Fluoride Is Essential To Dental Health

by: Dr. Andrew Koenigsberg and Dr. Rebecca Koenigsberg 

The introduction of fluoride in water and toothpastes over the last 70 years has led to large decreases in dental decay.

One of the 20thCentury’s Greatest health Achievements

Water fluoridation was a major breakthrough for national oral health when it was first introduced in 1945 in Grand Rapids, Michigan. In fact, the Centers for Disease Control and Prevention deemed it one of the 10 great public health achievements of the 20th century, helping reduce the chances of developing tooth decay.

Does fluoridated toothpaste eliminate need for fluoridated water?

Recently, people have questioned whether fluoride in the water is necessary as most people are exposed to fluoride in toothpaste. Recent studies have shown that communities with fluoridated water have lower rates of decay.Researchers discovered that counties in which more than 75 percent of the population had access to community water fluoridation saw a 30 percent reduction in dental caries.

What happens in if there’s very little fluoride in the water?

When fluoride in the water is unavailable,children  deemed to be at high risk by a pediatrician or a dentist,  a fluoride supplement can be prescribed to be taken on a daily basis.

Another option researchers have found to be effective is fluoride varnish, which helps re-mineralize the tooth surface and prevents the development and progression of caries.

Fluoride has been called the second most effective public health measure after vaccination in terms of disease prevention. And of course, parents play a critical role when it comes to maintaining their children’s dental health, by teaching them healthy habits early on.



Eating Ice Cream Shouldn’t Hurt – Treating Tooth Sensitivity

Ah, Summer. The season of iced coffee, ice cream and iced- anything that will cool you off from this heat! But, for those of us who suffer from tooth sensitivity, these methods to beat the heat can also be the culprit for some oral discomfort.

What Causes Tooth Sensitivity?

To understand tooth sensitivity, we must first understand a little bit about tooth anatomy. Each tooth has three layers- the hard, white outer layer is called the enamel. The yellow-ish, softer layer below that is called the dentin. And in the center of each tooth is the pulp, which contains nerves and blood vessels. Over time, if the enamel is worn away it can expose the dentin to the oral environment. The dentin has tiny channels which connect to the pulp of the tooth. So, if you take a sip of cold water and it washes over the exposed dentin, it can send that wave of energy to the pulp and cause a zing of pain.

How does the enamel wear away? Most often it’s from overzealous tooth brushing which can cause recession of the gums, leading to dentin exposure on the roots of the teeth. Dentin can also become exposed by tooth grinding, cavities, broken down restorations, some treatments for periodontal disease or erosion from acidic foods or drinks.

Treating Sensitive Teeth

And Now that we understand HOW it happens, what are some ways we can treat these issues? The first and most conservative step is to try a desensitizing toothpaste, such as Sensodyne, which contains potassium nitrate or calcium phosphate. The way these dentifrices work is by blocking the channels in the dentin that connect to the pulp. Pro tip: if you have sensitivity localized to one specific area, brush the toothpaste onto that particular area but DON’T rinse it off. The longer it sits, the more effective it is. Plus, it has an additive effect over time. If the desensitizing toothpaste isn’t doing the trick, let your dentist know. Often, we can do a small, non-invasive filling that helps to cover the exposed area. Plus, we can rule out any issues such as cavities and treat them as needed.

If sensitive teeth is an issue for you, let us know so you can get back to enjoying your cool summer time treats! And as always, we’re happy to answer any questions you might have. Leave a comment below or give the office a call at (212) 246-8700.


Dr. Sam’s Graduation👩‍🎓

Graduation tends to evoke a time for reflection and a chance to take a step back and look at the big picture. The day-in and day-out routine of a long schooling process can sometimes diminish the excitement that was so alive at the start—graduation gives you a chance to reignite that spark as you’re able to look back on your accomplishments and take your newly minted knowledge with you onto the next big thing.

Today, I get the opportunity to reflect as I graduate from my fellowship in implantology. Implantology is not a recognized specialty by the American Dental Association and this fellowship was an additional two years of part time schooling after 4 years of dental school and 3 years of a full-time residency in prosthodontics. (Yup, you heard that right. I had 9 years of school AFTER college.) So, as you can imagine, I have answered A LOT of questions about why I bothered “wasting” my time and money on a program teaching me information which someone else could learn on the fly. The bottom line is this: it was all done for my patients.

Towards the end of my prosthodontic residency, I came to realize that the more you know, the more you realize how much you don’t know. What I DID know was that I wanted to be able to provide implant surgery as an option to my patients and that I didn’t feel confident in the training I already had. Nor did I think that a weekend course on implant placement was going to satisfy my need to really be well trained and live up to the exceedingly high expectations of my midtown Manhattan patient base.

So, I enrolled in the Implantology Fellowship Program at Columbia University College of Dental Medicine where I learned from the best surgeons, clinicians and academicians in the game. Of course, there were points going through it where I was frustrated. But, now with the opportunity to reflect on my time in my fellowship, I can honestly say that I’m SO glad I did it. Not only did I gain the clinical skills and the confidence to perform these procedures in my practice, but I now understand the fundamentals of why I’m doing these procedures, the scientific rationale behind them and the biology that supports my decisions of one treatment or another.

How does this benefit my patients?  Probably in more ways than you realize. Not only do I have more formal training than almost any other dentist out there, but in a lot of cases I’m able to treat my patients from the beginning to the end of their treatment in the same office. (Of course, there are exceptions!) But my combination of prosthodontic and surgical training gives me the advantage of being able to see the big picture to better plan treatments, execute the treatment for patients in a convenient and efficient manner and achieve better outcomes for them overall.

Whew, that was kinda tough. I don’t like bragging, but in the spirit of reflection and moving forward, it’s important to recognize and be proud of what I’ve accomplished and why I went through it in the first place. With my graduation, my spark is reignited and I’m so looking forward to being able to move onto my next big thing: providing superior service to all of our patients at Gallery57Dental. Cheers!

Listen Up Ladies- It’s National Women’s Health Week  

It’s National Women’s Health Week! And since our oral health is an important part of maintaining our overall health, we thought we’d point out a few reasons why it’s especially important for the fairer sex to take care of those pearly whites. So come on ladies, let’s get our toothbrushes in formation…

Hormonal Changes

Whether you’re not a girl/not yet a woman, got a bun in the oven or are going through “the change,” fluctuating hormones can actually cause lots of issues in the mouth. Changing hormone levels most often manifest as bleeding or swollen gums. If these issues aren’t treated, the gum inflammation can progress into periodontal disease, or irreversible bone loss around the teeth.

Heart Disease

People with gum disease have an increased risk for heart disease and almost double the risk of having a fatal heart attack. Since heart disease is the number one killer in American women, that statistic alone should be enough to have all the women [who independent] brushing every day.


There are several studies that suggest that there is a link between osteoporosis and low bone density in the jaw. This is important because the teeth are anchored in the jaw bone and if there is gum disease, osteoporosis may lead to these teeth losing bone faster.

These are just a few of the reasons it’s extra important for women to take great care of their oral health. The best way to do that is by brushing and flossing at home and regular visits to your dentist. And we’ve gotta stay in the best shape we can, because who run the world? GIRLS!

Why Our Millennial Patients Are Crazy About Solea Laser

I have been using the Solea Laser for four years now. I love it and so do my patients. I use it daily and my patients leave thrilled. Even the most anxious patient gets excited after treatment, amazed that it did not hurt at all. Patients love that they can leave the office not feeling numb and go on with their day as normal.

The Importance Of Staying Current With Dental Technology

Modern high-end dental offices look very different than they did 10 years ago. Things are changing fast. Patients are educated and have unlimited access to all kinds of information. They appreciate the technology we have in our office and are coming to expect it from their providers.

Convenience And Comfort Of No-Shot No-Drill Laser Dentistry

My Midtown Manhattan patients are always short on time! They love how quick, easy and painless these procedures are. It’s no fun leaving the dentist numb, having to take time off work then waiting for the numbness to wear off and not being able to eat for hours on end.

At my office I use the Solea Laser, which numbs the tooth as I use the laser. Normally we prefer not to numb multiple areas of the mouth, so we only work in one part of the mouth. Since there is no shot with Solea, I can complete fillings in different areas on the same visit. Not only is the shot avoided but additional trips and possible time off from work are also saved. What used to be complicated procedures become simple. I have one patient with a gum growth from her pregnancy and I can remove it using the Solea without numbing or doing any invasive procedures.

Millennials Embrace New Technology

In my experience, I find the Millennial generation to be less dental-phobic than previous generations. This may be because of fluoride in the water, which results in less tooth decay. Millennials are also comfortable around technology and understand the value of and efficiency of this modern, new way of treating patients. They are excited about what laser can do for them and don’t find it intimidating. In fact it’s the least intrusive, quickest, most precise and comfortable treatment right now for dentists and doctors.

In my practice I incorporate technology and like to stay current. Especially when I feel it adds to my patient’s experience and provides a better service.


9 Often Ignored Symptoms Of Oral Cancer

April showers bring May flowers AND oral cancer awareness!

That’s right, April is Oral Cancer Awareness Month. Why should you care? Because 50,000 Americans are diagnosed every year with oral cancer.  Even though survival rates are pretty high, the key to successful treatment is early diagnosis. Luckily, you’re already scheduled to see the only health care provider who is looking in your mouth every 6 months, right?! Your dentist is usually the first to detect any changes in the oral cavity. Every time you come in for a cleaning and exam, we’re looking for any irregularities or abnormalities that could potentially be or become cancerous. But, in between those visits, it’s a good idea to look out for the following symptoms… and just a disclaimer, most of the symptoms listed below are VERY common and usually NOT cancerous. But, if it persists for more than two weeks, you should have it checked out.

1. Mouth sores

These lesions can be red or white, are typically painless and can pop up out of nowhere. These types of sores can also bleed spontaneously. Most often, the lesion is a cold sore or traumatic ulcer, which tend to resolve on their own after 7-10 days.

2. Lumps, bumps or rough patches

These you’ll typically notice with your tongue. (it’s got loads of nerve endings to make even the tiniest things feel huge!) Roughening on the inside of your cheeks does occur frequently, especially if you’re a cheek biter. But, if it continues to spread or a bump increases in size, that’s an indication it should be looked at.

3. Loose teeth

If you’ve had healthy teeth all your life and suddenly one to a few teeth in an area become loose, this could be an indication that there’s a growth that may be pushing the teeth out of the way.

4. Difficult or painful swallowing or a sore throat

Again, this is a common symptom but if swallowing becomes increasingly difficult or painful, or if you’re having trouble keeping food down, that’s an red flag to see a doctor. A persistent sore throat can also be an indication that something is amiss.

5.Ear pain on one side

I know, this one is bizarre. But, there’s a nerve in the lower jaw that can sometimes refer pain to the ear.  It will typically only appear on one side. So, if you have persistent pain and the teeth in the area have been ruled out as a source, there could be something else going on.

6. Altered Sensation

If a lesion gets big enough, it can interfere with nerve signals that can lead to numbness in certain areas of the mouth. You can also have your sense of taste altered or lost completely. Typically, this symptom doesn’t just come out of nowhere—there’s usually a progression of symptoms or pain leading up to this point. Numbness in certain areas of the mouth may not be readily apparent, but secondary symptoms such as drooling or trouble chewing may be noticeable.

7. Ill-fitting dentures or appliances

If you have a denture or other removable dental appliance that no longer fits, chances are that it’s just time for a new one. But, if you recently had a new one made or over time the fit has gotten significantly worse, there may be a growth that’s causing things to shift.

8. Trouble moving your jaw or speaking

Jaw pain alone is very common and usually can be attributed to mild temporomandibular joint (TMJ) disorder. However, when it’s accompanied by swelling, ill fitting prostheses or your bite feeling way off, that may be an indication to have it checked by a doctor.

9. Pain

Persistent pain of any kind is your body’s way of telling you that there’s something going on. So, if you’re having pain that does not resolve in your mouth, teeth, tongue, cheeks, throat or lips, let your dentist know. Even if it’s something that can be easily resolved, it’s better to be safe than sorry!

Now, before you start searching all of these symptoms on WedMD and convincing yourself you only have 24 hours to live, let me be the first to say that everything is likely fine. But to be safe, make an appointment with your dentist and have them take a look. Here at Gallery57Dental, we’ve got tools like a Velscope and 3D imaging to help us take a closer look if anything seems suspicious. Any questions? Leave us a comment below!

“Kissing While Wearing Invisalign Trays?” (And 6-Other Top Orthodontic Questions)


I would say most of my Invisalign patients are relapsed patients who have had braces in the past, but they but never wore their retainer and the teeth shifted back.Their ages range from teens to 70’s. All of them have the same traumatic memories of wire braces, brackets and food getting trapped in embarrassing situations!

I completely understand the hesitation to jump back in to the orthodontic boat and would love to address some common patient questions I get from people considering Invisalign treatment:

 Can I wear them out on dates? Yes! I would suggest taking out the trays before your date gets there and putting them back in after the meal (of course after you’ve brushed and flossed or rinsed out well and chewed some sugar free gum).

Will Invisalign trays show in selfies? Shockingly not! While it’s nice when you have the control to sort through and choose the photos that will be publically posted of you, this is not always an option! Patients of mine have found that overall their Invisalign trays do not show up in photos. If you have a big event and are feeling nervous you can take them out for photos, but of course try to limit the time with the trays out.

Can I kiss someone wearing Invisalign trays? The consensus is yes! No one notices. The feed back I got form patients dating or in new relationships it wasn’t an issue. I found patients would take them out in the beginig of treatment but by the end were more secure that no one would notice.

Will Invisalign trays affect my speech?  It may! But usually just for the first day or two. Sometimes not at all! Occasionally patients will lisp every now and then throughout treatment though this is uncommon.

My job requires public speaking, can I wear Invisalign trays at work? Yes! I found that patients may take out their trays for high pressure large public speaking situations but less so as they progress through their Invisalign. Some patients will  leave them in at work in general but take them out for big high pressure meetings.

I feel self-conscience about my appearance and will wearing Invisalign make it all worse?

The feedback  I have received from patients is that they tend to start feeling better about themselves a couple weeks into Invisalign! Most patients tend to lose some weight as snacking and drinking become a bit more of a shlep. My patients hygiene tends to improve too with the added brushing and flossing.

So tell me doc, what’s the deal with Invisalign what are the cons?

Of course there are and I like to be quite clear. Invisalign only works for a compliant patient. You need to wear them 22 hours a day for them to work predictably.  They need to come out at meals. You will inevitably have to remove them in public at times. You need to brush and floss 3-4 times a day! Hygiene is super important so you don’t damage your gums and teeth.

The attachments seem to be the main dread of patients! They are tooth colored composite that is placed on the teeth for the duration of treatment and removed at the end.  They can be pretty spiky and large. They tend to dull with time. I find as freaked out as any patient is, I always offer to remove them  after a week or two if they still bother you and no one ever comes back. Meaning you get used to them and no one notices them.

The long and short is, I love doing Invisalign because I believe it leaves my patients feeling good and sets them up for success. It can decrease chances of gum disease, calculus build up, staining, uneven wear (which can be ugly and hard to fix)and it’s relativity non invasive and I find patients LOVE It.

Do you have any questions I didn’t get to?

Please let me know and I’d be happy to answer.


What ACTUALLY Are The Ingredients In Toothpaste?

In the spirit of spring cleaning, we thought we’d take a closer look at the workhorse of dental cleaning products—your toothpaste! We know that it keeps your teeth and gums healthy, but did you ever wonder what it’s ACTUALLY doing for your teeth? Keep reading to find out…


I know this topic tends to be controversial and many “natural” or “organic” toothpastes out there promote that they’re fluoride free, but fluoride is SO important when it comes to helping fight cavities! In fact, the fluoride included in toothpaste is attributed to drastically lowering the rate of tooth decay in the country. Here’s how it works—enamel is the hardest substance in the human body, made up of 96% of mineralized material. That material is mostly a crystal called hydroxyapatite. When exposed to acids due to bacterial break down of sugars and carbohydrates in your diet, the hydroxyapatite can dissolve and lead to the formation of a cavity. This is where the fluoride comes in! The fluoride ions in toothpaste have a higher affinity for the enamel matrix, so it actually converts the hydroxyapatite into fluoroapatite, making the enamel even stronger and harder to breakdown. Fluoride also can help remineralize, or strengthen, areas which are just starting to form cavities.

Still not convinced you want it in your toothpaste? Most big brands only include 0.25% fluoride. (The percentage can go up to 1.1% for high fluoride content toothpastes, but those are usually by prescription only.) That tiny amount is enough to make a difference in fighting cavities.

The Minty Flavor

Truth: this does nothing. Menthol was added to toothpaste back in the early 1900’s, convincing users that the minty, tingling sensation was a signal that the toothpaste was working. But, the addition of the flavor created a drastic increase in use of toothpaste and it’s been included ever since.

Potassium Nitrate

This ingredient is typically only included in toothpaste marketed for sensitivity. The potassium nitrate works to block the channels that communicate with the pulp of the tooth, where the nerves and blood vessels reside. Pro tip: if your teeth are sensitive, after brushing your teeth and rinsing take a little bit of this toothpaste, scrub it on the sensitive areas, but don’t rinse it off! The potassium nitrate has an additive effect over time and the desensitizing action takes a little bit of time to start working.


This is the true abrasive in your toothpaste. The tiny, amorphous particles do the scrubbing on your teeth to remove plaque, stains, and make teeth look whiter!

Titanium Dioxide

This is what gives toothpaste its white, clean color.

Sodium Lauryl Sulfate

Ever wonder how you get the foaming action from your toothpaste? It’s the sodium lauryl sulfate that creates the bubbles.


This gives the toothpaste its sweetness, so it tastes good while you brush!

Any questions about what your toothpaste is doing for you? Post a comment below or connect with us on social media @Gallery57Dental!


Did You Know Your Dentist Can Treat Sleep Apnea?

by Robert C. Rawdin, DDS

The importance of sleep cannot be over-emphasized. Sleep replenishes your body and mind. Sleep allows your body to stay healthy and recharges your battery every day so you can be active and productive in your daily life.

If you don’t sleep well, you know it. Poor sleep or deprivation of sleep will take its toll on the way you feel and have negative health consequences. The reasons for poor sleep can be numerous, but there are many things you can do to help improve your sleep. The key is to identify what is causing your sleep issues.

Do you have a sleep disorder?

Sleep Apnea is a condition that greatly impacts the quality of your sleep. Many people who have Sleep Apnea are not aware that they have it. Estimates run, from 30-80 million people in the US are affected with sleep apnea, and are undiagnosed. With Sleep Apnea you actually stop breathing while you sleep. Each episode of non-breathing lasts at least 10 seconds and can happen hundreds of times per night! Without breathing, your body is deprived of oxygen and this can lead to serious health issues if left untreated; high blood pressure, diabetes, higher risk of stroke and heart attack, cardiovascular disease and weight gain. You also can’t get into deep sleep if your brain is constantly arousing you to start breathing.

What are the signs and symptoms of Sleep Apnea?

The signs and symptoms of Sleep Apnea are fairly obvious, but many people ignore them and feel they just don’t sleep well. Others have no idea they have Sleep Apnea – think of the high profile, recent headlines of train operators and the catastrophic results of working while sleep deprived. If you are feeling tired all the time, have morning headaches, snore a lot, feel irritable and/or depressed, have high blood pressure, or can’t lose weight, chances are that you have Sleep Apnea.

Not everyone with Sleep Apnea needs a CPAP

Most people, who know anything about Sleep Apnea, associate it with the CPAP machine. This is a mask that provides Continuous Positive Air Pressure. Many people reject the idea of having to use this and would rather do nothing. The CPAP is a very effective device to prevent sleep apnea. However, it is best employed in patients with severe Sleep Apnea. Contemporary wisdom these days agree that the use of oral devices are very effective treating Sleep Apnea in those with mild to moderate Sleep Apnea. Dentists who are trained in dental sleep medicine make these devices. Sleep appliances are also indicated in cases where patients cannot tolerate the CPAP or just refuse to use it.

Sleep tests are simple – and might save your life!

Testing for Sleep Apnea is quite simple. In most cases, a simple home sleep test is available. In the past testing meant a trip to a sleep lab where, ironically, no one really gets a good night’s sleep!

If you sleep poorly, you need to talk with your doctor or dentist. If a sleep test is indicated (based on answering a few questions), you can easily be set up to have a home sleep test. The treatment can be much simpler than you may have thought; an oral device is a non-invasive approach that is effective in about 85% of patients. The oral device is portable and easily used anywhere.

Treat your Sleep Apnea. It can be life changing and in some cases, life saving. To learn more, visit sleep.gallery57dental.com




Are All Sugar-Free Gums Created Equal?

Which sugar-free gum is the healthiest?

As part of our healthy lifestyle, we try to eat responsibly ie organic, non GMO, natural… and of course we only chew sugar- free gum.

We dentists recommend chewing gum because it increases the salivary flow in the mouth. Especially if chewed after eating, the increased salivary flow can help neutralize and wash away acids that are produced when food is broken down by the bacteria in plaque on teeth. But are all sugar free gums created equal? Not really.


Most conventional sugar-free gum uses an artificial sweetener called Aspartame, which does make food taste awesome, no doubt. Though counter intuitively, studies are linking these chemicals to weight gain!


Here’s the deal. The healthier options taste great, but that taste doesn’t last long. This is because they use alternative sweeteners like xylitol, which can have healthy benefits such as decreasing your cavities. But unfortunately it tends to lose flavor after a short time.

The consistency also tends to fall apart after a short while … the reason for that is that the brands we’re more familiar with use plastic! Most gum brands you’re familiar with contain synthetic rubbers, emulsifiers, the controversial preservative BHT and plastic called polyvinyl acetate.

There is no great substitute for the proprietary ‘gum base’ and that is why the healthiest brands simply don’t taste good for very long.

Be a savvy label reader

Also, if you’re going clean, beware! Many gum brands market themselves as “healthy” and use xylitol instead of Aspartame or sugar, but use fool coloring and other chemicals you may not want to chew on.

Becoming a savvy label reader, able to weed through confusing ingredient lists is always a great tool! The real answer boils down to your comfort level and tolerance to sacrifice taste and flavor for a clear conscience health-wise.

I hope this answered your questions! Please feel free to reach out with more!






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