__Contactless check-in__

When you book a visit, we’ll collect your [insurance](/insurance) and credit card info digitally before you come in. This helps ensure a [contactless check-in](/thegargler/reimagining-dentistry-for-a-post-covid-world) experience at the studio, with nothing changing hands. And it saves you time, for a shorter, safer visit. We’ll also tell you exactly what you’ll owe, so there aren’t any surprises.

__Pre-visit health check__

Before you come in, we’ll get in touch to ask if you’ve had any symptoms of illness, or if you’ve been around anyone sick. If you have, we’ll ask you to reschedule—and make doing so super easy. Taking this step is the best way to keep everyone healthy.

__Follow-up health check on arrival__

When you arrive, you’ll find yourself in a clean, modern studio. You’ll be greeted by a team member in gloves and a mask who’ll [take your temperature](/notice) with a contactless thermometer. If your temperature is within normal range, great. If you show signs of a fever, we’ll ask you to reschedule. We’ll also ask you again if you’ve had any symptoms of illness, or if you’ve been around anyone sick, in case anything has changed. 

__Required hand sanitizing, masks, and social distancing__

After your health check, we’ll show you to a hand sanitizer dispenser and ask you to sanitize your hands. We require masks in the studio. If you forgot to bring your own, we’ll provide you with one. We also require everyone to maintain social distancing.

![02 Staggered Visits](//images.ctfassets.net/otz9p93fkvjx/1HYU7euJY5xIyY6VnWVOiw/5ab008420e4048053ae393ae8b672cf3/02_Staggered_Visits.jpg)

__Staggered visits and no waiting__

The studio will feel calm and quiet. This is because we stagger when our members come in for minimal overlap, [as recommended by the CDC](https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html). You’ll be seen right away, with zero waiting, so you don’t need to sit in any common areas.

![03 Welcome Gift](//images.ctfassets.net/otz9p93fkvjx/4Oqob4MvTgMDnLWNGevKpO/43757a438b8b39ddd39a78edcc50ceaa/03_Welcome_Gift.jpg)

__A welcome gift__

Before you’re seen, we’ll give you a welcome gift: a prepacked Brush Bag with oral wellness products curated by our dentists.

![04 Suite For You](//images.ctfassets.net/otz9p93fkvjx/M2D0zjxeQNi5AXWXIMz63/b90c2e0b8f6894ce92b04712980ac13b/04_Suite_For_You.jpg)

__A suite prepared just for you__

After you’re checked in, we’ll show you to your suite, which we prepare just for you. All surfaces are sanitized with medical-grade disinfectant before you come in, and all equipment is single-use or medically sterilized, a process that kills 100% of germs, including viruses. Your suite has personal space where you can hang your coat, leave your bag, and charge your phone. If you chose a TV show to watch when you booked, it will be queued up on a ceiling-mounted TV over your chair. If you didn’t choose one, you can do so when you sit down.

__Enhanced PPE__

Wearing gloves and a mask is standard practice for dentists, hygienists, and dental assistants. Our clinical team members wear this personal protective equipment at all times. And for [enhanced safety](/notice), they also wear face shields.

__Fast, comfortable, and safe imaging__

Our state-of-the-art Planmeca Promax 3D imaging machine moves around your jaw instead of poking the roof of your mouth or making you gag. This machine turns x-rays into a comfortable, 30-second process. Because the machine is less invasive, it’s less at risk of spreading germs. It also uses 80% less radiation.

![05 Thorough Cleaning](//images.ctfassets.net/otz9p93fkvjx/6b1R4REld286tFfNgRvCHu/d9cc9bdeb17bdeb43e09f5f424ce9f29/05_Thorough_Cleaning.jpg)

__A thorough, gentle cleaning__

After you’ve wrapped up your imaging, you’ll return to your suite. Your hygienist will give you a thorough, yet gentle cleaning, using a topical numbing gel so you won’t feel a thing. 

The tools we use are quieter, gentler, and less intrusive, so you can focus on the TV show you’re watching overhead.

__A beautifying polish__

When your cleaning is finished, your hygienist will give you a polish to remove any cosmetic staining on your teeth. You’ll get to choose between mint polishing paste or a fun flavor like vanilla while you keep watching TV.

![06 Expert Exam](//images.ctfassets.net/otz9p93fkvjx/1GQh1bzmLStbK6y5U3FrsS/ad91d04d3936acaa44252c2fd391f8cf/06_Expert_Exam.jpg)

__An expert oral exam__

When your polish is finished, your dentist will come in and answer every question you have. Then they’ll examine your mouth and talk to you about your oral health with zero judgment. As part of your exam, you’ll get a complementary oral cancer screening. Since the mouth can be a front-line indicator of many diseases, dentists can identify early symptoms before they become more serious.

__Only the care you need__

If your dentist recommends additional care, they’ll show you exactly why by showing you a picture of your mouth on a screen. And you can make a decision about whether to proceed confident that your doctor’s interests and yours are truly aligned. [Our doctors aren’t paid a commission](/about) on procedures, so they only offer the care you actually need.

__Same-day dentistry__

Instead of asking you to come back at another time for treatment, we offer same-day dentistry. This reduces the number of trips you need to make, limiting exposure to germs while in transit. If you’d prefer to come back at another time instead, that’s completely fine.

__Contactless check-out__

That’s it. Your checkup is finished. If you owe anything for your visit, we’ll charge the card we have on file, so nothing needs to change hands. We’ll see you in six months!


Care at Tend isn't just painless, it's a pleasure.

Safe, soothing dentistry

When you book a dental exam with Tend, here’s what to expect.

01 Contactless CheckIn

Your First Tend Visit

The Gargler | Digital Oral Health Magazine - Tend

When we launched Tend a year and a half ago, one of the ways we wanted to reinvent dentistry was by using technology to make it more convenient. No more calling the office to book an appointment. No more difficulty finding availability as you and the office staff verbally compare schedules. No more rusty clipboard of paperwork handed to you when you come in. No more sitting around in the waiting room filling out forms in handwriting that doesn’t get a lot of practice. 

![full-bleed-2](//images.ctfassets.net/otz9p93fkvjx/2r21WL00JAJk0t9mlNrmyp/5f7b243c3823b2938ec3b4db3c2dbeb8/full-bleed-2.jpeg)

__A more convenient experience__

With the launch of our app, we just took a major stride in that direction. In our app, you can book a visit in just a few taps. You can choose from a wide range of times at a convenient variety of locations. If you need to reschedule, it only takes a few seconds. Before you arrive, we collect your insurance information and give you our best estimate of what you’ll pay. We also collect your medical information and your visit preferences, like what flavor of polishing paste you’d like and what TV show you want to watch when you come in. If your insurance information changes, you can simply open the app and update it—no waiting at a desk while someone types in a long sequence of numbers and letters. If you need orthodontic treatment, oral surgery, or cosmetic treatment, you can book a consult through the app with one of our amazing specialists. 

![in-line-3](//images.ctfassets.net/otz9p93fkvjx/7jIxxAIBwfmjLJyE06fpnC/436dc28e7bc9d09d7c0625a367c8e580/in-line-3.jpeg)

__Personal empowerment through education__

Our app also teaches you more about your mouth with articles from The Gargler, our digital magazine devoted to oral health. The Gargler features expertise from our Head of Clinical Development, Dr. Marc Schlenoff. Dr. Schlenoff is a Clinical Instructor and Lecturer at Aesthetic Advantage at NYU College of Dentistry and a former Program Director at Columbia University’s College of Dental Medicine. 

__The start of something big__

The dental industry has never seen anything like this: an easy way to book and manage your visits and get tips directly from acclaimed clinicians. But the version of the app we’re launching today is only the beginning. Creating a tech-enabled experience has always been key to our mission, and we plan to continue to invest deeply in our digital products. Here’s what you can expect to see in our app in the near future.

![in-line-4](//images.ctfassets.net/otz9p93fkvjx/4KLnxVGGNkkvV4cUCXn4tf/8f543508af2dc6998d632cbc953cb19f/in-line-4.jpeg)

__Sophisticated treatment planning__

Before, if your dentist recommended treatment or provided you with pre- or post-treatment instructions, that clinical information would either be entirely verbal and easy to forget, or it would only be captured in a printout and easy to lose. Soon, Tend members will have an entirely different experience. When their dentists recommend treatment, that recommendation will appear in the app. It will be accompanied by detailed information about the treatment in question, including answers to commonly-asked questions and the treatment’s cost. If a member proceeds with the treatment, they’ll receive pre-visit instructions in the app, and emails will remind them to view the instructions before they come in. After treatment, post-visit instructions will appear in the app as well. 

__Unprecedented insights into your oral health__

We think of the app as a way of putting you in control of your data. Before, your data was in a paper file at your dentist’s office. Soon, it will be in your hand. Want to see your x-rays? Just tap. Want to see a model of your teeth and gums with any treatment recommendations flagged? With the Tend app, you can. We’re taking what used to be inaccessible and making it accessible, so that you can digest it and make more informed decisions about your oral health. 

__Take smarter care of your mouth__

Download the app for [iOS](https://apps.apple.com/us/app/tend-dental/id1563915028) or [Android](https://play.google.com/store/apps/details?id=com.hellotend) and give it a spin. We’d love to hear what you think.

Today, we're thrilled to announce a major milestone in Tend’s history as a company—and in the history of dentistry. We are launching an app. This is the first app ever launched by a dental services provider—a sign of just how little the industry has invested in digital technology, and of how much room there is to grow.

full-bleed-1

square-hero

The First App from a Dentist

Maybe you went to your dentist with discomfort. Maybe you were referred to an oral surgeon. Or maybe you went to a routine dental exam without any symptoms and the implant recommendation came as a complete surprise. 

__And now you’re looking for a second opinion.__ 

This is extremely common. And we recommend it. An implant can be an amazing way to restore a missing, damaged, or broken tooth. But it’s a serious commitment. And a significant investment. So it’s crucial to: 

  A. Be absolutely sure you need one. This means ruling out less complex and costly alternatives, like a bridge, a root canal, or a removable appliance like a partial denture.

  B. Put your mouth in the best possible hands. This means having a doctor you love, whose guidance you trust 100%.

__Second opinions at Tend are the most objective.__

Tend is New York City’s top-rated dental studio, with 6 locations across Manhattan and Brooklyn. When you get a second opinion with us, the recommendation you receive will be completely impartial. This is because our general dentists aren’t paid a commission on procedures. They’re paid a salary plus a bonus tied to patient satisfaction. I.e. your satisfaction. So they’ll only recommend the care you need. 

If you don’t need an implant, they’ll tell you. If you do, they’ll tell you exactly why, walking you through the results of your imaging in detail. Then they’ll offer to book you a follow-up consult with one of our outstanding oral surgeons, who would place the implant if you decide to get it at Tend.

Either way, your dentist’s interests will be aligned with yours. That’s not true at other practices, where dentists make a commission on procedures, incentivizing them to be clinically aggressive.

![Joel Ayon Oral Surgeon](//images.ctfassets.net/otz9p93fkvjx/52ouVMDPdc1Cs6KP3AysgH/f81df664690307b80512cf0a3027caa9/Joel_Ayon_Oral-Surgeon_01.jpg)

__Tend has world-class doctors you’ll love.__

Not all dentists have extensive experience with implants. Our team does. When you [book a second opinion consult with us](https://www.hellotend.com/booking/studios?service=IMPCON), you’ll meet with an experienced general dentist at your local studio. These clinicians have been specially trained to evaluate clinical needs, and they work directly with our Head of Clinical Development, Dr. Marc Schlenoff, a former Program Director at Columbia University’s College of Dental Medicine. They’re also the top-rated dentists in NYC, with hundreds of reviews from patients who’ve had an amazing experience.

__Tend has beautiful, conveniently located studios.__

When you get a second opinion consult at Tend, here’s what you’ll experience. You’ll [book online](https://www.hellotend.com/booking/studios?service=IMPCON), fast, at a studio location that’s convenient for you, right by public transportation. When you arrive, you’ll enter a beautiful, soothing space and be greeted at the Welcome Bar. You’ll be seen right away (our average wait time is 3 minutes). Your care team will take images of your mouth and conduct a thorough exam. Then your dentist will patiently, clearly explain what they see and talk you through your options. No rushing, no jargon. We’re here to help.

Book a free 30-minute consult with one of the top-rated dentists at Tend.

Ready to get a second opinion on an implant?

So. You’ve been told you need a dental implant.

Tend dentist giving a second opinion consult to an implant patient

Implant Consult

Tend dentist giving a second opinion implant consult to an implant patient

How to Know for Sure if You Need a Dental Implant

There’s a lot of chatter around fluoride and its place in toothpaste and our public water: do we need it to strengthen teeth? Is it actually safe to use? The simple answer: though it isn’t the only way to strengthen teeth, fluoride is a safe and effective way to do just that. And there’s [over 70 years of research](https://www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation) to back it up.

__Fluoride prevents cavities__

Before we go deeper, let’s establish what fluoride is. Fluoride is a mineral that naturally occurs in our teeth, helping to strengthen the enamel that protects them from decay. Fluoride is incorporated into the mineral matrix that comprises the actual enamel, making it a key component in the preservation of your teeth.

You may be surprised to learn that at least [74.4% of the U.S. population has fluoride in their public water](https://www.cdc.gov/fluoridation/statistics/index.htm). Why? A study in the 1930’s [examined the correlation between tooth decay and water with naturally-occurring fluoride](https://www.cdc.gov/fluoridation/basics/index.htm). It found that communities with more fluoride had stronger teeth and therefore had less susceptibility to tooth decay. Because of these findings, cities around the United States started to put fluoride in public water in 1945. And the results have been astounding: [fluoride in water has prevented at least 25% of cavities in children and adults](https://www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation).

If you’re interested to see if your public water has fluoride, the CDC website provides a resource  for people living in participating states [here](https://nccd.cdc.gov/doh_mwf/Default/Default.aspx). If you’re in the 25.6% of places that don’t have it in their water, it may be more important to make sure fluoride is incorporated in your dental care routine.   

__Fluoride works in two ways__

The first is through ingesting it as a baby or child, as your teeth are forming. This is where having it in water becomes a factor: people born in NYC, for instance, initially have very strong teeth compared to people in areas with no fluoride in the water at all. In areas with water that doesn’t have fluoride, children can take vitamins with fluoride as a way to incorporate it into developing teeth, building the foundation to have strong teeth as an adult. (If your water has fluoride, this isn’t necessary.)

Fluoride also works topically, once the tooth is fully formed. Fluoride toothpastes and mouthwashes work by filling in the pores that exist in your teeth’s enamel with fluoride, thereby strengthening it against acidic or sweet foods, which can damage your teeth. A highly concentrated fluoride toothpaste can also be useful to lessen the sensitivity of teeth as we age. 

It is important to note, however, that while it can be important to use fluoride as an adult, the most crucial time for fluoride is the first 5 to 6 years of your life. After that, assuming you have good dental hygiene, using fluoride is more about maintenance.

__There is no evidence that suggests fluoride causes autism or cancer__

Now that we’ve established what fluoride is and what it does, let’s talk about the elephant in the room: the claims that fluoride can lead to autism, a lowered IQ, and a myriad of other conditions like cancer. 

There is [very little credible research](https://www.cancer.org/cancer/cancer-causes/water-fluoridation-and-cancer-risk.html) to support these claims. While an excess of anything can have harmful ramifications, at the recommended dosages, the worst that can happen with fluoride is that your teeth may develop white spots (or a few brown spots)—for example, if you take fluoride supplements as a child and also drink fluoridated water. As fluoride has become more prevalent in things like toothpaste and mouthwash, the U.S. has lowered the amount of fluoride put in water to ensure people are not getting harmful amounts. 

__The verdict: fluoride is legit__

Fluoride in our water is one of the most helpful public health initiatives ever undertaken in the United States. [The CDC named it one of the top ten public health achievements of the 20th century](https://www.cdc.gov/fluoridation/basics/index.htm). Fluoride is a practical, safe, and effective way for us to strengthen our teeth from childhood into adulthood. 

That said, there are other, fluoride-free ways to remineralize teeth for routine maintenance. One involves a mineral called hydroxyapatite. This mineral is what most of our tooth enamel is made of. Adding it to toothpaste has been shown to protect teeth in a way that’s comparable to fluoride. So if you still have concerns about fluoride, for any reason, look for a toothpaste with hydroxyapatite. 

Smile strong.

Then you’ll really like our oral health products. They use refreshingly real ingredients. And they only have legitimate claims that we stand behind as dentists and hygienists.

Like our “Is It Legit?” series?

In our “Is It Legit?” series, we weigh in on trendy topics in oral wellness, flossing fiction from fact so that you know what to trust your mouth with.


The Gargler - Fluoride

Fluoride: Is It Legit?

When a patient finds out they grind their teeth, they are usually met with a recommendation for an expensive mouthguard from their dentist and sent on their way. But why do we grind our teeth in the first place? Has stress related to Covid caused more grinding? And is grinding really such a big deal? Tend’s Head of Clinical Development, [Dr. Marc Schlenoff](https://www.hellotend.com/about), has these answers and more. (Spoiler: yes, grinding is, in fact, a *very big deal*.)

__Grinding can be caused by stress, but it’s also genetic__

While a lot of us grind due to stress, “some people who are seemingly under no stress grind because that’s just the way they’re hardwired,” says Dr. Schlenoff. 

__For stress-grinders, Covid is a factor__

Many if not at all of us have been under heightened stress since the start of the pandemic. And this would [logically lead](https://www.nytimes.com/2020/09/08/well/live/dentists-tooth-teeth-cracks-fractures-coronavirus-stress-grinding.html) to an increase in “the intensity and severity” of grinding, says Dr. Schlenoff. 

__Grinding produces a huge amount of force__

“Grinding can generate up to 1,100 pounds per square inch of pressure on your teeth.” To put that in perspective, that’s [3-6 times](https://www.chicagotribune.com/lifestyles/health/sns-health-teeth-stress-story.html) the pressure you use to eat.

__Evidence of grinding is easy to spot__

When people grind, the cusps of their teeth gradually become flatter, and shinier, then shorter. “I always show my patients a picture of the wear to show them exactly what’s happening,” says Dr. Schlenoff.

__Grinders typically grind for an hour or so per night__

“We grind and clench and then we stop and then we do it again...all night long,” says Dr. Schlenoff, adding up to about 60 minutes total.

__You’re more likely to grind if you snore__

Some snorers assume they couldn’t possibly grind their teeth while snoring, but sadly they’re wrong. In reality, “grinding is just momentary, and there’s almost a 100% correlation between snoring and grinding.”

__Grinding wears away at enamel, then at dentin__

Now for some dental anatomy: a tooth has layers that grinding destroys bit by bit. The first layer is the enamel, which coats the outside of the tooth and is “the hardest substance in the body.” Once you grind through this, you’re in trouble. Underneath the enamel is “dentin,” a yellowish substance that’s 11 times weaker than enamel. As a result, it will erode 11 times more quickly.

__Grinding affects multiple teeth at a time__

Grinding doesn’t just happen to one tooth: it occurs in a sliding motion that wears down many of your teeth simultaneously in a fairly symmetrical way. 

__There’s a point of no return when it comes to tooth damage__

Because the tooth gets softer the deeper you go, over time the damage grinding causes begins to accelerate. At a certain point, the damage is beyond repair and your teeth will require crowns. Dr. Schlenoff recalls, “I’ve had cases where I had to do crowns on every tooth in the mouth to rebuild them to their original height because people have worn them down so dramatically.”

__Repairing this damage can be incredibly expensive__

A single crown can cost up to $2500, depending on where you live. If your case is really extreme and you need crowns on every single tooth like Dr. Schlenoff’s patient, that could result in a whopping cost of $80,000. 

__There’s a way, way cheaper alternative__

Since there’s no way to consciously stop grinding (especially in our dreams and during a pandemic), our best mode of defense is a night guard. That’s a simple piece of plastic custom-molded to your mouth that you wear just when you sleep. A night guard typically costs less than a thousand dollars. We charge $599 if you don't have dental insurance, and if you do, it could cost significantly less than that. 

That translates to at least $79,401 that you could spend on say, two cars, some bougie vacations, and hundreds of takeout dinners instead. Because as much as we love the dentist, we’re pretty sure that having great wheels, sitting on a beach, and eating delicious food beats sitting in a dental chair. 

Here’s to strong enamel and grind-free teeth!

Book a dental exam at your nearest Tend studio, and one of our top-rated dentists will examine your teeth for signs of wear. 

Think you're grinding?

[8% of adults](http://sleepdisorders.sleepfoundation.org/chapter-7-sleep-related-movement-disorders/sleep-related-bruxism/p/) grind their teeth, but most have no idea about the long-term consequences.


Grinding_Horizontal

Is Covid Stress Ruining Your Teeth?

We love dogs, and we’d pretty much do anything for them. Case in point: we pick up their *poop*. And while we wouldn’t change a single thing about the play time, walks, nuzzles, or sloppy kisses, there *might* be a change or two we’d make in other areas. (See: the “picking up their poop” point, above.) Because, while a good pup snuggle is pretty much the cure for whatever ails us, being on the receiving end of a panty, slobbery huff of rancid dog breath? Not our preferred pastime.

__It’s time to pay attention to our furry friends’ oral health__

“Dogs are also prone to periodontal disease,” explains Dr. Marc Schlenoff, Tend’s Head of Clinical Development. “And yes, that can mean bad breath.” Since dogs shouldn’t ever eat sugar, they tend not to suffer from tooth decay, but plaque and gum disease can be a serious problem. In fact, periodontal disease is the most common clinical condition in dogs. Which means the number one thing you can do to keep your pup’s pearly whites healthy is brush their teeth. Every day. No, really. “You have to,” explains Dr. Schlenoff. Not only will this help freshen their breath, it will also prevent more serious problems—like bleeding gums and tooth loss.

![2021 2 Gargler BreathBiscuit Body2](//images.ctfassets.net/otz9p93fkvjx/5GvzmOtUJpek6DLFuMSciX/d5a761a9c3235c7d535ef0bda4b12b10/2021_2_Gargler_BreathBiscuit_Body2.jpg)

__Tend is here for all the mouths in the family__

While brushing your dog’s teeth is important, there are easier ways to support their oral health. Our new Breath Biscuits by Bocce’s Bakery in NYC are an all-natural, delicious dog treat to keep your canine’s canines healthy and their breath great-smelling. 

These wheat-free biscuits are made from just three good-for-your-dog ingredients: 
- Oat flour is a good source of vitamin B (for a healthy coat), linoleic acid (for strong skin), and fiber (to support digestion)
- Apples are a good source of vitamin C (which may reduce inflammation and cognitive aging in dogs)
- And mint is a long-time favorite to help mask halitosis

![2021 2 Gargler BreathBiscuit Body1](//images.ctfassets.net/otz9p93fkvjx/2vmncJ3sfrTyOD0yZWuNWz/2e177216197079de631bf9cdc71b87ff/2021_2_Gargler_BreathBiscuit_Body1.jpg)

__A dentist-approved dog treat__

In addition to these treats’ health-boosting ingredients, the mere act of chomping down on them or other crunchy snacks can help keep your pup’s teeth clean and in good working order. So pass one to your pup, then pucker up for a long round of minty-fresh dog kisses. Your pup—and your nose—will thank you.

We partnered with Bocce’s Bakery in NYC to make a healthy, dentist-approved dog treat, baked with mint for fresh breath. Because our canine’s canines need love too.

Breath Biscuits by Tend and Bocce’s Bakery

Let’s face it (literally): puppy breath isn’t always cute. 

2021 2 Gargler BreathBiscuits Header v2

A Kiss Assist for You and Your Dog

You’ve may have heard that gum is bad for your teeth. You may have also heard that it’s good for them. 

So…which is it? Does gum chewing lead to cavities and decay, or to whiter smiles and fresh breath? (Because really, can a product sold in the candy aisle actually help keep your teeth clean?) 

To get the 411 on chewing gum, we sat down with Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

__Choose the right chew__

It’s time to set the record straight: chewing gum can be good...if you pick the right kind.  

According to Dr. Schlenoff, chewing gum “is actually not bad for you at all—as long as it’s sugar-free.” 

__Sugar and your teeth: not so sweet__

What’s the problem with sugar? In your mouth, sugar gets broken down by bacteria. These so-called “bad bacteria” produce a few gnarly byproducts in the process, including dental plaque and acid. The acid can disrupt your mouth’s delicate pH balance, leading to enamel erosion and cavities, while the plaque can build up and harden, leading to tooth decay.  

__Sugar-free ways to sweeten the deal__

Fortunately for gum-lovers, there are sugar-free alternatives. Some popular sugar substitutes in gum include alcohol sugars (such as sorbitol, mannitol, and xylitol), aspartame, and stevia extract. 

Not only do these sweeteners avoid the problems caused by sugar, some may actually offer benefits for your mouth. For example, in addition to sweetening like sugar, gum made with sorbitol “has actually been shown to reduce tooth decay,” per Dr. Schlenoff. 

__Mouthwateringly good for you__

[Chewing gum naturally increases saliva flow](https://www.dentalhealth.org/sugar-free-chewing-gum), and “saliva flow is always a good thing,” says Dr. Schlenoff. Increased saliva flow helps to neutralize and wash away any lingering acids that are produced when you eat—which helps maintain your mouth’s pH balance and preserve your enamel. [One study found that people who chewed sugar-free gum for about 20 minutes after eating a meal actually had a lower incidence of cavities.](https://jada.ada.org/article/S0002-8177(14)63877-0/fulltext) 

__Watch out for TMD__ 

One important note: although sugar-free gum has a sparkling reputation, all that chewing can pose a potential risk. [TMD](https://www.mayoclinic.org/diseases-conditions/tmj/symptoms-causes/syc-20350941) (or temporomandibular joint disorder) can cause jaw and muscle pain as well as difficulty chewing. “Some people are more naturally disposed to TMD,” says Dr. Schlenoff, “but there’s an easy solution if that happens: stop the chewing.” 

__The bottom line__

Still unsure of how your gum stacks up? When in doubt, pick a pack with the [American Dental Association’s](https://www.ada.org/en/member-center/oral-health-topics/chewing-gum) Seal of Approval: reserved for sugar-free picks that aren’t going to harm—and may even help!—your oral health.

Be frank with your dentist. Not comfortable talking to your dentist about this kind of thing? Maybe it’s time for a new dentist. 

Worried about your own habits?

In our “How Bad Is It?” series, we answer your cringing questions about whether something you’ve done, or do everyday, is bad for your oral health (or completely harmless).

The Gargler - Chewing Gum

Chewing Gum: How Bad Is It?

If you have missing or damaged teeth, you know how disruptive that can be. Biting down into your favorite foods can become a source of anxiety. So can how you look when you’re smiling. 

Still, getting a complex restorative procedure may be intimidating in its own way. You may be afraid of the pain, the idea of drilling, even just the word “implant.” And as a result, you may not explore your options fully.

If you’re in that category, we want you to know something: [dental implants](https://www.mouthhealthy.org/en/az-topics/i/implants) are one of the most effective, durable, and beautiful ways to replace teeth. And getting them is a lot more comfortable than you might think. 

__How dental implants work__

“Implants tend to be much less uncomfortable than the perception,” explains Dr. Schlenoff, Tend’s Head of Clinical Development. 

The process involves [replacing a tooth’s root](https://www.perio.org/consumer/single-tooth-implant) with a small piece of metal—the “implant.” After the implant and the underlying jawbone come together, a dentist tops the implant with a gorgeous, long-lasting ceramic crown that looks and performs just like a natural tooth. 

Although the process sounds intimidating, dentists have been performing and perfecting the procedure for [more than 30 years](https://www.aaid-implant.org/dental-implants/what-are-dental-implants/). And they’ve become really good at making it comfortable.

__No nerves = no pain__ 

“In the bone where we’re attaching the implant,” says Dr. Schlenoff, “there really are no nerve endings. So, amazingly, that part of the procedure does not hurt.” 

There is some temporary discomfort afterward, he says. But that comes from “the manipulation of the gums” around the implant—not the implant itself. 

This means that, overall, “most people are very pleasantly surprised,” he says. “I’ve dealt with hundreds of implant patients, and most people are just fine the day after. Certainly by 48 hours later they’re back to their normal activities.” 

__A (worthwhile) wait__

Dr. Schlenoff does note that, once an implant is in, [it can take a few months](https://www.mayoclinic.org/tests-procedures/dental-implant-surgery/about/pac-20384622) for it to fully fuse with the bone before the final crown can be placed. (A temporary restoration can be placed in the meantime.) 

But the wait is worth it. Once the permanent crown is in, it looks and behaves exactly like a normal tooth—making chewing and smiling anxiety-free. And with proper care, a dental implant can last a lifetime. 

__Tend’s elite team__

If you need an implant, it’s critical to work with a skilled dental team—like the one Dr. Schlenoff leads at Tend. Each of our dentists is trained to make placing an implant as comfortable as possible. And to craft beautiful crowns that will be part of your smile for decades.

Since there aren’t any nerve endings where the implant sits, most people come away from the procedure “pleasantly surprised.”

The Gargler - Implants

Why Dental Implants Are Surprisingly Comfortable

In our experience, there are two kinds of dental patients: 1. those who are afraid of discomfort and want to avoid it at all costs; 2. those who want a bit of soreness to “prove” that their cleaning was thorough.

If one of these sounds like you, we want to talk to you about what level of comfort it’s realistic to expect during a dental exam (TL;DR, more than you think, but not total bliss), and whether discomfort and thoroughness really do go together (actually, no!).

__If you feel discomfort, and that’s worrying...__ 

We do everything possible to make your dental exam comfortable, from bringing your anxiety level down with a soothing space and distracting TV shows, to numbing sensitive gums with a topical anesthetic, to using gentler, state-of-the-art tools (more below). But there’s no way to 100% guarantee that you won’t feel a thing.

One reason: over-brushing at home. “A lot of our patients have very healthy teeth,” says Dr. Schlenoff, “but may be very aggressive when brushing.” Overly-vigorous brushing at the gumline can lead to thinner gum tissue and “a tiny bit of gum recession.” This can leave some tooth exposed that’s not protected by enamel. And without that protective layer, your tooth will naturally be more sensitive during exams.

The good news? This type of discomfort “is always transient and completely normal,” says Dr. Schlenoff. If you’re feeling any twinges, just raise your hand and let your hygienist know.

![2021 2 Gargler Soreness Header](//images.ctfassets.net/otz9p93fkvjx/67KV30YiriiOLjyvFiJuWq/3465f2bb23fdd0da12fa8ee370d608a2/2021_2_Gargler_Soreness_Header.jpg)

__If you’re not sore, and that seems weird…__

If you’ve been to other dentists, you may have internalized the idea that exams = pain. You may have even convinced yourself that pain is the only way to know you’ve had a good cleaning. But it turns out that when you take the latest tooth-cleaning technology and put it in the hands of skilled staff whose top priority is your comfort, it makes for a much more soothing experience. 

“We use ultrasonic scalers,” explains Dr. Schlenoff, referring to the instruments Tend hygienists use to remove plaque and tartar from teeth. “Ultrasonic” means the scaler uses soundwaves to blast buildup off your teeth. And since ultrasonic scalers vibrate faster than traditional scalers, they’re more precise and less painful. 

This means that you’ll likely be more comfortable during your cleanings than you were before. And that your teeth will also be just as clean, if not cleaner. So if you think you’re supposed to feel sore afterward, you may be sorely disappointed. (Sorry, we had to!)

Whichever type of patient you are—afraid of discomfort, expecting it and even kind of wanting it—we’re here for you. Book a checkup at your nearest Tend studio, and we’ll make your cleaning as soothing as it is thorough.

A dental exam that’s so much more than routine

Let’s back up. How much soreness are you expecting?

2021 Gargler Soreness Header v3

How Much Soreness Is Normal from a Dental Exam?

As wearing masks becomes part of our new normal, so does the unwelcome aroma of “mask breath.” That’s your own bad breath trapped inside your mask.

“Masks are designed to keep things in,” says Dr. Schlenoff, Tend’s Head of Clinical Development. “They have layers and layers of fibers. So if your breath is bad, your mask will contain it.”

And if you wear a mask over and over, and it isn’t washable, it could start to take on that odor for good. 

It’s a small price to pay for being safe. But it can still be “pretty gross,” says Dr. Schlenoff. We used to worry about other people smelling our bad breath. Now we’re our own victims.

There’s a solution for this. And it’s not mints, gums, sprays, strips, or any other breath fresheners. Those just “mask” the problem. You need to treat it at the source to actually get rid of it.

“Bad breath can come up through the gastrointestinal tract,” says Dr. Schlenoff. “It can come down through the nose. But most of the time it comes from your mouth. And it’s usually just a hygiene issue. The bacteria in your mouth smell because they weren’t cleaned out.” 

The majority of those bacteria live on your tongue.

“It’s an ideal hiding place,” says Dr. Schlenoff. “Bacteria love it. It’s moist. It’s protected. It has an uneven surface. It’s almost the perfect environment for bacteria.”

Some people brush their tongues like they brush their teeth. “But it’s very difficult to brush your tongue properly,” says Dr. Schlenoff. “Toothbrush bristles are made of flexible nylon, and they give a lot. So they’re going to miss things.”

It’s better to use a tool designed specifically for tongues. That’s why we created the Tidy Tongue, a tongue cleaner with a rigid wiper that slides gunk off like a little zamboni.

You can test this for yourself. First, brush your tongue with a toothbrush and see how it looks. Then use the Tidy Tongue and see how much more icky white stuff comes off. That white stuff is plaque, the same bacteria you brush off your teeth. But on your tongue, there’s way more of it. 

Dr. Schlenoff uses his Tidy Tongue at night. But you can use yours in the morning, or even twice per day. Whatever feels right for your routine. Tongue cleaning only takes a few seconds.

And once you start, you’ll be able to mask up and exhale freely.

When left to its own devices, your tongue becomes a home for bad-breath-causing plaque. Enter the Tidy Tongue, a stainless-steel tongue cleaner designed by our dentists.

Introducing the Tidy Tongue

Clean your tongue to treat bad breath at the source.

Tidy Tongue Gargler

Don’t Just Mask Your Mask Breath

Straight smile seekers, *we have good news for you*. There’s a revolutionary new orthodontic technology, available exclusively from Tend. It’s called [Breezy Braces](https://www.hellotend.com/breezy-braces), and it uses a NASA-developed material to invisibly straighten your teeth with zero maintenance. 

Before we get into the details, let’s talk about your situation.

__You want to straighten your teeth.__

Maybe you had braces as a kid, then stopped wearing your retainer. Or you never had braces and thought you wouldn’t need them. But...your teeth have begun to drift. 

At first, you could ignore it. It even looked kind of cool and rugged. But now, not so much. You’re getting embarrassed, and you’re worried about where this is headed. Your teeth may also be getting harder to clean and yellowing (or worse) if they’re overlapping and crowded.

__But you don’t love your options.__

Other orthodontic treatments look terrible, aren’t sanitary, have to be removed every time you snack, get lost, get eaten by dogs, and aren’t actually invisible. In fact, they can be highly visible, resulting in doubletakes from friends and coworkers as they try to figure out why your smile looks...different. 

__That’s where Breezy Braces come in.__

[Breezy Braces](https://www.hellotend.com/breezy-braces), powered by Inbrace, give you everything you want—a beautiful, confident smile and fewer dental issues down the line—without any of the embarrassment or hassle.

__Breezy Braces are actually invisible.__  

Breezy Braces are truly 100% hidden. As in, the only way someone will know you’re wearing them is if you tip your head back and show them what’s behind your teeth. This allows you to smile freely throughout your treatment.

__They’re totally hands-off.__

Breezy Braces require next to no maintenance. You can eat and drink (and kiss) whenever you want. And you won’t have to touch your teeth with your fingers.

__They’re more comfortable.__ 

Other orthodontic treatments hurt periodically as they’re tightened or swapped out. Breezy Braces are different. They move your teeth gently and continuously throughout your treatment, so there aren’t any peaks of discomfort. 

__They’re easier to clean.__ 

Breezy Braces are designed to be super hygienic. Their rising and falling shape allows you to brush and floss like you normally would. (Or, if you don’t floss, there won’t be anything in the way of you starting. Sorry!)

__They’re rocket science.__

Breezy Braces are made possible by an incredible technological advance. They’re crafted from a material called shape memory wire that was originally developed for spaceships and satellites. Shape memory wire is flexible, but always returns to its original shape. 

With Breezy Braces, a thin piece of shape memory wire is “programmed” specifically for your smile, then placed behind your teeth. It slowly and gently moves your teeth until it achieves its final shape.

__They’re affordable.__

In NYC, orthodontic treatments start around $1,850 and go up to about $7,000. 

Breezy Braces cost $5,000—right in the middle. They cost more than the cheapest straightening option. But in our opinion, that’s a small price to pay for a far better experience.

__And they’re placed by an orthodontist.__

Unlike other orthodontic treatments, Breezy Braces aren’t put in at home, with no clinical oversight. They aren’t even placed by a normal dentist. They’re placed by an orthodontist. That’s a dentist with special training in the art and science of moving teeth. This ensures that they’ll actually work, and that if any adjustments need to be made, an expert is on call to help—all for the same price.

__Here’s how it works.__

You start by talking with an orthodontic specialist (for free) about your smile and whether Breezy Braces are right for you. Next, you’ll visit a Tend studio for 3D imaging. If you decide to move forward, your orthodontist will craft your Breezy Braces specifically for you. Then you’ll come back to have them placed. Every 6-8 weeks, you’ll return for a quick check-in to make sure everything is going according to plan.

__You’ll have a whole new smile in as little as six months.__ 

And by the time your Breezy Braces come off, you may not even remember you had them.

Interested in learning more? Book a free consult and spend 15 minutes chatting about your smile and whether Breezy Braces are right for you.

Book a free consult

Breezy Braces Gargler


Introducing Breezy Braces
A new care-free, can’t-see straightening technology that goes behind your teeth, exclusively at Tend.

Straightening Just Got Revolutionized

If you’ve heard of [veneers](https://www.hellotend.com/veneers), you probably know that they’re a way of [gorgeously remaking](https://www.cosmopolitan.com/style-beauty/beauty/a13051650/what-are-veneers/) spaced, uneven, worn down, chipped, or stained teeth. But you probably didn’t know that they’re also a way of transforming the shape of your face, making it more symmetrical, accentuated, and youthful, like a face lift.

Let’s take a step back.

__What are veneers again?__

Veneers are super thin layers of porcelain that a dentist with special training applies to your teeth. They’re works of high-tech artistry, blending 3D imaging with a dentist’s aesthetic eye to create a beautiful, [natural-looking](https://www.nytimes.com/2010/10/21/fashion/21SKIN.html) smile. And they’re incredibly durable: when well cared for, they can last for decades.

__How many do I get?__

Dentists usually recommend getting veneers in multiples of two, for the most symmetrical effect. For cost reasons, you don’t want to get more veneers than you need to achieve the look you want. That said, you don’t want to get too few, or only part of your smile will look new. 

This can be a difficult calculation for patients. That’s why, at Tend, we offer per-smile pricing. No matter how many veneers you need, your price will be exactly the same. So there’s no reason to hold back on your smile makeover.

__What’s the process?__

At Tend, the process begins with me. If you’re interested in veneers, we’ll do a free, 30-minute virtual consult to talk about your smile and whether veneers are right for you. 

If they are, and you want to move forward, I’ll match you with a Tend dentist who I’ve personally trained. You’ll come in for 3D imaging, and your dentist will show you a digital preview of your new smile. This visit takes about 50 minutes. 

Sometimes, the best way to make your smile sing is to supplement veneers with crowns, implants, and other types of restorative work. If your dentist recommends that, you won’t pay anything more.

The next step is temporary veneers. In about 70 minutes, your dentist will remove a thin layer of surface enamel from your teeth, and you’ll leave with a temporary version of your new smile. This lets you test it out with friends and family members. 

When you’re ready, we’ll mill your permanent veneers. Our lab uses state-of-the-art technology, and we hand glaze the porcelain for exquisite natural detail. 

In your last visit, also about 70 minutes, your dentist will apply your permanent veneers. And you’ll start smiling.

__And veneers also change the shape of my face?__

Veneers do more than remake your teeth. They actually transform the shape of your face. As you age, your mouth loses elasticity and muscle tone, making your face less symmetrical. Veneers make you look younger by supporting your mouth’s musculature and accentuating your cheekbones. 

The effect is similar to what you’d get from a face lift. But unlike a face lift, veneers don’t involve surgery. And thanks to temporary veneers, you can actually see what you’re getting before it becomes permanent.

Interested in exploring whether veneers are right for you? Let’s talk!

Spend 30 minutes talking to Dr. Schlenoff about your smile and whether veneers are right for you. Virtual veneers consults are completely free.

Book a virtual veneers consult with Dr. Schlenoff

Veneers Gargler 2

How Veneers Transform the Shape of Your Face

On March 20th, with Covid-19 cases in New York City skyrocketing, we closed our studios to do our part in managing the pandemic. Today, with cases on the decline, we’ll begin the process of reopening. But the “Tend” our patients experience now won’t be the same as before. We’ve remade every moment of our patient journey to put the health of our patients and our team first.

When we first opened in 2019, we rethought every little detail of going to the dentist to create a soothing, trustworthy, judgment-free, and personalized experience that our patients would actually look forward to. We used the same approach to reimagine dentistry for a post-Covid world. Our safety measures aren’t simply bolted onto the experience we built before. They’re a fully integrated part of a brand-new experience that we redesigned from scratch.

These are the three areas we focused on:

![02 Safety Through Digitial3](//images.ctfassets.net/otz9p93fkvjx/1DaeWeKwcGwWuz6nmatuCW/ea3b997c82bbf56e79008a494dec46b8/02_Safety_Through_Digitial3.jpg)

__Safety through digital innovation__

Pre-Covid, we checked insurance cards and took credit cards at the front desks in our studios. Today, we collect this information digitally before you come in. This ensures a contactless check-in and check-out experience at the studio. It also saves you time for a shorter, safer visit. The custom intake flow we created is fast and seamless with very few clicks, no forms to print out and bring with you, and no annoying phone calls back and forth.

Three days before your visit, we reach out by email to perform a health check. We ask if you’ve experienced any Covid-19 symptoms, or if you’ve been exposed to anyone sick. If you have, we make it super easy to reschedule.

![03 Reimagined In Studio](//images.ctfassets.net/otz9p93fkvjx/1KwueR5Jm74XNPyWYBFnYm/ac9233a652c59ce335a88564065d3269/03_Reimagined_In_Studio.jpg)

__A reimagined in-studio experience__

Pre-Covid, we promised zero waiting at our studios. Today, we make the same promise, but we stagger visits with even more buffer time to minimize patient overlap. This means you’ll arrive in a calm, quiet space where you’ll be seen right away, without sitting in any common areas or passing other patients in the halls. And, of course, we require masks, social distancing, and hand sanitizing for all inside.

We also perform a temperature check on arrival and a follow-up health check, to make sure you haven’t developed any new symptoms or been exposed to anyone sick. Before your checkup or procedure begins, we ask you to swish with an antiviral rinse that reduces the viral load in the mouth, if one exists. This measure helps keep our team safe. And by protecting our team, it ultimately protects you.

Medically sanitized surfaces and sterilized equipment are standard practice for dental offices. For clinical team members, so is wearing PPE like masks and gloves. We are stepping up these practices by cleaning every surface you might touch, just for you, before you come in, professionally sanitizing our studios every night, and enhancing our clinical team’s PPE by adding face shields.

![04 Only The Visits](//images.ctfassets.net/otz9p93fkvjx/1CsXMw6oxfSwXFFTp1sUj4/ee243c2cb05e2b94026cdfdd6e5dc72a/04_Only_The_Visits.jpg)

__Only the visits you need__

Pre-Covid, if one of our dentists recommended that you get additional treatment like a filling, we’d ask you to come back on another day. Today, we offer treatment right away to reduce your trips to and from the studio and your germ exposure while in transit.

Ever since we closed our studios on March 20th, we’ve been offering free virtual visits. We are continuing to offer virtual visits. If you’re not sure whether you need to be seen, give us a call. We’ll talk through your concern and give you a recommendation on how to proceed, weighing how you feel with what you’re comfortable with, given your health and family circumstances.

![05 Whole You Focus2](//images.ctfassets.net/otz9p93fkvjx/2XpMGsDxwfFPTDtLlIW6IO/7d058a9eec54cd916b2f2d0df83c7263/05_Whole_You_Focus2.jpg)

__A whole-you focus__

From the virtual visits we’ve conducted, we know that New Yorkers have been living with significant dental issues for weeks or months. They need restorative and, in some cases, emergency care that they haven’t been getting. We are reopening for them. And as soon as you’re ready, we’ll be here for you.

When we reimagined dentistry the first time, we focused on reframing your expectations about how relaxing it could be. How credible. How accepting. How customized. Today, we want to reframe your expectations again. We want you to look forward to your visit because you know that we’re putting your safety first with new digital tools, a new in-studio experience, and only the visits you actually need.

Oral health is important. But it’s just one part of overall health. We are focused on the whole you.

— Doug and Marc 

*Doug Hudson is the CEO and Co-Founder of Tend. A serial healthcare entrepreneur, Doug has founded and led several consumer-facing ventures, including serving as founding CEO of SmileDirectClub and Chairman and CEO of DiabetesCareClub, CPAPCareClub, and HearingPlanet. He splits his time between NYC and Nashville with his wife and three daughters.*

*Dr. Marc Schlenoff is Head of Clinical Development at Tend. Prior to Tend, Dr. Schlenoff was a Program Director at Columbia University’s College of Dental Medicine. He was also the Medical Director for Columbia University Health Care. The Consumer’s Research Council of America named Dr. Schlenoff one of America’s Top Dentists for nine consecutive years.*


01 Hero DrSchlenoff2

Reimagining Dentistry for a Post-Covid World

“If you do it right,” says Dr. Marc Schlenoff, Tend’s Head of Clinical Development, “there’s no reason to brush more than once per day.”

“Doing it right” means brushing so thoroughly that if you were to use a disclosing tablet that reveals plaque on your teeth, you wouldn’t find any. Plaque builds up every 24 hours, so in theory one perfect brush per day should do it. (If plaque is left unbrushed for more than 24 hours, it will layer, harden, and damage your enamel.) 

But here’s the catch: “doing it right” is really, really hard (even for a dentist). It requires a level of thoroughness most of us aren't used to. 

That’s why—even though you could brush once per day—“you shouldn’t,” according to Dr. Schlenoff. Brushing a second time helps remove “any plaque you missed” during round one. And unless you’re a superhuman brusher, you need that. 

So stick with it!

If you want a judgment-free, educational dental experience, you've found the right place. Book a visit with one of our amazing dentists and hygienists at your nearest studio.

We answer the questions you're afraid to ask

You’ve probably been hearing all your life that you need to brush twice per day. But—prepare to have your mind blown—you don’t necessarily have to.


Do I Really Need to Brush Twice Per Day?

We all know that smoking cigarettes is awful for oral (and overall) health—[thank you, decades of PSAs from the CDC](https://smokefree.gov/quit-smoking/why-you-should-quit). But what if what you’re smoking doesn’t contain tobacco? As the availability (and legality) of marijuana increases nationwide, it’s natural to wonder if increased use is as harmful to your mouth as tobacco products are. 

To find out, we sat down with resident expert Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

__Smoking pot has been linked to gum issues__

“There have been studies that show that marijuana can be a causative factor in periodontal disease,” says Dr. Schlenoff. Meaning, we’re less worried about the effect smoking marijuana has on your teeth, and more worried about the effect it can have on your gums. [According to a 2017 study from Columbia University published in The Journal of Periodontology](https://www.dental.columbia.edu/news/recreational-cannabis-used-often-increases-gum-disease-risk), “frequent recreational use of cannabis—including marijuana, hashish, and hash oil—increases the risk of gum disease.” 

“You can tell a smoker by the way their gums look,” explains Dr. Schlenoff, “They’re sort of a grayish color because there’s not a lot of blood in there.” Researchers have long understood that the combination of nicotine—which constricts blood vessels—and heat in cigarettes [can restrict blood flow to the gums](https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html), which leaves them vulnerable to infection. And it seems the Columbia study has found the same link with marijuana, a nicotine-free substance. 

__Vaping may be just as bad (or worse)__

When it comes to the newest trends on the market, the research is less clear cut, since there hasn’t been enough time to conduct studies focusing on long-term effects. “We just don’t have that kind of data yet,” explains Dr. Schlenoff. 

That said, [you may have seen headlines](https://www.foxnews.com/health/vaping-harming-teeth-study) warning about the effects of vaping on your teeth and gums. It’s not hard to imagine why: exposing your gums to heat restricts blood flow. Plus, most [e-cigarette liquid typically does contain nicotine](https://smokefree.gov/quit-smoking/ecigs-menthol-dip/ecigs), which is a known oral health offender. The bottom line: when it comes to vaping, signs point to it being risky for your oral health—and, of course, your overall health, as vaping has been increasingly linked to [severe and even fatal respiratory problems](https://www.fda.gov/news-events/public-health-focus/lung-illnesses-associated-use-vaping-products). 

__CBD results have been more positive__

CBD, on the other hand, may be a different story. There is some preliminary research that suggests cannabidiol (the chemical name of CBD) [may prevent bone loss](https://www.ada.org/en/member-center/oral-health-topics/cannabis), which would help keep your teeth stable and sturdy. However, it’s very preliminary: so far, it hasn’t even [been tested](https://www.ncbi.nlm.nih.gov/pubmed/25517414) [on humans](https://www.ncbi.nlm.nih.gov/pubmed/19070683). And importantly, all studies involved CBD that was injected or consumed, not smoked.

__All things in moderation__

So is the occasional pot smoker or vaper doomed, then? When it comes to incidence of gum disease for smoking, at least, Dr. Schlenoff says that “it’s very clear that your risk is proportional to how much you smoke.” 

The more you smoke, the higher the risk. The same is likely true of vaping. (For weed and CBD gummies, there’s currently too little research to know.)

Be frank with your dentist. Not comfortable talking to your dentist about this kind of thing? Maybe it’s time for a new dentist. This shouldn’t be an awkward conversation.

In our “How Bad Is It?” series, we answer your cringing questions about whether something you’ve done, or do everyday, is bad for your oral health (or completely harmless).


Weed: How Bad Is It?

I’m just going to get to it: I’m breaking up with you. That fuzzy feeling you give me just isn’t doing it anymore.

I know this may come as a shock to you, but I’ve felt this way for a while and was just too scared to act on it. The truth is, I’ve finally found someone who will be there for me, who’s a lot nicer than I ever could’ve imagined, and most importantly, makes my teeth strong instead of weak: my new Tend dentist.

I’ll always remember our good times: eating candy at the movies, all the times I forgot to floss or brush and you stood by me, growing in the night. Because you thrive in the bacteria of an unbrushed mouth, it couldn't be helped. I’ll always cherish how hard we laughed about how gross my breath smelled that one morning. Or how your friends Tartar and Cavities kept overstaying their welcome. 

But that’s the thing though, right? Our relationship was never just us. If it was just you and the other millions of friendly bacteria in my mouth, it would be one thing. But I’m slowly accepting that you and your buds are a package deal. And I deserve better than that. 

I know you’ll come back to me. That’s only natural. But I feel compelled to warn you: my new Tend dentist will always be there to support me in getting rid of you again.

Maybe one day we can get to a point where we’re friends, where we can give each other heartfelt hello’s as I scrape you off my teeth at night. But for now, I’m going to make a clean break. I hope you understand.

Don’t cry because it’s over. Smile because of all the candy we ate.


Our amazing clinical team can help. They're really good at writing breakup letters to plaque like this one.

Ready for a breakup?

In some ways this is the hardest letter I’ve had to write. And in some ways it’s the easiest.

Dear Plaque

If you keep up with the latest wellness trends, you’ve probably heard about charcoal. In the last few years, it seems to have lent its pitch-black hue to just about everything: skincare, ice cream, lattes—and oral wellness products. We’ve seen charcoal show up in [toothpaste](https://shop.hellotend.com/collections/tend-picks/products/twice-early-bird-twilight-toothpaste), [mouthwash](https://shop.hellotend.com/collections/tend-picks/products/hello-naturally-fresh-mouthwash), [floss](https://shop.hellotend.com/collections/tend-picks/products/cocofloss-single), and even the bristles of [toothbrushes](https://soothsonic.hellotend.com/?utm_source=shop_home&_gl=1*16x14q6*_gcl_aw*R0NMLjE2MDM0MjMzOTUuQ2owS0NRancyOFQ4QlJEYkFSSXNBRU9NQmN5eFNQUko1NmJKUVVLRkNIeWV1R3hFbnBfVXZkeHhhRlhGWTBKR29BaVdPYTdNc0xHektvc2FBcE1XRUFMd193Y0I.&_ga=2.71390803.175980659.1603423396-594925918.1600095315&_gac=1.229445998.1603423396.Cj0KCQjw28T8BRDbARIsAEOMBcyxSPRJ56bJQUKFCHyeuGxEnp_UvdxxaFXFY0JGoAiWOa7MsLGzKosaApMWEALw_wcB). But what’s it actually doing there? 

We checked in with Dr. Marc Schlenoff, Head of Clinical Development at Tend, to get to the bottom of the charcoal trend. 

__The claim: activated charcoal helps you “detox”__ 

Activated charcoal, the flavorless ingredient at the heart of the movement, is essentially a form of carbon that’s been treated to make its surface more porous. Theoretically, the holes on the surface of charcoal particles help them pick up and clear away other substances. 

It’s why you so often hear the word “detox” in connection with charcoal. The idea is that ingesting it, washing your face with it, or even brushing your teeth with it helps draw out chemicals and impurities, leaving behind a flushed body, clearer skin, or, in your mouth, pearlier whites and fresher breath. 

__The reality: when it comes to your teeth, there’s no proof__

“I went through the research,” explains Dr. Schlenoff, “and I couldn’t find one single solitary study that advocated for charcoal among independent, unbiased analyses.” 

He’s not alone in that finding: [according to a 2017 review from the Journal of the American Dental Association](https://jada.ada.org/article/S0002-8177(17)30412-9/fulltext), there’s “insufficient clinical and laboratory data” to substantiate any safety or efficacy claims about charcoal in toothpaste. 

__Charcoal could be really bad for your chompers__

Charcoal is abrasive, and there’s concern among dentists that, over time, exposing your teeth to it could wear away your enamel. “No matter how finely you grind up the particles it’s still abrasive,” adds Dr. Schlenoff. 

[A study presented at the 2015 Academy of General Dentistry Annual Meeting](https://www.epostersonline.com/agd2015/node/72) found that activated charcoal was more abrasive than traditional whitening toothpastes (and suggested it may not be that effective as a whitener). 

__Excess abrasion can actually lead to yellower teeth__

[The American Dental Association](https://www.mouthhealthy.org/en/az-topics/w/natural-teeth-whitening) cautions that using overly abrasive materials on your teeth can actually make them look less white and more yellow. That’s because if you totally wear away your enamel, you’ll expose the layer below: dentin, a softer, less protected substance that (you guessed it) is yellow in color. 

__Been brushing with charcoal? Don’t panic__ 

A single tube of charcoal toothpaste is unlikely to cause that much damage. That’s because when it comes to abrasion, “it’s cumulative,” assures Dr. Schlenoff. The longer—and harder—you brush, rinse, or floss with charcoal, the greater the risk. 

__And if you’re using charcoal mouthwash, consider safer alternatives__ 

“It’s not worth the risk at all,” says Dr. Schlenoff. When it comes to fresh breath or whiter teeth, “there are [much safer ways](https://soothsonic.hellotend.com/?utm_source=shop_home&_gl=1*16x14q6*_gcl_aw*R0NMLjE2MDM0MjMzOTUuQ2owS0NRancyOFQ4QlJEYkFSSXNBRU9NQmN5eFNQUko1NmJKUVVLRkNIeWV1R3hFbnBfVXZkeHhhRlhGWTBKR29BaVdPYTdNc0xHektvc2FBcE1XRUFMd193Y0I.&_ga=2.71390803.175980659.1603423396-594925918.1600095315&_gac=1.229445998.1603423396.Cj0KCQjw28T8BRDbARIsAEOMBcyxSPRJ56bJQUKFCHyeuGxEnp_UvdxxaFXFY0JGoAiWOa7MsLGzKosaApMWEALw_wcB) to achieve that result.”

Check out our online shop. It has toothpastes hand-picked by our dentists. They're safe, and you'll love using them every day.

Need a charcoal-free toothpaste?

In our “Is It Legit?” series, we weigh in on trendy topics in oral wellness, flossing fiction from fact so you know what to trust your mouth with. 


Charcoal: Is It Legit?

It’s hard to crack open your third (or fourth, or fifth…) can of the day and not feel a little worried that seltzer drinking could be damaging your teeth. What’s actually in seltzer? And does it matter for your oral health?

To find out just how bad—or not—a sparkling water bent can be, we sat down with Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

__Seltzer drinking isn’t something to lose sleep over__

Compared to drinking soda and other not-so-great-for-you beverages, drinking seltzer “isn’t really something to worry about,” says Dr. Schlenoff.

__Unless your seltzer contains citric acid__

When it comes to your teeth, the danger of many canned and bottled drinks, even the sugar-free ones, is mostly centered on a single ingredient: citric acid. Citric acid is naturally found in citrus fruits, and an artificial version is commonly used as a preservative and flavor-enhancer in some of America’s favorite bevvies.

__Citric acid erodes enamel__ 

By lowering the pH of your mouth, citric acid can [erode your enamel](https://www.ada.org/en/member-center/oral-health-topics/erosive-tooth-wear). Combine that with another popular ingredient—sugar—as many soft drinks do, and, according to Dr. Schlenoff, you’ve got the “perfect conditions for tooth decay.”

__Seltzer is more acidic than water__

“Part of the seltzer-making process involves mixing water with something called carbonic acid,” explains Dr. Schlenoff. (That’s the “carbon” in “carbonation.”) “So there’s a little bit of acidity that’s brought into the mix,” which is one reason seltzer tastes good.

__But only slightly__

The acidity “isn’t dramatic,” says Dr. Schlenoff, though he cautions that seltzer companies don’t share the exact pH levels of their products with the public, so it’s [hard to know what the long-term effects of drinking them will be](https://cspinet.org/tip/your-seltzer-habit-harming-your-teeth).

__To play it safe, swish with water__

“All it takes is a swish of water to rebalance the pH of your mouth,” says Dr. Schlenoff. So after you get your seltzer fix, swish with water for a few seconds to bring your mouth’s pH level back to normal. But before you do anything else, check your favorite brand’s ingredient list. And if you see citric acid or sugar, take out a water glass instead.

That’s why we call ourselves a dental wellness company. We help you form healthy habits with personalized nutritional tips, product recommendations, and more.

We believe dentists shouldn’t just solve problems. They should prevent them.

*In our “How Bad Is It?” series, we answer your cringing questions about whether something you’ve done, or do everyday, is bad for your oral health (or completely harmless).*

Seltzer Horizontal

Seltzer: How Bad Is It?

“If you had to choose, __brushing at night is more important__,” says Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

At night, you’re brushing away “the accumulation of sugary and acidic things we all eat and drink throughout the day.” In the morning—unless you’re a midnight snacker (which, fair)—your teeth are still pretty clean, since they haven’t really been used. Brushing in the morning is more about freshening your breath and getting rid of any plaque you missed the night before. 

That said, __Dr. Schlenoff definitely does not recommend skipping your morning brush.__ Long-term it will affect your oral health, and short-term people may “stand a little further away from you.” But let’s say you’re a parent negotiating with a particularly brushing-averse kid: if you have to give up something at the bargaining table (just once), now you know what to do.


No matter when you brush, our dentists will make you feel completely and utterly care for.

No judgment ever

Brushing twice per day is standard practice. But are the two brushing moments equally important? The answer, it turns out, is no. 

MorningVsNight Horizontal

Is Brushing at Night More Important Than in the Morning?

We’re often simply told we do it, recommended an expensive mouthguard, and sent on our way with little to no more information. But *why* do we grind our teeth in the first place? Do I *have* to wear my night guard? And is grinding *really* such a big deal? Tend’s Head of Clinical Development, [Dr. Marc Schlenoff](https://www.hellotend.com/about), has these answers and more. (Spoiler: yes, grinding is, in fact, a *very big deal*.)

__Grinding can be caused by stress, but it’s also genetic__

While a lot of us grind due to stress, “some people who are seemingly under no stress grind because that’s just the way they’re hardwired,” says Dr. Schlenoff. 

__Grinding produces a huge amount of force__

“Grinding can generate up to 1,100 pounds per square inch of pressure on your teeth.” To put that in perspective, that’s [3-6 times](https://www.chicagotribune.com/lifestyles/health/sns-health-teeth-stress-story.html) the pressure you use to eat.

__Evidence of grinding is easy to spot__

When people grind, the cusps of their teeth gradually become flatter, and shinier, then shorter. “I always show my patients a picture of the wear to show them exactly what’s happening,” says Dr. Schlenoff.

__Grinders typically grind for an hour or so per night__

“We grind and clench and then we stop and then we do it again...all night long,” says Dr. Schlenoff, adding up to about 60 minutes total.

__You’re more likely to grind if you snore__

Some snorers assume they couldn’t possibly grind their teeth while snoring, but sadly they’re wrong. In reality, “grinding is just momentary, and there’s almost a 100% correlation between snoring and grinding.”

__Grinding wears away at enamel, then at dentin__

Now for some dental anatomy: a tooth has layers that grinding destroys bit by bit. The first layer is the enamel, which coats the outside of the tooth and is “the hardest substance in the body.” Once you grind through this, you’re in trouble. Underneath the enamel is “dentin,” a yellowish substance that’s 11 times weaker than enamel. As a result, it will erode 11 times more quickly.

__Grinding affects multiple teeth at a time__

Grinding doesn’t just happen to one tooth: it occurs in a sliding motion that wears down many of your teeth simultaneously in a fairly symmetrical way. 

__There’s a point of no return when it comes to tooth damage__

Because the tooth gets softer the deeper you go, over time the damage grinding causes begins to accelerate. At a certain point, the damage is beyond repair and your teeth will require crowns. Dr. Schlenoff recalls, “I’ve had cases where I had to do crowns on every tooth in the mouth to rebuild them to their original height because people have worn them down so dramatically.”

__Repairing this damage can be incredibly expensive__

A single crown can cost up to $2500, depending on where you live. If your case is really extreme and you need crowns on every single tooth like Dr. Schlenoff’s patient, that could result in a whopping cost of $80,000. 

__There’s a way, way cheaper alternative__

Since there’s no way to consciously stop grinding (especially in our dreams), our best mode of defense is a night guard, or a simple piece of plastic custom-molded to your mouth that you wear just when you sleep. A night guard typically costs less than a thousand dollars. We charge $599 if you don't have dental insurance, and if you do, it could cost significantly less than that. That’s a savings of $79,401 or more if things were to really go awry.

Here’s to strong enamel, and grind-free teeth!

80,000 Reasons to Stop Grinding Your Teeth

When you’re looking for a dentist, you’re probably aiming to check a few different boxes: you want your dentist to be close to where you live or work, you want them to have good reviews, and you want them to take your dental insurance (if you have coverage). 

On this last point, you’re probably looking specifically for someone who’s “in network” with your insurer. “Out of network” feels like something to avoid: we associate it with more expensive care, specifically big surprise bills that show up in the mail months later.

And these associations are often justified. If a dentist is “in network,” it means they’ve negotiated set rates with your insurer. So you’ll just owe your normal deductible and coinsurance. If a dentist is “out of network,” they may bill you for more than your insurance will pay. Thus the surprise bills.

However,  if Tend is out of network with your insurer (we can’t speak for the other guys), it can actually be a good thing. 

For 80% of our out-of-network members, dental exams are *fully covered*. By dental exams, we mean your twice-per-year cleanings, with x-rays, an oral exam, and a polish. We also include a free oral cancer screening ($60 value), so you get more thorough care than you might elsewhere, without paying anything extra.

Summed up, if you’re coming in for an exam, there’s only a 1 in 5 chance that being out of network will be any different than being in network. And if you’re in that 20%, we’ll make sure you know ahead of time and allow you to cancel, no questions asked.

If you have more questions about being out of network, give us a call at (212) 686-3686. We’ll talk you through it. 

See exactly what you’ll owe for your exam with our real-time insurance checker.


See if your dental exam is covered

With Tend, being out of network can actually be a good thing.

OutOfNetwork Horizontal

Why Being Out of Network Can Be a Good Thing

Maybe you’ve walked by our Flatiron Studio. Maybe you’ve seen “Look forward to the dentist” or “A new kind of dental office” in the windows of our upcoming FiDi and Midtown Studios. Or in an ad online. Maybe you’ve visited our website. Maybe you’re intrigued.

*Who are these Tend people? They’re hiring. Do I want to work for them? Do they want to hire me?*

In my last post, I talked about how Tend is innovating for our guests. We want to be the first dental experience they actually look forward to. Dear dentists, today I want to talk about how we’re innovating for you. We haven’t just rethought dental care from the patient’s perspective. We’ve rethought it from yours.

# A beautiful place to work

Our studios are designed to soothe. Gorgeous tube lighting. Warming wooden paneling. A custom fragrance in the air. They’re also designed to earn trust. Simple, encouraging hues. Framed diplomas on the walls. Screens in front of each chair so guests and dentists can discuss treatment with imaging as a common reference point. And they’re designed to reframe expectations. A room just for freshening up with swishy, swirly walls. Super-friendly front desk staff. Netflix on ceiling-mounted TVs.

For you, this means calmer, more trusting patients, who are actually enjoying their experience. It also means working in a gorgeous, elegant office, equipped with a lounge where you can eat, meet, and relax.

![1 SpQ75pu5tXdnXg4Ew9bV5Q](//images.ctfassets.net/otz9p93fkvjx/5oUKnYsgFJCPMqCZPF5i3s/6efe97e3bb82f80732e46bcb0217a3f3/1_SpQ75pu5tXdnXg4Ew9bV5Q.jpeg)

# State-of-the-art tech

Like many forward-thinking dental practices, we’ve invested in the latest technology. Extra-oral x-rays with 80% less radiation. Quieter handpieces. Scalers that don’t require a spit bowl. We see faster, more comfortable care as key to reframing our guests’ expectations about what dental can be. That means state-of-the-art tools at your fingertips.

Our investment in tech extends beyond hardware. When our guests book visits online, for example, we ask them for their [insurance info](https://www.hellotend.com/insurance) and their medical history. This streamlines in-studio operations and reduces wait time, which makes our guests happier and more relaxed when you see them.

![1 2BatcABlJgvuNpa 8xY9NA](//images.ctfassets.net/otz9p93fkvjx/55EWV2dIc5GUBoMSzNrqKQ/9ef5fb0d7a46c8ed3cbadf7d130da9ed/1_2BatcABlJgvuNpa_8xY9NA.jpeg)

# A culture of collaboration

If you’re a Tend dentist with a complex case and you want input from a colleague, you have an array of resources available to you. You can consult with another dentist in the studio where you’re based. You can call on the broader network of Tend dentists. Or you can turn to Dr. Marc Schlenoff, our Head of Clinical Development. Until he joined Tend this year, Dr. Schlenoff was Director of Advanced Education in General Dentistry and Assistant Professor of Prosthodontics at Columbia University’s College of Dental Medicine. Before Columbia, Dr. Schlenoff was in private practice for more than 30 years with a specialization in aesthetic dentistry. He collaborates with our clinical team as a whole to make sure each of our dentists feels 100% supported.

![1 52UwH2sfzwwH2A5sHqrAVQ](//images.ctfassets.net/otz9p93fkvjx/6zbd5B1jg4NHpV9eQruK0u/c3632853e1761595788dbac56b7e7e43/1_52UwH2sfzwwH2A5sHqrAVQ.jpeg)

# Continuing education

Dr. Schlenoff’s role includes continuing education. He’s created a program, called Tend University, that keeps our clinical team up to date on all of the latest developments in science-based care. It also delves into the business side of dental. You may be the world’s most incredible clinician, but you may still be able to learn something about hospitality: how to talk to guests in different consumer segments at different points in their journeys, for example. Or you may still be able to learn something about leadership: how to run a huddle, how to hold people accountable, how to do talent reviews. Combine skills like these with your existing clinical abilities, and you’ll be a powerful operator.

# A new win-win approach to compensation

If you’re a dentist who earns a commission on procedures, your pay month-to-month may be unpredictable. You may also detect a sense of distrust in your patients that, for the vast majority of clinicians, is totally unfair. Are your treatment recommendations really in their best interests, your patients may wonder, or are they in yours?

This perceived conflict of interest can make things awkward fast. Let’s say you’re seeing a brand-new patient who needs work done, but they’re asymptomatic. Now you have to do an internal calculation: should I bring my diagnosis up now and risk making my patient feel suspicious? Or should I wait to gain their trust, potentially delaying care to their detriment?

We’re eliminating this problem with a new win-win approach to compensation. We pay you a competitive base salary with an additional bonus based on several key metrics, including Net Promoter Score (a common experience metric that measures guest satisfaction). This provides stability for you, aligns your interests with your guests’, puts your guests at ease, and ultimately makes them more likely to accept the care they need. It also takes productivity out of the equation.

![0 4EEThGxoSoIbVDVF](//images.ctfassets.net/otz9p93fkvjx/1KdZ2mizyT636kIxuiw5Kd/42ad8183c8a1a6d656d927a543274436/0_4EEThGxoSoIbVDVF.gif)

# Three common career paths

Many dentists choose between three common career paths: 1) starting their own practice, 2) working for another practice or practices, or 3) joining a dental support organization.

Starting your own practice allows you to build something from scratch, which is an extremely rewarding experience. But it will put you (on average) $475,000 in debt. And that’s on top of the debt you likely already have. In 2018, the average dental school graduate owed $285,184 (a 400% increase since 1990), according to the ADA. Starting a practice also requires skills you might not have acquired in dental school: how to market, hire, manage an office, look great on social media and third-party booking sites, and so on. If you’re like most dentists, you got into the field because you love taking care of people. You don’t necessarily love marketing performance metrics or training front desk staff.

Working for another practice is an option. You can pay down some of your debt and hone your clinical chops. But unfortunately you’re at the whim of the practice or practices you contract with, and that may mean irregular hours, or shifts at different practices on different days of the week. This route keeps your options open, but without a partnership track, it won’t help you build a long-term, sustainable practice of your own. It also doesn’t necessarily provide mentorship.

Joining a dental support organization can provide stability. You know you’re part of a larger parent company that can do the heavy lifting when it comes to marketing and operations. But most DSOs are fully staffed in the major markets you most likely want to live in. They also tend to operate their practices as silos, so there isn’t a strong culture of collaboration.

![1 Vg2hh7NXlBPhCNIOz3o3aA](//images.ctfassets.net/otz9p93fkvjx/wO2JQFnsK6zbHlQTX3TvM/9c14979cb7a0d3fb2b6e928a40775419/1_Vg2hh7NXlBPhCNIOz3o3aA.jpeg)

# A fourth option: Tend

I want to personally offer you a fourth option. Tend is currently opening studios in Manhattan and Brooklyn, and we need outstanding dentists to build them into thriving practices. Most of all, we’re looking for dentists who want to change the way dentistry is perceived. To shift the conversation from fear to anticipation. Lack of trust to confidence. Pain to comfort. So-so to out of this world. We want our guests to look forward to seeing you.

Sound like something you want to be a part of? <a href="mailto:joinus@hellotend.com">Drop us a line</a>

*A letter from our CEO, Doug Hudson, to dentists everywhere.*