AboutZev Kaufman, D.D.S. Expertise I can answer any question from simple routine dentistry to very complex dentistry with emphasis on reconstructive, cosmetic, and implant dentistry. My expertise is in co-ordination of very complex treatment plans with other dental specialists or as a one-man-team, since I have extensive training in Prosthodontics, Surgical Implantology, and orthodontics.
Experience Over a decade in private practice of Surgical Implantology and Prosthodontics. Founder and owner of Prosthodontics & Implant Surgery of Manhattan, PC.
Clinical Assistant Professor at the Post-Graduate Department of Periodontics & Implant Dentistry at New York University College of Dentistry.
Lecture weekly since 1999 on advanced Implant Prosthodontics at New York University College of Dentistry Post-Graduate Program in Periodontics & Implant Dentistry.
Former clinical assistant professor of Dental Radiology at the NYU College of Dentistry.
Former clinical and lecture faculty at Lincoln Hospital, Dental residency program.
Former clinical and lecture faculty at St. Barnabas Hospital (Bronx, NY) dental residency program.
Lecture nationally on Prosthodontics and Implant Dentistry.
Organizations Memeber of the American College of Prosthodontics.
Memeber of the Acacdemy of Osseointegration.
Member or the Omikron Kappa Upsilon (OKU) Honors Dental Society.
Member of the American Dental Education Association.
Education/Credentials Graduated with Honors from New York University College of Dentistry.
Post-Graduate training and certificate in the specialty of Prosthodontics.
Post-Graduate training and ceritificate in Surgical and Prosthetic Implant Dentistry.
Honors-program in Comprehensive and Applied Practice Management.
Honors-program in Orthodontics.
Awards and Honors NYU Cervice award to the community.
OKU honor society.
National Dean's List.
National Who's Who.
Question Hi, my daughter (just turned 15)was slow to lose all of her baby teeth with 4 left to go. Her ortho suggests palate expansion due to crowding rather than permanent tooth removal. Her profile looks fine (his assessment) and he does not report poor jaw size relationships between the maxilla and the mandible. However, the teeth in the mandible tilt inwards with too much of an angle and my daughter cannot easily bite into an apple due to crowding. SO, here's my question - given that her profile looks right, will the expansion change her look when you look straight at her from the front? We are concerned that when her mouth is closed that visually from the front, her cheeks/lip will be pushed out giving a "chipmunk" sort of look. Sorry I can't describe this better. She has a slender, oval shaped face. I had similar problems with crowding - ortho had 4 cuspids & wisdom teeth removed. My smile has the "dark" gaps on either side of my mouth. We had hoped to avoid this for my daughter but not at the risk of changing a pretty face for chipmunk-like cheeks/lips due to expansion. What is your experience in the visual results from the front when patients are NOT smiling? I couldn't find any pictures.
Answer Dear Civia:
I have a daughter, as well, although she is only 3 and 1/2, and I understand our concern for her well being...
Here's what I have observed over the years...The problem with removal of per-molars to compensate for lost space is, as you described, formation of the black buccal corridor spaces, the way you have it. That is the best scenario...many times an oval profile becomes flat and you get a gummy smile with teeth portioned too far into the mouth (like the skater Christy Yamaguchi). Nevertheless, the "chipmunk" look that you described is also a possibility. What you should also consider is that most orthodontists are trained to get the "case finished" as soon as possible, and that is done with extractions. It take much longer to do Functional Orthopedics (expansion etc.).
What I would recommend, since I cannot see and evaluate your daughter myself, is to go to www.braces.org and locate another orthodontist in your area for a second opinion. However, before you decide to go to one, describe the problem over the phone, and ask the orthodontist if they will consider expansion and Functional orthopedics as a first choice (I personally prefer that mode of treatment). Some orthodontists have imaging software that will allow them to suggest, via a computer program, what your daughter might look like following treatment. Ask about that as well.
I with you lots of luck and best wishes to your daughter.
Sincerely,
Dr. Zev Kaufman
