A Fitting Tribute to a Man with a Perfect Smile

Ready or not, life often presents unexpected, difficult situations that we don’t quite know what to do with.

Like when Waterloo residents Mandee Rauscher-Woodring and her husband Kenny Woodring learned through a routine ultrasound that their son would be born with a cleft lip and palate.

“I was so scared for my son,” Mandee remembered. Babies born with cleft lip and palate often struggle to thrive because feeding is difficult. They undergo painful surgeries as infants, children and teens and work hard to overcome big challenges with hearing, speech and their dentition.

Mandee Rauscher-Woodring and her son Nathan

Mandee Rauscher-Woodring and her son Nathan

After careful consideration, she and her husband decided to switch providers and deliver their son at Strong Memorial Hospital, where a team of specialists from pediatric and plastic surgery, pediatric medicine, dentistry, audiology, social work, and speech and language are available to treat patients with cleft and craniofacial anomalies. There, Mandee and Kenny learned about a special and relatively new treatment done at UR’s Eastman Dental, called the Nasoalveolar Molding Technique, or NAM. A retainer-like device is placed in the infant’s mouth and over three to four months, helps align the bones, reduce the size of the cleft, reduce the number of surgeries needed, and dramatically improves the surgical and aesthetic result.

Despite the two-hour commute each week (often in snowstorms) for treatment at Eastman, Mandee and Kenny decided the NAM would be the best approach for their son, and began treatment one week after his birth on November 8, with Dr. Erin Shope, a pediatric dentist and NAM expert.

Throughout the following weeks, they, like other parents, found the NAM to be frustrating to deal with, and the baby was not thrilled about having it secured with tape.

“It was like a puzzle getting all that on there and for it all to stay,” said Mandee, who admitted wanting to give up at times, but knew she had to stick with it for Nathan’s benefit. “I used to get so anxious knowing I had to take it out to clean it and put it back in. And just when I would become more comfortable, there would be another change or another thing to tape.

“One time his skin broke out and became infected,” she continued. “The last few weeks were the hardest because it was nearly impossible to get the tape to stay from his middle lip to the NAM. But Dr. Shope is such an amazing, caring, flexible, supportive human being! She was very understanding and very professional.”

And then the Rauscher family experienced a horrible tragedy. One of Mandee’s brothers, 26-year-old Kory Rauscher, died in a snowmobile accident in early January.

(l to r) Kory's father Dave Rauscher, Great Aunt Jean Rauscher, Uncle Peter Rauscher, family friend Carol Hendrickson, Uncle Doug Rauscher, Aunt Cheryl Rauscher

(l to r) Kory’s father Dave Rauscher, Great Aunt Jean Rauscher, Uncle Peter Rauscher, family friend Carol Hendrickson, Uncle Doug Rauscher, Aunt Cheryl Rauscher

One of four children of David and Kelly Rauscher, Kory was a perfectionist– a hardworking, fun loving guy who was a good son, a great friend and brother to Mandee, Jamie and Brandon.

“He wanted everything he did to be just right and would get frustrated if they weren’t,” said his older sister Jamie Rauscher. “We worked together since he graduated college, lived together in Pennsylvania for a while, fought together, laughed together, and traveled together. We were very much alike which created a special bond and relationship, to say the least.”

After earning his business degree, Kory went to work for his father at the family business, D.C. Rauscher, Inc., a natural gas services company. He began as a laborer, then equipment operator and eventually assumed the role of Operations Manager.

“When he wasn’t working, Kory loved spending time on the golf course,” said Jamie, who works at the family business. “I believe it was a place where he could escape the speed and demands of the industry and world in which we operate on a daily basis.”

banner-kory-golf benefit(2014)Three of his closest friends wanted to pay tribute to Kory by hosting a charity golf tournament at a golf course in Waterloo where Kory played often. “They just wanted all of his friends and family to be able to come together in an environment in which Kory enjoyed himself.”

kory-5725When Kory passed, many friends and colleagues wanted to make a donation in Kory’s name, and asked the family for suggestions on where. It was Kory’s father David who suggested directing donations to Eastman Dental, as a way to help other families managing care for babies with cleft lip and palate.

“It was a tough time for us with money and I was very anxious about how we were going to afford everything with new insurance plan, travel, copays,” Mandee said. “I was very thankful to Eastman for all they did. Dr. Shope always wore a smile and always gave props to us for doing most of the work. I was also thankful that Dr. Shope had great communication with the cleft team and they, along with Lenora the social worker, were able to find some financial support for us with gas.”

“I saw how much time and effort my sister and her husband had to commit to Nathan and his care since birth,” said Jamie. “I bought her some tape once… it is expensive! I love that we were able to raise money to help other families receive the care that Nathan has to make his surgeries successful.”

Panorama 1On a beautiful Saturday summer morning, 200 people gathered to honor their lost brother, son and friend, to celebrate how his life, despite how tragically short it was, made such a huge impact on so many around him.

Kory's brother Brandon Rauscher

Kory’s brother Brandon Rauscher

“The weather was amazing and the atmosphere was just perfect!” Jamie said. “People who had never golfed in their life participated and had an amazing time. When I walked through the rows of golf carts as people were getting ready for the shotgun start, I got an overwhelming feeling of Kory telling me ‘this is the coolest thing I have EVER seen’!”

presenting the check

Jamie Rauscher (left) presents a check to Dr. Erin Shope

Thanks to the generosity of area businesses and friends and family, The Kory Rauscher Golf Tournament raised more than $3,500 to benefit children and families caring for their child with a cleft lip and palate and using the NAM.

“We are very happy to have used the NAM,” Mandee said. “I realize now that Nathan may have had to have multiple surgeries for his lip to come out as good as it did with just the one surgery. He looks great. The NAM did a lot in such a short time.”

“Little Nathan has been nothing but a gracious gift from God from the minute Mandee told us she was pregnant,” said Jamie. “He has taught us all so much about love and life and continues to everyday, especially through his surgeries and perseverance in overcoming his obstacles.

“Raising money to share and spread smiles on other babies’ faces and in their families’ hearts is as much a blessing to us as it is to those it will help,” added Jamie. “Most importantly Kory had a perfect smile so it’s only fitting that we help others smile in his memory.”

All photos taken and donated by JD Photography

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Residents and Rocks Motivate This Alum

Dr. Fishman with one of his pieces

Dr. Len Fishman is a professional sculptor.

Len Fishman is kind and unassuming, and almost always is seen wearing a broad, contagious smile. “I love this phase of my life,” he said matter of factly. “I live simply and want for nothing.” His life is full because it has everything he loves – his family and friends, his work as an orthodontics professor and as a professional sculptor.

“I love coming to Eastman to teach and assist residents with their research,” said Fishman, 81, who drives an hour and a half from his Skaneateles home three days a week. “I get very close to the residents and value and respect their friendship. There’s something in our department that bonds all of us together. We have very bright, highly motivated residents who love to learn. Why wouldn’t I do this? We are all so lucky!”

Fishman decided he wanted to be an orthodontist after taking a one-week course in it during his two-year service in the U.S. Army as a dentist. He spent a year in the Eastman Dental Center Pediatric Dentistry program before he was accepted into the Orthodontic program.

“While in school, my wife and I were living in an attic and I managed to do some general dentistry Friday nights and Saturdays to help pay our expenses,” he said.
When he finished the program (Pedo ’59, Ortho ’61), he and his wife Mimi decided to set up an orthodontic practice in Syracuse which would allow him to establish a cleft palate team at the Upstate Medical Center. But not knowing anybody in Syracuse, it was a challenge to start a private practice.

“I managed to borrow $3,000 from a bank and rented a very small third floor office,” Fishman recalled. “With some waiting room furniture bought at a tent sale, two beauty parlor chairs and an x-ray machine, I was in business – and I only spent half of the borrowed money!”

When he finally had three patients, Fishman scheduled them all at the same time so it looked like he was a busy orthodontist.

“I loved every day I could practice orthodontics,” Fishman said. “I couldn’t wait to get into my office.” In 1963, Dr. Subtelny asked him to teach one day a week. “It has been 51 years of teaching and I hope I can continue for a long time,” Fishman said, who closed his private practice in 1996.

“Through the years, Dr. Subtelny encouraged me and gave me the confidence to rise to the occasion and reach goals I wouldn’t have otherwise.”

Equal to his love for teaching orthodontics, Fishman is passionate about sculpting stone. Throughout his childhood, he would always gravitate to making something, like model airplanes. But the level of his talent and skill wasn’t revealed until he took a required aptitude test for dental school. “That test showed complex line drawings of three dimensional objects, and asked what it would look like if you turned it 90 degrees in different directions,” Fishman said. “They also gave me a large piece of chalk and a knife to carve what a given diagram was indicating.” Fishman performed so well on that test, the dental school insisted he be admitted right away, skipping his last two years of undergraduate study.

He and Mimi and their three children lived three blocks from Syracuse University, where he took all the evening art classes they had to offer, and sculpting stone soon became his favorite medium. That was more than 30 years ago, and he has been a professional stone sculptor ever since, acquiring additional training along the way from the Castle Hill School of Art in Truro, MA, and the Vermont Professional Sculpture Workshops.
Fishman has won many professional ribbons, has exhibited in several galleries and has sold numerous pieces. He works primarily with alabaster stone for the abstract sculptures he makes and uses marble or wood for the bases.

“I prefer to have the stone progressively dictate the design of the final sculpture rather than having a preconceived idea of the final form before starting,” he said, explaining his creative process. “This leads to many discoveries and is a far more exciting approach. I want the stone to reveal to me the form that it wants to be. Working in this manner allows me to repeatedly modify and become more excited with the creative design.”
Fishman starts with a rock that weighs about 60 pounds imported from different countries. “I often position and reposition the rock and don’t start carving for days,” he said. “It is very important that the design comes from the rock itself rather than forcing it.”

Fishman said he prefers to work with abstract designs so he can establish a desired visual effect that also conveys appropriate feelings. “Detaching the viewer’s eye from reality often provides an opportunity to experience the visual experience on a more emotional level,” he explained. “A finished piece is not successful unless both objectives are achieved. People will interpret a work of abstract art very differently, but it is important to the artist to feel personally attached and satisfied with the result.”

Fishman enjoys working with stone as a medium because it is inherently three-dimensional. “Actually, there are a lot of similarities between designing a sculpture and designing an occlusion and face,” he said. “Three dimensional design is more complex and challenging to deal with as all surfaces need to integrate with each other. The eye must travel around the stone in order to produce the energy and movement required for a successful design. I very often ‘open up’ the stone by carving within and through it, thereby further enhancing and integrating the three dimensional design with both negative and positive spaces.”

One of his favorite pieces was a consignment piece to be purchased and given as a wedding present for a couple he knew quite well and knew they loved music. “The stone was quite large, and had a beautiful translucent quality about it,” Fishman described. “The sculpture represented a lot of musical energy, togetherness, and sensuality.”

No matter how tired Fishman can be, once he enters his barn studio, he is energized and usually ends up spending several hours in there. The studio is on his property in Skaneateles, where he’s lived since Mimi passed away some 15 years ago.

When he’s not sculpting or teaching, Fishman enjoys his three children. His eldest son Jon, who is the drummer for the rock band Phish, his wife Briar and their five children live in Maine; David attended art school and now runs Mimi’s Guest House in Puerto Rico, named after their mother; and Julie, who has a professional culinary school background, manages a Williams Sonoma store in the Syracuse area.

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URMC Mourns Passing of EIOH Orthodontics Chair Dr. J. Daniel Subtelny

Dr. J. Daniel Subtelny

Dr. J. Daniel Subtelny

J. Daniel Subtelny, DDS, a pioneer in the field of craniofacial orthodontics and longtime chair and faculty member at URMC’s Eastman Institute for Oral Health, passed away Sept. 17 at the age of 92.

His esteemed 60-year career and dedication to orthodontics, Eastman Dental and his students are unparalleled. Widely regarded as one of the world’s foremost educators in orthodontics, he founded the Cleft Palate Team at the Eastman Dental Dispensary and incorporated the diagnosis and treatment of patients with craniofacial anomalies into his orthodontic curriculum. Many other orthodontic programs around the world followed suit.

“Dr. Subtelny’s influence and impact on the profession and his students are immeasurable,” said Eli Eliav, DMD, PhD, director, Eastman Institute for Oral Health. “His passing leaves a permanent void, but his legacy will live indefinitely.”

Hundreds have benefited from his teaching style and leadership. Widely known and admired for the Hot Seat, a series of highly stressful classes where one resident takes direct questions from him for hours about every aspect of orthodontics. Many credit the Hot Seat experience for building confidence, knowledge and leadership unlike any other.

Hot seat photo

And What Else? Dr. Subtelny (center) helped shape the minds of many through his Hot Seat class, including alumni (l to r) Drs. Fishman, Sommers, Juson and Spoon.

“Hot Seat makes you aware that you don’t know it all and that there is more than one way to approach a problem,” said Michael Spoon, DDS (Ortho ’91). “What Dr. Subtelny uniquely contributed is an historical perspective and knowledge base that is shared by almost no one else. You won’t find what he knows in Pub Med or on the internet.”

“Hot Seat is about how you should look at things—it’s about how to make things happen effectively or how to prevent them from happening,” said Jeremiah Juson, DMD (Ortho ’13). “It is a learning experience that I will be proud to pass on to the next generation.”

“The extensive knowledge and the positive effectiveness of Dr. Subtelny’s leadership as a teacher is exceptional,” said Len Fishman, DDS (Pedo ’59, Ortho ’61).

Edward Sommers, DMD (Ortho ’78) added that Dr. Subtelny’s  tremendous love and passion for orthodontics strongly influenced the alumni, faculty and residents to have the same love and passion. “He continually gave residents the stimulation and ability to learn and improve over the course of their careers and lifetime,” he said.  “He can never be replaced.”

Dr. Subtelny hosted a holiday party each year in his home for the residents, and always took the time to get to know them and their families beyond the classroom. “He taught so much more than orthodontics,” said Cristina Incorvati, DDS, (Ortho ’93), a sentiment shared by many. “He taught me how to pursue my goals with great passion, energy and perseverance.”

Dr. Subtelny dancing

Dr. Subtelny enjoyed dancing, as shown here at his 90th birthday party.

“We have lost a teacher, a mentor and a friend,” said Natalie Parisi, DDS, (Ortho ’95) “He will be greatly missed but never forgotten. Of all the things he taught me, possibly the most important was to enjoy life with vigor.”

In 2000 the Eastman Orthodontic Alumni Association and the University of Rochester established the J. Daniel Subtelny Endowed Chair and Professorship to preserve his educational legacy. This professorship will not only serve as a legacy for Dr. Subtelny, but will recognize the achievements of future EIOH Orthodontic Department Chairs and provide vital financial support to assist them with the division’s educational and research programs into perpetuity.

Dr. Subtelny receiving an awardIn 1997, the Orthodontic clinic at Eastman Dental was renovated and named in his honor. The same day, the Mayor of Rochester, NY, and the Monroe County Executive presented him with a Joint Proclamation stating that June 20, 1997, be named the J. Daniel Subtelny Day. This was in recognition for his years of treatment of children with craniofacial needs.

Subtelny is the only individual to date to have received all four of the following highest honors in the orthodontic profession:

• American Association of Orthodontists’ research honor, the Milo Hellman Award (1959)
• American Association of Orthodontists’ honor for teaching, the Louise Ada Jarabek Memorial International Orthodontic Teachers and Research Award (1993)
• American Board of Orthodontics – Albert H. Ketcham Memorial Award (1996)
• AAO’s James E. Brophy Distinguished Service Award (2006).
He was also presented the New York State Dental Association’s highest honor, the Jarvie-Burkhart Award, in recognition of the great service rendered to mankind in dentistry.

He has lectured on six continents, trained hundreds of orthodontic graduate students, published 70 peer reviewed scientific papers, several book chapters and wrote a text book titled Early Orthodontic Treatment.

Throughout his career, Dr. Subtelny served as president of the American Cleft Palate Association, the International Society of Craniofacial Biology, and the American Board of Orthodontics. He is also a Diplomat of the American Board of Orthodontics, a Fellow of the International College of Dentists, a Fellow of the American College of Dentists, and a founding member of the North-Atlantic component of the Edward H. Angle Society of Orthodontists.

He served on many editorial review boards including the American Journal of Orthodontics and Dentofacial Orthopedics, the Journal of the Angle Orthodontist, and the American Cleft Palate Craniofacial Journal.

He has also been recognized by the American Cleft Palate Association for his distinguished service, and the University of Pennsylvania School of Dentistry honored him with a distinguished Alumni Award in 1997. In 1999, he received an honorary doctorate degree from the University of Athens. The American Association of Orthodontists also named its 2006 education conference in Subtelny’s honor.

photo of Hot Seat book

Dr. Subtelny recently published an autobiography, aptly titled Hot Seat.

Subtelny graduated from the University of Pennsylvania School of Dentistry earning a Doctor of Dental Surgery degree. He received his orthodontic certificate and Master of Science degree from the University of Illinois.

Predeceased by his wife, Dr. Joanne Subtelny and brother, Dr. Michael Subtelny, Dr. Subtelny is survived by his children, Dr. Gregory Dan Subtelny and Alysa Subtelny Plummer; grandchildren, Benjamin Joseph and Ty Daniel Lantz-Subtelny; brother, Stephen (Ann) Subtelny; numerous nieces and nephews; and his special family at the Eastman Institute for Oral Health.

Friends may call Friday, Sept. 26, 4-7 p.m. at the Anthony Chapel, 2305 Monroe Ave. A memorial service will be held Saturday, Sept. 27, 10 a.m. at Christ Episcopal Church, 36 South Main St., Pittsford, NY 14534. Interment will be private. In lieu of flowers, contributions may be made to American Cleft Palate/Craniofacial Association, 1504 East Franklin St., Suite 102, Chapel Hill, NC 27514 or the J. Daniel Subtelny Endowment Fund, EIOH Office of Advancement, PO Box 278996, Rochester, NY 14627-9006.

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Eastman Dental Loses Beloved Family Member – Dr. Subtelny

Dr. Subtelny

Dr. J. Daniel Subtelny passed away September 17.

Dr. J. Daniel Subtelny passed away peacefully in his sleep September 17. He was 92.

His esteemed 60-year career and dedication to orthodontics, Eastman Dental and his students are truly unparalleled. Widely regarded as one of the world’s foremost educators in orthodontics, he continued to serve as chairman and program director of EIOH’s Orthodontics and Dentofacial Orthopedics Division.

Hundreds have benefited from his teaching style and leadership. Widely known and admired for the Hot Seat, an intense class Dr. Subtelny developed and became every orthodontics resident’s rite of passage. Many credit the Hot Seat experience for building confidence, knowledge and leadership unlike any other.

Year after year, residents and faculty express their gratitude for his endless support, guidance and kind mentorship. It’s no surprise he’s the only one who has earned all four of the highest honors in the orthodontics profession:
• American Association of Orthodontists’ research honor, the Milo Hellman Award (1959)
• AAO Foundation’s honor for teaching, the Louise Ada Jarabek Memorial International Orthodontic Teachers and Research Award (1993)
• American Board of Orthodontics – Albert H. Ketcham Memorial Award (1996)
• AAO’s James E. Brophy Distinguished Service Award (2006).

He also received the New York State Dental Association’s highest honor, the Jarvie-Burkhart Award, in recognition of the great service rendered to mankind in dentistry. The NYS Dental Association is a constituent of the American Dental Association and represents more than 13,000 dentists practicing in New York State.

Dr. Dan Subtelny will be deeply missed. As soon as we have details about a memorial service, we will share them. In the meantime, please keep his family and orthodontics family in your thoughts and prayers during this very difficult time.

Posted in Eastman Institute for Oral Health | 9 Comments

Toothbrush Techniques? EIOH Experts Weigh in

Only brush the teeth you want to keep, many dentists will quip.

man brushing teeth stockBut joking aside, how often and how well we brush our teeth can make a significantly positive or negative impact on our oral health. A study published recently in the British Dental Journal and gaining wide media attention, showed that there is little agreement among experts around the world on the technique that is best to prevent cavities and gum disease.

Eastman Institute for Oral Health experts say the best technique for one person may not be the best approach for another.

“Frankly, the best technique is whatever each person needs to do to for their particular dental situation,” stated Michael Yunker, DDS, EIOH assistant professor and assistant program director for the Advanced Education in General Dentistry program. “Most people think the purpose of brushing and cleaning between the teeth is to remove food particles, when the real purpose is to remove dental plaque–the almost invisible layer of fluids, cells, food debris, and microorganisms that collects on the surfaces of the teeth and gums, leading to dental disease if left in place.”

Because people are different, proper oral hygiene requires different approaches, depending on the oral conditions of each individual patient. In the past, Dr. Yunker said that patients were instructed to use the biggest, stiffest brush available and to brush hard. “This is no longer the case,” Dr. Yunker explained. “A smaller brush will contact difficult-to -reach areas and the soft bristles are best for use against the delicate gum tissues.”

Dr. Michael Yunker Eastman Institute for Oral Health

Dr. Michael Yunker
Eastman Institute for Oral Health

“Additionally, if there are spaces between the teeth that allow the bristles of the brush to extend to the areas between the teeth,” continued Dr. Yunker, “then more of the tooth surface can be reached by the toothbrush.” However, if the teeth are crowded or at least touching, then the bristles are only able to contact the part of the teeth that is visible, no matter how well a person brushes.

“And then there are some who need an electric toothbrush because they have a disability or simply don’t have the dexterity to use a regular toothbrush,” he added. “For some, another person may actually have to do the cleaning for them. You have to use whatever is easiest that still does the job. If the work becomes too hard or too time-consuming, a person’s natural instinct is to not do it.”

After surveying dental association guidelines in the United States, Australia, Brazil, Canada, Denmark, Finland, Japan, Norway, Sweden and the United Kingdom, British researchers and authors of the study learned that six different methods of manual tooth brushing are recommended (described below). They also reviewed guidelines published by toothpaste and toothbrush companies, and textbooks at Eastman Dental Hospital in London, among other sources. Many, including the American Dental Association, recommend the Bass technique, holding the brush at a 45-degree angle to the gum and making very short back-and-forth movements.

“Generally, I suggest a scrubbing technique similar to the Bass Technique for brushing with the bristles directed toward the gum and into the spaces between the teeth, trying to get the tips of the bristles to go into the area between the teeth and between the teeth and gums,” explained Dr. Yunker. “For the biting surfaces of the teeth, I suggest a back-and-forth scrubbing motion.”

Cleaning between the teeth depends on the condition of the gum tissues, and the size of the spaces between the teeth, Yunker added. “If there are minimal spaces between the teeth, then flossing is best, making sure to wrap the floss around the tooth to keep from cutting into the gum tissue,” he said. “But if there are larger spaces between the teeth or the patient has bone loss from periodontal disease, I suggest Stimudents or other types of interdental picks or circular bristle brushes for cleaning. They are easier to use than floss and cover more surface area.”

Joseph Fantuzzo, DDS, MD, chair, Oral and Maxillofacial Surgery Division, also said that recommendations will vary per person, especially if they are recovering from oral surgery or for effecting hygiene around their dental implants, for example. “I recommend minimally brushing twice daily using a modified bass technique. I encourage my patients to spend 10 seconds per each tooth surface, and always remind them about the critical importance of flossing.”

mother and son brushing teeth stockStill, brushing is only part of an effective system of oral hygiene that will prevent and reduce dental problems, Dr. Yunker emphasized “An effective system of oral hygiene includes good nutritional habits, limiting snacks between meals, cleaning between the teeth, getting enough fluoride and visiting a dentist regularly on a schedule individualized for the patient.

Toothpaste
So many options! How does one know the best choice for a healthy smile?

Dr. Yunker suggests using fluoride-containing toothpaste that is not a tartar control paste, a stain removing paste, or a whitening paste. “These are too abrasive and if used by a vigorous brusher, will cause tooth and gum abrasion,” he said. “Some people are sensitive to the chemicals in tartar control toothpastes and notice gingival sensitivity and irritation after use.”

For more information about the wide range of toothpaste options, visit http://www.webmd.com/oral-health/guide/weighing-your-toothpaste-options
Toothbrushing Methods

Fones – this is the oldest method and is recommended mainly for children, using large sweeping circles over the teeth, with the toothbrush at right angles to the tooth surface.
Bass technique – emphasizes plaque removal from the area above and just below the gum line by holding the brush at a 45-degree angle to the gum and making very short back-and-forth movements.
Modified Bass – the bristle position and predominantly horizontal brush movements stay the same, but use vertical and sweeping motions to create circles
Stillman – similar to the Bass technique, but using vertical motions
Scrub – the simplest technique, the toothbrush is held parallel to the gingiva and horizontal motions are used to scrub the gingival crevice in an ordered fashion.
Hirschfield -circular motion is much smaller and concentrated

Other Brushing Tips:
Brush at least twice a day. One of those times should be just before you go to bed. When you sleep, your mouth gets drier. This makes it easier for acids from bacteria to attack your teeth.
Brush lightly. Brushing too hard can damage your gums. It can cause them to recede (move away from the teeth). Plaque attaches to teeth like jam sticks to a spoon. It can’t be totally removed by rinsing, but a light brushing will do the trick. Once plaque has hardened into calculus (tartar), brushing can’t remove it. If you think you might brush too hard, hold your toothbrush the same way you hold a pen. This encourages a lighter stroke.
Brush for at least two minutes. Set a timer if you have to, but don’t skimp on brushing time. Two minutes is the minimum time you need to clean all of your teeth. Many people brush for the length of a song on the radio. That acts as a good reminder to brush each tooth thoroughly.
Have a standard routine for brushing. Try to brush your teeth in the same order every day. This can help you cover every area of your mouth. If you do this routinely, it will become second nature. For example, you can brush the outer sides of your teeth from left to right across the top, then move to the inside and brush right to left. Then brush your chewing surfaces, too, from left to right. Repeat the pattern for your lower teeth.
Always use a toothbrush with soft or extra-soft bristle. The harder the brush, the greater the risk of harming your gums.
Change your toothbrush regularly. Throw away your old toothbrush after three months or when the bristles start to flare, whichever comes first. If your bristles flare much sooner than every three months, you may be brushing too hard. Try easing up.
Choose a brush that has a seal of approval by the American Dental Association. The type of brush you use isn’t nearly as important as brushing the right way and doing it twice a day. Any approved brush will be a good tool, but you have to know how to use it.

Sources: British Dental Journal (www.nature.com/bdj)
Simple Steps to Better Dental Health (simplestepsdental.com)

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Pediatric Dentist Learned to Address Barriers, Advocate for Patients at EIOH

Dr. Mathew

Dr. Mathew

When Moncy Mathew, DDS, MPH, who graduated from the Eastman Dental pediatric dentistry program, encountered patients with complex psychosocial issues, he sought consultation with Eastman Dental’s social worker.

During on-call one evening, Dr. Mathew recognized that a dentist’s responsibility does not end with providing emergency dental care in the hospital’s Emergency Department.

“While patients have dental needs, we rarely understand the obstacles families experience in trying to access dental care,” he said. “One of the most difficult challenges we face when treating children is addressing those barriers. Teamwork is very important in dentistry, and collaborating with social work allows us to address barriers and to be successful in treating children who otherwise would suffer from not being part of a dental home.”

The following scenario describes how the collaboration between Pediatric Dentistry and Social Work has benefited a patient.

Suspected Dental Neglect
little girl toothache stockDr. Mathew was called to the ED late one night when a 2 year-old female presented with a dental abscess, large facial swelling, and fever. Initially, the patient was brought to a local hospital emergency room; however was transported to Strong Hospital via ambulance.

During the oral assessment, Dr. Mathew identified extensive cavitation on multiple teeth, with some teeth requiring extraction.” The child’s mother reported that she obtained sole custody since leaving the relationship eight months ago and that the child’s father is incarcerated.

Following a psychosocial risk assessment the ED Social Worker filed a Child Protective Report for suspicion of medical neglect and lack of proper guardianship. The child was discharged the next morning and instructed to follow up at Eastman Dental.

Dr. Mathew and EIOH Sr. Social Worker Lenora Colaruotolo discussed the case and strategized how to approach the family. Despite two voice mail messages, the family failed to follow through or confirm the child received follow-up dental care with another dental provider. Due to the severity of the child’s treatment needs, along with the concern that the dental neglect was soon going to cause a subsequent visit to the ED, we collaborated on how to facilitate the child’s care.

The assigned Child Protective caseworker and Colaruotolo partnered to support the mother in obtaining insurance for the child, and follow up with Eastman Dental. As a result, the child received necessary dental care in the operating room under general anesthesia.

Getting to Know Dr. Mathew

Why do you want to be a pediatric dentist?
As a Public Health Dentist, my efforts had been focused on preventing dental caries at the population level. I had been involved with water fluoridation, school-based fluoride rinse programs and dental sealant programs at the state level. While working as faculty at the dental school, I was asked if I would work locum tenens for a school-based dental program to cover for a dentist on maternity leave. I began to enjoy working with children and wanted more. Over the next 5 years, I received more locum tenens requests and every experience was better than the previous one. I realized, although late in life, my calling was to working with children and decided to pursue pediatric dentistry.

How did you become interested in dentistry?
I always wanted a profession that included working with my hands. After exploring numerous options, I decided to pursue dentistry as it had more of an emphasis on the ‘art’ of dentistry within the science of the profession. It appeared very rewarding when something that you could do with your hands could help people attain a better quality of life with improved oral health.

Describe your experience with Eastman Dental.
During the residency match process, I had ranked EIOH as my first choice. One of the factors that influenced my decision was the presence of a social worker within the dental department. No other program that I interviewed at had a social worker.

The pediatric dentistry program has a perfect balance between didactic coursework and clinical experiences. Dentistry is so much more than just teeth – the resources available through the Strong Hospital made my experience more well-rounded and enjoyable. I hope the knowledge and skills learnt at EIOH will help me be a more compassionate dentist.

Posted in Clinical, Community Dentistry, Eastman Dental Center, Education, Social Work Dentistry | Tagged , | 1 Comment

$1.3 Million Prosthodontic Clinic Renovation Complete at Eastman Dental

prostho clinic entranceDental patients have begun to enjoy the recently completed $1.3 million renovation and expansion in Eastman Dental’s Prosthodontic clinic.  Additional treatment rooms, the latest technology and new equipment have improved patient privacy and comfort, and enhanced care provision.

“This is another example at Eastman and the Medical Center of our commitment to patient care excellence,” said UR Medicine CEO Bradford C. Berk, M.D., Ph.D., at the ribbon cutting ceremony. “Similar to the new children’s hospital and the new cancer center, Eastman Institute is undergoing a transformation to meet the same state-of-the-art standard we expect in all of our clinical spaces.”

A formal ceremony was held to celebrate the new space.

A formal ceremony was held to celebrate the new space.

University of Rochester employee Mary Hines, 55, decided to give Eastman Dental a try when her teeth and gums became very sensitive to cold air, along with discomfort when chewing hot or cold foods.

After she was examined by Eastman Dental’s periodontist (a dentist who specializes in treating gum disease and placing dental implants), Hines learned that she had severe gum disease, which was not only causing her sensitivity, but also causing her teeth to become loose (view her story on video).

Mary Hines teeth before

Mary Hines’ teeth before treatment

“Gum disease becomes severe when the plaque on the teeth isn’t treated properly,” expained Tal Rapoport, D.M.D., the periodontist who treated Hines. “The bacteria basically take over and travel down to where the teeth are attached and eat away at what’s holding the tooth in place. Bone loss, inflammation, gum bleeding, sensitivity and pain are definitely present at this point.”

Dr. Rapoport provided Hines with extensive periodontal treatment, including a thorough and deep cleaning.

“Severe periodontal disease almost always requires some surgery, as well,” Dr. Rapoport explained. “When everything is clean, the gums will attach back to the tooth and bone. In some cases, bone loss can be reversed with adding new bone to the area.”

This is one of several new rooms with the latest technology.

This is one of several new rooms with the latest technology.

“After the inflammation has been taken care of, it’s important to know that it’s critical to keep the gums healthy or the disease will recur,” she added. “In addition, placing dental implants while there is active periodontal disease will likely contribute to the failure of the implant.”

Now, with her periodontal disease treated and regularly monitored, Hines was ready to move forward with getting the dental implants she’s always wanted. A childhood injury caused her front tooth to die, and her gum disease created tooth movement, resulting in a large, undesirable space.

Between Eastman Dental’s reputation for excellent work, affordable rates, a discount as a UR employee, and some insurance coverage, Hines said the choice was easy.

Mary's teeth after

Mary Hines’ teeth after treatment at Eastman Dental.

To accomplish her esthetic goals with the limitations of her bone loss, Rapoport and Chief Prosthodontist Resident Elyce Link-Bindo, D.M.D., worked together using the latest technology in 3D surgical planning before removing Hines’ top teeth and placing six implants.

Over the next several months, Drs. Link-Bindo and Rapoport made sure Hines was comfortable with her ability to chew, speak and smile during the transition.

Dr. Tal Rapoport

Dr. Tal Rapoport, Eastman Dental Periodontist

“Throughout the year-long treatment time, I had to make removable

Dr. Elyce Link-Bindo, Prosthodontist

Dr. Elyce Link-Bindo, Prosthodontist

dentures to allow for healing after the implants were placed,” explained Dr. Link-Bindo. “When the implants were healed, I made her two different sets of temporary teeth to assess her esthetics and speech throughout the process.”

These temporary teeth attached to the implants and molded her gum gum tissue to make the teeth look as they were coming out of the gums. Dr. Link-Bindo and Hines had met several times to ensure all of the Hines’ esthetic desires were addressed. Once everything had healed and she was satisfied with her new look, Dr. Link-Bindo made her final teeth prosthesis.

“If I knew then, what I know now,” Hines reflected. “But I’ve become really passionate about my cleanings; they taught me how to brush my teeth right, and the importance of flossing. Overall, it’s been a wonderful experience.

“The care I received at Eastman Dental has been awesome, and felt like they cared about what I was going through,” Hines said. “They made my life different. Before, I wouldn’t even talk or smile. I would mumble because I didn’t want anyone to notice my teeth. Now I smile a lot more!”

For more information or to schedule a free screening, call 585-275-1147 or visit Eastman Dental.

 

 

 

Posted in Alumni, Clinical, Eastman Dental Center, Eastman Institute for Oral Health, Education | Tagged , , , , , | 2 Comments