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

Posts for: January, 2013

By Dr. Mark Shulman
January 25, 2013
Category: Oral Health
MaintainingAProperBiteCanKeepYouLookingYoung

Even with good dental hygiene and care, your teeth may show signs of wear as you age. Fortunately, we now have ways to treat these symptoms of aging and restore a youthful look and function to your teeth and jaws.

How Do Teeth Wear?

All the tissues in your body are constantly in a process of breaking down (catabolism) and rebuilding (anabolism). During childhood the anabolic processes exceed the catabolic processes. But after you have reached physical maturity the balance changes and the breakdown process begins to draw ahead of the building up. The result: signs of wear.

In your teeth, the outer layer, the enamel, is a hard, mineralized substance that is resistant to wear. Under the enamel is a layer called dentin, which is a living tissue something like bone. As teeth age, the dentin layer thickens, causing teeth to lose some of their whiteness. Most wear to your teeth comes from the pressure of the upper and lower teeth's biting surfaces against each other. How much wear occurs depends on your bite or occlusion (how the teeth are aligned, and how they meet) and the ways in which you use your teeth.

Constant interactions between the biting surfaces of your teeth result in removal of small amounts of enamel. Your body naturally compensates for this wearing away of material. As teeth wear, they erupt from your jaws by tiny amounts, moving slightly up or down to stay in the proper occlusal relation with the teeth on the other jaw. They also slowly move toward the front of your mouth.

If the wear becomes excessive, your body can no longer compensate for it. At this point you may find that your bite relationships are not working correctly, and the lower third of your face loses height. This creates or accentuates an older appearance.

Some people clench or grind their teeth, applying greater than normal — and damaging — forces to their teeth. This problem, often a reaction to stress, is called bruxism. It can cause a number of problems from jaw pain to loose teeth or excessive wear or tooth fractures. If you suffer from excessive wear due to bruxism, a professionally made mouthguard may prevent further damage.

Modern Dentistry Can Restore a Youthful Look

Modern dentistry can successfully restore the normal shape, appearance and function of worn teeth by installing porcelain crowns or veneers. These not only replace the tooth structure lost through wear, but they also restore the bite relationship. Crowns on excessively worn teeth can dramatically improve tooth color and facial appearance, resulting in a more harmonious, younger look.

Contact us today to schedule an appointment to discuss your questions about dental wear and aging. You can also learn more by reading the Dear Doctor magazine article “How and Why Teeth Wear.”


DontLiketheDrillNowTheresDrill-FreeCosmeticDentistry

If you have a tooth that just doesn't look good because of decay or injury, a porcelain laminate veneer is probably a good way to make it look as good as it ever did — and maybe even better! Dental veneers are composed of thin layers of dental ceramic material. They essentially replace the original tooth enamel and require preparation of the tooth by removing a small amount of enamel to allow room for the placement of the veneer.

Recently, more and more dentists have been using minimal prep or prepless techniques that do not require this preparation. In such cases, the porcelain is bonded directly to the outer layer of the tooth's enamel. Highly skilled dental technicians can design a custom-fit veneer that feathers into the tooth just short of the gum line.

Prepless techniques cannot be used in all situations, but when they are used appropriately the results are beautiful and very stable. Should you get prepless veneers? The following is a list of advantages and disadvantages of prepless veneers.

Advantages of prepless veneers include:

  • Tooth preparation or reduction is not needed, leaving the original tooth whole.
  • They are not placed under the gum tissue, eliminating the possibility that the restorations negatively impact the gum tissue.
  • They can be used to change the appearance of teeth that are too small or misshapen making the teeth look larger and eliminate unwanted spacing.
  • They can be used to “lengthen” teeth that have been worn down by grinding.
  • Since the underlying tooth has not been reduced, prepless veneers are reversible and practically risk-free.

Disadvantages include:

  • There are many cosmetic situations in which they cannot be used, and traditional veneers (requiring preparation) must be used instead.
  • Prepless veneers cannot be used in cases in which orthodontic treatment is recommended to move the teeth, such as improper tooth position, poor bite, or a poor facial profile.
  • Since they are added on to existing tooth structure, they do not work for teeth that are relatively large or in a forward position in a smile.
  • They do not usually work for lower teeth because of space restrictions.
  • They cannot replace lost or damaged enamel.

Working with prepless veneers requires special skills and training. Please discuss our credentials and experience with us when you inquire about this technique. We can assess your specific situation and let you know whether restoration without the drill is appropriate for you.

Contact us today to schedule an appointment to discuss your questions about prepless veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”


By Dr. Mark Shulman
January 07, 2013
Category: Dental Procedures
Tags: denture  
FullDenturesFrequentlyAskedQuestions

If an adult has lost his or her teeth (a condition called “edentulism”), full removable dentures (false teeth) can restore the person's appearance and ability to bite, chew, and talk properly. Even with our current extensive knowledge about tooth care and restoration, over 25 percent of Americans have lost all their teeth by the time they are 65.

How much do you know about dentures? Test yourself below.

How does tooth loss affect your bones?
Bone is a living substance that is constantly changing and rebuilding itself, depending on signals it receives from surrounding tissues. The bone that surrounds your teeth is called alveolar bone (from “alveolus,” meaning sac-like). To keep healthy, alveolar bone needs stimulation or function such as chewing and your teeth touching your opposing teeth. If you lose your teeth, bone begins to melt away (resorb).

How can we minimize bone loss during tooth extraction?
We can maintain bone volume by using bone grafting techniques. While this sounds scary, it is a relatively easy procedure. The principle of bone grafting is to build a sort of scaffolding on which your body begins to build and maintain its own bone. Bone loss can be prevented by the placement of a few dental implants.

How are dentures designed and created?
The dentures that look best and work best for you are based on your original teeth. We often utilize photographs of how you looked with your natural teeth, along with your input about possible changes you would like to see. First we take detailed impressions (molds) of the residual ridges in which your teeth once rested. From these we make denture bases of a light cured plastic resin. We attach horseshoe-shaped rims made of wax to the bases, to simulate the position of the teeth as we work out their design and spacing, based on both appearance and function. The prosthetic teeth are then tried out in your mouth, adjustments are made, and the dentures are processed in a dental laboratory. The final product substitutes a pink colored plastic (methyl methacrylate) to represent the gums and white plastic material as the teeth, created to make them look as natural as possible.

What is your part in the denture fitting process?
As a patient with new dentures, you must learn to use your jaw joints, ligaments, nerves, and muscles in new ways to help stabilize your dentures and to relearn to speak, bite, chew, smile, and laugh with these new structures. It takes a little practice, but with your removable dentures you can once again enjoy a complete and normal life.

Contact us today to schedule an appointment to discuss your questions about full removable dentures. You can also learn more by reading the Dear Doctor magazine article “Removable Full Dentures.”


By Dr. Mark Shulman
January 05, 2013
Category: Oral Health
YouThinkYouHaveSleepApneaWhatNow

Nearly everyone has snored at some point in life. However, if your sleeping partner routinely tells you that you suffer from this problem, you really should take action to confirm or deny your suspicions. You may be like one of the 50 to 70 million people in the US alone that suffer from Obstructive Sleep Apnea (OSA), a medical condition in which the upper airway (the back of your throat) collapses during sleep thus limiting your intake of oxygen. And this condition is serious. If left untreated, OSA can lead to a stroke, impotence, an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease.

The first and most important step you should take if you snore is to obtain a thorough examination by both your primary-care physician and our office. We have completed specialized training in sleep medicine so that we can not only diagnose but also thoroughly treat your sleep disorders.

If you are diagnosed with this problem, relax. We have many ways we can treat your condition. One of the most common methods is to provide you with oral appliance therapy. This first line of treatment involves our making a customized oral appliance (mouthpiece) that will hold your lower jaw forward. By doing this, we can move your tongue away from the back of your throat so that your airway is less likely to get blocked while you sleep. (It is this blockage that causes the infamous snoring sound.)

Another option we may consider using to treat your sleep apnea if it is moderate to advanced is a Continuous Positive Airway Pressure (CPAP) machine. These machines require you to sleep with a mask over your nose and/or mouth and produce continuous pressure in your windpipe so that your tongue is forced forward away from your airway. Not only can these machines potentially eliminate your snoring, but they can also give you the restful night's sleep that you have been missing.

The last and most permanent solution for treating certain non-responsive cases of sleep apnea is surgery. This option is typically reserved for the most advanced cases to eliminate or reduce an obstruction to the airway.

Contact us today to discuss your questions about sleep apnea or to schedule an appointment. You can also learn more about sleep apnea when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”




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