Monday, June 1, 2020

Okun Orthodontics is Now Open


Dear patient,

In a surprise announcement by Governor Cuomo on May 31, all dental office in New York State are permitted to open June 1, 2020. We are so excited to be able to get back on track with all of your treatments.  In order to provide a safe environment for you when you are in our office, we are following the guidelines of New York State, the Centers for Disease Control, the Department of Health, the New York State Dental Association, and the American Dental Association for infection control and social distancing. Please read this letter so you know what to expect when you come to our office.

Everyone in the building must wear a mask over their mouth and nose at all times except when it is necessary to remove it for dental (or medical) treatment.

Call from the parking area to see if we have a room open for you.  Reception area seating has been limited to maintain social distancing. We have also eliminated high touch items from the reception area; there will be no blocks, books, magazines, patient information pamphlets or game cube controllers available until the Corona Virus is no longer a threat, so there is no entertainment waiting for you in our office. We are making an effort to schedule more lightly to minimize wait times and maintain social distancing; this might mean that you will be offered fewer options when scheduling your appointment.

Only one person may accompany a patient into the office.  Please leave additional “visitors” (siblings, friends, parents) at home.  If a second parent would like to participate in a treatment discussion, we will include them over a video-conference medium like face time or Skype.

Take the stairs; avoid the elevators if you don’t need them. The doors to the stairways are propped open so that you don’t need to touch them. The elevators are limited to 2 passengers at a time.

Use the bathroom before you leave your house. We can’t control the number of people in the building’s restrooms.

Please wait at the door to the office until there is someone at the front desk to greet you, take your temperature, and ask you screening questions.  If you or someone with whom you have spent time has had a fever, cough, shortness of breath, inexplicable loss of taste or smell, or has tested positive for COVID19 in the last two weeks, please call to reschedule your appointment. If you come with these symptoms we will not be able to treat you and we will be rescheduling your appointment anyway.  Also, if you develop these symptoms within 2 weeks of the time you were here, please call us so that we can notify anyone with whom you may have had contact in our office.

Once you have passed pre-screening, you will be directed to a sink in the treatment room for all parties to wash their hands with soap and water.  Patients will rinse with ioRinse to minimize the number of viable microbes that may be aerosolized during treatment procedures.  IF YOU ARE ALLERGIC TO IODINE PLEASE LET US KNOW SO THAT WE MAY GIVE YOU AN ALTERNATIVE RINSE. Please throw paper towels in the green pail near the entrance to the room, not under the sink.  Please save your cup in case you need it to rinse during your appointment.

After your appointment, please wait in the treatment room until there are no other patients waiting at the front desk.  Then walk to the reception room and speak to the front desk staff through the glass window to schedule appointments or make payments.

We look forward to seeing you again and are happy to answer any questions you may have about the steps we take to keep you, and every patient, safe in our practice. To make an appointment, please call our office at (914) 253-0722. 

Thank you for being our patient. We value your trust and loyalty and look forward to welcoming back our patients, neighbors and friends.

Sincerely,

Dr. Judith Okun, Tracey, Corinne, and Deborah

Tuesday, April 7, 2020

The Power of Prayer

Years ago I read a Reader’s Digest Summary of a scientific study on the Power of Prayer which had been published in a medical journal. The patient records of cardiac patients from several hospitals were compiled and then divided into two groups, to make each group (the test and the control) equal by severity of illness and types of treatment.  The names of the patients (with some personal information about each of them) in the test group were given to strangers with the instructions for each person to pray for his/her assigned patient “in any way you see fit.”  None of the patients or hospital personnel were told who was in the study group.  At the end of the study there was a statistical difference between the groups, as if the test group was given a “miracle drug.”(Note that this study would have been illegal in today’s world because of HIPAA privacy laws.) 
We are living in a unique time.  Every continent in the world, except Antartica, has been affected by this COVID-19 pandemic.  Our hospitals are overwhelmed with the sheer numbers of infected patients who need care. There are not enough respirators and personal protective equipment to meet the needs. Businesses and schools have been closed to limit the spread of the illness. Routine medical care has been put on hold. Dentists cannot deliver needed care to our patients because the illness is spread by both breath and saliva; Dental procedures aerosolize the virus, and the virus stays airborne for up to three hours. Dentists do not have hospital air filtration, hospital gowns, and N95 masks which would be necessary to deliver care in our offices. 
We need to slow down the rate that this virus is infecting people, and we need to limit the number of people who are infected- both those that are ill and those that are asymptomatic carriers. Social distancing is one tool we are using to limit the spread of the virus, but it is not enough.  We all need to pray, in whatever way is comfortable for us. Pray for a speedy end to this pandemic, for a speedy and complete recovery for the people who have been infected, for the mental health of all of us living in social isolation, for the return of a healthy economy, and for the return of our normal lifestyles, before the virus took over.- A personal note from Dr. Judith Okun

Friday, April 3, 2020

One Day, A Corona Virus Update


Dear Patients,
Once again, I need to stress to you that the New York State "stay at home" law has deemed all of dentistry “non-essential business”. This law only permits dentists to see emergencies of pain, infection, and trauma that might cause you to go to the emergency room. New York on Pause was put in place to enforce social distancing to slow the spread, and hopefully decrease the total number of Coronavirus cases. All of us should be doing our part in this social distancing effort.

The Governor's original “'stay at home” mandate extended through April 19, 2020 and was soon extended to April 22. As of today the American Dental Association is recommending that we extend the policy to only see emergency procedures through April 30. The end date seems to change every few days as they learn more about the spread of the virus and its impact. Since we do not know when we will be returning to work, we are delaying rescheduling patients for at least another week, in hopes of not having to call you every week to reschedule your appointments.

It causes me much distress to tell any of you that I cannot see you to adjust your braces, take care of your loose brackets or poking wires, or keep your treatment on course for a timely debond (removal of braces at the end of treatment.) Some of you have been worrying about what impact this delay will have on your treatment. To set your mind at ease, I want you to know that if the NY Stay at Home law continues only until the end of April it should not have a dramatic impact on most of your treatments. 

If it extends longer it will mirror the experience of our patients who attend sleep-away camp, and the impact will be related to how well you took care of your orthodontic appliances. This means, those who followed the rules about avoiding sticky/chewy foods, cut food thin, took smaller bites and kept up with oral hygiene will usually not prolong the time it takes to successfully complete their case. Those who don’t keep their mouth and orthodontic appliances clean, don’t wear their appliances as recommended, eat food they shouldn’t or in ways unsafe for their braces will need to be “put back together” after this unforeseen delay and may very well extend their treatment time. 

The social distancing law does not, prevent us from having virtual treatment visits. Some of you have already taken advantage of tele-dentistry by emailing to me a photo and brief description of your orthodontic problem (along with your phone number) so that I can call you back to discuss your issue. If we are not back at work by the beginning of May and you wish to have a virtual visit, you can email me at drj@okunortho.com and provide me with your cell phone number for a “What's App” or “Facetime” call. For some patients this will only give them the assurance that their treatment is on track. For others I may change the direction of elastics or the force of the headgear. If you are running out of elastics, please let me know so that I can mail more to you.

In the meantime let's use our stay at home time productively. I am forever hearing people say “one day” I will have time to do this or that. As this Coronavirus Pandemic has shown, we don't know what tomorrow will bring. Instead of waiting for “one day” to have less time at work and more time with our families (the two most common end-of-life regrets), let's take advantage of this unexpected opportunity to bond with our families and make special memories. If your family is still working in an essential business, thank you for all you are doing to keep all of us safe at home.

“One day” we will all be back at school and work. Hopefully it will be soon, and we at Okun Orthodontics can get back to giving you the orthodontic and TMJ treatment which you deserve. I look forward to hearing from you,

Dr. Judith A. Okun 

Wednesday, March 25, 2020

Stay-At-Home But Keep Your Treatment Moving Forward

Okun Orthodontics remains closed, except for emergencies, until at least April 20, because of Governor Cuomo's executive order for New York State to close non-essential businesses in order to limit the spread of corona virus. We are permitted to see emergencies of pain, trauma and infection. If you are having an emergency, please take a picture of the problem, and email it with a description to Dr. Okun directly at drj@okunortho.com.  We are still returning phone messages, so please feel free to leave messages on our phone answering machine (914) 253-0722.
No one knows how long this state of emergency will last, and how long non-essential businesses need to remain closed.  Please confirm with us that your appointment is still valid before heading out to see us. Please also TAKE THIS STAY-AT- HOME EDICT SERIOUSLY. Even though there are no cases of COVID-19 in children, your children can still bring the virus home to you on their hands and clothes.  The longer that people disregard the social distancing guidelines, the longer our lifestyles and the economy will be held hostage by the spread of the virus.  Today I was speaking with a 90 year old woman who was reminiscing about the polio epidemic of her childhood (causing infantile paralysis.) She remembers the closure of swimming pools, movies, and ball games.  That epidemic came to an end, and so will this one.
Remember that we still have a portal available through our website www.okunortho.com for you to view your appointments, images, and financial information.  You can print out any information you need to submit your healthcare finances for flex plans and tax documents.
Many of you are home schooling your children.  We will be posting home schooling ideas in future posts.  As always, remember to keep your teeth and braces clean, use fluoride rinse, wear your elastics, retainers, guards, and headgears as prescribed.  This current situation may slow down the progress of your treatment because I can't see you monthly, but you can certainly keep your treatment moving forward.
Dr. Okun

Friday, March 20, 2020

Keeping You Safe at Okun Orthodontics during the CoronaVirus Pandemic



We closed our office at Okun Orthodontics, except for urgent care/emergencies, for the last three weeks of March, ending April 5, 2020, at the recommendation of the American Dental Association and the Department of Health because of the COVID-19 pandemic. When we re-open in April we will continue to follow precautions to limit the spread of Corona Virus.  Steps we have incorporated for the foreseeable future include:



Distancing: All patient families will be sent to different room to await their turn.  The goal is that one family does not breathe on another.  If your family group is too large for the treatment room, please have some of your family members wait in the car.  If anyone in your family is sick, please leave them at home. In addition, we will not be greeting anyone with handshakes and hugs.


Hand Washing: Upon entering a treatment room, everyone will wash their hands with antimicrobial soap and water.



High touch areas will be minimized and disinfected: Doors to the stairwells and to our office are propped open so that you do not need to touch doorknobs. Handles of waiting room chairs as well as treatment room surfaces will be disinfected frequently.



Pre-treatment rinsing: We have ordered ioRinse, a natural and organic antiviral mouthwash which does not contain alcohol, for patients to use before treatment. IoRinse has been proven effective at inactivating Coronavirus, Rhinovirus and Norovirus at 25ppm molecular iodine. The ioRinse formula is 4x the experimental strength. By pretreatment rinsing we will minimize generation of airborne virus during our procedures.



UV light: We have six Germguardian UV-C Air Sanitizers to kill airborne pathogens. They are located in all "patient access" rooms of the office.



Air circulation: We are leaving the windows open and are using fans to circulate the air. Before the age of antibiotics Tuberculosis and Influenza were treated with fresh air and sunlight. Patients in open air tents did significantly better than patients in closed barracks.



During difficult times it is important to work together. I have always stressed the team approach to our patient’s treatment and look forward to your participation in the team effort to control this pandemic crisis.
Judith A. Okun DMD
14 Rye Ridge Plaza, Suite 243, Rye Brook, NY 10573 (914) 253-0722

Orthodontic emergencies during the CO""VID-


Dear Patients,

Under normal circumstances, I have always made every effort to see every “emergency patient” in a prompt manor. Unfortunately, we are not living in normal circumstances.  I am following the guidelines of the American Dental Association and The Department of Health in keeping the office “closed” except for urgent or emergency care for the next two weeks to minimize the spread of Corona Virus.

If you are in pain please call.  I will be seeing emergency appointments on Tuesday March 24, Wednesday March 25, Monday March 30 and Wednesday April 1, by appointment only.  We will resume a full schedule starting the week of April 5.

Please read the following guidelines for emergencies:

Loose brackets: While a loose bracket is an emergency that we would like to see within a few days during normal times, during this CoronaVirus pandemic we need to follow a different standard.  If the loose bracket is not causing pain, and is not attached to a chain elastic (that is where the colored circles are connected to each other in an elastic chain), it can wait until after the current ban on elective treatment.  If you have a question as to whether it is an emergency, take a picture of it with your phone and email it to drj@okunortho.com.  Dr. Okun will evaluate if it needs to be seen immediately.

Loose bands: If the metal ring on your back tooth comes loose it should be removed so that you don’t chew on it.  If you can’t remove it from the end of the arch-wire it is an emergency.  If it is attached to a palatal expander it is an emergency. If removing it prevents you from wearing a head-gear we need to evaluate on a case by case basis. Call the office and leave a message.

Arch-wire pokes: If the arch-wire has slid to one side and is poking you please try to push it to the other side using a needle nose plier.  If you cannot, and if wax does not stay on the end, this is an emergency, but may need to wait a few days until we have a cluster of emergencies to see.

If a retainer or guard is broken, wear the larger piece but save the smaller one. Take a picture of it and email it to us to see if you need to be seen immediately. If a retainer is broken and the pieces stay together when it is in your mouth and are held together by the wire when it is out of your mouth, continue to wear it but call so that we can schedule a repair appointment.

I will continue to check the office answering machine (914) 253-0722 so that I can return your calls. If you are having an emergency that can’t wait for a call back please also email me at drj@okunortho.com.

As Mayor Tom Roach (of White Plains) tells us, “We are stronger together when we stand apart.”  Stay at home, stay healthy, and I’ll see you soon.  
Dr. Okun

Tuesday, April 2, 2019

Headaches and Sinus Rinsing


Spring Allergy season is here, and so are the associated headaches, itchy eyes and runny noses.  Did you know that sinus pain can manifest as upper tooth pain?  Did you know that Sinus pain can increase the severity of a TMJ headache that is caused by clenching and grinding of your teeth?
One simple, over-the-counter method for managing sinus pain is sinus rinsing.  This is a volume rinse of warm sterile saline which decreases the volume of irritants (and allergens) in the nose and sinuses, decreases the inflammation of the mucous membranes which line this respiratory region, and decreases the accumulation of mucus. Sinus rinsing can be performed daily, does not interact with any medications, and will clear the way for topical medications (like nasal steroids) to reach the inflamed surface.
The old fashioned method of sinus rinsing is with a Neti Pot, but this delivery method requires an abnormal tipping of the head which can irritate neck and jaw musculature.  The newer method, made by NeilMed, is a plastic bottle delivery system with a cone shaped cover which extends to a straw that inserts in the bottle.  Warm pre-boiled water is placed in the bottle up to the dotted line (8 ounces) and a buffered salt packet is added.  To rinse, lean forward over the sink, place the dome shaped cap in one nostril, and squeeze gently.  The water will go up one nostril, and if the path is clear, will descend the opposite nostril.  If the path is not clear, simply remove the bottle and let the saline drip out.  Blow your nose to remove the loosened mucus and rinse again until 4 ounces have been used for each side of your nose. (Do not squeeze the bottle hard. It will cause the salty water to go down your throat.)
It takes time for water to boil and cool to the correct temperature, so I have come up with a short cut.  I keep a tempered glass bottle (from marinara sauce) by my stove.  Every time I have boiled water for another use (like tea or coffee) I save the extra in this jar.  This way I have a store of room temperature pre-boiled water.  When I am ready to rinse my nose I put only 3 ounces of water up to boil. While it is cooking I get my NeilMed bottle and salt packet from the cabinet, pour 5 to 6 ounces of pre-boiled water into the bottle, and add the salt packet.  By then the new water has come to a boil, and I add the hot water until I reach the 8 ounce line.  I shake the contents, and check the temperature on my wrist before rinsing so that I know the saline will not be hot enough to burn before using it to rinse my nose.  I sinus rinse when coming in from time outdoors during seasonal allergy seasons, and after being in an area which is too fragranced (air fresheners and perfume) or too smoky (from smokers or fireplaces.) I also wash my face and hands, and if possible, shower and change into clothes that do not also smell from the allergen environment.  In this way I am not re-breathing the same irritants all night long. In addition to decreasing headache pain, sinus pressure and nasal stuffiness, post nasal drip and nasal congestion. Keeping the time of the allergen exposure short also decreases the severity of other allergy issues like asthma.
http://shop.neilmed.com/Products/Sinus-Rinse/Sinus-Rinse-Regular-Kit

Sunday, September 23, 2018

At the high school reunion of the first 5 graduating classes of Blind Brook High School, last night we recognized the teachers who helped develop who we are and honored Bruno Ponterio, our elementary and middle school principal. While I am mourning the aging and loss of my parents’ generation and recognizing the one year anniversary of the death of my Uncle Jack Kabcenell, I am also feeling the loss of my own generation. Last night I heard of the recent death of Billy Russillo, and the not so recent death of Jeff Sollender. May they, as well as Seth Baygell, Roopi Sethi, Jennifer Johnson, Mitchell Quat and David and Melissa Heinsohn always be remembered.