(Note: The dentists profiled received the greatest number of nominations from their professional peers. Many excellent practitioners are not profiled and did not make the list that can be downloaded from page 3. Their exclusion should not diminish their fine reputations. General dentists will be included in a future issue. When looking for any new specialists, check for board certification.)
Periodontal disease is not a simple thing, Andrew Malinowski says. The many types of disease and the variables of each unique case make periodontal disease comparable to cancer in complexity. “There’s not just one cancer,” Malinowski says. “And there’s not just one periodontal disease.”
Worse, periodontists and physicians are finding that periodontal disease—essentially bacteria that cause rapid breakdown of gum and tooth structures—could be linked to heart attacks.
That’s where Malinowski comes in. More than 30 years in practice has armed him with the clinical expertise to tackle just about any degree of gum disease. “I’m like a troubleshooter for general dentists. The general dentists send patients to me with pretty advanced periodontal disease. We do the examination, diagnosis, treatment plans—basic stuff. Basic, but heroic at times,” he says with a laugh.
Periodontics is the specialty that deals with the foundation of teeth—bones, gums and the ligaments that goes around each tooth. When bacteria caused by dental plaque and tartar infect those structures, gingivitis, inflammation and periodontitis could follow. Tooth loss might be next.
Malinowski’s first recourse is removing harmful bacterial plaque nonsurgically. If that doesn’t work, surgical procedures that involve reshaping and regenerating gum and bone come into play. Don’t panic. It’s not as bad as it sounds. “Surgery is a lot more tenable than it used to be,” he says. “We used to perform gingivectomies where all the infected gums would be cut off. It was horrible. Now, there are different surgical approaches.”
Thank modern techniques such as the reverse bevel flap, a procedure that involves opening the gum to repair or remove damaged tissue, then stitching the gum back together. Gingival grafting is another industry staple. That’s when healthy tissue from the back or the roof of a patient’s mouth is grafted onto a patient’s receding or damaged gumline.
“Of course, today the amazing thing is we have materials that can grow new bone,” Malinowski says. Advanced bio-material called Emdogain essentially tricks the body into growing new bone in areas where bone has been stripped away.
Malinowski, who practiced in Greenville for 20 years, now serves a growing population in Sussex County. The resort area landed a good one in Malinowski. He’s a former assistant professor of periodontics at the University of Pennsylvania graduate department, and is currently on staff for Christiana Care Health System, Alfred I. duPont Hospital for Children, and St. Francis Hospital. He’s a diplomate of the American Board of Periodontology and a Delaware State Dental Society Award for Excellence winner.
The University of Pennsylvania School of Dentistry grad serves mostly older clientele, but younger patients oftentimes need gingival grafting or structural repairs done prior to orthodontic work. In either case, Malinowski can handle it.
“In dental school, everybody wanted to be a chief,” he says. “I wanted to be an Indian with the knowledge that I could be a chief.”
Page 2: Oral and Maxillofacial Surgery | Douglas Ditty
Douglas Ditty might be one of only a handful of oral and maxillofacial surgeons in Delaware, but he holds a distinction that’s rare even in such specialized company: a medical degree.
Two years of general surgery training, eight months of intensive care and trauma surgery training, and four months as a second-year anesthesia resident at the University of Pennsylvania comes in handy when he is repairing broken jawbones and soft tissue lacerations.
“I am proud of my medical school education,” he says. “It really helped me in my practice, kept me ahead of many of the things I do.”
A self-described perfectionist, Ditty has been practicing for five years in Dover, and he holds staff positions at Kent General Hospital and Milford Memorial Hospital. Though common procedures like wisdom teeth extractions and dental implants make up the bulk of his work, his duties range widely, from surgery to correct sleep apnea, to repairing jaw joint issues, and facial traumas, such as dog bites. “It really is a lot of everything,” he says. He also performs in-depth orthognathic surgery—physically moving the jaws of patients with structural deformities to improve their bites and facial aesthetics.
Ditty uses his surgical and anesthesia acumen to improve the lives of his patients, but immersing himself in education and technology has kept him on his toes.
“I really do enjoy all the various advances in technology in our field,” he says. “CT scanning, for example, is becoming a big part of the procedures I do.”
Following a CT scan, Ditty can use a 3D rendering of a patient’s mouth to first place implants digitally before using the same renderings to create custom implants. “I’m always open for trying new technology,” says Ditty, who travels to the University of Pennsylvania every other week to teach dental residents at the school’s oral surgery clinic. “Trying to stay involved in academics, attending conferences, continuing education—it’s all very important to what I do,” he says.
Equally important to Ditty is providing excellent customer services to his wide-ranging patients in the state’s capital.
“We find out exactly what the patient’s concerns are and then try to figure out the best way to address those concerns,” he says. “That is, hands down, the most important part. It’s also important to make sure patients understand the limitations of oral surgery, the things we just can’t do.”
For a surgeon of Ditty’s caliber, that isn’t much.
Page 3: Orthodontics | Constance Greeley and John Nista
The bumper stickers are virtually ubiquitous in New Castle County. Minivans, station wagons and SUVs at every stoplight are tagged with the same black initials on a white background: GNO.
The initials stand for Greeley and Nista Orthodontics, and the stickers are part of a prize patrol-like contest where the bearer can win free orthodontic care. Though the contest seems more befitting a radio station than a dental office, it’s one of the many elements of fun embraced at the popular North Wilmington and Newark practice.
“We have a lot of fun with the things that we do,” says John Nista, who represents one-half of the 20-year-old practice, along with partner Constance Greeley.
Contests, community involvement and a fun, video game-laden waiting room are all great marketing tools, but the practice is about more than fun and games. Serious success has come from the duo’s intense focus on providing the very best in clinical care. “We share those core values of integrity and honesty,” Nista says. “That, and we demand the very best from ourselves and each other.”
That’s accomplished by almost total immersion in the world of orthodontics and dental care. New techniques and new technologies are introduced at a constant pace. The pair communicate daily with a high level of confidence and drive toward continuing training.
“We do lots of continuing education,” Greeley says. “I have orthodontic review CDs in my car that I play. It’s nerdy, I realize, but it’s what we have to do. But if you love what you do, it doesn’t seem like work.
“John and I work very hard to be ahead of the curve. When new things come out, we don’t necessarily want to adopt them right away, but we look into them, study them, attend courses about them. We ask: Can this work in what we do? That’s what keeps our partnership so alive.”
Greeley and Nista are also part of an inter-disciplinary study club of local dentists and specialists who meet regularly to discuss overlapping patients in order to streamline care.
“Now we’re finding out how good oral hygiene and dental occlusion really help people have a better quality of life,” Greeley says.
The pair are clearly doing their part. Greeley, a graduate of Temple University School of Dentistry, is a past president of the Delaware State Dental Society. For 30 years, she’s maintained a spot on the Cleft Palate Team at Alfred I. duPont Hospital for Children. She currently serves as president of the Middle Atlantic Society of Orthodontics. Nista, who attended dental school at the University of Pittsburgh, is the incoming president of the state’s dental society.
With their expertise in areas such as self-ligation wires—which are not tied to each tooth to minimize pressure on the teeth when they move—as well as 3D cone beam imaging technology, the popular Invisalign treatment and temporary anchorage devices, Greeley and Nista bring the best and latest in the industry to their many patients. They’re not all children.
“Orthodontics isn’t just for kids,” Greeley says. “There are a lot of adults who didn’t have the opportunity to get braces as kids. We try to treat them with the same care and respect as our children. They just don’t get as many toys out of the deal.”
Click Here to download Top Dentists (194 KB). Dentists listed in this PDF were the most recommended by their professional peers, as determined by a Delaware Today survey of Delaware-licensed dentists. Descriptions include their dental schools. YIP denotes years in practice. NA denotes information not available. Addresses listed are for main offices only. Dentists may have others.