Sleep Apnea: As many as 90 percent of all cases are undiagnosed

Healthy Smiles by Rita Tempel, DDS – This column was originally published in the Gettysburg Times, February 15, 2018

There is a rising health issue among our population: sleep apnea. The number of people with obstructive sleep apnea (OSA) has steadily increased over the past two decades, but the most alarming thing is that it’s estimated that 80-90 percent of those affected are undiagnosed! I am compelled to talk about this topic today because, not only am I seeing more and more patients with sleep apnea, but members of my own family are also affected by this disorder.

So what is sleep apnea? It’s a disorder which causes a person to briefly stop breathing when asleep. Currently, more than 100 million people globally have been diagnosed with OSA. One of the most common indicators that someone has sleep apnea is a tendency to snore while sleeping. But that’s certainly not the only sign.

A landmark study was just released in the fall of 2017 with incredible findings specific to women and OSA. Here’s what they found: Women who have difficulty falling asleep, frequent awakenings, and restless sleep may indicate they have OSA.

Daytime clues that women may have OSA include mood symptoms, such as feeling depressed, anxious, irritable, or impatient, or always feeling tired or drained. Women with OSA may notice that they struggle to stay awake and may actually fall asleep at the wrong time or place, like at work or in public places. Women may also be experiencing cognitive difficulties—forgetfulness, foggy or fuzzy thinking, and trouble with word-finding, focus and concentration.

But there’s more. Additional studies, in both men and women, point to a link between sleep apnea and high levels of the amyloid protein associated with Alzheimer’s disease. However, by diagnosing sleep apnea in its early stages, people may actually DELAY the onset of Alzheimer’s disease, along with the risk of heart disease, high blood pressure, Type 2 diabetes and obesity. This is far-reaching, into so many areas of our health!

This is all valuable research, but we need to apply it to our loved ones. If you suspect you or a loved one may be at-risk for OSA, talk to your doctor or dentist. That’s right—your dentist! My dental practice, along with many others, helps patients get screened for, diagnosed and treated for OSA. I now offer a home sleeping test unit which will test you for obstructive sleep apnea. If you already have been diagnosed with sleep apnea and do not like wearing your CPAP, I will work with your physician or board-certified sleep physician to offer you an oral appliance solution. These customized oral appliances worn at night are durable pieces of medical equipment which not only alleviate the symptoms and health effects of OSA, but can increase your lifespan.

Researchers are urging medical professionals to help raise public awareness of OSA. I hope that by writing this column, I am doing my part! Please share this vital information with your friends and family—it could be life-changing.

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles, a cosmetic and family dental practice located at 2018 York Road (Route 30 East), Gettysburg. She is a Sustaining Member of the American Academy of Cosmetic Dentistry. For more information, see GettysburgSmiles.com, follow Gettysburg Smiles on Facebook, or call 717-339-0033.

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Dental Care is Critical for Baby Boomers

This column was originally published in The Gettysburg Times, January 17, 2018

Healthy Smiles by Rita Tempel, DDS

More and more American children are receiving dental care today than ever before—what great news! This trend has been on the increase for several years now and is cause for celebration.

But “babies” of another age—baby boomers—are unfortunately visiting the dentist less frequently and that is cause for concern. In today’s column, I’m going to shed a light on some of the facts regarding the critical need for baby boomers to resume and maintain their dental health.

“Baby boomers” are usually defined as the generation born directly after World War II between1946 and 1964. As a result of aging baby boomers, the elderly population of the United States is projected to increase from 48 million in 2015 to 92 million in 2060. Many health providers and health agencies are preparing for the increase in health services that will be required to take care of baby boomers as they age.

We are seeing a downward trend in dental visits by all working age adults today. This has been occurring the past several years and while it has a ripple effect on all adults’ overall health, it’s especially dangerous for baby boomers to skip their dental checkups.

Fewer seniors are requiring dentures today because their teeth are still relatively healthy—that is a very positive note! But here is the downside: Since many baby boomers and seniors still have their teeth, they remain at-risk for oral diseases and disorders. For example, as we age, we experience decreased salivary flow—called xerostomia. With a decrease in salivary flow, people are at a higher risk of tooth decay. Without regular dental checkups, tooth decay may go unchecked and undetected for some time, until there is pain and an emergency situation. Why do some baby boomers put themselves in this position, when regular checkups can easily prevent these situations?

Additionally, here are a few scenarios that can happen to patients of any age, but particularly those among the baby boomer and aging population: Patients who have lost some teeth should maintain regular dental checkups to ensure good dental health, particularly in these susceptible areas of their mouth. And for patients who aren’t happy with their smiles, implant dentistry or cosmetic dentistry can impact patients’ nutrition as well as social lives—both proven to increase lifespan.

Dental checkups, from the baby years, into baby boomers’ golden years, can ensure smiles for years to come!

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles, a cosmetic and family dental practice located at 2018 York Road (Route 30 East), Gettysburg. She is a Sustaining Member of the American Academy of Cosmetic Dentistry. For more information, see GettysburgSmiles.com, follow Gettysburg Smiles on Facebook, or call 717-339-0033.

 

Who is really in charge of your dental care?

Healthy Smiles by Rita Tempel, DDS – This column was originally published in The Gettysburg Times, December 20, 2017

Ask yourself this question:  “Am I really in charge of my dental health?”

Over my 25 years of practice, I have met and worked on thousands of patients. And the majority of patients that I have had the pleasure of meeting have dental insurance.

Unfortunately, over the years, dental insurance is paying for less and less each year—in terms of dollars, benefits and procedures. Which brings me to this extremely important and timely question:  Are you in charge of your dental health or are you allowing a dental insurance company to make your decisions for you?

As we finish 2017, many patients rush to “use their benefits” before the end of the year. Ask yourself, “Why now?” Offices have limited openings with only weeks remaining on the calendar, and they may not be able to treat you. Maybe you found out your insurance is changing from one company or another. Often I hear patients say, “Now I have to find someone who takes my insurance.”

Again, I ask you, “Who is in charge of your dental care?” I would ask you to carefully consider the relationship you have built with your dentist and the quality of care you’ve received over the years. If you are seeing a dentist you like and trust, why would you leave?  Is the $10 (or more) you might save, more important than staying with your continuation of care?

I have heard of many new types of dental plans coming in 2018. Some of these plans have even more ridiculous limitations than those imposed upon patients in 2017. Some patients blame their employers; however, the employers are “sold” on these plans, often not realizing the limitations provided to their employees.

So with a new year approaching, are you going to be the patient who is really in charge of your dental care?

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles, a cosmetic and family dental practice located at 2018 York Road (Route 30 East), Gettysburg. She is a Sustaining Member of the American Academy of Cosmetic Dentistry. For more information, see GettysburgSmiles.com, follow Gettysburg Smiles on Facebook, or call 717-339-0033.

 

The Silent Epidemic of Cracked Teeth

Healthy Smiles by Rita Tempel, DDS – This article was originally published in The Gettysburg Times, October 18, 2017

A cracked tooth in need of a crown

Did you know that cracked teeth are to blame for the third-leading cause of tooth loss?  Cracked teeth are considered a silent epidemic because we often observe these cracks before symptoms begin. In other words, cracked teeth are “silent” until the fracture worsens.

Why do teeth develop cracks? Although there are many reasons, here is one common scenario: A patient may have had a large filling placed in a tooth years ago. This large filling placed because of a large cavity—although necessary—will weaken the remaining tooth structure. This tooth is at risk for developing a crack, simply from stresses on the weakened tooth due to clenching, grinding, or chewing hard foods like pretzels or ice cubes. All of these actions take place on molars. So it makes sense that lower molars are the most common teeth to develop cracks, followed by upper molars and premolars.

What are the symptoms, and how do you know when the cracked tooth is transitioning from “silent” into an area that needs treatment? Once the crack worsens, patients either report a broken tooth, hot and cold sensitivity, and/or pain when biting. That’s typically when the patient calls for an emergency visit.

Once the tooth is symptomatic, treatment will most likely be a crown or full coverage restoration. For my patients, I will typically make them a temporary or provisional crown first to ensure their symptoms have subsided. If the symptoms subside, we continue with the final crown. If the symptoms haven’t subsided, then the tooth may need a root canal.  However, if the crack extended onto the root itself, the only treatment is extraction.

How do we prevent losing teeth? First, routine dental visits are critical to document the condition of your teeth. Any cracks visualized by the dentist may require treatment before symptoms develop. This early treatment may increase the lifespan of your tooth!  Cracks are typically treated with resins, onlays and crowns. For example, if a crack is on one side of the tooth, we may be able to treat it with a simple, tooth colored bonded resin. However, if the crack travels from one side to the other, a crown is required.

Take care of your smile—and the smiles of your loved ones—by “listening” for any changes within your mouth, especially in formerly “silent” cracked teeth. Time can be precious so please do not delay in scheduling an appointment to preserve your healthy smile.

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles/Dr. Rita Tempel & Associates, a family dental practice located at 2018 York Road (Route 30 East), Gettysburg.  She is a Sustaining Member of the American Academy of Cosmetic Dentistry as well as a Preferred Provider for Invisalign. For more information, see GettysburgSmiles.com or contact Dr. Tempel at 717-339-0033.

 

 

“Give Back a Smile”

Healthy Smiles by Rita Tempel, DDS – This column originally published in The Gettysburg Times, September 20, 2017

October is Domestic Violence Awareness Month, and I want to focus this month’s column on an aspect of domestic violence that is often overlooked or unrecognized—the dental injuries sustained by many women or men. Although it is not yet October, I want to spread the word about a life-changing program, in hopes that area residents may be encouraged to come forward and have their smiles repaired and thereby, have their confidence and lives restored.

My dental practice is affiliated with a charitable program offered by the American Academy of Cosmetic Dentistry called “Give Back a Smile.” If you or someone you know have sustained dental injuries from a former partner or spouse, please read the following guidelines and encourage her/him to apply for free dental work. First, the applicant must be free from all abusive relationships, and in a different home from the abuser, for at least a year. That means the injuries must have happened at least one year ago.

“Give Back a Smile” helps repair some of the worse dental injuries a person can experience—injuries to the front teeth. These are the teeth that we typically see when people smile. There are so many ways that domestic violence can damage a person. Losing the desire to smile, I believe, has one of the most tragic effects on a person’s life.

The Give Back a Smile application process starts by finding the application online at www.aacd.com/aboutGBAS. I will also be posting links from my Facebook page, www.facebook.com/GettysburgSmiles. Please share the links or posts on social media to help spread the word.

The applicant will need to complete the application with their domestic violence or sexual assault advocate, case manager, counselor, faith leaders, therapist or doctor. Once the application is received by the Give Back a Smile charity, applicants will be notified within 30 days and matched up with a dental provider. I’m honored to be the volunteer dental provider for our area, and I’m honored to have helped restore smiles to numerous patients with the desire to reclaim their smiles and their lives.

I will leave you with a testimonial from a Give Back a Smile patient named Mona:

“It was the day after Valentine’s when the man I thought loved me shot me at close range. My jaw was shattered and my palate severely damaged… I was devastated… and disfigured. While grateful to be alive, my face had become a gruesome and inescapable reminder of one person’s brutality. That all changed when I was given the phone number for Give Back a Smile. (They) were able to return to me the smile that had been so violently stolen.”

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles, a cosmetic and family dental practice located at 2018 York Road (Route 30 East), Gettysburg. She is a Sustaining Member of the American Academy of Cosmetic Dentistry. For more information, see GettysburgSmiles.com, follow Gettysburg Smiles on Facebook, or call 717-339-0033.

Healthy Smiles: Summer Vacation Tips

Healthy Smiles by Rita Tempel, DDS – This article was originally published in The Gettysburg Times, July 19, 2017

Summertime schedules can be crazy—I know first-hand! The calendar fills up quickly, between vacation plans, picnics, and fun activities. But medical appointments also take priority, especially for families who prefer their children not miss school days or school sports. In this column, I’d like to pass along some dental tips for summertime.

  • Make summer dental appointments early. Summer unfortunately goes by all too quickly! I encourage parents to make appointments for their children as soon as possible before summer appointments are booked and the new school year has begun.
  • Dental issues on vacation? Make sure your dentist’s phone number is programmed into your cell phone, or keep his/her business card in your wallet for emergencies. Many dental emergencies can be resolved over the phone, especially if you have kept regular 6-month checkups with your dentist. Calling your dentist can help you determine whether your issue is something that can wait until you arrive home, or needs to be treated immediately.
  • How to properly pack your toothbrush. At home, your toothbrush has the chance to air dry between uses. When traveling, it’s important to keep your toothbrush separate and clean, so use a toothbrush holder or resealable plastic bag. In between uses, leave the holder or bag open so your toothbrush can dry.
  • Stay on track. One of the main purposes of going on vacation is to escape the “daily grind.” While your schedule may be relaxing, it’s important to continue your dental hygiene routine and not become lax. We often consume indulgent treats or drinks on vacation, so don’t let your guard down on brushing and flossing.
  • Take flight with sugarless gum. When you’re flying, ear pressure is relieved by chewing, so gum is a great choice. Sugarless gum or xylitol gum make great choices!
  • Beat the heat with water. Whether you’re at the beach, in the mountains, or by a lake—remember that water is the best beverage of choice for many reasons. From a dental perspective, sugary drinks such as soda, sports drinks, lemonade, etc. are okay once in a while, but when consumed regularly, can lead to cavities.
  • Can’t drink the water? Let’s say you’re headed to an exotic locale, or you’re embarking on a wilderness trek, where the water source is compromised. In those cases, always use bottled water to brush your teeth.
  • Prevention is the key to avoiding catastrophe. Many dental emergencies, whether experienced at home or on vacation, can be prevented by maintaining a regular schedule of dental visits every six months. Be sure to stay up-to-date on all of your medical appointments, so that you can maximize the enjoyment of your hard-earned vacation time!

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles, a cosmetic and family dental practice located at 2018 York Road (Route 30 East), Gettysburg. She is a Sustaining Member of the American Academy of Cosmetic Dentistry. For more information, see GettysburgSmiles.com, follow Gettysburg Smiles on Facebook, or call 717-339-0033.

Changing Times in Dentistry

Healthy Smiles by Rita Tempel, DDS

This article was originally published in The Gettysburg Times, May 17, 2017

A couple of weeks ago I attended my annual dental meeting of the American Academy of Cosmetic Dentistry (AACD). This year’s meeting, held in Las Vegas, was outstanding. Every year we are introduced to new technologies and materials to improve the quality of level of care we can provide to our patients.

Over 25 years ago, our only options for crowns were either metal or porcelain fused to metal. Today, we have so many options for “porcelain” or “ceramic” crowns. The different materials have advantages and limitations, so it is very important that as a dentist, I know my patients’ health, diet, functional or grinding habits, as well as what kind of toothpaste they use since all of these factors affect the different types of ceramics in a patient’s mouth.

A few months ago, I wrote an article on the abrasiveness of toothpaste. Still today, I review my toothpaste charts with patients to show that something as innocent as toothpaste can and will affect one’s oral health and restorations. Imagine what a diet of soda drinking, sucking on lemons, and ice chewing will do to teeth and ceramics?

The world of dentistry is changing. So what does the future hold? Robotics were mentioned at this year’s meeting as being the future of dentistry. Slowly but surely, technologies are replacing what used to be mainstream dental care. Also, the styles and types of dental practices have drastically changed over the last decade. Solo practices or one dentist offices where the dentist stayed and practiced for 30+ years are being replaced by group practices, corporate practices and boutique style practices. Corporate practices tend to market heavily with “cheap deals” and have a high turnover of staff and doctors. Boutique style practices invest in their services and offer patients high quality services with individualized attention.

As a sustaining member of the American Academy of Cosmetic Dentistry, I abide by the code of ethics to dedicate the knowledge I acquire for the betterment of the health and well-being of my patients. The AACD has world-class lectures and hands-on workshops which lead AACD members to provide excellent clinical dentistry with responsible ethics. To achieve esthetic excellence, the AACD has established parameters and criteria to guide AACD dentists through the process of delivering responsible excellent esthetic dentistry.

Every time I return to from an annual meeting with some of the best dentists from around the world, I am inspired to continue to “sharpen the saw,” up my game, and offer my patients the “Ferrari” or best of the best that today’s dentistry offers.

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles, a family dental practice located at 2018 York Road (Route 30 East), Gettysburg. For more information, see GettysburgSmiles.com, follow Gettysburg Smiles on Facebook, or call 717-339-0033.

Oral Cancer: 10 Quick Facts You Need to Know

Healthy Smiles by Rita Tempel, DDS

This article was originally published in The Gettysburg Times, April 19, 2017

April is Oral Cancer Awareness Month, and since dentists are usually the first health professionals to detect oral cancer in patients, I want to provide 10 facts to help combat this disease—one of the fastest-growing cancers today. Information is provided by the American Dental Association, American Cancer Society, or Oral Cancer Cause.

  1. The main risk factors: Tobacco is the primary risk factor, but an increasing risk factor is the sexually-transmitted disease Human Papillomavirus (HPV), especially the HPV-16 strain. Additional risk factors include excessive alcohol use, a high rate of exposure to UV sunlight rays, and poor nutrition.
  1. Symptoms of oral cancer: If the following symptoms do not resolve or go away after two weeks, see your dentist: an ulcer that doesn’t heal; sore throat; red or white patches; difficulty swallowing, speaking, or moving your tongue or jaw; or a lump on your neck, lips, or in your mouth.
  1. Who is most at-risk? Historically, men have been twice as likely to develop oral cancer than women, due to a higher rate of tobacco and alcohol use (defined as more than two alcoholic beverages daily). Since cancers of the mouth and oropharynx or throat take years to develop, patients are typically 55 years or older when first diagnosed. However, HPV-related oral cancer patients are younger and may not have smoking and drinking habits as risk factors.
  1. How do I get screened for oral cancer? The American Dental Association recommends that dentists provide oral cancer screenings as part of regular patient exams. It’s painless and only takes a few minutes. Your dentist is looking for any signs of the symptoms mentioned above.
  1. What are the statistics? The American Cancer Society estimates that nearly 50,000 people will be diagnosed with oral cancer in 2017, with nearly 10,000 people dying due to the disease.
  1. Where does oral cancer strike? Patients usually develop oral cancer in the tongue, tonsils, gums, throat, cheeks, floor of mouth, lips, and minor salivary glands in the roof of the mouth.
  1. How does oral cancer affect everyday life? Oral cancer can affect how you feed your body with food and drink, how you speak, the ability to kiss a loved one, or how you smile. Some patients have their mouths reconstructed, teeth removed, or areas of their tongue removed.
  1. Why is oral cancer often called “a silent killer?” The symptoms are often undetected or undiagnosed until a patient is in the late stages of the disease (stages 3 or 4) when the chance of survival can be as low as 20-30%.
  1. How do we as a society combat oral cancer? Like many cancers, early detection is the key. If caught early (stages 1 or 2), oral cancer survival rates may be as high as 80-90%. Regular dental checkups are essential.
  1. What can I do? Talk to friends and family, especially those who don’t receive regular dental checkups. Encourage them to visit a dentist regularly, not only for oral cancer screenings, but for increased dental and overall health.

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles, a family dental practice located at 2018 York Road (Route 30 East), Gettysburg. For more information, see GettysburgSmiles.com, follow Gettysburg Smiles on Facebook, or call 717-339-0033.

What Cold and Flu Season Does to Your Dental Health

Healthy Smiles by Rita Tempel, DDS – This article was originally published in The Gettysburg Times, Wed, March 15, 2017

We’re not out of the woods yet—cold and flu season peaks between December and March, but usually lasts through May. If you or a loved one gets sick, here are six steps you can take to ensure your dental health doesn’t suffer during your recovery.

  1. Remember your routine. First, this may seem obvious, but a lot of people forget to continue brushing their teeth regularly when they’re sick. Even if you’re resting in bed most of the day, it’s important to keep up with your oral hygiene routine by brushing twice a day for at least two minutes. The simple act of cleaning your mouth will probably make you feel better, too!
  1. Stay hydrated. When you’re sick, you need plenty of fluids. Often, medications such as antihistamines, decongestants, or pain relievers, contribute to a dry mouth, which puts you at a greater risk for cavities. Drinking plenty of water is the best way to combat dry mouth. Throat lozenges or cough drops also help, but keep reading!
  1. Go sugar-free. If you need cough drops, check the packaging and purchase those labeled “sugar free.” Otherwise, if you’re spending a lot of time with sugary cough drops in your mouth, the higher your chances that bacteria—feasting on that sugar—is putting you at risk for cavities.
  1. Use caution with cold sores. If you develop cold sores on your lips, they are highly contagious, especially during the early stages of the eruption of the lesion. Do not share utensils, do not kiss anyone, and do not touch the lesions and then touch others.
  1. Swish and spit. If you have the stomach flu, unfortunately it often leads to vomiting. This coats your teeth with acid from your stomach. You may be tempted to brush your teeth right away, but that would actually spread the acid throughout your mouth. It’s actually better to swish with water, spit, and rinse out your mouth. After waiting 30 minutes, then you can brush your teeth.
  1. Replace your toothbrush. It’s always better to err on the side of caution, and replace your toothbrush after an illness. Or, you may run it through the dishwasher to kill any lingering germs.

Wishing you a healthy remainder of the cold and flu season!

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles, a family dental practice located at 2018 York Road (Route 30 East), Gettysburg.  She is a Sustaining Member of the American Academy of Cosmetic Dentistry as well as a Preferred Provider for Invisalign. For more information, see GettysburgSmiles.com, follow Gettysburg Smiles on Facebook, or contact Dr. Tempel at 717-339-0033.

How Diabetes Affects Dental Health

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Healthy  Smiles by Rita Tempel, DDS – This article was originally published in the Gettysburg Times, February 15, 2017

Diabetes is often called an “epidemic” in America. According to the Centers for Disease Control and Prevention (CDC), nearly 30 million Americans now have diabetes. Here in Pennsylvania, 1.45 million residents (nearly 13% of the adult population) are affected by diabetes. Even more surprising, 3.5 million Pennsylvanians (35.8% of the adult population) have prediabetes with blood glucose levels higher than normal. Since the diabetic population is on the rise, I’d like to take time in today’s column to address how diabetes affects dental health.

First, let’s define “diabetes:” a disease in which the body cannot properly control the amount of sugar in the blood because it does not have enough insulin. There are basically three types of diabetes: Type 1 (juvenile diabetes), Type 2, and Gestational Diabetes (occurring during pregnancy).

The most common and serious connection between diabetes and dental health is gum disease. According to the American Diabetes Association (ADA), gum disease is one of the leading complications associated with diabetes, right up there with heart disease, stroke, and kidney disease. In fact, the ADA states that it’s a “two-way street,” because research shows that people with diabetes are more susceptible to gum disease, and serious gum disease may affect blood glucose control and contribute to the progression of diabetes. This is mainly because diabetics are more susceptible to bacterial infection and have a decreased ability to fight bacteria that invade their gums.

What are some of the warning signs associated with gum disease?

  • Bleeding gums during brushing or flossing
  • Redness or tenderness of the gums
  • Gums that have pulled away from teeth
  • Bad breath
  • Changes in the way your teeth fit when you bite
  • Changes in the way that your partial or complete dentures fit

In addition to gum disease, additional oral health issues that are often associated with diabetic patients include:

  • Oral infections
  • Fungal infections such as thrush (white patches in the mouth)
  • Slower healing process after dental surgery
  • Dry mouth, which increases the risk of cavities

So what can diabetic patients do to maintain a healthy balance between their overall and dental health?

  • It is critical that diabetic patients see their dentist for cleanings at least every six months; possibly every three months if the patient has gum disease.
  • Regular brushing and flossing, at least twice a day, is also critical.
  • It’s also of vital importance to be aware of any changes in dental health, such as the warning signs for gum disease listed above, and then making dental appointments to stay on top of any potential issues.
  • Drink plenty of water.

Hopefully all of this information helps you or a loved one successfully maintain dental health in the midst of diabetes. Regular dental visits and communication with your dentist are more important than ever, to maintain both your overall and dental health. Although diabetes is a serious disease, I believe patients can successfully maintain their smiles through it all!

Dr. Rita Tempel is the owner and founder of Gettysburg Smiles/Dr. Rita Tempel & Associates, a family dental practice located at 2018 York Road (Route 30 East), Gettysburg.  She is a Sustaining Member of the American Academy of Cosmetic Dentistry as well as a Preferred Provider for Invisalign. For more information, see GettysburgSmiles.com or contact Dr. Tempel at 717-339-0033.