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Safe and Effective Dentistry

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QUESTION: Why should every dentist use a rubber dam?

ANSWER: A rubber dam is a 6” by 6” piece of either latex or non-latex material that, when small holes are placed in it, can be stretched over teeth. When in place, the rubber dam isolates the teeth from the mouth, which allows the dentist great visibility and control of the tongue, lips and cheeks, plus the ability to work without saliva touching any bonded surface, a requirement for any adhesive procedure. For the patient, the advantages include a feeling of safety, as isolation from mercury removed from teeth and some noxious materials used in dentistry are provided, as well as control of the tongue.

Every dental student in America was trained using a rubber dam. Ninety-five percent of dentists abandon its use when they graduate from dental school. The best clinical dentists routinely use a rubber dam during their treatment, and this is not open to debate.

QUESTION: Why should crowns be the treatment of last resort in patients in their 20s, 30s and 40s?

ANSWER: The outside of a tooth is called the enamel. It is the strongest part of a tooth, which stops a tooth from flexing, and it is extremely wear resistant. When a crown is placed on a tooth, all of the enamel is completely removed from the tooth, which renders the tooth much weaker.

As dental history, rules were formulated in the early 1900s that described when a tooth was deemed weak and needed the protection of a crown or an onlay. These rules remained valid until 1992, when dentists learned to bond to the inside of a tooth, called dentinal bonding. Once dentists had the ability to bond to dentin, the rules for defining a weak tooth changed. Teeth that have direct bonded resins placed under a rubber dam are no longer weak and can survive 15 to 20 years without the need for a crown.

The purpose of a “Conserve and Delay” philosophy (conserve enamel and delay the placement of a crown) is to enable a tooth to remain in the patient’s mouth for an entire lifetime. Early placement of crowns often leads to loss of a tooth and the need for a dental implant when the patient is in their 60s and 70s.

QUESTION: Why is it so hard to find a good dentist?

ANSWER: The real question is, “What does a patient mean when they say ‘find a good dentist?’”

Is a good dentist a dentist who charges the least amount of money? Is a good dentist one that takes your insurance, or one who does all kinds of treatments and never refers to a specialist? Is a good dentist the dentist with the highest standards, the most continuing education and the most talent?

A good dentist is extremely easy to find if you are honest with yourself and are concerned only about dentistry. My criteria for an excellent dentist are:

•Has at least 10 years of experience and approximately 3,000 or more hours of continuing education
•Takes lots of photographs of their work
•Routinely uses a rubber dam for restorative dentistry
•Refers to dental specialists when it is in the patient’s best interest
•Does not see multiple patients at the same time
•Has an office that is neat and clean and maintains the same staff members for a long time
While not every good dentist will meet every single criterion on this list, they should meet many.

QUESTION: Why does dentistry cost so much?

ANSWER: If you look back over the last 35 years, you will find that the cost of houses, cars, groceries and college degrees have risen about ten times during that period. The cost of dental care has risen about four or five times during that same period. To put things in perspective, my wife earned $7,500 in her first job and her first new car cost $2,500. HLM

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Gerald C. Benjamin, DDS, brings tireless devotion to his work, 39 years of experience in restorative and esthetic dentistry and the highest quality service to create extraordinary smiles in the New York Capital District. Dr. Benjamin believes it takes a team to achieve the long-lasting effects of a great smile. His practice is located at 18 Division Street, Suite 205 in Saratoga Springs, New York; call 518-583-1116 for a consultation.