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WDG Live

– [Interviewer] Hi, and welcome back to Winnetka Dental Group live. We’re here with the lead prosthodontist at Winnetka Dental Group, Dr. Michael Czarkowski. How’s it going Dr. Czarkowski?

– Wonderful. It’s a nice rainy day, good day to do Facebook live.

– [Interviewer] Glad to be here and today we have a special episode where Dr. Czarkowski’s gonna walk through some of his more challenging cases. So let’s start with the first one.

– As a prosthodontist we are trained in every aspect of restorative dentistry. What is exciting about being a prosthodontist is the different challenges that present to us with each case so it’s not like a cookie cutter solution, so we have to be creative in our approach on how we take care of patients. And this particular young lady had was missing, congenitally missing one of her front teeth, a lateral incisor and went to her dentist and said, “You know I don’t wanna wear anything removable for the rest of my life”, she was getting ready to go to college and so she had implant placed by a surgeon I work with, oral surgeon and when the dentist finished the case she was terribly unhappy and I could see why. If you look at, here’s her facial profile, very striking young lady, and if you look at a closer view you can see that on the lateral, the veneer that was made doesn’t quite fit up to the gum line.

– [Interviewer] All right, let’s zoom in a little bit so the viewers can see,

– Okay, no problem.

– [Interviewer] what we’re talking about.

– So you could see there’s a demarcation line from where the veneer that the dentist made doesn’t really fit close enough to the gum line and look at the lateral here on this side it’s diminutive so it’s really not a life-like representation of what a lateral incisor should look like.

– [Interviewer] So essentially her teeth they’re not proportionate and they’re not like

– They’re not life-like in

– Life size.

– Life size, correct.

– [Interviewer] Okay.

– So if we take different views of it you can get a little bit better perspective you can see how this doesn’t fit well so it’s not a real pretty tooth and then on the lateral other side where the implant is like I went through all this trouble to have a tooth made doesn’t look proportionate in my mouth so she was referred to me. If we look at the x-rays we have plenty of space to implants placed properly so it wasn’t that the surgical placement was incorrect it was the way the dentist and the technician made the crown. Here you can see the implant in the bone, this is the healing cap that’s put on so that the gum doesn’t overgrow it and this is the outline of the crown so you can see it’s under contoured here so that gives it that diminutive look. So we’re gonna change this for her by two, one reprepping this tooth and my technician is very artistic, he’s trained in Japan, he’s a very artistic technician and then we did some tissue sculpting here to open up a trough a bit more with our soft tissue laser. We can do this, it’s not traumatic to the patient at all and you can see now we’ve reproportioned the size to fit her mouth.

– [Interviewer] And they definitely look a lot more like normal I guess.

– Right. So now she feels like she got what she was expecting here as a result. We take a look at the final result. You’ve got a smile that matches

– [Interviewer] Wow.

– the rest of the patient’s

– It’s beautiful.

– She’s very study conscious young lady. So these kind if cases are really in my mind slam-dunks cause I know that the foundation’s correct, I’ve got a willing patient who’s aesthetically driven wants to have as nice a smile as can patients don’t come and say, “Oh just give me a so-so smile”. They wanna have a ‘wow’ smile and she’s one of these patients so she was very patient. It didn’t take us that long. We were done in five weeks from start to finish.

– [Interviewer] So Dr. Czarkowski how does something like this happen?

– Well I think because people don’t necessarily or the technician, the dentist and the technician don’t necessarily understand how to do an aesthetically driven restoration and I see it quite often I mean it’s, you don’t see great dentistry because it blends in in the patient’s mouth. You see plenty of people if you walk around look closely at their smile you say, oh you know I do, it’s my business so I look at people’s smiles and go oh I wish I could you know reach out to them and say, “Listen we can do miracles with people’s mouths and I think that you could get a better result in the hands of a prosthodontist” and that’s the training and the experience. When we’re in our training we have to do all the lab work so we understand all the deficiencies that can occur and we have to sculpt teeth that look natural in the mouth and we have two or three professors looking over our shoulder every step of the way so it’s kinda ingrained in our psyche that we will only accept perfect 10 restorations from our technicians. I spent a lot of time with my technician, he’ll bring it to me like a week or so before the appointment and I’ll say, “Well I need, we need to do a little of this to that crown or add a little bit here or change the shade or change the shape” and it’s a work of art. It’s not just a cookie cutter result that a patient would get. There’s a lot of thought and attention to detail. And in dentistry the devil is in the detail.

– [Interviewer] So right out of prosthodontics school you guys probably have hundreds if not maybe thousands of hours of experience working on similar cases and things like these.

– I was in my program for three years and my average nightly sleep was four hours a night.

– [Interviewer] Wow.

– For three years so but keep in mind most of the prosthodontists they’re selected because their manual dexterity is probably greater than most general dentists and the second thing is we’re passionate about what we do. We really love the ability to restore a patient’s form and function to as close as what mother nature would. We try to fool mother nature.

– [Interviewer] Well with this case Dr. Czarkowski you guys are definitely getting away with fooling mother nature because this is a beautiful case.

– Thank you.

– And thank you for sharing with us.

– Thank you.

– [Interviewer] All right and til next time.

– Thank you.

– [J] Hello, and welcome to Winnetka Dental Group Live, a program where we answer all of your dental related questions. Today is the start of our dental implant series. My name is Joshua, and I’ll be your host today. I’d like to start off by introducing the lead prosthodontist of Winnetka dental group, Dr. Michael Czarkowski. Dr. Czarkowski has 40 years experience in prosthodontics and general dentistry. He has restored approximately 4,000 dental implant cases. He was a team dentist for many Chicago professional athletic teams including the Chicago Sting and the Chicago Bulls. He was involved with the Department of Defense and pre-deployment dental screening and dental treatment of service members from all branches of the military. Dr. Czarkowski has been consistently chosen by his peers as one of the top dentists in Chicago, and has received awards from the Chicago Tribune, and Top Dentists for the past eight years. So let’s welcome our dental implant expert, Dr. Michael Czarkowski.

– Thank you, Joshua.

– [J] Dr. Czarkowski, I just have to ask you, how do you become a top dentist? Like, how are you chosen? Like, in my mind, as a consumer, I feel like all of these awards are, I don’t know, I guess, paid for.

– They’re not contrived, Top Dentists and the Chicago Tribune award is a peer-reviewed system of acknowledging people who have clinical skills that are held in high regard by their fellow colleagues. Our names are nominated and voted on by peers that have received the award in the past, so it’s quite an honor, I’ve been very, very happy, I’m always very excited to see if I was again selected, and nominated, and selected, for this award, and each year, so it’s quite an honor, I’ve been very humbled by it.

– [J] Wow, I had no idea. You know, I’m a huge Chicago Bulls fan. You have to tell me, what was it like being the team dentist for the Chicago Bulls? I mean, do you have any stories?

– No, well, you know, the Chicago Bulls, to be involved with the Chicago Bulls, to be on the inside, I’m a big sports fan, many people are big sports fans, to be involved, look on the inside is a completely different perspective than being a fan. You have, people forget how young these players are, they’re mostly in their 20s and early 30s, there’s this tremendous demand on them besides their athletic abilities, and to perform each game to their highest, to such a high level, they also have to deal with dealing with the media, travel schedules, nagging injuries. Their family is the sports team, the Bulls are a terrific organization, they were very supportive of their players, they wanted to make sure that their players were well taken care of, both medically and dentally. So, it was exciting, I got to meet some of the legends of the game, so it was a very exciting period of time in my life.

– [J] Wow. Okay, Dr. Czarkowski, you know, I have to be perfectly honest with you, I’m not entirely sure what a prosthodontist is, and why should I see one versus a general dentist? You have 40 years of experience as a prosthodontist and a general dentist, so I feel like you are uniquely qualified to answer this question.

– It’s a great question. A prosthodontist is one of the nine recognized dental specialties. There are approximately 195,000 general dentists and only 3,500 practicing prosthodontist in the United States. It’s an intense three year residency that we learn every aspect of cosmetic and restorative dentistry, and we are basically, when we’re finished, we are experts at being able to treat a patient in that arena.

– [J] So, would it be fair to say, or make the comparison that a general dentist is like a general practitioner, and a prosthodontist is more of a specialist?

– I would agree. A general dentist is well-versed in routine procedures, and simpler restorations, fillings, and crowns. Compared to the medical profession, a prosthodontist is closer to a plastic surgeon, as far as cosmetic dentistry is concerned, an orthopedist, as far as implant treatment.

– [J] Wow. What about in terms of continuing education? Would it be fair to say that a prosthodontist has to have more continuing education than a general dentist, as well?

– Prosthodontists typically congregate in, we provide most of the continuing education programs to general dentists, so we’re very much at the cutting edge, trying to field test and make sure that the techniques, and appliances, and then the implants that we use and materials, are fit to be used by general dentists. So we are providing the continuing education, they seek out our expertise to help them expand their skillset.

– [J] Wow, thank you so much for clarifying that. I think from now on I’m only going to see a prosthodontist.

– Wonderful.

– [J] So, we compiled a list of questions of the most commonly asked dental implant questions, and I think the first and probably more obvious one is what exactly is a dental implant?

– A dental implant is a replacement tooth root. It is made out of surgical grade titanium that the bone heals. It’s like a titanium screw that’s placed in the jawbone that anchors, that provides a strong foundation, for fixed, non-removable prosthesis, and also removable prosthesis. It’s been a tremendous adjunct since its introduction in early 80s from Sweden, by Dr. BrÃ¥nemark, to our ability to restore form and function for our patients. It’s a life-changing experience for dentists and patients.

– [J] Wow, okay. So, why do people get dental implants?

– They’re missing some or all their teeth, or they have dentures that they can’t function on, or they have extremely debilitated dentition, they’re uncomfortable with how their smile looks. So it gives them the opportunity to restore, like I said, form and function, their smile, their confidence, and their ability to enjoy foods that they haven’t had that in the past.

– [J] Wow, great. So, do you have any very, like, top, memorable smile transformations over the past 40 years and, you know, 4000 implant cases that you’d like to share with us, or can share?

– Yeah, of course. I mean, it’s a very satisfying experience for the dentist to be able to restore and rebuild somebody’s smile. My favorite thing to do for all these patients is when we’re done with the case, and some take a while from the start to completion, to hand the patient the mirror, and they look at their smile, and there’s this huge emotional relief that this cross, this oak they’ve been carrying, that they don’t have a great smile, they can’t function, they’re uncomfortable, is relieved. They look at themselves, they’ve done something that’s extremely helpful for their persona and for their health in general. That’s probably the most important thing, it’s to watch their reaction when they look in the mirror and they say, ‘wow, I’m whole again’.

– [J] That sounds incredible, wow. Thank you for sharing that, Dr. Czarkowski. So, the next question is, how long will dental implants typically last?

 

– Dental implants are very stable in the mouth. They do require care, and if properly taken care of, they can last a lifetime. We recommend that the patient, once they have their restorative procedures completed, they visit their dentist twice a year, sometimes more, if they have diabetes, or they smoke, or have heart disease, we ask that they come in on a more frequent basis for cleanings and examinations and maintaining their mouths at home just like a natural tooth, brushing and flossing.

– [J] So, do I require any special, like, toothbrush or toothpaste, or, like, mouthwash, anything like that, or?

– No, just the ADA approved toothbrushes, dental floss, toothpaste, that’ll be fine.

– [J] Wow. Dr. Czarkowski, thank you so much for answering our questions. That concludes our show for today, stay tuned next week for part two!

– Looking forward to it.

– [J] Thank you.