Dentist - Towson
8600 LaSalle Rd. Suite 406 Severn Bldg.
Towson, MD 21286
410-321-0551

Posts for: November, 2011

By Dr. Mark Shulman
November 27, 2011
Category: Oral Health
Tags: oral health   tmd   tmj  

The term TMD means “Temporomandibular Disorder.” But if you suffer from this disorder, it means pain. The pain can be mild or severe, acute or chronic, and it can appear to be centered in different locations, making it difficult to diagnose.

People who clench or grind their teeth because of stress often experience the pain of TMD. They might not even know they are engaging in these habits, because they do them subconsciously, for example when driving in traffic or engaging in vigorous exercise. Another cause of TMD might be an injury such as a blow to the jaw.

You can feel your temporomandibular joints working if you place your fingers in front of your ears and move your lower jaw up and down. On each side the joint is composed of an almond shaped structure at the end of the lower jaw, called the condyle, which fits neatly into a depression in the temporal bone (the bone on the side of your skull near your ear). A small disc between the two bones allows the lower jaw to move forward and sideways. The joints are stabilized by ligaments and moved by muscles.

TMD pain is the result of a process that begins when a stimulus such as psychological stress or an injury to the joint causes spasms (involuntary muscle contractions) in the muscles that move the joint. Blood vessels in the muscle begin to accumulate waste products, causing chemical changes and lactic acid buildup in the muscle. Nerves in the muscle then signal the brain to stop the movement of the jaw by registering pain.

TMD pain can appear to originate from various locations in your jaw, head, or neck. This is why it's important to make an appointment with our office for a professional assessment and diagnosis.

Treatment aims to relieve the symptoms of pain and discomfort and to prevent them from recurring in the future. Treatment can include heat, mild painkillers, muscle relaxants, soft diet, and simple jaw exercises, as well as education regarding the causes of TMD. To prevent further pain you may be provided with a “bite guard,” or referred to relaxation training with a licensed therapist. A bite guard is designed to prevent the lower teeth from biting hard into the upper teeth. It is commonly worn at night, but can also be worn during the day if clenching and grinding are apparent.

If these simpler treatments do not solve the problem, we may recommend more complex procedures such as bite adjustment or, as a last resort, surgical treatment may be needed.

Contact us today to discuss your questions about TMD. You can also learn more by reading the Dear Doctor magazine article “TMD: Understanding the Great Imposter.”


Dental implants traditionally have a high success rate with numerous studies showing long-term success rates of over 95%. This is just one of the reasons they have been widely accepted as the best method for permanently replacing missing teeth. In fact, over-dentures, which are full dentures supported and stabilized by at least two dental implants, are now considered the standard of care by the American Dental Association (ADA) for people who have lost all of their teeth in one or both jaws. And while they have a high success rate, there are some factors that can compromise the success rates of implants.

These factors are generally divided into three categories: general health concerns, local factors, and maintenance issues.

  • General health concerns: Your general health, lifestyle, and habits can play a major role in the success of dental implants. For example, smoking, diabetes, osteoporosis (porous bone) or a compromised immune (resistance) system can all negatively impact implant healing and success. And if you have a history of radiation treatment to your jawbones, you are at a higher risk for complications.
  • Local factors: Some examples of local factors that can affect implant success include bone quality and quantity — having sufficient bone in the right place to accurately secure and locate the implants.
  • Maintenance issues: While implants are excellent high tech replacements for missing permanent teeth, they do require routine maintenance. This includes daily cleaning and continued professional care. Otherwise, implants are just like any other technically sophisticated devices — they may be susceptible to breakdown.

To learn more about dental implants, read “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.


By Dr. Mark Shulman
November 13, 2011
Category: Oral Health

If you like soft drinks and carbonated colas, beware. Acids in these drinks may be dissolving the minerals in your teeth — a process called chemical erosion. And don't think that natural fruit juices or sports and high energy drinks are any better than sodas. They also contain acids that dissolve the surface enamel of your teeth. Once your enamel is lost, it is gone forever. It cannot naturally recover.

Sadly, teeth in children and teenagers — an age group most likely to drink large quantities of soda and juices — may be more easily eroded by acids. These youngsters have not had long-term exposure to fluorides which harden tooth enamel and protects them from acid erosion.

The Difference between Erosion and Decay
Chemical erosion is not the same as tooth decay (cavities). In chemical erosion, acids in your mouth react directly with minerals in the outer enamel of your teeth. In the case of tooth decay, bacteria in dental plaque (a bacterial film that forms on your teeth) utilize the sugars in the drinks and produce acids that attack your teeth.

After Acidic Exposure, Wait 30 Minutes to an Hour before Brushing
You may think that the solution to chemical erosion is to brush the acidic solution from your teeth as soon after drinking them as possible. But tooth brushing immediately after can actually accelerate chemical erosion and make it worse. After they are bathed in an acidic solution, minerals in the tooth surface become partially dissolved. Brushing at this time may brush away the affected layer. If you wait a half hour to an hour, your saliva will have time to neutralize the acids and harden the tooth surface by adding minerals back into it.

Drinks Less Likely to Cause Dental Erosion
Instead of drinking colas and sports drinks, stick to water and/or milk, which have the added benefit of supplying calcium to help add minerals back to the tooth surface.

If you must sip on juices or soft drinks, try to do so only at mealtimes. This is preferable to drinking them all day long, which leaves your teeth constantly bathed in an acid solution. Avoid swishing the drinks in your mouth, and sip them with a straw to reduce contact between acidic drinks and your teeth.

Contact us today to schedule an appointment to discuss your questions about acid erosion of teeth. You can also learn more by reading the Dear Doctor magazine article “Dental Erosion.”


Of major importance in all wedding day plans is to ensure that you have your special day captured on film. And it is that fact that influences most brides and grooms to take a long and hard look in the mirror to observe their smiles. Not only do wedding dates motivate many brides and grooms to address concerns regarding their smile, it also serves as the perfect time for their parents to pursue their smile makeover dreams so that they too feel good about themselves in your wedding photos.

A proper smile makeover should have a two-fold design plan that ensures you obtain optimal functionality and oral health while creating the cosmetic look you want. Starting with the basics, a thorough dental cleaning is the least expensive way to remove stains and freshen both your smile and breath. We will also use this consultation to learn about your concerns, goals, expectations, and wedding day timeline to create the action plan for future treatments in reaching your smile makeover goals. You may also want to discuss whitening your teeth during your appointment, as whitening teeth is an effective way to brighten your smile a few shades in as few as 1 to 2 appointments plus whitening while at home.

If your smile makeover is a bit more challenging, relax. There are a wide variety of tools and techniques available that include bonding, veneers, crowns, bridges, and dental implants for restoring your smile. Or we may work closely with a specialist such as an orthodontist to straighten your teeth or a periodontist for periodontal plastic surgery that can alter your gum tissues and their relationship with your teeth. The most important tip to remember is to schedule your first dental appointment soon after you become engaged so that you have plenty of time prior to the big day to attain your picture perfect wedding day smile.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule an appointment. You can also learn more by reading the Dear Doctor article, “Planning Your Wedding Day Smile.”




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