21st Century Smile
One Woodstock dental practice is helping to change the face of modern dentistry.
21st Century Smile
Welcome to the modern mouth: At Woodstock’s Tischler Dental, high-tech cosmetic procedures, a focus on holistic health, and a spa-like atmosphere transform the dreaded visit to the dentist
By A. J. Loftin • Photographs by Jennifer May
There was a moment, a couple of months after opening his new dental building last January, when even Michael Tischler wondered if maybe he hadn’t gone over the top. He’d just invested $4 million to build a world-class dental facility on nine acres in Woodstock; landscaped the property with dozens of new trees and shrubs; installed hundreds of thousands worth of new high-tech equipment; outfitted the place with a seven-zone air purification system, Brazilian cherry wood floors, leather couches, plasma TVs — even an auditorium. All this, plus he had a large staff and two other dentists to feed (one of them his own father). What if the risk didn’t pay off?
But, says Tischler, it did: The practice, already at 3,000 clients, continues to grow, with the faithful traveling to Woodstock from all over the region and even abroad. And now, he asserts, flashing a crisp white smile, “I wouldn’t change a thing.”
It’s easy to get swept up in the enthusiasm for dentistry at Tischler Dental. You walk in, a shambling biped with an indifferent mouth full of food-chewing implements, but pretty soon you’re ready to sell your firstborn for a better set of choppers. This psychic realignment begins the moment you enter the brand-new 10,000-square-foot facility, which recently was named “Best New Building Project of the Year” by the Ulster County Development Corporation and the Ulster County Chamber of Commerce. There are four reception stations, each manned by a lovely young woman ready to serve. A long leather couch, vaguely Italianate tables and armchairs, plants and flower arrangements, and the sounds from two outdoor waterfalls all evoke the lobby of a five-star hotel or a spa.
It looks like the kind of place where you could order up a pedicure, and in fact there is a trend in dentistry toward “dental spas” where you can do just that.Tischler Dental doesn’t offer spa services, but the practice does encompass acupuncture and other Eastern-inspired holistic techniques. “We may look like a spa,” says Tischler, “but I don’t want spa services in my dental office. I love the fact that these [spa] places are trying to relax people, but I think there are other ways to do it.” Such as? “Nature,” he says. “Large windows. Calming materials and colors. Credentials and experience.”
Dentistry has undergone a revolution in the past 10 years or so, and Tischler is front and center in leading the charge. To begin with, it has become more like the field of plastic surgery than internal medicine. According to the American Academy of Cosmetic Dentistry, demand for teeth-whitening procedures alone has risen more than 300 percent over the past decade. Not only are new and better techniques constantly being developed to improve the appearance of teeth, but now a person can even elect to get an entirely new set of pearly whites. In the past, people who outlived their teeth had to be content with wearing often-clunky and uncomfortable dentures; now, with bone grafting and surgical implants, it’s possible to build a new mouth from the ground up.
But the whole experience of going to the dentist has been transformed, too. Patients can now opt to have “conscious sedation” — delivered via pill or intravenously — to allay fears of uncomfortable procedures. There is also an emphasis on holistic dentistry, the use of nontoxic materials (good-bye mercury fillings), and a better understanding of how the health of your teeth and gums can affect your entire body. Tischler, a noted national expert who frequently trains other dentists in cutting-edge techniques, says simply: “I want this to be a center where people come to have their lives changed. That’s what I’m about.” Hence, the practice’s trademarked slogan: “The next level of care. Experience it.”
My visit to Tischler Dental began with a tour given by Michael’s assistant, Aimee Kouhoupt. We reviewed the wall of fame: Dentistry Today’s annual listing of the “Top Clinicians in Continuing Education” included Tischler’s name each of the past five years. With quiet pride, Kouhoupt showed me the four hygiene rooms, all with chairs that face your choice of either a flat-screen TV or large windows looking onto a wooded landscape. We then admired the five “operatories”: surgical rooms where Tischler, his father, and associate Dr. Fred Milton treat their patients, each equipped with all the finest gadgetry. I gawked at the in-house photography studio, furnished with professional lights and backdrop, which is used to create before-and-after shots of clients’ smiles.
“People come from all over the country,” said Kouhoupt. “We have one patient who owns a resort on a tropical island, she comes up here. People fly into Albany airport or take a car service up from New York City. And if people need to stay over, we make all their arrangements and we drive them to their hotel and back.” Their total Concierge Service Package allows patients traveling from outside the area to enjoy a “Dental Retreat,” offering dental restoration and rejuvenation as well as award-winning accommodations at the nearby Emerson Resort and Spa.
For all its spit and polish, Tischler Dental remains very much a family business, right down to the décor. The very professional-looking nature photographs on the walls were taken, and personally printed in a darkroom downstairs, by Michael Tischler. The furnishings and color schemes were done by Michael and his wife, Jan. Michael’s father, Maurice (“Buzzy”) Tischler, who founded the practice 50 years ago, donated his collection of amusing folk-art figurines (which depict dentists pulling teeth and torturing unhappy patients) for a prominent display in one hallway. Michael himself oversaw “every square inch” of his new building.
Buzzy is a friendly-looking fellow, very warm and fuzzy, his white beard and mustache only partly concealing a dazzling new set of choppers. He first moved his family to Woodstock in 1971, more or less on a whim. “I came up for a weekend — a couple of my patients had second homes up here — and I decided I’m never going back to the city. I had a practice on Washington Square, I had three young children, and I was a professor at New York University. I left everything.” But within months he had a larger clientele in Woodstock than he’d had in New York City. He said he never expected Michael to become a dentist, but added that all three of his children have gone into one form of medicine or another. “They’re all into healing, all super people.”
Many years ago, Buzzy discovered the value of combining dentistry with acupuncture. He became certified in the procedure, and now routinely uses acupuncture needles (typically inserted in the ear or face) to relieve pain and/or help to relax his patients. (That afternoon, he was planning to give himself acupuncture treatment to relieve back pain.) Buzzy was also ahead of the curve in his commitment to cosmetic dentistry, a field some traditionalists still reject. “Even 50 years ago, it was my favorite part of dentistry,” he said. “I’m a sculptor [he works in stone, wood, and gold]. I like carving and shaping, finding the shape that’s right for someone’s face.”
Committed as he is to employing cutting-edge techniques, there is also an traditional side to the elder Tischler. “I did all my own dentistry up until this year. I pulled my own teeth, did root canals, did my own fillings, because I never liked dentists, never trusted them,” he admits. “But this year Michael took over. He did seven implants for me. I’m very proud of him. He’s special. I learn from him. He’s so far ahead of me, I can’t believe it.” So now that his son has everything under control, is Buzzy planning to retire? Absolutely not. “I can’t understand why people retire, unless they don’t like what they do. There’s nothing better than helping somebody.”
Dr. Fred Milton completes the dental trio. A relatively recent recruit (he joined the group four years ago), he had a practice in cosmetic dentistry in Miami, but was lured north, as he said, “by a woman.” Milton favors a holistic approach to dentistry, which to me sounds like a fancy word for old-fashioned common sense: “We try to look at the whole person, at the person’s health history,” he says. “I like to say that teeth are a mouthful of evidence. You can see systemically what’s going on with the person, whether they have too much calcium or phosphorus — it all shows up in the mouth. You can understand a person’s life by their teeth.”
Milton has actually taken the practice of holistic dentistry to new (and sometimes controversial) heights. He is one of the few practitioners in the world trained in Resultant Force Vectors (RFV), a method of assessing and treating body pain by adjusting the teeth. In fact, he claims he has been able to cure many chronic problems including muscle pain in the neck, back, and legs with this technique. “One patient had lower back pain for a long period of time, and by making just a few adjustments in the mouth, the pain went away. In one case the patient had vertigo and after making adjustments, in several weeks it improved. There is a little-known relationship [between the teeth and the rest of the body] that few physicians are aware of. If we can determine by tests — such as biting down on paper — then we can make changes to relieve or eliminate pain,” says Milton.
And as for Michael, well, in some ways he is like a kid in a candy store when it comes to all the new technology in his office. He shows me a computer in his operating room, where he clicks to some compelling before-and-after photographs. “Isn’t this cool stuff?” he asks. Next, we see 3-D images from his digital CT-scan machine (Tischler is one of the few area dentists with his own CT-scanner). “All of my implant cases are done using the CT-scan,” he said. “I can see exactly how much bone is in any given place.” Tischler specializes in techniques to grow bone where none exists, using demineralized, freeze-dried, sterilized cadaver bone placed under the gums. Over the course of several months, the body’s own cells turn it into new bone, he said. Receding gums? It’s now possible to grow new gum tissue by grafting connective tissue from the palate.
For patients looking to improve the appearance of their smile, Tischler favors the
whitening process Zoom!® by the company Discus Dental. It’s a package deal: Discus supplies the peroxide-based whitener as well as the mercury metal halide light used to speed and enhance the whitening process. Tischler claims the process creates less tooth sensitivity than the more common whitening trays that are used at home, but there’s controversy in the field on that point, as well as on the efficacy of the light. Zoom!® doesn’t come cheap, either to the dentist (kits can cost up to $1,500) or the client with yellow teeth (who has to shell out $500 per session).
It is perhaps not surprising that Tischler’s ambitions extend beyond patient care. He envisions dentists coming to Woodstock not just from around the country, but from all over the world, to watch him work and hear him talk. “I want to become an international attraction to people who do this kind of work,” he says. He takes obvious pride in his state-of-the-art facility, which will play an inportant role in his future aspirations. “When you spend money the right way, you get it back,” he said. “This place is an investment. Why not have a place I love, that represents me? Fear of dentists is the number-one fear in the world — well, it’s in the top five, anyway — so when people come into a calming atmosphere, when they feel more comfortable, we can do better care.”
Getting a Modern Mouth
The Zoom!® Teeth Whitening System is one of many bleaching alternatives. It uses a hydrogen peroxide mixture to bleach tooth enamel. A special low-heat light is used to activate the chemicals, causing the hydrogen peroxide molecules to bond to the teeth, and whiten the enamel. The procedure takes about an hour and lasts for two years.
Average cost: $500
Veneers are used to treat gaps and teeth that are permanently stained, poorly shaped, or slightly out of alignment. Tischler Dental uses porcelain veneers from Da Vinci Dental Studios, the same company used on ABC’s Extreme Makeover, to create “smile makeovers.” Bonded to the front of the tooth, veneers usually require two or three appointments. Average cost per veneer: $1,500
Tischler uses his own in-house CAT-scan machine to plan and perform implants better, faster, and safer — often in one day, depending on the bone quality. A national expert on implants, he uses demineralized, freeze-dried, sterilized cadaver bone placed under the gums to grow new bone. Average cost per tooth: $2,200
Tischler is certified in this new technology which allows patients to be conscious and in control, but completely relaxed during dental work. Continually monitored for blood pressure and oxygen saturation level, patients can’t drive after this procedure. Cost: $300-400 (the cost is usually integrated into the overall treatment, although it is not covered by insurance)
Tischler, who is experienced in periodontal surgery, uses a dental laser to treat gum disease. The laser often eliminates the unpleasant aftereffects associated with many dental procedures, including soreness, bleeding, inflammation, stitches, and numbness.
All 12 treatment rooms at Tischler Dental are outfitted with one of these digital camera systems. About the size of a dental drill, each camera can magnify an image of a tooth 30 times. The image is then displayed on a TV monitor for the patient to view.
The Mouth-Body Connection
While Dr. Fred Milton (left) believes that chronic body pain can often be relieved by simple tooth adjustments (see main story), there has long been a recognized connection between gum disease and the health of your entire body. Reseaerch now shows that periodontal disease can be related to heart disease, stroke, Alzheimer’s disease, diabetes, premature births, and gastric ulcers. Periodontal bacteria can enter the blood stream, travel to major organs, and begin new infections. A substance called C-reactive protein is produced when inflammation such as gum disease occurs. Several major studies recently indicated that the levels of C-reactive protein may be as important an indicator as cholesterol in determing cardiovascular health.
The Mercury Mess
Are mercury fillings really bad for you? Some consumers and dentists argue that standard amalgam (or “silver”) dental fillings — a mix of metals bound together with mercury — pose a health threat. (This mixture doesn’t use the same type of mercury that raises red flags for fish consumption — that’s known as methyl mercury.) Opponents of amalgam fillings contend that dangerous metallic mercury vapor is released from the fillings and absorbed by the body when chewing and drinking hot liquids. This toxicity, they say, can be linked to health problems ranging from Alzheimer’s disease to depression; other countries (including Canada, Germany, and Sweden) have banned or discouraged mercury fillings. Yet the National Institutes of Health and the American Dental Association both report that mercury fillings are completely safe. One ADA spokesman says that “you would have to have 400 to 500 fillings in your mouth” to produce toxic levels of mercury. At Tischler Dental, mercury fillings are not offered.
Dr. Buzzy Tischler believes acupuncture relaxes his patients and helps manage pain
Spacious and comfortable, Tischler Dental's luxurious lobby is part of the new 10,000-square-foot facility
Plenty to smile about: Dr. Michael Tischler in his new office in Woodstock