This interview is with Avi Israeli, Dental Implantologist / Owner at Sage Dental NJ.

Avi Israeli, Implantologist / Owner, Sage Dental NJ

Avi, could you please introduce yourself to our audience at DentalNews.io and share a bit about your background and expertise in dentistry?

My name is Dr. Avi Israeli, and I am an Implantologist specializing in Full-Arch All-On-X ImmediaTEETH® Dental Implants. For the past 18 years, I have been dedicated to restoring patients' smiles in private practice and am proud to be one of the pioneers of the all-inclusive concept for implant treatment.

In 2006, with the support of my business partner and wife, Deborah, I established Sage Dental NJ. The name "Sage Dental" was inspired by the green Ethan Allen wallpaper that adorned our original office. I introduced the innovative concept of offering comprehensive implant care under one roof, allowing patients to have their individual implants placed and restored in a single location. This approach not only simplified the process but also provided significant cost savings.

By 2021, our practice had grown to include eight operatories, and I decided to further reduce overhead costs by building an in-house dental lab. This move led Deborah to develop our all-inclusive pricing methodology, a unique approach designed to keep dental care affordable for our patients. Currently, I produce over 40 arches per month, consistently and routinely, for the past three years.

What path led you to specialize in the field of dentistry, and what particularly fascinates you about addressing missing teeth?

To be honest, I initially aspired to pursue a degree in medicine like my brother. However, I performed much better on the DAT, the entrance exam for dental schools, which led me down a different path. I didn't start off particularly strong in dental school, but I found my passion through an Esthetic Dentistry residency, essentially the first year of a Prosthodontics program. This interest led me to earn a proficiency certificate and gave me the basis to hand-design functional restorations. I became deeply fascinated by dental occlusion, form and function, and the blend of aesthetics with balanced functionality. A turning point came when I received one-on-one mentorship in Dental Implant Surgery from the current president of the AAID. This experience opened my eyes to an entirely new aspect of dentistry that I not only loved but also excelled in.

Can you recall a particularly memorable patient case involving a missing tooth that posed a unique challenge, and how did you approach their treatment?

I typically approach patients with the assumption that they may not be fully informed, so I take the time to educate them in a practical and understandable way about their treatment options and potential outcomes. Most of the patients I see have severe periodontal disease, which has led to loose or broken teeth, a history of substance abuse that has significantly damaged their teeth, or past restorative dental work that has since failed, resulting in underlying decay. In most cases, their teeth need to be removed, and a full-mouth of implants is necessary. The majority of my patients present challenging cases. Each one is unique, and I rarely encounter 'easy' patients. It would be difficult to single out just one case, as many of my patients require complex and extraordinary treatment plans.

Based on your experience, what are some common misconceptions patients have about replacing missing teeth, and how do you address these misunderstandings?

Patients often assess the significance of their missing teeth based on their location. If the gap isn't visible when they smile, they might ignore it until it becomes a bigger issue, such as when surrounding teeth start to loosen or fall out. What many patients don't realize is that missing teeth lead to bone recession, which, over time, can impact neighboring teeth. This is typically how the downward spiral of tooth loss begins.

What advancements in dental technology have you witnessed throughout your career that have significantly improved the treatment options for missing teeth?

Over the past 22 years in dentistry, including 18 years in private practice, I've witnessed remarkable advancements in technology and aesthetics. Today's dental implants are far more sophisticated, causing less trauma to patients, enabling faster recovery times, and achieving higher success rates in integrating with the surrounding bone. Recently, the emergence of in-house labs has allowed dental professionals to regain control over aesthetics, form, and function. The introduction of surgical guides and even robotic assistance for more precise implant placement has also become a reality. These innovations have led to improved accuracy, increased longevity, and a wider range of treatment options for my patients.

When considering different treatment options for a missing tooth, such as implants, bridges, or dentures, what factors do you prioritize in your decision-making process with the patient?

I consider myself, above all, an ethical practitioner. If there's a chance to save a patient's teeth, I will always prioritize and recommend restorative treatment plans. However, many of the patients who come to see me have decay that is too advanced to justify saving their teeth. In these cases, I typically suggest one of two treatment options: ImmediaTEETH® Zirconia All-On-X Full-Arch Dental Implants or ImmediaTEETH® Hybrid All-On-X Full-Arch Dental Implants. Both options involve the removal of teeth, bone grafting, implant placement, and the attachment of a permanent, non-removable bridge—all in a single day. This approach is particularly appealing to my patients because they can simply take a nap and wake up with a full set of non-removable teeth.

How do you counsel patients on the long-term implications of not replacing a missing tooth, and what impact can this decision have on their oral and overall health?

It's straightforward—if patients choose to 'ignore' their missing teeth, the bone will eventually recede, leading to neighboring teeth becoming loose or breaking, which can ultimately result in complete tooth loss and the need for full-arch implants. Addressing the issue early by replacing the missing tooth with a single implant can help prevent or delay significant tooth loss. When a patient has numerous missing teeth, their ability to consume healthy, vitamin-rich foods essential for optimal health and longevity is significantly reduced. It's often said that all disease begins in the mouth. Therefore, a proactive approach to overall health begins with the preservation of teeth and the surrounding bone.

In your opinion, what are the most important qualities for a dental professional to possess when helping patients navigate the challenges of a missing tooth?

Understanding the problem and exploring potential solutions is essential for case acceptance. I prefer to explain scenarios in relatable, everyday language. I often use the analogy of building a house to illustrate the difference between 'restorative' dental work and full-arch implants.

If you see a house that needs repair, you have two options: you can either strip the walls down to the foundation and rebuild around the existing structure (similar to restorative dentistry, including single implants, crowns, bridges, etc.), or you can demolish the house completely and start from scratch (akin to full-arch implant treatments). In the first scenario, you're constrained by the existing structure and must 'build around' what is already there. In the second scenario, you're starting from the ground up, which allows you to address issues like an overbite or a gummy smile—problems that wouldn't be corrected by simply working with the existing framework.

Thanks for sharing your knowledge and expertise. Is there anything else you'd like to add?

When you truly love what you do, it doesn't feel like "work"—it becomes a way of life.