Brush twice a day, floss regularly and go easy on the sugary drinks and foods, then lather, rinse and repeat. This is the formula for a lifelong, healthy smile. Sometimes, however, the smile needs a little help.
Whether a patient needs to straighten teeth, have new ones installed with the utmost precision or simply whiten their smile, oral health professionals in the Philadelphia suburbs are some of the best equipped in the country, aided by cutting-edge techniques and 21st-century technology that has revolutionized dentistry. Even so, the industry has expanded to include services such as bone regeneration, dermal fillers to give the face more lift and plumpness in the aftermath of surgery and appliances to correct potentially life-threatening conditions such as obstructed sleep apnea.
“The world of dentistry is constantly changing,” says Alan M. Smolen, D.D.S., of Yardley Dental Arts in Yardley. “Today we can offer patients with crowded teeth or gaps between their teeth an alternative to braces [with Invisalign]. … Invisalign uses clear orthodontic aligners that move your teeth just like braces. The difference is that you can clean your teeth easily, eat the foods you like and no one will know you are straightening your teeth, unless you tell them. After treatment your teeth will look better, work better and are easier to clean.”
Invisalign orthodontics uses computer software to design and manufacture the aligners that actually move the teeth. Using a virtual model, a patient can actually see the movement of his or her teeth while progressing to the final position of the teeth before the process even begins, according to Dr. Smolen.
“On average, you can expect 10 to 12 months of treatment,” he says. “When making cosmetic changes to your teeth, Invisalign also can be used to reposition your teeth for a better result. All it takes to see if you are a candidate for Invisalign orthodontics is a few photographs and some models of your mouth.”
Technology has left perhaps its most significant imprint on areas such as planning, milling and installing dental implants. Although dental implants have been the standard of care for those with missing or poor dentition for more than a decade, many patients over the years have been told that they do not have adequate bone for a smile built on implants. Some implant centers with recommend bone grafting from another part of the body to build up the inside of the mouth, though this tends to be a lengthy process that requires multiple visits for the patient. One practice “game changer,” specifically in the realm of dental implants, has come from bioactive modifiers for use in bone regeneration in the jaw to support teeth. Although bone regeneration is not new, per se, many of the newer materials used can help grow bone in a predictable fashion in parts of the mouth where a patient has diminished bone or otherwise compromised sites.
“One thing that has changed is the introduction of the in-office 3-D cone beam scan, which is analogous to a CAT scan but with 200 times less radiation,” says John Whytosek, D.M.D., of Main Line Periodontics & Dental Implants, P.C., in Bryn Mawr. “This helps us treat and plan the patient’s implants according to how much bone they have and we can avoid vital structures when planning placement. We also use this for a lot of immediate implant placement and some new procedures for people who are losing all teeth or wearing dentures; we can place the implants one day and they can have teeth the next. Even for a single tooth, we’ll do the extraction and they will have an immediate implant and a temporary restoration so the patient doesn’t have to use an interim partial denture.
The cone beam scan can define the quantity of bone a patient has so the dental professional can “map out” vital structures such as nerves and sinuses to avoid causing complications such as permanent numbness, according Dr. Whytosek, who has been in practice since 2001.
“Implant technologies have changed significantly. There are different surfaces utilized and bone-preserving qualities,” he says. “Before it was acceptable to lose a little bone around an implant, and some of that has been eradicated. It’s awesome.”
At the Pi Dental Center in Fort Washington, prosthodontists Thomas J. Balshi, D.D.S., and Glenn J. Wolfinger, D.M.D., uses a technique called No Bone Solution (trademarked as No BoneZ Solution) for prospective patients with a deficiency of bone. Here, special longer and stronger implants called zygomatic implants can be placed directly into cranial bone. These implants serve as anchors for a fixed prosthodontic smile that can be aesthetically and functionally customized for each patient. The use of zygomatic implants eliminates the need for grafting and can be accomplished with the Teeth in a Day implant protocol. In this one-step procedure, implants are placed along with a temporary nonremovable smile in a single visit. These temporaries are a “sneak peak” of the more sophisticated finished smile, but the healing gums are never without attractive, fully functional teeth.
Such technology and techniques have been embraced by dual board-certified specialists such as James A. Vito, D.M.D., a periodontist and prosthodontist whose office is based in Wayne. “Before we even pick up a knife, we can see whether a patient is a good potential candidate for implants,” he says. “This is a situation where we can help somebody who is basically ‘a dental cripple,’ who has lost teeth due to periodontal disease, trauma or dental decay. Within a 24-hour period, we can remove their teeth—if they have teeth—put in dental implants and in a short period of time thereafter install a restoration that they can immediately function on.”
Some locally based practices, such as Amsterdam Dental Group, which has offices in Paoli and Center City, have embraced on-site laboratories outfitted with the latest technology to enable complete control of the restoration process, from start to finish. Likewise, at the Pi Dental Center, the CM Ceramic Prosthesis enables its prosthodontists to offer patients a smile that looks completely natural. The fabrication of this final smile is now driven by computers and robotics, thereby providing predictable precision. CAD/CAM technology applied to dentistry means that both the design of the teeth and the manufacturing of the smile are computer assisted. Prior to the creation of the final smile, the technician virtually designs every aspect, using an optical laser to scan the pattern and then passing it into robotic “hands” that mill a framework made from titanium. Individual crowns made from a product called lithium disilicate are also robotically milled and then attached to the titanium framework to produce the sparkling, luminescent smile.
This technology has many advantages for the patient, as the digital record of the teeth makes all the custom details of the case easily retrievable for lifelong maintenance of the smile. The CM Ceramic Prosthesis also has the ability to replicate gum tissue with a wide range of color choices to enhance the naturalness of the smile, according to the practice.
Some advances in dental medicine are less about aesthetics and more about quality of life. Although Marc A. Levin, D.M.D., specialize in restorative dentistry and cosmetic makeovers, a growing part of his practice comes from the treatment of snoring and obstructive sleep apnea. Collectively, these conditions affect as many as 55 million Americans, according to Dr. Levin, and it not only is disruptive to one’s sleep but is also potentially deadly; when former Philadelphia Eagle Reggie White died in 2004, for example, medical reports suggested sleep apnea contributed to his death. The traditional treatment for sleep apnea has been the CPAP (continuous positive airway pressure) machine, or what Dr. Levin calls “the Darth Vader mask.” Although CPAP is an effective treatment for sleep apnea, not everyone can tolerate it.
“It works great for the people who can use it, but the percentage of people who can use it on nightly basis is 30 percent or below, so 70 percent of people with obstructive sleep apnea aren’t being treated,” he says. “Along comes oral appliance therapy, which is similar to retainer, that people wear when they sleep. Each one is custom fit, and it advances the lower jaw and keeps the airway open. It also keeps them from snoring. It’s as effective as CPAP, with a higher rate of compliance.”
These FDA-approved appliances, which are manufactured by an off-site dental laboratory, are based on molds of the patient’s mouth. Dr. Levin, who is a part of eOs Sleep, a network of highly skilled and uniquely qualified dentists and otolaryngologists who successfully treat snoring and sleep apnea, has been offering oral appliance therapy for three years.
“We have portable sleep tests rather than them having to go to sleep center, and people come back for follow-up visits to do a repeat sleep study to see that it’s working,” he says. “For married people, someone’s snoring or sleep apnea is affecting more than one person. I’ll have spouses come in and tell me, ‘I just wanted to give you a hug, because now we can sleep in the same bed again.’ Nobody hugs you and says, ‘You changed my life,’ after doing a filling.”
Although technology and techniques may change and will continue to get even better, there’s nothing more important than the individual who is employing them. No matter the need—solving a toothache, providing a much-needed teeth cleaning after more time away from the dentist’s chair than recommended, or providing a complete dental restoration—these highly qualified, supremely educated oral health professionals excel at fulfilling it.
Oral Health Resource Guide
When in need of preventive maintenance, a total smile makeover or something else to improve the function or aesthetics of the mouth, turn to some of the most skilled professionals serving patients in the Philadelphia suburbs.
Amsterdam Dental Group
Visit amsterdamdentalgroup.com for details on locations in Paoli and Philadelphia.
Benjamin A. Cassalia, D.M.D.
308 N. Main Street, Chalfont
215-822-6320 | drcassalia.com
Blue Bell Periodontics
676 Dekalb Pike, Suite 207, Blue Bell
610-272-4482 | bluebellperio.com
Buckingham Orthodontics/Sam Kadan, D.M.D.
Visit teethsostraight.com for details on locations in Bala Cynwyd, Chalfont, Doylestown and Harleysville.
Comprehensive Family Dentistry
759 Newtown-Yardley Road, Newtown
215-860-0738 | weglosfamilydental.com
David Stall Dental
1646 West Chester Pike, Suite 1, West Chester
484-999-0614 | davidstalldental.com
James A. Vito, D.M.D.
523 E. Lancaster Ave., Wayne
610-971-2590 | jamesvito.com
Main Line Periodontics & Dental Implants, P.C.
29 Morris Ave., Bryn Mawr
610-527-6061 | mainlinedentalimplants.com
Matarazzo & Milici Group
One Crescent Drive, Suite 300, Philadelphia
215-389-3161 | navyyardsmiles.com
The Oral & Maxillofacial Surgery Centers of Dr. Schelkun
Visit omscenters.com for details on locations in Warminster, Fort Washington and Richboro.
Pediatric & Adolescent Dentistry of the Main Line
780 W. Lancaster Ave., Bryn Mawr
610-527-2434 | pdmainline.com
Pennsylvania Center for Dental Excellence
11905 Bustleton Ave., Philadelphia
215-969-4400 | pcde.com
Plymouth Periodontics
120 W. Germantown Pike, Suite 225, Plymouth Meeting
610-825-4334 | plymouthperiodontics.com
Yardley Dental Arts
501 Floral Vale Blvd., Yardley
215-504-2400 | yardleydentalarts.com
