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

Posts for: January, 2014

By Dr. Mark Shulman
January 28, 2014
Category: Oral Health
Tags: oral cancer  
OralCancerOverviewWhatYouShouldKnow

Cancer is never a pleasant topic. Yet, rather than wish it away, many people have chosen to take an active and positive role in the prevention and early detection of the disease. Did you know that you and your dentist, working together, can help identify a major class of cancers in the early stages? Let's spend a few moments discussing oral cancer.

Oral cancer is dangerous. Although it accounts for a relatively small percentage of all cancers, it isn't usually detected until it has reached a late stage. And at that point, the odds aren't great: only 58% survive 5 years after treatment, a rate far less than that of many better-known cancers. It is estimated that in the United States, this disease kills one person every hour, every day.

Oral cancer used to be thought of as an older person's disease — and it still primarily strikes those over 40 years of age. But a disturbing number of young people have been diagnosed with the illness in recent years, making them the fastest-growing segment among oral cancer patients. This is due to the sexually-transmitted Human Papilloma Virus (HPV16). So, while long-time tobacco users and heavy drinkers still need screenings, most young people do too.

What's the good news? When it's detected early, the survival rate of oral cancer goes up to 80% or better. And having an oral cancer screening is part of doing something you should be doing anyway — getting regular dental checkups. That's one more reason why coming in to our office regularly for your routine examination is so important.

Of course, if you notice any abnormal sores or color changes in the tissue around your mouth, lips, tongue or throat — especially if they don't go away in 2-3 weeks — come in and see us right away. They could be just cold sores — or not.

An oral cancer exam is fast and painless. It involves a visual inspection of the mouth and surrounding area (face, lips, throat, etc.), during which we may also feel for lumps. We'll also gently pull your tongue from side to side, and check underneath it for early signs of a problem. If needed, we can schedule a biopsy for any suspicious areas. Sound easy? It is! So don't ignore it — remember that early detection could save your life.

If you would like more information about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”


By Dr. Mark Shulman
January 24, 2014
Category: Dental Procedures
Tags: root canal   endodontics  
NeedaRootCanalFearNot

Perhaps you or someone you know has been told they will need root canal treatment. Maybe you're experiencing some unexplained tooth pain, and you think you might need to have this procedure done. Nervous? You shouldn't be! A good understanding of this common and relatively pain-free dental treatment can go a long way toward relieving your anxiety.

What's a root canal? It's the small, branching hollow space or canal, deep within the root of the tooth. Like an iceberg in the ocean, a tooth shows only part of its structure above the gum line: That's the part you see when you smile. But about two-thirds of the tooth — the part called the root — lies below the gum. A healthy root canal is filled with living pulp tissue, which contains tiny blood vessels, nerves and more.

A “root canal” is also shorthand for the endodontic treatment that's called for when problems develop with this tissue. For a variety of reasons — deep tooth decay or impact trauma, for example — the pulp tissue may become inflamed or infected. When this happens, the best solution is to remove the dead and dying tissue, disinfect the canals, and seal them up to prevent future infection.

How is this done? The start of the procedure is not unlike getting a filling. A local anesthetic is administered to numb the tooth and the nearby area. Then, a small opening is made through the chewing surface of the tooth, giving access to the pulp. A set of tiny instruments is used to remove the diseased tissue, and to re-shape and clean out the canals. Finally, the cleared canals are filled with a biocompatible material and sealed with strong adhesive cement.

After root canal treatment, it's important to get a final restoration or crown on the tooth. This will bring your tooth back to its full function, and protect it from further injury such as fracture. A tooth that has had a root canal followed by a proper restoration can last just as long as any other natural tooth. And that's a long time.

If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”


EndtheEmbarrassmentofStainedTeethwithWhitening

You have a beautiful smile, but you hesitate to show it because of your stained teeth. Fortunately, whitening techniques could take away that embarrassment.

There are two basic types of tooth staining or discoloration: extrinsic, in which the stain is on the surface of the teeth and mostly caused by substances like coffee, wine or tobacco; and intrinsic, which occurs deep within the tooth, caused by such factors as aging, previous dental treatments and fillings, the use of antibiotics (tetracycline, predominantly), or over-exposure to fluoride.

Whitening or bleaching is an effective and relatively affordable solution for many instances of both intrinsic and extrinsic staining. Bleaching solutions are available in over-the-counter (OTC) home kits or as a professional application in the dental office.

Most bleaching solutions use carbamide peroxide, a chemical compound that is effective in removing most stains. OTC home applications contain carbamide peroxide (or an equivalent) in concentrations of about 10% as opposed to 15-35% found in professional solutions. Though less costly than a professional application, OTC products take longer (usually up to three weeks) to achieve desired results. With its stronger solution, a professional application in our office can achieve the same level of brightness in only one or two visits. We may also use special lighting to accelerate the chemical process, as well as rubber dams or gels to protect gums and soft tissues from solution irritation during the procedure.

Although effective, whitening isn't a permanent solution — over time the effect will fade, usually six months to a year depending on how you care for your teeth. Matching tooth color can also be difficult in some cases, especially if you have a mix of natural teeth and artificial crowns or bridges. And, whitening may not be adequate for some types of staining.

Regardless of which application you wish to use — OTC or professional — it's a good idea to visit us first for a professional consultation. We can recommend whether whitening is a good choice for your particular type and level of staining, or if some other option like porcelain veneers might be the better choice. Regardless, there are solutions to the problem of staining, and a way to gain a brighter smile.

If you would like more information on bleaching, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Whitening.”


AlthoughChallengingSmileZoneImplantscanAppearBeautifullyLife-Like

Dental implants have quickly become the restoration of choice for two basic reasons: they effectively restore the lost function of missing teeth and simultaneously rejuvenate the smile with their life-like appearance.

Achieving a life-like appearance, however, isn’t always a simple matter. A restoration in what we dentists call the “Smile Zone” (the upper front area that displays both teeth and the gum line when you smile) requires careful planning and technique to ensure they appear as life-like as possible.

Our first concern is whether there’s enough bone to fully anchor an implant. Bone is a living, dynamic tissue that goes through cycles of dissolving (resorption) and growth. The normal forces of biting and chewing transmit through healthy teeth and stimulate growth in the bone. When the teeth are missing and no longer transmit this pressure, the bone will eventually resorb only and not grow.

Adjacent teeth could also be affected with bone loss if the extraction was difficult and a bone graft was not placed into the extraction socket to preserve bone. This not only puts adjacent teeth at risk of gum and bone loss but can also have implications for the final smile appearance. This bone also supports the triangular tissue between teeth known as papillae which give teeth their arched appearance. If the bone isn’t adequate, there’s less hope that the papillae will regenerate.

With these concerns it’s very important to consider how the implant and crown emerges from the gums in the Smile Zone. Recent developments in implant design are helping in this regard. The design change of the top of the implant re-orients the gum tissues in relation to the implant from vertical to horizontal, which dentists call “platform switching.” This provides greater stabilization where bone mass is limited, and helps create a more aesthetically pleasing result. There are also other techniques, such as surgical tissue grafting of the papillae that can further enhance the final appearance.

Although creating a natural, life-like appearance in the Smile Zone is difficult, it’s not impossible. It’s important first to undergo a complete dental examination and profile, where we can advise you on your best options to achieve a beautiful smile.

If you would like more information on the relation of implants to the aesthetics of your smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Implant Aesthetics.”




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