out that the paint used contained LEAD. The Chinese became indignant when we complained and said, "You told us that you were concerned about price. You didn't say that you wanted safe."

China has always cheated.

I do not feel comfortable about taking drugs made outside of the United States.

How do YOU feel about that?

Shake Your Head

You know that dentists are only permitted to see emergency patients during the Pandemic. I was scheduled to see a patient for a new patient examination on May 18 but the patient called stating that he had  a problem.

The patient sent me an X-Ray of the painful tooth and stated that his tooth hurt and the gum tissue was swollen. I looked at the X-Ray and sent it up to Root Canal Experts so that Dr. Banchs could look at to see if he should see the patient for a 3-D Scan? The tooth had a previous root canal but the tooth was still infected. Dr. Banchs that that it would be beneficial for him to see the patient and we gave his office the patient's cell phone number.

A few hours later, I get an email from Root Canal Experts stating that the patient did not want to pay for a consultation.

When Tricia told me this, I asked her to call the patient and cancel his upcoming appointment in our office.

As EVERYONE knows, I am interested in taking care of my patient in the best possible way and always doing the right thing. Obviously this person was not interested in Excellent Clinical Dentistry and cannot stay in our office.

If a patient wants mediocre dental care, there are many, many dental offices to select from. If a patient wants EXCELLENCE, they have a handful of dental offices capable of delivering that quality of dentistry.

For me, it is about taking care of patients that want to be taken care of..
It is NEVER about the money.

Simply Amazing

Last night at about 10:30, I received this very kind note via email:

Dr Benjamin, When my son Steven was in third grade, 8 yrs old, he fell and chipped his front tooth on his way home from a birthday party. He was terribly distraught when he get home so I called you. Even though it was a Saturday, you told me to bring him into the office. He had gone to bed and had fallen asleep and I told you that so you said to let him sleep and to bring him in on Sunday morning. You fixed his tooth (using a blue light) and he was once again a happy camper. His mother was also very appreciative. He is now 40 years old and he just had to have the procedure redone. What a good thing you did that day so many years ago. I thought you might like to hear his story and to hear how your great work lasted 32 years! Thanks once again. Sincerely,

32 years ago was a period in my career before I went on a CE (Continuing Education)  explosion that ultimate includes about 7200 hours of World Class Continuing Education. Back then, a was a young average dentist. My work has almost always stood the test of time. The oldest crown that I can keep track of is about 45 years old. A crown that I placed on my wife's tooth, 1 year out of school laster 30 years.

I am very grateful for Steven's mother's email. Do you really think that Steven's mom remembers or cares about what I charged her 32 years ago?

Physicians and Dentist Must Stand Up for Our Patients and ourselves.

https://www.youtube.com/watch?v=Mvlqh0JN55M&feature=youtu.be

You MUST WATCH this video by an ER Doc who is complaining that physicians are told what to do by MBAs rather than be allowed to take care of their patients.

Take care of patients. Do the Right Thing.

Watch the video.

Just so You Know

As you know, most dentists are closed by order of the Department of Health except to perform EMERGENCY treatment. As one would expect, there are always dentists who will cheat and just continue with their regular scheduling.

My online colleagues say that they are seeing 10 emergency patients a DAY.

Our office has been closed for 3 weeks and I have had 3 emergency calls. THREE.

WHY?

Because the treatment that we provide is performed at the highest possible way that I can. ONE PATIENT PER HOUR..

Do my crowns fall off? NOPE

Do my bonded resin fillings fall out or rot out? NOPE

Are you having a crown placed and then develop a toothache? NOPE.

I do my very best to take care of YOU. You may pay more at the time of treatment but you won't have 'issues' with my work and if you go out 10-20 years, you will see that you actually paid less than at other offices.

Think about that.

Just So That You Know.

I was looking for an email address and an email popped up dated October 18, 2007. Our office Recession began July, 2007 when the headlines in the New York Times read: Congress starts to pay attention to Wall Street ie the Housing Credit Crunch.

The problem? I had no patients despite sitting in my office for 10 hours a day. And no one told me that we were on the verge of the Great Recession.

I sent an email to the manager of the lab I had been working with explaining my woes and the possibility of moving to Saratoga Springs.

This is the email that Tom sent to me:

Dr. B.,

You're one of the finest dentists I've know, clinically and professionally. Your patients have ben receiving the finest in quality care with you as their dentist. More people need to understand that. Maybe a move to a more patient friendly area would be best. They certainly would never be better served with you as their dentist.

Tom

This was very gratifying to see again especially at a time when again, I have no patients.

UNKNOWNS

The Unknowns are by definition, unknown.

That said, it is often common to hear someone say, "How could I know the unknowns."

Many dentists will often ask, "How could I be EXPECTED to know the unknowns?"

The truth is that most often, the unknowns that the dentist claimed were unknown, were only unknown to him or her  BECAUSE, they were to lazy to learn the KNOWN facts.

It is true, that you can NEVER KNOW THE TRUE UNKNOWNS, but it is our obligations as professionals to learn everything that we can because most things ARE KNOWN.

When People (and Government) Doesn't Want the People to Know the Truth

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Clinical Trials Update 

March 24/31, 2020

Despite Law, Most Clinical Trial Results Still Not Posted

Anita Slomski, MA

JAMA. 2020;323(12):1124. doi:10.1001/jama.2020.2814

Less than half of US clinical trial results are reported on ClinicalTrials.gov in accordance with US law, according to a recent study in The Lancet.

Of the 4209 trials due to report results by January 2018, only 40.9% did so within the 1-year deadline, and 36.1% of the trials were still unreported by September 2019. Surprisingly, US government-sponsored trials had the lowest compliance. The authors blamed lack of enforcement.

A separate Science investigation backed up the findings. Of the more than 4700 trials the publication examined, 55.3% were reported late or not at all.