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Written by Stacie M. Waldman

Published: 23 January 2018

Created: 23 January 2018

Last Updated: 23 January 2018

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Why are the third or final set of molars called wisdom teeth? Because they usually grow when people are in their late teens or early twenties. In and of themselves, wisdom teeth are not a problem, but more often than not they are misaligned or cause other issues in the mouth.

Wisdom tooth removal has become a popular rite of passage for graduating high school students because many dentists and surgeons recommend removal of these teeth prior to, during, or just after college. There seems to be a lot of confusion and concern about why one would choose to remove these teeth if they're not causing acute pain or other issues. We contacted Dr. Benjamin Kur of Westchester Oral & Maxillofacial Associates to learn more.

Dr. Kur is in his tenth year of practice as a board-certified Oral and Maxillofacial Surgeon. I had a chance to chat with him to find out about the risks and benefits of the procedure and who should consider it.

What are the indications for wisdom tooth removal?
Indications for wisdom tooth removal include:
• Pain
• Crowding in the mouth (not allowing second molars to erupt properly)
• Wisdom teeth growing in at an angle (or incorrectly positioned making second molars susceptible to bone loss because it's hard to clean between the second and third molars)
• Cysts (these are benign but also contribute to bone loss in the second molars)

Why is potential bone loss an issue and therefore an indication to remove wisdom teeth?
Dr Kur said, "According to the literature and the American Association of Maxillofacial Surgery, if a person 26 or younger has their wisdom teeth removed, the body will regenerate bone and it is much more likely that there will not be severe issues related to bone loss like a periodontal pocket, for example. Bone will actually regrow on the back of the second molars through age 26. A lot of times we see patients in their 30,'s, 40's and 50's who still have their wisdom teeth with irreversible damage. The second molar becomes susceptible to loss, a much more serious problem," Dr. Kur explained.

Is the preventative removal of wisdom teeth elective surgery?
Dr. Kur reiterated that there are specific indications for wisdom tooth removal. Even if a patient is not currently in pain, it does not mean the surgery is elective. "It's a necessary surgery for many people," he said. "The whole reason we encourage parents to have their kids' wisdom teeth removed before age 26 is not just prophylactic. The evidence suggests that after the age of 26 the body's ability to regenerate bone is diminished. Preventative is not the same as elective. In my professional opinion impacted wisdom teeth should be removed if indicated in 14 to 26-year-olds." Surgery is only indicated for specific situations, according to Dr. Kur. "For example, if a 43-year-old came into my office with impacted molars and they weren't bothering him, we wouldn't recommend removal; his body's ability to regenerate bone if there was bone loss in his second molars would be minimal and the benefit of the procedure would not outweigh the risks. However," he added, "this would not be the same recommendation we would make for a healthy 15 or 24-year-old because the benefits of removing the wisdom teeth would exceed the risks based on bone regeneration potential, among other things."

What are the risks associated with wisdom tooth removal surgery?
Dr. Kur explained that there is a common misconception about the procedure. "There's a nerve that is housed in the mandible, or lower jaw. That nerve provides sensation but no movement. So, one common misconception is that a person will have a droopy lip or a part of their face won't be able to move. Numbness that persists for a short period of time can be an issue in a small number of people who are predisposed to this," Dr. Kur said. "Sometimes we take a Cone Beam CT Scan to see where the nerve is in relation to the roots and therefore the nerve. We may also do a partial tooth removal so as not to potentially disturb the nerve. We always remind patients that this nerve does not supply motor function, just sensation, so the only nerve-related risk is related to sensation and not movement." Whereas there are risks to this and any surgical procedure, Dr. Kur also emphasized the risks of not removing wisdom teeth can be substantial and should be understood by the patient and his/her parent or guardian.

Can a patient have their wisdom teeth removed by a dentist? How may this procedure differ from having it done by an oral maxillofacial surgeon?
According to Dr. Kur, a patient can have their wisdom teeth removed by a general dentist. However, Oral and Maxillofacial Surgeons are highly trained in anesthesiology. "We recommend that patients are IV-sedated for this procedure. It relieves patient anxiety and fear and makes the experience much more pleasurable for the patient. Although the patient is sedated, they are conscious and breathing on their own. Being sedated is also related to patients using less pain medication post-operatively. The majority of patients do choose IV sedation/anesthesia and are glad they did for both their comfort and safety, both of which are our priorities."

What is done to make patients comfortable post-operatively and what is the recovery like after wisdom tooth removal?
In most cases Dr. Kur uses dissolvable stitches and the recovery period is usually 3-5 days of post-operative swelling and soreness. "We are very cautious with pain medication these days and we usually recommend prescription-strength ibuprofen." He added that most people return to work or school within two to three days.

This post is sponsored content from Dr. Benjamin Kur who lives in Scarsdale. Find him at work in Hawthorne/Valhalla directly across the street from Westchester Medical Center. Valet parking available (no tips accepted). He is currently welcoming new patients.

Dr. Benjamin Kur
Westchester Oral & Maxillofacial Associates, PLLC
www.westchesteroralsurgery.com
914-592-0440

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Written by Emmeline Berridge

Published: 08 February 2018

Created: 08 February 2018

Last Updated: 08 February 2018

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The departure of Scarsdale's Boys Varsity Basketball coach Bill Murphy has caused a ripple effect throughout the School community. In addition to Murphy, Head Lacrosse and Assistant Field Hockey Coach Genette Zhongetti has been let go from her position, just a month before preseason of Lacrosse, and head Field Hockey Coach Sharon Rosenthal just resigned as of today. The recent coaching turmoil leaves Scarsdale needing to fill 3 head coach positions, and begs the question: what's going on in the athletic department?

In an email sent to players and parents on Wednesday, January 31st before the basketball team's game at New Rochelle, Scarsdale Athletic Director Ray Pappalardi said that Murphy would not be attending the game. The Raiders lost 51-49, dropping to a record of 10-7 for the season. Following a meeting with Pappalardi on February 2nd, Coach Murphy, who was just four regular season games from the end of his third year with the program, was abruptly let go from his position. Last season, Coach Murphy was named Section 1 Coach of the Year, and led the team to a stunning overtime loss against Mount Vernon in the Section finals.

Pappalardi met with the team on Friday, unable to disclose most information. The following days gave way to a host of questions and overall confusion, even from within the team. Saturday practice was cancelled. The Athletic Department returned the next day with news that Assistant Coach Justin Washington would fill the position of interim head coach. There are conflicting reports on almost every detail of this story: Murphy was either fired or forced to resign, although it is unclear if he ever signed any formal paperwork. The incident allegedly began as a result of complaints from one or two parents about Murphy's conduct on the team's two annual trips to Miami. According to comments by Murphy, he is under the impression that a parent, whose senior child was suspended for inappropriate actions toward an assistant coach in a game earlier this season, wanted him out of the coaching position. The parent cited both trips, when Murphy had been drinking in front of the players and apparently drove them in a van (this information is unclear as well), as concerns about his professionalism and lack of regard for player safety.

On Saturday afternoon, Murphy reached out to the community via email. He emphasized the importance of transparency in the situation and arranged a forum at Willow Ridge Country Club on Monday, February 5th at 7:30 to bring closure and to clarify any unanswered questions. During the forum, the aforementioned parent arrived with a lawyer in order to prevent any defamation of character. Murphy was given the opportunity to tell his side of the story and address larger concerns he had about the nature of the conflict. He recognized parental power and influence over the administration as a central problem, admitted to drinking one social beer while on the trip, and emphasized that he was not drunk at any instance. According to a story in the Scarsdale Inquirer, Murphy said, "I had a beer on this trip, yeah ... It's what you do as a coach. Not everybody, but you're in Miami, you have a game, you play hard; yeah, you have a beer."

A number of players and parents spoke at the forum, expressing their support for Coach Murphy and their discontent with the manner in which the process was handled. A parent-organized committee has been formed to exonerate Murphy's name and address the growing issue of how the school handles parent involvement in athletics decisions.

The Scarsdale Board of Education also met on Monday night. Assistant Superintendent Andrew Patrick addressed the matter, saying, "We have a recommendation from the administration to terminate boys' varsity basketball coach Mr. Billy Murphy. The board met with the administration to discuss this matter. Clearly severing a coach-athlete relationship in the middle of a season is a very serious step to take. We do not make this recommendation lightly. We do not think this step should be used to draw any broader conclusions about our coaching staff or program as a whole. Rather this decision is about the conduct of one individual and the safety and well being of all of our student athletes."

Even without Murphy the team still had a game to play against White Plains on Tuesday night (2/6). Before the game, Athletic Director Ray Pappalardi and Principal Ken Bonamo met with players and parents, and "several concerns were raised," according to an email sent by Pappalardi to the parents of the JV and Freshman Boy's teams. The administration addressed a number of issues in the email, including the safety of student athletes on the court, the lack of communication from the district (which has allowed others to fill the void), the turnover of coaches creating an unattractive environment for good coaches and ineffective methods for communicating in emergency situations. The administration also consulted with the team whose members expressed the desire for a head coach who "knows them well and who would not deviate from the current system," as they are just a week away from playoffs. This is how the decision was made to choose assistant Coach Justin Washington as the head coach. Pappalardi ended the email by noting, "although I regret the disruption caused for our student athletes and their families, I know we have acted in the best interests of our students."

Tuesday's game against White Plains celebrated the seniors in their annual Senior Game, an interesting close to a dramatic weekend for the Boys Varsity team. The team started off slow, down 20-29 against a team that they had beaten earlier this season. However, they picked it up in the second half and ended up defeating White Plains 65-60, giving Washington his first win as head coach.

Hearing the roar of the packed student section midway through the second half, it would be difficult for an outsider to recognize that anything had gone wrong at all. Still, the unrest sparked by Murphy's removal is far from being quelled. This incident opened up a chasm of deeper issues within the athletic department, including the role of parents in the decision making process for Varsity teams. The Boys team continues its season Thursday February 8 at Mount Vernon and Saturday February 10 at home for the Maroon and White tournament.

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Written by Joanne Wallenstein

Published: 16 January 2018

Created: 16 January 2018

Last Updated: 17 January 2018

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How high are the retaining walls in front of the proposed addition at Greenacres? Where will the storm water go and what about the humid conditions in the gym? We posed some questions about the renovation and expansion at Greenacres School to Assistant Superintendent Stuart Mattey in December and received his responses on Thursday, January 11, 2018. The questions concerned the siting of the building, air quality, the budget and sustainability.

Though some of the answers beget more questions, here is what we learned:

(Question) There is a $1,000,000 budget line for historic renovation/preservation premium allowance. Please explain how those funds will be used:

(Answer) These funds have been budgeted in the proposed bond in order to provide the ability for enhanced detailing, both interior and exterior in order to preserve, maintain and further the integrity of the historic architectural elements/qualities of this building.

(Point of information:) The building is not included on the state or federal register of historic buildings.

(Question) What is the contingency % for the renovation at Greenacres and where can I find those funds in the bond proposal?

(Answer) As per normal scope estimating, all estimates for all of the identified scope items in the proposed project include a percent amount set aside for contingency (approximately 17%) there is also contingency for cost escalation (5%) and 13.5% set aside for soft costs.

(Question) What is the plan for drainage and storm water management? The size of the building will expand and pretty much cover all the building site – where will the water go?

(Answer) The proposed addition and associated disturbance is below the 1-acre threshold for storm water management (established by the NYSDEC) and does not require post construction storm water management practices. However, the project design has elected to incorporate storm water management controls into the scope and consulted with the village on a schematic level. Roof runoff, as a result of the new addition coverage, will be captured and mitigated using an appropriately-sized underground storage facility (vault) that will detain and control the release of storm water into the existing municipal separate storm sewer system. Mitigation will be achieved by controlling up to the 100- year, 24-hour rainfall event back to below pre-construction flow rates.

Air Quality

Humidity levels in the gym were reported at 65% in October, 2017. The new renovation calls for the existing windows to be covered up by the building addition. Air conditioning will not be included for the gym. The district's report says, "The chief problem with high indoor humidity from a health standpoint is the potential for mold growth. Humidity levels greater than 30% increase the potential for mold growth and high humidity, 60% or greater can cause biological contamination." The humidity levels in on the lower level of the school ranged from 63% to 71% and the humidity in the gym was measured at 65%.

Therefore we asked Mattey the following question:

(Question) Please let us know how fresh air will be brought into the gym and how the humidity will be decreased?

(Answer) Fresh air will be brought into the Greenacres gym via the existing relatively new heating and ventilating units, which operate to current code. Filtration will be added on the outdoor air intakes to reduce any intake of dust. Humidity would be controlled the same way it is currently, through the introduction of fresh air. That space will essentially remain the same as its current operation which is similar to all other buildings except for Heathcote where a ventilating unit is proposed in the project as it currently does not have one.

Building Design

We also noted that the renderings of the proposed building show the elevation from an aerial view or a point way out in the field. They do not show how the building would appear to a person standing on the sidewalk in front of it. Some have expressed concern that since the proposed three story building extends almost to the sidewalk on Huntington Road, it will be imposing and out of scale with the neighborhood.

Therefore, we requested that architect provide a rendering from the vantage point of a person standing in the plaza at the Huntington Road side of the school. We asked for a drawing that shows the view up to the roof and to each side.

Mattey responded: "The architect is currently working on additional renderings now that the BOE has approved the project to move forward to District voters. "

We are also concerned that the new building is being cut into a hill, requiring the use of retaining walls. We asked, "What is the height of the retaining wall in front of the building?"

(Answer) The retaining wall in the student gathering area starts at 18" as a bench and rises to a height of 60"  (5 feet) of which will include that same 18" bench (18" of bench + 42" of retaining wall at the highest point). The retaining wall immediately outside of the Learning Commons will start at approximately 60" at the new entranceway and gradually decrease to approximately 12" as it approaches Sage Terrace.

Do you have questions about the proposal? Post them in the comments section below and we'll see if we can get some answers.