#implants#teeth#dentistry#people#crown#dentists#patient#bone, #feinberg, #roots, #years #practitioner#good#restorative#dentistry#bridge#wrong#porcelain#worst#restoration#bone loss
Restorative dentistry principles and challenges.
o Dr. Feinberg is a restorative dentist with a focus on full coverage restorations.
o He grew up in a family of dentists and learned crown and bridge work from his father, a master and pioneer in the field.
o Dr. Feinberg's father had an amazing mentor who taught him the principles of dentistry at its roots.
o These principles have been lost in modern dentistry, which veered off track with the advent of porcelain-to-metal crowns.
o Acrylic and gold are the best materials for dentistry, but they are not widely used due to aesthetic concerns.
o The use of porcelain-to-metal crowns leads to problems such as flaking and recurrent decay.
o Dr. Feinberg has tremendous retention with his crowns and doesn't have issues with temporaries falling out.
o Implants are often recommended as a last resort, but they can be a hodgepodge of different fillings and crowns.
o Dr. Feinberg believes that saving teeth should be the priority before considering implants.
o He advocates for good crowns
Today's Valuable Free Resources/Links:
· Valuable resources to help you save your teeth, click here: www.theONWARDprogram.com
In this episode, I introduce you to Dr Edward Feinberg.
is a graduate of Tufts University and practiced Dentistry in Scarsdale, New York for more than 40 years. Now practicing in Arizona (www.edwardfeinbergdmd.com), he is the successor to a unique tradition of restorative dentistry. He was trained by a master and pioneer in full coverage restorative dentistry, Dr. Elliot Feinberg. The techniques used by Drs. Edward and Elliot Feinberg have been documented with more than 100,000 pictures taken during the past 70 years. Dr. Feinberg is currently Director of ONWARD, an online teaching organization for full coverage restorative dentistry (www.theONWARDprogram.com). To date he has created more than 30 online courses for the site. The site also has an extensive library of downloadable materials, a weekly blog, and a forum.
Dr. Feinberg is a nationally recognized lecturer and a noted author of scientific and educational articles for dental publications, a textbook, The Double-Tilt Precision Attachment Case for Natural Teeth and Implants, and a book of essays - Open Wide: Essays on Challenges in Dentistry to Achieve Excellence.
Join me for this episode of Mommy Heal Thyself to learn how to Save Your Teeth.
(Note, this was transcribed using a transcription software and may not reflect the exact words used in the podcast)
Welcome to Mommy Heal Thyself. We featured guests that provide you with the tools, resources and strategies you need to say no to a life of pain and suffering all forms of preventable disease, toxic drugs and unnecessary surgeries. We hope to inspire you to boldly reclaim your ability to heal, and to serve ones to love.
Dr Michelle 0:00
100,000 pictures taken during the past 70 years. Dr. Feinberg is currently the director of onward an online teaching organization for full coverage restorative dentistry. To date, he has created more than 30 online courses for this site. And the site also has an extensive library of downloadable materials, weekly blogs and a forum. Dr. Feinberg is nationally recognized lecturer and a noted author of scientific and educational articles for dental procedures sorry dental publications, and a textbook. The top the textbook is double tail precision attachment case for natural teeth and implants. And he has a book of essays, open wide essays on challenges in dentistry to achieve excellence though, Dr. Feinberg, tell me what brought you into this field of restorative dentistry and exactly what does that mean?
Dr Feinberg 1:01
Well, restorative dentistry most of my background really is crown and bridge work. I grew up in it. My dad was a master and pioneer of crown and bridge and full mouth reconstruction. So and it's different from what's being taught in dental school. So why was trained completely different from what's what's out there? And my dad had an amazing mentor. So I really go back to the roots of dentistry and somewhere along the line, dental care veered when it comes to crown and bridge work veered off the track of what came before and went in a different direction, and they're not seeing the same kind of results. I have dentistry in the mouth that I did 30 and 40 years, and you can't get that kind of longevity unless you follow basic principles that were outlined at the interest tree's roots.
Dr Michelle 1:59
What are some of those principles that were at the roots of dentistry that have changed now in today's contemporary world?
Dr Feinberg 2:08
Well, I think everything happened with the advent of porcelain to metal when that first came. The first full coverage restorations for crown and bridge work was gold and processed. Acrylic and gold is still the best material ever devised for dentistry. People may not want to show gold but that is still the best material has the best properties and last the longest of any other any kind of material. So that is where dentistry came from. And when they started with porcelain to metal, that's when the troubles began. Because when you when they made crown and bridgework they didn't really do anything to the root surface except curate the root surface and then they would make their margins on uncut tooth structure, which is what I do. And so the crowns are like mason jar covers, which is the best known thing ever devised for preserving so I almost never get to K under my crowns for that reason. But if you try to put a porcelain to metal restoration over the shoulder and its springs, the porcelain will flake off the margin. So they came up with the idea of putting a bevel on the on the sharp edge where their root surface meets the the prepared ledge on the tooth. And that's when the troubles began. Because somebody came along and said, Oh, let's make our margin to the end of the bevel. And it looks like a straight line to the naked eye but under a microscope, it's a jagged line. And so when you try to make your margin to that line, there are points of tooth structure that have been cut that are not covered. And that's why a lot of dentists have trouble with recurrent decay under their crowns. Something I don't have. I also have tremendous retention. So I don't have crowns falling out. I don't have temporaries falling out. And that's another big problem that dentists are having with crown and bridge.
Dr Michelle 4:26
Yeah, I know of a couple of people that have had that issue where they've had crowns and they fall out or as you said, there's an infection that develops and the same thing I've heard with implants and you are so accurate in saying that there we don't have the same longevity. I had a patient of mine just recently who had implants and then she went to another practitioner, and I think she had the implants for about 15 years. And then when she went to the next practitioner, he said, Oh, we're gonna have to take them all out and replace them and she was like, Oh my God, and those things are not cheap. So um and I just heard just scary things and and all of it becomes just very confusing for the normal consumer. You know, to figure out okay, do I do an ordinary dentures or do I do an implant? Do I do titanium I do or do is ceramic. You know, and then we have quote unquote holistic dentistry where you know, it has to be done a certain way to remove fillings that turn out to be toxic because they start to leach into the bloodstream, bloodstream and create all kinds of issues. So what are some of the typical problems that you see people have when they come to either you or to other restorative dentists that you have trained?
Dr Feinberg 5:53
Well, I think the number one thing that people should try to do is save their own teeth first implants. Should be a last resort, except in certain circumstances, like if you're born with missing lateral incisors and you have a perfect match. What ends up happening to people is even if you go to all the implant lectures and you watch the professor's showing these cases, if you look carefully, and notice all the teeth around this space, where they're putting the implant, they all have big fillings and are going to need crowns or they have crowns on them already. If you know how to do good crown and bridge you can do something good for the entire area where you minimize the forces you make ideal architecture to help preserve the roots in the bone and that patient's problems are solved for the entire area, while a single tooth implant does is fill a hole or a space. And so the patient ends up with a hodgepodge. And their problems are never solved. And so I think that's wrong. This is what I call piecemeal thinking, which is now rampant in my profession, probably because of the insurance companies because they want to pay for piecemeal and not for what's really best for the patient. In fact, in dentistry, insurance is not even insurance. It's payment assistance. That is all it is.
Dr Michelle 7:20
The end, but a bigger ticket items like implants there is no insurance really and truly, I mean I love it. The profit of implants for my son versus dentures, and basically they said, well, insurance doesn't cover this and it's going to be close to 6000 per tooth. You know he has two missing teeth from an accident. And I want you talking $12,000 for duty, you know,
Dr Feinberg 7:48
well the thing is not so much the money who's going to be doing it, because if you spend that kind of money in at least 30 years, that's a good investment. But if you spend that kind of money in the last five years, that's not such a good investment. And that's what's happening to a lot of patience. Um, so you i One of the things that I would tell anybody is, don't you don't be afraid to get a couple of opinions. Don't just accept one person's word for it. And if one person can't save a tooth, that doesn't mean that another one can't. So we're not you know, less the same in every field. You have good bad and everything in between. So I would encourage people to get, you know, find out, get to take your time, get some opinions, and try to figure out what's best for you. Nobody could make that determination. And nobody should push you into treatment, unless you decide that you want that as a doctor means teacher. So I always look at my job as to educate people. So I want to give them choices. I want to tell them, you know what's good and what's bad about each choice, and what I would recommend, and then whatever they want to do is fine. You know, I mean, I'm okay with it. It's I just want them to have all the information so they can make the best choice for themselves. And that's what I think our role is really to do the work you know. Yeah, sorry. Go ahead.
Dr Michelle 9:17
So what are some things that people can do to save their teeth?
Dr Feinberg 9:24
Well, the first line of defense the real problem in dentistry is most people get into trouble with losing bone, Perry and that's called periodontal disease. We don't know how to grow it back. So everything we do in dentistry, everything is geared poor toward preventing a bone from being lost. So the number one thing that we know causes bone loss is letting tartar and plaque and calculus build up because that can cause the gums to become inflamed and that can spread to the underlying bone. So the single best thing anybody can do is have regular hygiene and good home care, because it removes that one factor that we know causes bone loss. Another factor that we know contributes to bone loss is missing teeth. Because what tends to happen is the teeth around the spaces drift and the teeth opposite the spaces erupt into the spaces, and then the teeth start taking forces in abnormal directions. I nobody knows at what point the body's not going to accept that. And in human beings, one of two things goes wrong either the teeth were or the bone goes and then you have a mess to restore everything. Then you're so if you can prevent that from happening. Then you can hold on to your teeth hopefully for a lifetime and that's the goal of dentistry should be prevention. So when you do crown and bridge, you want to correct all the things that are wrong. You want to minimize the forces on the bone and the roots so that the body can maintain it. And you know, a lot of times people who do crown and bridge look at that as tooth coverings and not as corrective. So I'm looking at it from a corrective standpoint. I'm taking advantage of Wolff's law in the 1700s wolf discovered that bone is deposited in and resorbed in accordance with the stresses placed on it. So if you minimize the forces on weak teeth, very often they tighten up. So we have all different methods that we can employ first is to try to make the teeth smaller, ideal shape and form. And a lot of times we connect them together so that they help each other out rather than each tooth having to carry the load all by itself. And so I've had patients where with teeth that are the worst teeth you ever saw with her with a minimal bone and poor root anatomy. And I was able to restore their mouth and it lasted 30 years. And you wouldn't expect that that's possible. But with good dentistry it is possible.
Dr Michelle 12:19
So what do you suggest for people who have missing teeth?
Dr Feinberg 12:25
I think they should go to a really good practitioner and have their say everybody's different. So if there's destruction, you have to figure out what caused the destruction. So sometimes I don't know whether the teeth are in harmony with the muscles. And in order to find out I have them were a diagnostic appliance. So I can see if there's any changes where the teeth are not in the right position. And then you can determine diagnostically what would have to be done in order to correct that problem. Sometimes it's crown and bridge. Sometimes it's orthodontics, sometimes it's a combination of both. So every case is different, depending upon the patient, but the take your time and not rushing to major treatment. Get a couple of opinions what makes sense to you what, what, what what you think you're going to have the best outcome with and at all costs. Try to hold on to it. I'm sorry.
Dr Feinberg 13:35
I don't course try to hold on to your teeth. The worst restoration in all of dentistry is the lower denture because the muscles of the tongue and the cheek lifted up and almost nobody is comfortable because dentistry doesn't know how to make a good lower denture and it doesn't matter who makes it. But and that's the only time that I try to talk patients into doing implants is if they have no lower teeth. Otherwise usually they have other choices. I have a lot of choices in my armamentarium I know how to make a good precision attachment case, which is removable rolls. That's not taught anywhere. So and those cases last longer than any other kind of case on the worst teeth you ever saw. And and yet nobody knows anything about it. And that's what I wrote my textbook on because it's such a shame and that works well with implants so you could stay away from the the bad anatomy where you have to do sinus lift grafting and and other kinds of grafting in order to try to place an implant that's long enough that it could actually support the restoration. And that's the other thing that I don't like that I see. There's this tendency to extract the teeth and put four implants in. They call this the oil on four case. And I think this is one of the worst things ever, ever devised. Because half the time they can't put good implants in. And then if one of them goes that patient is screwed and you have to have a contingency plan if something goes wrong, so the patient doesn't have to do the whole thing over. I think they're owed that. So when I work up a patient, I spent a lot of time thinking about it. What happens if this happens if that happens, what how can I design this so that the patient doesn't have to go do anything over if something goes wrong with that weak abutment? I give that a lot of thought because that's a lot of patients are reaching to do dentistry, they're owed that kind of thinking. And yet no one talks about it in my field. So I'm kind of like you know, out there alone in the wilderness because I was trained differently. I don't care if they call me a dinosaur. I have 70 years of cases all done according to the same basic principles that says I'm right.
Dr Michelle 16:16
Yeah, you know, it's like with everything, you know, whether you're buying an appliance or a car or tea. It seems that the things of today are disposable every couple of years. You have to do it all over again and it's just horrible. So now what I'm yes some you
Dr Feinberg 16:35
this is what I do. Yeah, hmm. Yeah. Yeah, they resort last resort, not a first resort. Ever. Some exceptions. There were some exceptions to the bottom. Yeah, well, the bottom teeth,
Dr Michelle 16:55
so go ahead. Okay. So now, when we're talking about the upper dentures, you know, so you were talking about like dentures or I think they call them flippers, you know where you you're able to put in the removable ones, you know, in the in the upper area. And that is important to do to maintain the integrity of the rest of the mouth. So you know, unfortunately, a lot of people because they're so overwhelmed with the cost of implants, and that's all that's being presented to them right now. They'll end up doing nothing. And you're saying that that is dangerous because it starts to compromise the integrity of the rest of the teeth, not only the teeth in the upper jaw, their lower jaw but the opposing teeth as well in my career.
Dr Feinberg 17:44
You know, a good practitioner wants to help his patient and not all not all my patients are wealthy. And I think it's important to have things in your armamentarium to help those people too. So like, I see people being turned away because they broke a tooth and they they they're being presented with the with the with the permanent crown and everything right off the bat. And at the emergency visit, which I think is not right. It's not fair. I can make a good temper. Already with a copper band that fits like a permanent is not going to fall out on teeth that are flush with the gum with no posts no nothing. And, and this way, they have to navigate socially These are human beings. I wouldn't let anybody walk around with no to no tooth. I would come up with something that I could do for them, even even on a temporary level so that they could navigate and then I want those teeth there that when they're ready to do the work, they're there and they could do it. Now one of the saddest things is to have patients when they when they go to the dentist than they are turned down because they don't have any money. And now when they're ready to do the case, the teeth are all gone and lost. And they can't even do the case. Now it's even going to be even more expensive. And that's what happens to a lot of people that's not fair. And this is what I'm trying to educate dentists because you know, you can still make some money on those patients. But those patients are like could like likely turn around and be great sources of referrals teeth for you. If you're if you handle them nicely and you treat them like human beings, because I wouldn't want to walk around with no tooth and i i wouldn't let any of my patients walk around with no teeth. I think that especially in the front. I mean that's, that's, that's terrible, but that's what they're doing. But a lot of it is because they don't know how, in all fairness, it's not because they are mean or they want to do this to people they just simply no one showed them. That's the purpose of the teaching website is to try to teach them and then I'm giving them new options for treatment that they can use to help people Oh, hello.
Dr Michelle 20:52
recording in progress I live out in the country so I always have interesting internet then if so, the key is that there's only one of you and everyone can't come to you. So what are some options do you? Do you have a course that people can refer their doctors to or do you have a directory of practitioners that have trained under you that you know, people can look up? What are some resources that
Dr Feinberg 21:25
don't actually work? There's only a handful of people who were trained like me, unfortunately. But there are a lot of people who can do good implants. And if somebody needs implants, for example, they could go to any ask any oral surgeon who were the best practitioners to work with and get a good good referral because implants have to be they have to be designed from the restorative perspective. So the restorative dentist has to make sure the implants are put in the right place because otherwise you could have a nightmare. And I have patients for example, like if they're putting the right place you can have school hole access. So if something goes wrong in the future, all you have to do is unscrew it, do whatever you need to do and screw it back. But a lot of dentists make implants with with abutments when they cement the crown on the abutment, and if something goes wrong, you'd have to cut the whole thing off and do the entire thing over and I don't think that's fair. So sometimes you can't help it because that's where the bone is, but at least strive for it. So they have to make some kind of guide or it's called a stent to place the implants and it can either be done conventionally by hand and I made a lot of them all myself or can be done by the computer. And I've done both ways and they both they're both good. And but you have to that's what I would do if I needed an implant I would I would look to get the best practitioner and if you know what good oral surgeon who places a lot of implants, they know who the better people are to work with those that'd be that would be a good referral. That's my Sit down.
Dr Michelle 23:17
Do you have any any resources that ordinary consumers can access? Were you either talk about this more in depth or can people do a consult with you or something of that nature? Do you have a book for I
Dr Feinberg 23:36
have my book Yeah, my book on essays which I you know, I wrote it's a collection of essays from my blog last year on my website. And it while it's designed primarily to market to dentists, a lot of it would be very good for the average person. There's some they would find it very interesting and informative. So I think that might be a good place to start. And it's available on Amazon
Dr Michelle 24:07
well. Ah, wonderful. So, ladies, I'm going to be including in the show notes a link to his website where he has training for dentists. And so you can refer your dentist to that site because a lot of dentists but not a lot all dentists have to do continuing education anyway. And if this is something that more and more people talk about and demand Guess what? They will do it because they want to make you happy because you're the consumer and you're the one that pays their bills, right? So I always say ask for what you want. So I'm going to be including in the show notes the link to his website that has training for dentists, as well as information pertaining to his book. And thank you so very, very much for joining us today Dr. Feinberg and telling us more about the importance. They are T very important message. Is there any last thing you'd like to share with us any last tip or advice that you'd like to give us?
Dr Feinberg 25:21
Well, my main advice would be to not let anybody push you or talk you into treatment. Think about it. Get some opinions before you decide what to do. A lot of dentists a lot of patients will do that with medical care but will do whatever their dentist says because, you know they have a long standing relationship with him or her and you know, I think if you're going to have to do extensive work, you should get a couple of opinions and not just accept the only one opinion. That's my that's my best advice.
Dr Michelle 26:01
Absolutely. Well thank you once again for joining us and I will see all of you ladies next time for mommy heal thyself by recording stopped. Awesome.
Unknown Speaker 26:17
Well, thank you. You know, I could talk about dentistry all day.
Dr Michelle 26:24
I know, I know. It's so fantastic and awesome. You've just given me so much insight, like I said, because this is something that so many people are dealing with, and they're all because you know, you just go in and they're like, Oh, this is what you have to do. And they don't give you any options. So it's very good to hear. That's right. That's not where me
Dr Feinberg 26:47
that's not fair. I'll tell you, I'll tell you I kind of said it. But there were a lot of dentists who were terrific at doing implants, but not so good at crown and bridge. And they shy away from crown and bridge. And so the answer to every problem is implants. Like all you have is a hammer everything looks like a nail and that's what's going on which is wrong. You know, they feel confident with your implant skills but they don't always turn out the way they say. It doesn't work like that. I make have, you know when I lecture I show plenty of failures and especially
Closing: Thank you for tuning in for this episode of Mommy Heal Thyself, if you liked what we're doing here, please share subscribe, like us and leave a comment. Your feedback is very much appreciated.
Transcribed by https://otter.ai