Blogs From Our Hartsdale, New York Cosmetic Dental Practice
At Hartsdale Dental Care, we believe in creating a relationship with our patients that goes beyond the office doors. We've specially created this section of our site to share with you important dental questions.
Dr. Andrew Woo
Seeing great dentists motivate me. Just like any field, in dentistry, there are some good ones, some bad ones, and some great ones. I'd like to learn from the best and try to copy what they have been successful for years of practicing dentistry. . . Peter Dawson, John Kois, L.D. Pankey, Cathy Jameson, Linda Miles, etc. If I've ever been good, that's because I try to stand on the shoulder of those dental giants. As Dr. Dick Barnes said, I am trying to be a better dentist every year.
Similarly, as a young associate dentist, that's what I absorbed like sponge when I work with Dr. Anthony A. for a year and half. One day, when he put me aside and said, "I have seen your work and mostly you. . . You are a good guy. . . I am tired now, but I have made it. As you can see, we have wonderful patients come here, some rich, some poor, some smart, some working family. Just right mix. Just do as I have done in here, and you will be successful. . . Buy this practice from me. . . Who in the right mind would say no to that propostion? When a King hands you the key to the kingdom, how would anyone not take it? I said, "Yes. I will. Thanks Dr. A." That was seven years ago.
Just like a son tries to make his own mistake/life, I have tried and learned some more along the way. Even though I really miss the days that I worked along with him, I would do the same thing of being independent if I ever do it all over again.
I am happy when I make patient's teeth match just like the person who owns it. I believe that beautiful person should have beautiful teeth. I think smart people should have smart teeth. I think healthy people should have healthy teeth. . . Well, you've got the idea.
I don't know how many times I see the gap between the teeth and the person who owns it(pun intended). Often I see an immaculately dressed or brilliant person walks in (which, by the way, are a lot in Westchester, NY) and I see their poor teeth. If I take photograph of the teeth and try an imaginary matching game of the teeth and the person who owns it, I wouldn't be able to to. Because often the picture of teeth doesn't belong to the person at all. Often I wonder if the person truly know how their teeth looks like. After all, no one showed me my mouth closely through photography before I got into the dental school.
Yellow teeth seems to show others that you might have bad back teeth or you don't really care of your health. In comparison, when your teeth are porcelain white, (it gives off as fake) at least it doesn't look unhealthy. I got sad when I see someone who looks worse than their actual teeth are. With magic wand, I wish I could fix the teeth instantly and tell the person that you now have no reason to be afraid of smile for life! When I see any person who smile fake or doesn't smile because of their bad teeth, I know it can be fixed. Modern dentistry is just as amazing as any apple iphone.
If you don't want to be bothered like billionare, Paul Allen or Madonna, that's another story. You can get away with bad teeth if you are that famous or rich. But I really see no reason for normal people to live with that condition. You really don't have to. . . I am not sure how much the person knows what can be done and why would anyone to live with it as you see in their smile like singer Jewel or actress Kernst Durnst. Woopi Goldberg has it. Sharon Stone has it. Hilary Clinton has it. So many people own bad teeth.
Flossing is the best way to kill a bacteria. Plaque (sticky deposite of the bacteria) lives between the teeth and most are anerobic, meaning bacteria lives well when there is no oxygen. So, when you floss, your main effect is to supply the oxygen and kills the bacteria. Taking the chiken that got stuck during your lunch might feel good, but that is not the right reason. Still if you floss, you will get the benefit regardless.
How to floss? First of all, take out the floss like you are a millionaire. Don't take out tiny amount. Pull out as much as you like. Then, use middle finger and wrap the floss around the middle finger. Then the index finger will be free to use the floss and engage between the teeth. Closer the index fingers, you'll get more control. Instead of forcing floss straight down with your index fingers, make slanted angel of 45 degree, which is half of 90 degrees and use sliding motion to get to the bottom of the crown.
After all, I haven't found anyone who doesn't know how to brush. Electric brush or manuel doesn't matter as long as you brush. That is another topic. . . But I still have to find new patient who comes to my office with perfect flossing technique yet. I am practicing in this location for more than seven years now. The real statistics show that the number of percentage of people who floss reguarly is less than 15 percent of the population in U.S. If you get rid of 100,000 dentist out from that number, the average non-dental people who floss regularily would be extremly low figure.
The real education comes from repetition and monitoring the progress. So, let us monitor and teach how to keeping up with flossing. Don't go for a home run if you are not flossing regularly now. Try to go for two times per week. Keep it realistic and see if you can stay with that number. Then, don't fall back and see if you can get the number to three times per week.
New dentistry of root canal treatment doesn't hurt. Comon cliche of hurting like root canal treament is so old. Actually, there is a scientific reason that the modern root canal treatment doesn't hurt. Old method of treating root canal was using sharp needle-like instrument called file. When the file is turn clockwise, it is natural motion to push little infection toward the end of the root, which causes pain. Newer technique uses Niti wire (memory wire that keeps its shape). It is turn counterclock wise and bring all the debris outward. That is why modern root canal treatment rarely hurts the patient.
After the root canal treatment is done, it is critical to fix the top portion of the tooth. The house analogy is so perfect here. The root canal treatment is like fixing the basement. And crown is like putting a roof of the house. Actually, number one reason tooth is failed after the root canal treatment is not having proper top/cover. Depends on the situation, crown can be changed to other very durable restoarions. But rarely filling alone is strong enough for the tooth after the root canal treatment.
Well done root canal treated tooth is supposed to last lifetime. But over lifetime, the tooth might be sensitive once in a while. Please mention it to me during the checkup visits. I often tell the patient that it is small price to pay to keep your tooth. After all, keeping your tooth with root canal treatment is so much better than the best implant tooth.
I encourage my parents to come in the treatment room and watch what I am doing while I am fixing the tooth. Actually there is no right or wrong answer to this question of "should I stay or should I go". But I believe in non-authorative type of environment. After all, that is how I raise my kids. . . Not by stick but by love. . . If you trust me doing the best for the kid and you don't want to see, you don't have to be in the room.
But ground rule is so important. In order for me to treat kids, parents has to understand what is helping the situation and what is not helping the situation while in the room.
Most importantly, please don't use negative words to kids. "It won't hurt. . . No pain. . .There is no needle/shot. . . It is almost over". . . Kids are smart. Kid is thinking, if it is not going to hurt, why my mom is keep saying it won't hurt? When negative words are used, it doesn't matter whether you said "It won't hurt or I would hurt". All he/she hears is the word, "hurt".
We use kid's language and show kids what is going to be done before doing anything. For example, we use tooth counter to see the sugar bug. And we use sleepy juice to put the tooth to sleep and tickle the tooth or blast the sugar bug with whistle.
Overall, thing are much smoother if parent can become "silent observer". If any time you are concerned about child's safety, you can ask and stop me. If mother talks, my assistant talk, and I talk, it is overwhelming for kid to follow.
So, I can treat any child who I can communicate. As long as child can open their mouth, keep head still, and hand down, I can treat. Usually, that means five or older. If I can treat my five year old son without sedation, I can treat others. No. I don't put kids to sleep. If behavior therapy wouldn't work, then, I would refer to a pediatric dentist, who could use general anesthesia with anesthesiologist in hospital setting.
Because it is so important and matters to you. In modern dentistry, there is at least three ways to fix your teeth. So, the old method of " The doctor knows the best" and telling the patient what to do is over. I often say to the patient, "I can't make you a dentist and you don't want to be." But I want you to make educated decisions on the treatment suggestions. Sometimes, patient thinks I am suggesting what is most expensive treatment for them. If that happens, it is a failed communication between the dentist and the patient. After all, there is no cheap treatment. All dental treatments are expensive, aren't they? All dental treatment is profitable in dentist's point of view! Simply, I would make more money by doing "fillings" without talking to a patient. But that is not the point. Point is what would patient benefit the most and patient know what patient have decided.
Clear example of this is whether tooth should be treated with root canal treament or implant treament should be done by taking the tooth out. It is a heated debate in dental profession as well and dentists argue over what is the best for the patient. But, to make a long story short, real issue is what is the best for the patient and what is the least invasive procedure to start. It shouldn't not be based on the money. Actually, nowadays, the cost of each procedure is about the same anyway(root canal, post& core, and crown vs. implant surgery and implant crown). But if I were patient myself, I would like to know myself whether my dentist "explore" all the possible measures before taking the tooth out. That might means root canal treatment first and see if the tooth can be saved first.
A lot of dentistry is two minutes waiting game. Dentist have to wait a lot, believe or not. Dr. Seuss is so right. Life is full of waiting room. So, I would like to talk while I am waiting. I haven't found any more powerful drug to calm my patient( especially kids) down than talking. Adult find comfort knowing that I am a good guy. Kids finds that I am goofy and then they start to relax more. That's why I am so chatty.
Good dentist is someone you feel comfortable. This is the question that I asked for myself forever. Who is a good dentist, anyway? Someone who offer a dirt cheap treatment? Someone who has exqusite technique, yet talks like robot? I often wondered why so many dentist are so lookalike. Because they're all doing the same thing and their work becomes their personality. Common sense goes miles way. If you don't feel right, then the dentist is not right for you. Old streotype of male or female dentist doesn't work. No one will blame you for choosing specific ethnicity or gender, but overall quality of dentist can't be measured by that.
Secondly, from a web site, you should be able to see the dentist's name and profile at least. It is okay to have clinic name, but dentist shouldn't hide under the name; not being able to see any of the dentist's work or profile is not right. Old way of dentistry was that if I am so good and caring, patient will line up and I don't have to do anything. I wish that day is still here. Because it is kind of pure. . . If I can really sing beautifully, that is all I need to be a singer. . . Anyway, new way of dentistry is different. Young patients ask me, "Dr. Woo. Why don't you advertise? Don't you have something to be proud of?" As you can see, the thinking is changed. Generation X, Y, and Z does't think advertising as solicitation but way of communication. That is why it is not illegal anymore for dentist to advertise.
Lastly, being able to do very difficult work itself alone doesn't mean a good dentist. But if the dentist doesn't do any of the procedure except simple filling, the dentist might not be a good one because it means that the dentist is not keeping up or learning new things. Any professionals needs constant learning. In fact, every 10 years or so, dentistry changes so much that good dentist should update the technology and techniques. That's why after about 5 years from the dental school graduation, it doesn't matter which dental school you graduated from (I still love my University of Minnesota). It shouldn't matter because you must have acquired new stuff along the way. I don't want to go to the dentist who uses only things that he/she learned from dental school over and over again without being better. That's why dentist is required to take continuing education as mandatory requirement.
No. I don't love teeth. Actually, far from it. Any professional who are in trench for more than 10 years from school will agree with me that the procedure becomes routine. I haven't talk to any brain surgeon but I am pretty sure that it is not the procedure that it motivates them. I do love life and the fact that I can change almost anybody's smile into healthy and normal. It is really nice view from the top of dental mountains, where I can see the whole valley of dentistry. I am not different from any other hard working dentist. But, I know I am at the zenith of my career. I love baseball and if I were pictcher, I am like a guy who can throw 94 miles fast ball with all command of other pitches to strike. When I see a little girl just like my daughter, and I can already visualize her transformed beautiful face right in front of me, how can I not get happy about it? I don't know how not to be. That's why I am soooo passionate about it. That's all. No mattter how good I do dentistry, I didn't invent any of the procedure and I am practicing what is already proven in scientific literature, testing and FDA. I know I will not get into the dentistry hall of fame. And that is okay with me. Changing one person at a time and make them beautiful and keep it beautiful is good enough for me. It is not about teeth. . . It is not about me being an expert. . . It is about you.
Because it should last lifetime. That is the most important and simple answer. Just like cars are getting better every year, implant parts are being updated and gets beter every year by implant companies. Actually, the price of implants came down significantly. Someone calculated that twentry years ago, we paid rougly 15,000 for braces. Now braces cost less than half or third of that in U.S.
When choosing implant dentist, common sense goes long way. For example, good implant can't and shouldn't cost below 1500 from start to finish. Because the price of any dental material is the same whether it is in Hawaii or New York. In fact, price of good implant is the same "expensive" all over the world. As much I don't love the analogy, the old adage is true in this case ; "you get what you paid for". You might not have to pay the top of the line fee, but implant shouldn't be the lowest price in the area. Because any dental and medical fee is not dependant just on the price of the material. Rent, location, and overhead of the practice plays big role in determining the fee of the dental implants.
Good news is about five years ago, dental insurance company started to reimburse implant procedures as implants becoming mainstream, especailly urban metro areas. Still, it is far from the perfection and majority of dental insurance companies only pays partial portion of the total cost of the implants.