Case of the Month for December

-Composite bonding done to restore broken tooth.

Congratulations Dr. Lotardo :D

1,000 Hours!
Congratulations Dr. Lotardo
Dr. Salvatore Lotardo completed his 1,000th hour of continuing education credits last year. The New York State Department of Education requires dentists to complete a minimum of 75 hours every three years, but Dr. Lotardo’s devotion to advancing his knowledge and technical expertise has allowed him to far out achieve those standards.
In an effort to stay at the cutting edge of dental technology Dr. Lotardo feels he must continue on this path of education to provide his patients with the latest and best treatment options and outcomes. As a member of both the American Academy of Cosmetic Dentistry and the American Academy of Implant Dentistry he hopes to become an accredited members of both academies something very few dentists have attained. His commitment to the profession and his caring for patients makes us feel so comfortable referring our friends and family to the practice.
- The Bella Smiles/Nesconset Dental Staff

Gummy Smile ????? :S

Treatment of uneven and excess gum tissue allows for more symmetrical and natural looking smile. Most often treated with a laser that minimizes healing with very little discomfort.

Call us at 631 724 0094 to set up a free consultation, if you are unhappy about your gummy smile

Case of the Month for October :D

" With proper understanding of the layering and shading of composites,
restorations can be blended seemlessly with the natural tooth"

case of the week (upon special request :D )

"Closing the space between your front teeth can be simple, painless and very natural looking."

F.A.Q and Answer :D

FAQ: Why do I need a crown? Can't you just fill it?

Answer-A tooth can only be filled so much before it becomes weak and can break or even fracture. If the cusp (pointy edge) of a tooth breaks, or the inside or outside surface of a tooth is broken, then a crown is the treatment of choice and the best long term option. A crown or "cap" covers the entire tooth and provides the best protection. Crowns can be made of metal, porcelain, or a combination of both. With todays advanced materials, we can make a crown entirely out of porcelain so it looks and feels just like a natural tooth.

Another Case of the Month :D

our patients requested more cases of the month which involved cosmetic veneers, well check out this great case done in our office if you were interested please give us a call to set up a free consultation 631 724 0094

before and after case of the month :D

"Canine Substitution: Some people are congenitally missing their permanent lateral incisors. One way to correct this is to move the canines into the lateral position and then bond the canines to look like laterals. The case of the month demonstrates bonded canines in the lateral position."

Before and After Picture

This patient recieved a composite filling blended to match remaining tooth structure.

If you have any of the issues in the before picture and would like to fix it give us a call at 631 724 0094 to set up a free consultation

A Case Of Diastema :-O !!!

“Come together, right now….”
-Lennon and McCartney








Composite Veneers by Salvatore Lotardo DDS

Diastema is the term for any space between two teeth. The midline diastema (space between the two upper central incisors) is by far the most common. Some celebrities have embraced their diastemas and have become part of their persona.




Many people have a diastema and in most cases it may give some character, but for some they feel it detracts from their smile. With the advent of new materials and techniques patients have very conservative options available to eliminate these spaces.
In order to determine the best treatment we need to establish the etiology or cause for the diastema. The most common cause is the shape of the teeth. If the central incisors are rectangular shaped rather than ovoid this will lead to formation of a space. This is also the most easily corrected. Simply adding composite bonding to the side of the teeth will establish proper contours and close the space, and this is done without any harm to the teeth

Another common reason for spaces is a tooth size discrepancy. Simply put this is when the teeth are too small for the size of the jaw. For these cases bonding can be done to make the teeth wider, but if the shape of the teeth is good the orthodontic treatment (braces) may be the treatment of choice. There are now many esthetic options for orthodontic treatment (Invisalign, Ceramic Brackets, Short Term Orthodontics), and in some cases treatment can be completed in a few months.

Any spaces between teeth that were not previously there or are getting worse can be a sign of a problem. Gum disease weakens the support for the teeth and they become mobile and eventually spread out from biting forces causing spacing. Gum disease needs to be treated early to prevent systemic illness and tooth loss.

If you love your space and want to remain in the gap tooth club with Madonna, David Letterman, Arnold Schwarzenegger, Anna Paquin and Woody Harrelson, it worked for them. But if you are looking for a change or think your smile will look better and give you more confidence without the space; see your dentist for a consultation.

THINKING ABOUT GETTING VENEERS???

THIS PATIENT CAME IN TO OUR OFFICE WITH THE LACK OF CONFIDENCE ABOUT HER SMILE. HOWEVER, AFTER GETTING COMPOSITE VENEERS TO RESTORE PROPER TOOTH LENGTH, SHE WALKED OUT HAPPY AND PROUD.

BEFORE


AFTER



IF YOU ARE INTESTED OR EVER CONSIDERED GETTING COMPOSITRE OR COSMETIC VENEERS CALL OUR OFFICE TO SET UP AN APPOINTMENT FOR A FREE CONSULTATION (631)724-0094 AND ASK ABOUT CURRENT PROMOTIONS!

BEFORE AND AFTER PICTURE

"BEFORE AND AFTER PICTURE"

THIS CASE DISPLAYS THE BENEFITS OF COMPOSITE BONDING. THE PATIENT HAD CHIPPED TEETH, HOWEVER AFTER BEING TREATED AT OUR OFFICE, THEY WALKED OUT WITH A BEAUTIFUL SMILE.




BEFORE




AFTER

HOW IT ALL BEGAN

“It was twenty years ago today…”
Lennon and McCartney


While working in the drab denture lab at the Stony Brook School of Dental Medicine, I overheard a conversation regarding the best current new wave bands. The Cure, Depeche Mode, U2 and such names were being bandied about. The year was 1986. Having definite opinions on the subject, I felt obligated to chime in with my own suggestion; the Smiths. Another first year dental student sporting a Kajagoogoo inspired mullet was the apparent master of ceremony. Since me and the mullet were once in cover bands we were obviously the only ones qualified to make such rankings.

I asked the mullet touting dude two questions, the first; what instrument did he play? - “Keyboards”. The second; what’s your name- “John Caesar”. Our band Lipstick Vogue was born shortly after, and from that day on we balanced the rigors of dental school with the never ending goal of becoming the Island‘s top New Wave cover band.



Playing gigs on the weekends, studying for exams, and treating patients were a challenge but a partnership began from those experiences that would become the foundation for our practice. In 1992, one year after the completion of our residencies we opened the doors to Nesconset Dental Associates. Our first tagline was “we treat you like family”. Followed by “dentistry the way it ought to be!”, and more recently “we’re gonna make you smile”.


I’m happy to say twenty years later we still treat our patients like family, and provide quality dentistry at affordable fees. Over the years we’ve learned a lot, stayed up to date with the latest techniques and technologies but our commitment to those values has remained. The biggest change for us has been in the hair department. John retired the mullet shortly after Nirvana and grunge relegated new wave to a novelty seen on VH1 Classics. As for me, let’s just say I save a lot of money on haircuts these days.



-Salvatore Lotardo DDS

A SMILE MAKEOVER STORY

“Lovely Rita Meter Maid”

You don’t need a beautiful smile to be a beautiful person. But then again, like a beautiful home where the façade and entry make the first impression a smile can be the welcome to the observer’s eye.

Much more than just esthetics, a smile translates the unspoken language of emotion. A smile communicates happiness, confidence, warmth, trust and more. The smile is an invitation to friendship. A smile can be silent hello or agreement.
So when a patient comes to me and tells me they don’t smile because they don’t like the appearance of their teeth, I know they are missing out on a part of life. Social interactions become skewed. The grumpy old lady down the block is really someone’s sweet grandma but she never smiles because she is embarrassed by her teeth. That girl at the party is stuck up and unapproachable because she barely talks to anyone, but inside she is dying to laugh, chat and smile but she has an ugly front tooth and talks with her hand over her mouth. I’ve heard all the stories. I am fortunate to have the ability to play a part in a smile makeover.

Case Study: This patient (figure 1) presented with discolored and crowded teeth. After a records and a comprehensive exam were completed a treatment decision was reached. Orthodontic treatment would be done followed by porcelain veneers on the upper six front teeth.

fig 1



The orthodontic treatment consisted of brackets on all teeth and was completed in 18 months. At that point impressions were taken to create a diagnostic wax up. The diagnostic wax up allows us to design how the smile will be on a stone model. After which the teeth are prepared and temporaries are made from the wax up. The patient then wore the temporaries for one and returned to make custom changes to shape, size and color as per the patients liking. Was the temps were exactly the way we wanted them, photos and models were sent to the lab for fabrication of the permanent porcelain veneers.

fig 2


The patient was very happy with the outcome (figure 2), and now smiles even more than she did before. One day we hope to treat the lower and back teeth as well for an even bigger wow factor.
Salvatore Lotardo DDS

**PROMOTIONSS***

For those who are having trouble opening the picture, it states that our office is running a promotion for new patients. This is how it works, all new patients can come in for a cleaning, exam, and full x-rays for a VERY low price of $99.00 only. We also have a promotion for our existing patients; if you referr a friend or family member and they come in for any sort of treatment in our office, you will get $20 dental dollars. The $20 dental dollars can be applied to any services rendered in our office,they can be saved up and used later on as well or they can be applied to any other patients in the same account or family. There are no limits to how many dental dollars you may earn or use. However, they cannot be credited. For any questions, comments, or concerns please give us a call at 631 724 0094

"DENTAL TIP" something to always consider before choosing a dentist

Responsible Esthetics

Cosmetic dentistry has been around a long time but has changed dramatically over the years. In the Forties, Hollywood starlets would get their teeth capped so that they were “ready for their close-ups Mr. DeMille”. Because techniques and materials were limited back then, much of the tooth structure had to be sacrificed to obtain an acceptable result. Dentistry progressed through the years and great improvements were made for patient comfort and higher quality care.
But it wasn’t until the early eighties when predicable bonding to teeth was achieved that the modern era of cosmetic dentistry really began. There is a lot of confusion over the term “bonding”. I often hear people say “I had my teeth bonded”, but that could really mean many things. Bonding really refers to the method by which dentist adhere materials to tooth structure. Most commonly the esthetic materials we bond are composite and porcelain.

With composite and porcelain; crowns, fillings and veneers can be bonded to the teeth for natural looking tooth colored restorations. Porcelain veneers are thin shells of porcelain which are bonded over the teeth became very popular because patients were able to receive “smile makeovers” in a few visits, producing dramatic changes in shape and color. This power to transform a person’s smile had its consequences. In my opinion we became too aggressive and not open to consider other more conservative options.

The present era of responsible esthetics aims to achieve excellent cosmetic results while minimizing the removal of healthy tooth structure. Direct composites material can be used to mimic tooth structure so well, many times any preparation of the tooth can be avoided. Porcelain veneers can be made so thin now that no preparation or addition only restorations are possible. The use of adjunctive services such as orthodontics and implant also enable the dentist to provide less invasive and irreversible treatment in the pursuit of beautiful and healthy smiles.

“With great power, comes great responsibility.” --- Spiderman

Helpful dental tip for those with a "GUMMY SMILE" :S

The Gummy Smile


Many patients come in with a complaint of a “gummy smile” and want to know if it can be fixed. The answer is yes, however a determination of what caused the gummy smile must first be diagnosed. Once a diagnosis is made the various treatment options for that specific case can be discussed.

Some causes of gummy smile (excess gingival display) are very common and the treatments can be easily accomplished. Many times, during development the front teeth don’t fully erupt and a portion of the tooth remains below the gum line. In these cases the teeth appear short but once the excess gum is removed they have a normal appearance and less gum shows with smiling. The next most common occurrence is related to the skeletal or bony development of the upper jaw. If the upper jaw grows more than the lower you can get the typical “buck teeth” appearance with accompanying excess gum. Typically this can only be treated with orthodontics and in some cases orthognathic surgery where the jaw must be repositioned.

The lips can also contribute to a gummy smile. A hyper-mobile lip is when the muscles used for smiling pull too hard and causes the lip to go up higher than it should. A short upper lip is just that, and in that case the upper lip is not long enough to cover the upper teeth. These are less common and until recently not routinely treated. With the advent of Botox injections for numerous applications, success in treated lip related gummy smiles has been achieved.

What looks good can be very subjective. Studies have been done and there is a range of how much gum can show before a smile is considered unattractive. For women some gum showing is acceptable and often times desirable, ala Julia Roberts. On the other hand what really matters is how you feel about yourself, for example Katie Couric the poster child for gummy smiles, did quite well with her smile.

NDA case of the month before and after picture

No prep porcelain veneers. My philosphy of minimally invasive dentistry extends to cosmetics as well. When possible my goal is to create natural esthetics without damaging tooth structure. With proper planing and execution results like these are predictable.

before and after picture

If you have an old bonded filling that doesn't blend seemlessly, new composites can be made to mimic natural tooth with conservative techniques that preserve your natural tooth sturcture."

Before and After picutres of services rendered in our office

BEFORE N AFTER SLIDE FOR ONLINE - flash slideshow

worn out teeth

          Worn Teeth: problems of a Modern Society

                    I see more patients that suffer from worn teeth than ever before. This seems to be a phenomenon of our modern style of living. The advent of processed foods, sugar and chemicals in our diets could be a factor along with the high stress lifestyles we have all grown accustomed to (or have we?). Combine this with people living longer and keeping their teeth longer the dental profession faces new challenges in predictably treating these cases.  Cosmetic and reconstructive dentistry has become more desirable and affordable, and now patients more than ever people want to have their teeth restored back to a more youthful appearance.

Most often people begin to notice that their teeth appear shorter or they don’t see their teeth as much when they smile. But treating worn teeth can be more complex than just “making the teeth longer”. When evaluating these types of cases the first thing we need to do is determine what caused wear and appearance. The most common causes I see today are 1) abrasion due to grinding and 2) erosion due to diet or gastric reflux.

          Many people grind or clench their teeth, usually at night when they are sleeping but daytime clenching and grinding is becoming more common. Bruxism is the term for this condition.   Stress, sleeping habits, misaligned teeth all could be contributory factors for bruxism. The goal for successful treatment is to attempt to reduce the grinding and restore the teeth to ideal esthetic forms. Because it may be impossible to completely eliminate grinding we need create a biting environment (occlusion) that works for that patient. Also protection of the restored teeth after treatment needs to be considered.

          Erosion can cause similar wearing of the teeth to grinding but how you get there is completely different. Erosion is a chemical process whereby the tooth structure is weakened by acids then worn away by normal things like chewing and brushing. Erosion appears to be a modern problem. Primitive teeth studied prior to the introduction of   sugar and soft drinks into our diets didn’t seem to suffer the effects of erosion. Soda and citrus fruits are very acidic and if consumed frequently can cause serious erosion of teeth. Teeth eroded in this way have a very specific appearance but once identified the diet can be changed and the problem corrected. After the teeth are restored there is then little risk moving forward.

          Acid reflux, GERD and bulimia cause acids from the stomach to attack the biting surface of back teeth and the back of front teeth. The damage to the teeth is a combination of the acid demineralizing or weakening the enamel and then chewing and brushing removes the softened tooth structure. This type of erosion has a unique appearance and its own treatment considerations, but as previously described once the problem is corrected the teeth can be restored back to their original form and function.