Top Dentists 2011: Watch Your Mouth
That’s what dental professionals are trained to do. These specialists do it especially well.
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Dr. Stanley Goloskov sits in a small consultation room of his Wilmington office, Mac PowerBook on his lap. Oxyfresh toothpaste and rinse, ProClean Sonic toothbrushes and Crest Whitening Strips stand on a nearby shelf for anyone who wants them.
Goloskov summons an image of his next patient’s mouth on the computer screen. The patient is a middle-aged man who had worn dentures most of his life. “We needed to do something for him,” Goloskov says. “Things were failing in his mouth.” Teeth were decaying. Gums were receding. Bone was eroding. Unchecked, the patient could have lost his few remaining upper teeth.
Goloskov’s solution: installation of a bridge anchored to five or six implants. The fix is permanent—thus eliminating the need for a removable partial plate and annoying dental adhesives—and easier to maintain. It will prevent further loss of the gum and bone that hold teeth in place. And, just as important, the result is sturdier and more comfortable. “This improves the structure immensely,” Goloskov says.
Most of us can’t imagine the inconvenience of tooth decay or gum and bone loss so severe that eating—even speaking—becomes excruciatingly painful. Goloskov, in practice for 38 years now, noticed the problem as a young man.
“Back then, many 60- or 70-year-olds didn’t have teeth,” he says. “I saw the ravages of that. One of the things you do socially at that age is go out to eat with your friends. If you can’t do that, it messes up your adult senior life.”
Or your young life. Dental problems strike at all ages. Goloskov believed he could help.
Though considered a general dentist, he has narrowed his practice to restorative and cosmetic dentistry. Professionals can become certified in specialties such as periodontics and prosthodontics after two or more years of closely supervised postgraduate training, but confident and experienced general dentists can perform many of the same treatments, such as installing bridges and crowns, as a prosthodontist does, and making implants, as a periodontist does.
“Over the years, I’ve loved this, so I’ve taken many courses in it,” Goloskov says. “Things we feel comfort with, we can focus our practices on. You can be as good as any specialist.” In some cases, as with the patient on the PowerBook, he “quarterbacks” a team of caregivers.
Goloskov was attracted to dentistry by the science of healing, as well as the “artistic flair” required to create and install dental prostheses. He earned his bachelor’s and doctor of dental surgery degrees from the University of Maryland, then went to work.
Goloskov keeps up on the latest advances by reading the International Journal of Periodontics and Prosthodontics and Journal of the American Dental Association, by completing the 100 hours of continuing education required of every licensed dentist in Delaware, and by meeting monthly with study groups of other local dentists to share information and consult on interesting cases. He also makes regular presentations to other professionals, such as a lecture in March for residents at Christiana Hospital about new composite materials. “The presenter learns a whole lot more than the students,” he jokes.
Beyond the singular quantum leap of implant dentistry, which allows dentists to fix prosthetic teeth to screws placed in the patient’s jawbone, overall advances have occurred slowly and steadily during his time in practice. Materials continue to improve. He speaks of matrix metalloproteases such as zinc endopeptidease, which improve the bonding and strength of implants, and of morphogenetic proteins, which are helping researchers regenerate bone.
The next big thing: “They’re growing teeth in the lab,” Goloskov says. Practical application may not be viable for another 10 or 15 years, he says, but, “that’s pretty neat.”
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