AboutDentalSchools.com - Worldwide dental schools and dental colleges directory

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Beasleydentistry.com - Dr. Brad Beasley's cosmetic dentistry has won medals in International Smile Gallery competition.

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Californiaimplantdentist.com - Dr. Robert Thein is a diplomate of the American Board of Oral Implantology who practices implant dentistry in the Los Angeles area.

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Chicago Dental Implants - Dr. William Cohen is a renowned cosmetic dentist in Chicago who offers dental implants done with an artistic eye.

Cleveland cosmetic dentist - Dr. Jay H. Goldstein practices in the Cleveland suburb of Beachwood.

Cleveland Dentist - Dr. Brad Hylan practices general and cosmetic dentistry in Cleveland.

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Dr. Sparkly Smiley - A child's first visit to the dentist.  25 cents goes to Operation Smile & AAPD's Healthy Smiles Healthy Children Foundation.

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Fredericksmiles.com - Dr. Nils Olson practices cosmetic dentistry in Frederick, Maryland, and is accredited with the American Academy of Cosmetic Dentistry.

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NDScare.com -Naperville Dental Specialists is a clinic of several dental specialists in one practice. They provide cosmetic, pediatric, and implant dentistry as well as orthodontics and surgery.

New Jersey Cosmetic Dentist - Dr. Allyson Hurley is an accredited member of the American Academy of Cosmetic Dentistry.

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    Dental implants serve as anchors for teeth that don't move when you speak or chew!  Dental implants may be thought of as artificial tooth roots which allow the fabricated teeth to be firmly attached to the mouth.  They may be used to replace all teeth missing in a jaw or just to replace one or several missing teeth.  The treatment choices can vary tremendously.

   Most dental implants are made from commercially pure titanium, a very biocompatible metal.  This metal is so biocompatible it is used with heart pacemakers.  A dental implant could, however, develop an infection around it similar to a tooth, and this could lead to a need to remove it.  Titanium is also very strong.

    To understand how dental implants work one may consider the jawbone as a piece of wood and a dental implant as a screw.  There needs to be enough length, width and depth of wood to contain a screw of a given size without the wood fracturing during insertion.  In addition, a longer and wider screw in dense wood will hold better than a shorter, narrower screw in soft wood.  The anatomy of the individual patient determines the amount of bone (length, width and depth) that is available for dental implants.  This can vary greatly in different areas in the same jaw or in the opposing jaw.  This anatomical variation may be due to osteoporosis, traumatic loss of a tooth or teeth, infection around a tooth destroying jaw bone, prolonged cigarette smoking, and the presence of normal anatomic landmarks like nasal sinuses and facial nerves that travel through the areas involved.  Lastly, the upper jaw may generally be consider to be a soft wood like balsa while the lower jaw may be considered a hard wood like oak.  Therefore, with all other things being equal, the prognosis of implants in the lower jaw should exceed that in the upper jaw.

   The most common type of implant technique involves a dental implant screw that is made in two pieces:  1) The first piece is about 10 millimeters long and at its top there is an internal female screw threading.  2) The second piece is about 5 millimeters long and at its bottom there is a male external screw threading.  The first piece of the dental implant screw is placed and left to heal in the jawbone under the gum, unseen and undisturbed, for 3 to 6 months.  After 3 to 6 months the gum is minimally surgically opened and the second piece is screwed into the first piece.  The gum is sewn back and this second implant piece now protrudes through the gum and a crown (cap) can now be made to cement to it.

    There are other types of dental implants; some also go into the bone like that described above but have very different shapes.  Other types of dental implants sit on top of the bone (not in it) but under the gum.  There are other types of dental implants that just sit in the gum.  Patients should seek dental implant care from a premium implant dentist who is skilled and very experienced with all types of dental implants.  Some dentists learn one technique over a weekend course and start offering services in implant dentistry.

   The type of implant chosen for each patient depends upon a complex interaction between functional and cosmetic needs, available bone, quality and quantity of remaining teeth, medical health, emotional temperament, treatment time and finances.

   The treatment options available for patients are frequently quite varied and are better discussed in the office on an individualized basis.

     Dental school students and dentists interested in dental implants should read Dr. Leonard Linkow, a major historical figure in implant dentistry since the 1950's.  Now retired, four of Dr. Linkow's classic textbooks are reproduced with permission and exclusively available for free by clicking on this Dental Textbooks hyperlink.

Mandibular Implants Dental Implant textbook

Maxillary Implants Dental Implant textbook

Theories and Techniques of Oral Implantology (Vol 1) textbook

Theories and Techniques of Oral Implantology (Vol 2) textbook

--Dr. Jeffrey Dorfman, Director

The Center for Special Dentistry

NYC

The Center for Special Dentistry®

Creative Solutions for Complex Dentistry

Dr. Jeffrey Dorfman, Director

The Center for Special Dentistry® is comprised of a large group of dentists and dental specialists, dental laboratory technicians, dental hygienists, and students. We offer premium services in a spacious, new mid-town Manhattan office:

 
Our practice particularly enjoys Oral Rehabilitation Dental Reconstruction - Smile Makeover - for dental phobia patients involving our multi-specialty in-office team. We are sought out for the most complex cases in dentistry.  Significant cosmetic changes can occur in one treatment visit.  We provide stunning full mouth Teeth Porcelain Dental Veneers in just two visits.  We have performed Oral Microbiology Culture testing on our periodontal gum disease patients and have referred them for medical examinations for over two decades.  This was long before the relationship between gum disease and heart disease or diabetes hit mainstream media.  Dental hygiene and oral health are important for your entire body.

We offer unique Dental Fear Phobia Management techniques that include:  1) Providing significant pain control with gentle dental anesthesia during, and appropriate pain medication, after office visits, 2) Providing significant dental anxiety reduction with behavioral therapy and when necessary through the use of medication - nitrous oxide gas & dental sedation, 3) Providing realistic treatment plans and time/action calendars based upon individual patient needs.  Professionally and/or physically powerful people frequently need assistance with dentist fear management because of their difficulty in giving up control over a sensitive part of their body.  We give our patients the control they need to feel comfortable.

New patients may schedule an initial visit using the Appointment Scheduler or by calling 212.758.1000.  At The Center for Special Dentistry® a patient may consult with or be treated by a Cosmetic Dentist, Periodontist, Endodontist, Oral Surgeon, Pedodontist and/or an Orthodontist during one visit. Our practice does not participate in any managed care dental insurance plans but dental plan insurance payments may be applied towards patient balances.  Payment plans and major credit cards are accepted. 

Our private practice also has a significant academic teaching component partially because Dr. Dorfman is a former professor at two dental schools.  We frequently have visiting dentists and/or dental students from around the world studying with us.  Our pre dental school Dental Education Program offers college graduates who intend to become dentists the opportunity to learn by watching master clinicians.

This dental website provides over 4,000 pages of exclusive content written or edited by Dr. Jeffrey Dorfman.  Nearly all of the procedures shown in the pictures were taken in our office.  The bulk of the content is in the  Dental Photos, Dental Articles and Dental Textbooks sections above.  Nearly two million pages of our dental internet content is downloaded each month.

Our dental website has been on online since 1998.  It is our mission to provide free information on dental care and dental health to a global internet community.  Additional links may be found here.

Smiles are Romantic®

Sugar is bad for your teeth. The issue really is the frequency of eating sugar and the duration of its presence in your mouth. It is probably better for your teeth if you ate a lot of sugar over a relatively short period of time, and then cleaned your teeth, than if you just kept a few pieces of sugar candy in your mouth all day long.

It is not usual to see patients who have been relatively cavity free for many years suddenly present with new cavities. An increase in sugar intake is almost always the cause.

Fruit and fruit juice contain citric acid which, given the name, is highly acidic. Fruit juice may also contain sugar additives. Though fruit and fruit juice are excellent nutritionally they can also be a significant cause of cavities. Again, the issue is frequency of contact with the citric acid and the duration of its presence in your mouth.

Drink all the juice and eat all the fruit you want but do so in a finite amount of time and then ideally, clean your teeth.

Several glands in the mouth secrete saliva. They respond to many stimuli including acidity and dryness. Saliva helps to cleanse teeth, begins digestion of food and acts as a lubricant to the food we swallow.

Drinking water is a convenient way to clean your teeth when you don' t have access to a toothbrush, floss and/or mouthwash. It is also an extremely important part of daily nutrition. An average adult should drink about 50 ounces of water, or its equivalent, per day. You should drink even more water if you also consume significant amounts of caffeine or alcohol because these drinks cause dehydration. Water is the only liquid that should be kept bedside for those who get thirsty at night.

   Orthodontics is the dental specialty associated with straightening crooked, rotated or malpositioned teeth in children and adults with fixed or removable braces. An Orthodontist is the dental specialist who usually performs this procedure.

     Orthodontics physically moves teeth with braces into their proper position by pushing them through bone.  When the proper amount of pressure is exerted on teeth (with the use of wires and springs) bone will disappear (resorption) in the area where the tooth is being pushed and will reappear (deposition) in the area where the tooth was originally.

     It is usually healthier to treat crooked teeth with braces rather than cosmetically (without braces) because orthodontics actually corrects the problem while non-orthodontic methods cosmetically hides the problem.  The drawback to orthodontics is that treatment can typically involve six months to two years of annoying braces while non-orthodontic cosmetic treatment can frequently be completed in one to two weeks.

     One big benefit of premium orthodontics is the dramatic decrease in time necessary to complete many orthodontic cases.  High volume insurance practices will typically spend 10-15 minutes per patient per month while a premium orthodontic practice may spend 60 minutes per patient every two or three weeks.  Braces that might have taken two years might be completed in one year but at greater cost to the patient.  For many adult patients the timesavings is worth the cost.

     Traditional fixed (non-removable) braces have brackets that can be clear (white) or metal.  Premium cosmetic orthodontic practices typically only offer clear (white) brackets.  Fixed braces are typically used to treat more complex orthodontic problems.  They can be used to correct rotations and can cause bodily movement of teeth through bone.

     Removable braces (spring-loaded or Invisalign type) look much like a retainer or bite plate but they aren’t the same since they are used to actually move teeth.  Removable braces are typically used to treat less severe orthodontic problems where teeth may be crowded out of the dental arch, in either direction to the tongue or lip, but where the teeth are not rotated.  Though these braces are removable the patient must have the dedication to wear them close to 23 hours a day during active treatment to physically move the teeth.  This is in contrast to wearing a retainer only at night to hold teeth in position following active treatment.  Beware of dentists and orthodontists offering removable braces for anything other than simple tooth movement or you will probably waste your time and money.

     Crowding of lower front teeth is common and continuous throughout life regardless of the presence of wisdom teeth. This occurs because our lower teeth tend to move forward over time.  This crowding of teeth occurs slowly, yet progressively, over decades.

     The lower front teeth of most people bite against the inside of the upper front teeth. As one (or more) lower front teeth begin to be pushed out of the dental arch they typically hit harder against their opposing tooth in the upper arch.

     Over time this upper tooth (or teeth) will also begin to be pushed forward resulting in an unattractive smile that is more susceptible to gum disease. Notice this happening to many of your friends and family who are over the age of 50. Proper diagnosis and early careful treatment by an Orthodontist can help prevent this because these problems get increasingly difficult to treat as the years of damage increase.

--Dr. Jeffrey Dorfman, Director

The Center for Special Dentistry
NYC

Wisdom teeth can cause significant damage to surrounding healthy teeth and gums. The flap of gum tissue that covers a partially submerged wisdom tooth also provides a great breeding ground for bacteria that can cause long-term gum problems around adjacent teeth. This type of gum infection can sometimes flare-up quickly and painfully without much advance warning.

A partially submerged wisdom tooth also frequently presses against the adjacent molar in front of it; this can cause a cavity in the healthy tooth.  This can occur without symptoms!

These are some reasons why patients inevitably remove their wisdom teeth.  Don't wait for the damage to occur or for emergency pain before you seek treatment.

An Oral Surgeon is the specialist who typically performs these surgeries. He can remove one, two, three or all four of your wisdom teeth in one visit. The skill of a surgeon can have dramatic impact on the level of post operative discomfort.

To view photographs of Wisdom Teeth Extraction click on 'Dental Photos' at the top of this page and then in the left margin choose 'Wisdom Teeth'.  This section contains hundreds of photographs.

     The intention of root canal therapy is to eliminate infection and tooth pain.  An Endodontist, a root canal specialist, should typically perform this procedure.

     Symptoms that might indicate the need for root canal therapy include: 1) significant, constant pain, including pain that can wake you up at night, 2) increased symptoms specifically when you lie down, 3) significant sensitivity to hot or cold, 4) pain upon chewing on that tooth, 5) a darkening of the color of only one tooth, or, 6) the appearance of a pimple or fistula in the gum.

     A tooth might need root canal therapy even in the absence of any pain.  This can occur if the damage to the nerve is so severe that all sensation of pain is lost.  Root canal therapy may still be indicated to prevent the spread of infection, asymptomatically, in the surrounding jawbone.   

     The two main objectives of root canal therapy are:  1) to completely clean out diseased tissue and bacteria from within the tooth to the end of the tooth roots and 2) to completely fill the internal hollow root with a good filling material also to the end of the tooth roots.

     There are many techniques and materials available to accomplish this; some are great and many are bad.  Some of these bad techniques allow the dentist to quickly, yet incompletely clean out and incompletely fill the internal hollow root and this can be the cause of future problems including continuing pain and infection.  Patients should ask to see the final x-ray following root canal therapy.  It's better to get something done right the first time in a premium dental practice.

     Root canal therapy is NOT painful when properly performed in a tooth that has not yet reached the point of becoming a painful emergency.  Some people mistakenly wait until they have severe pain before seeking root canal therapy.  They are the cause of the pain, not the procedure itself.  An important lesson is therefore to seek out root canal therapy if you think a tooth is becoming more symptomatic; don't wait for the emergency.

     Root canal therapy should ideally be left to specialists and this is what patients should expect in a premium dental practice.  The skill level of the dentist determines the amount of time/visits required for root canal therapy. The Journal of The American Academy of Endodontics consistently shows comparable success rates of 95% for either single or multiple visit root canals therapies, assuming they are performed at the same skill level. A good root canal specialist should be able to complete your root canal in one hour in one visit.  There should usually be no pain during the procedure.

--Dr. Jeffrey Dorfman, Director
The Center for Special Dentistry
NYC

Oral Surgery is the dental specialty associated with tooth extractions (frequently wisdom teeth), dental implant placement, removal of pathology (disease) and realignment of the facial bones including the TMJ. An Oral Surgeon is the specialist who usually performs these procedures.

Click on specific topics at left for information on Oral Surgery procedures.

To view photographs of Oral Surgery click on Oral Surgery Photos, Wisdom Tooth Extractions, Extraction of Teeth, or Dental Implants and scroll through the numerous pages listed at the bottom of the table  These sections contain hundreds of photographs.

     Periodontics (Gum Therapy) treats bad breath, swollen and/or bleeding gums and a bad taste in the mouth that is caused by bacterial infection.  A Periodontist is the dental specialist who typically treats gum disease.

     Many patients are mistaken in their belief that dental cleanings are trivial and high volume managed care insurance offices are sufficient for this kind of work.  The truth is the skills of individual hygienists vary as greatly as those of dentists and high volume offices will typically schedule patients in 15 – 30 minute time slots whereas premium practices will typically schedule patients for one hour.  (Who has time to sterilize the room between patients??)  If bacteria is left behind after a poorly performed cleaning then the ravages of tooth decay and gum disease may progress unnoticed by the naked eye.  Patients may only begin to notice years after the damage has occurred.  A Periodontist should be available to diagnose these problems early especially since most dentists fail to diagnose gum disease.

     A combination of early gum disease diagnosis, early preventive therapy and bacterial cultures with species-specific antibiotic regimens should dramatically reduce the need for gum surgery in a premium, conservative periodontal practice.  Our practice sends cultures to the Oral Microbiology Testing Lab at Temple University School of Dentistry.  Our office is relatively rare in providing this service but the reader will agree after a review of the literature on the National Institute of Health's U.S. Government website (www.NIH.gov).  The results we obtain are quite significant.

     If a patient still needs gum surgery then all the initial preventive care described above should dramatically reduce the amount of teeth involved. 

     There has been a lot of recent press regarding the relationship between periodontal and cardiovascular (heart) and other diseases.  There is a lot of truth to this and is one reason why we have been obtaining periodontal bacterial cultures of our patients for 23 years.  It is logical that the presence of chronic bacterial infection anywhere in your body is unhealthy; why leave it in your mouth?  Again, refer to the NIH website to review  'periodontal and cardiovascular disease' for an unbiased, scientific opinion.  Most patients in our office who demonstrate significant periodontal infection are referred to an internist and cardiologist for examination.

--Dr. Jeffrey Dorfman, Director
The Center for Special Dentistry
NYC

We offer thorough check-ups and analysis of the bacteria in your saliva for determining decay and periodontal risk.

Tooth decay and gum disease is caused by specific species of bacteria. These bacteria can be detected in your saliva through microscopic and DNA analyses. We can also test these bacteria for antibiotic resistance so that if antibiotics are appropriate for your therapy we can pick the most effective one and minimize your dosage.

 Preventive dentistry is based upon sound diagnosis.

The species of bacteria that cause cavities and gum disease are different. Mechanical cleaning of your teeth with regular dental cleanings, flossing and brushing will help get rid of all the species of bacteria. Chemotherapy with mouthwashes, however, is specific to the species of bacteria we want to primarily eliminate. There are two types of mouthwashes: 1) those that are directed towards eliminating the bacteria associated with cavities and 2) those that are directed towards eliminating the bacteria associated with gum disease. These mouthwashes should be used twice a day, everyday, after flossing and brushing.

Any over the counter mouthwash with Fluoride is effective in reducing cavities. Some brand names include Act or Fluorigard but generic Fluoride mouthwashes will work as well. We typically recommend Fluoride mouthwashes for children under age 18 and adults who are experiencing a lot of new cavities.

There are only two mouthwashes, however, which have been scientifically proven to reduce the bacteria associated with gum disease: Peridex and Listerine. Peridex is an expensive ($18/bottle) prescription mouthwash that is significantly more effective than Listerine but has side effects, most notably tooth stains develop which can be removed by dental cleanings. We recommend Peridex for patients who have more advanced gum problems. Listerine (or Listerine Mint Flavor, or generic equivalents of Listerine) is the only other mouthwash on the market which is effective in fighting gum disease and is the product we recommend for most adults who are not experiencing a lot of new cavities. Other mouthwashes, e.g. Plax, Scope or generics, have not been shown to be clinically effective.