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

Posts for: April, 2014

By Dr. Mark Shulman
April 28, 2014
Category: Dental Procedures
Tags: root canal  
DoesRootCanalTreatmentLastForever

Perhaps you’ve been told that you need to have root canal treatment in order to save one or more of your teeth. By now, you know that the procedure itself is essentially pain-free, and that it has an excellent chance of success. But you may be wondering — just how long can you expect that “saved” tooth to last?

The short answer is: decades… or even a lifetime. But in just the same way that no two fingerprints are exactly identical, neither are any two teeth with root canals. There are some factors that could result in one tooth having a greater longevity after root canal treatment (RCT) than another — but before we go into them, let’s look at what RCT actually involves.

When infection and inflammation is allowed to get a foothold deep inside a tooth — usually due to uncontrolled decay or trauma — the nerves, blood vessels and connective tissue that make up the tooth’s pulp begin to die. If left untreated, the infection can spread out of the tooth and into the bone of the jaw. This may lead to further problems, including the development of a painful abscess, and eventual loss of the tooth.

Root canal treatment involves gaining access to the infected pulp tissue through a tiny hole made in the tooth, and then removing it. Next, the space inside the tooth is disinfected and filled with sterile material, and the access hole is closed. Afterward, a crown or “cap” is often needed to protect the tooth and restore it to full function in the mouth.

One factor that can influence how long a treated tooth will last is how soon the tooth is restored following the root canal procedure: The sooner it receives a permanent filling or crown, the longer it is likely to last. Another factor is whether or not the underlying infection has spread into the bone of the jaw: A tooth that has received RCT promptly, before the infection has had a chance to spread, is likely to have greater longevity.

Some of the other factors that may influence the longevity of a tooth after RTC are: the location of the tooth (front teeth are easier to treat and receive less biting force than back teeth); the age of the individual (teeth become more brittle over time); and what other work needs to be done on the tooth (such as the placement of posts, which may in time weaken the tooth’s structure.) In general, however, there’s no dispute that a tooth which has received a quality root canal treatment should last for many years to come — if not an entire lifetime. And to many people, there’s simply no substitute for having your own natural teeth.

If you would like more information about root canal treatment, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Root Canal Treatment: How Long Will It Last?


WhatsTheDifferenceBetweenBridgeworkandDentalImplants

When a natural tooth can’t be preserved, it is important to have it replaced as soon as possible. Presently, there are two excellent tooth-replacement systems in wide use: traditional bridgework and high-tech dental implants. What’s the difference between the two methods?

Essentially, it comes down to how the replacement tooth is secured in the mouth. In the dental implant system, a natural looking prosthetic tooth is solidly anchored in place by a screw-like titanium implant. This is inserted directly into the bone of the jaw in a minor surgical procedure, and over a short period of time (usually 6 – 12 weeks) its titanium metal structure will actually become fused with the living bone.

With bridgework, however, the support for the prosthetic tooth (or teeth) comes from the healthy teeth adjacent to it. These teeth must be prepared (shaped) by carefully removing some of the outer tooth material (enamel and some dentin), which enables them to be fitted with coverings called crowns or caps. Crowns are often used on their own, to restore teeth that are missing too much of their structure to be treated effectively with standard fillings. But the bridgework system goes one step further.

Instead of making individual crowns for each tooth, a dental lab will fabricate a bridge — a single unit consisting of crowns for the prepared teeth, plus complete prosthetics to replace the missing tooth (or teeth). A three-unit bridge, for example, consists of one complete prosthetic tooth to replace the one that’s missing, plus two crowns for the adjacent “abutment” teeth. It’s possible to have larger bridges as well: For example, a six-unit bridge might consist of two complete prosthetic teeth in the center, with two crowns for abutment teeth on each end, all linked together in one piece.

While bridgework has been used effectively for decades, it is now being gradually supplanted by dental implants. Implants don’t require the removal of healthy tooth material from abutment teeth, and they don’t place extra stress on those teeth; plus, they generally last much longer than natural tooth bridges. However, the dental bridge remains a viable alternative for tooth replacement in many circumstances.

If you would like more information about dental bridgework, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Crowns & Bridgework.”


ProperOralHygieneisJustasImportantforImplantsasitisforNaturalTeeth

One of the great benefits that patients with implants enjoy is their imperviousness to decay: unlike a natural tooth, bacteria have no effect on the materials in an implant’s construction. That doesn’t mean, however, you can become lax in your hygiene habits — although the implants may not be susceptible to disease, the surrounding gum tissue and bone are. If those tissues become infected you could start to lose the implant attachment and, as it progresses, the implant itself.

In fact, the gum tissue that surrounds the implant may be more susceptible to infection than those around natural teeth. Teeth maintain a connection with the jawbone through the periodontal ligament. Besides securing the tooth, the gum tissue has fibrous attachments to the tooth to help the gum tissue endure a lot of wear and tear and resist the invasion of bacteria and food particles. Implants are anchored directly into the jawbone (where bone eventually grows and attaches to the titanium implant surface) and don’t develop an attachment with the ligament. Implants, therefore, don’t have the benefit of resistance to bacteria and food particles that natural teeth receive through these fibrous attachments.

As a result, patients with implants need to establish a conscientious habit of effective oral hygiene. Daily removal of bacterial plaque from teeth surfaces through brushing and flossing (and semi-annual office cleanings and checkups) greatly reduce the risk of infection and subsequent inflammation. It’s also important to monitor the condition of your gums, especially around implants. If you begin to notice bleeding, red or swollen gums, or other signs of possible gum disease, you should contact us as soon as possible for an assessment.

Proper care for implants and their supporting tissues is just as necessary, and perhaps more so, than it is for natural teeth. By providing that care, you’ll help ensure years of effective service from your implants.

If you would like more information on hygiene practices with implants, 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 “Infections Around Implants.”


By Dr. Mark Shulman
April 09, 2014
Category: Oral Health
Tags: oral health   nutrition  
HerbalSupplementsDoYouHavetoTellYourDentist

If you’ve come in to our office lately, chances are you’ve been asked to fill out a form or answer a question about what medications — both prescription and non-prescription — you are currently using. Of course, if you’re taking a blood-pressure drug or a pill to help control your cholesterol, you wouldn’t hesitate to put it on the list. But how about those vitamins and herbal supplements you take — do you really have to list those too?

The answer is a definite yes — and some of the reasons why may surprise you. Did you know that many “natural” dietary supplements can have potentially serious interactions with other drugs you may be prescribed? For example, herbal preparations made from the plant called St. John’s Wort are often used by people seeking relief from depression or anxiety. However, the active chemical compounds in this herb can interfere with some anesthetic drugs, and may make it harder for you to recover from the effects of anesthesia. Ginkgo biloba and some other commonly used herbs have a similar effect.

Even some vitamins have the potential to cause negative interactions. Large doses of Vitamin E, for example, can increase the risk of internal bleeding in people who are taking blood thinners or non-steroidal anti-inflammatory medications (NSAIDS), such as aspirin and ibuprofen. These medications are commonly prescribed for pain relief after minor dental procedures.

Does that mean you have to stop taking vitamins and herbal supplements if you may need a dental or medical procedure? Not necessarily. Vitamins are indeed vital to your health, and a deficiency in one or more of these important substances can result in serious diseases — like scurvy, which formerly plagued sailors lacking access to fresh fruits and vegetables. If you’ve been told you have a vitamin deficiency, taking vitamin pills is a must.

But the best way to get the proper amount of vitamins is through a healthy, well-balanced diet rich in fruits, vegetables, and whole grains. Not only does consuming these foods give you the most “natural” source of vitamins — it also provides you with other essential micronutrients and fiber, and it is low in fat and cholesterol.

No nutritional supplement is a substitute for a healthy diet — and that’s something we’d like everyone to remember. We’d also like to remind you to tell us about ALL the medications and supplements you’re taking, especially if you’re going to have a procedure. Giving us complete information will help ensure that you’ll remain as healthy and safe as possible.

If you have questions about dietary supplements, nutrition and your teeth, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Vitamins & Dietary Supplements: What Every Consumer Should Know.”


By Dr. Mark Shulman
April 01, 2014
Category: Dental Procedures
Tags: root canal  
RootCanalTreatmentAFirst-TimersGuide

It’s often said that thereĆ¢??s a first time for everything: Driving a car by yourself; getting your first “real” job; even… having a root canal?

Now don’t get us wrong — we’re not wishing that anyone should go through a medical procedure, no matter how minor. Yet the fact remains: A root canal procedure is one of the most common treatments performed in many dental offices… and, especially for first-timers, it’s one of the most misunderstood.

Let’s start off with the biggest misconception of all. Have you heard that a root canal is an exceptionally painful treatment? Get ready for some news: It just isn’t so. The fact is, in the vast majority of cases, having a root canal procedure is comparable to cavity treatment in terms of discomfort. Yet it brings immediate relief to the intense pain that can result from an infection in the pulp of the tooth. To understand how this works, we need to look a little closer at a tooth’s anatomy.

The hard outer surface of the tooth doesn’t have nerves, so it can’t “feel” any sensations. But deep inside of the tooth lies a bundle of nerves, blood vessels and connective tissue called the pulp. Safely sealed off from the outside world, pulp tissue is needed for proper tooth development, but has no essential function in adults. Sometimes, however, a deep cavity or a crack in the tooth allows bacteria to infect this soft tissue. That’s when the tooth’s pulp will let you know it’s still there — by causing the sensation of pain.

Pulp tissue fills a branching network of tiny canal-like passages, which can be compared to the roots of a plant. When infection develops in the root canals, the best treatment is to remove the diseased and dying tissue, clean out and disinfect the passageways, and seal up the area against further infection. This, in essence, is a root canal procedure. It is performed under local anesthesia, so you won’t feel any pain as it’s being done. When it’s over, a crown (cap) will be needed to restore the tooth’s appearance and function.

What happens if you need a root canal but don’t get one? If you can manage to ignore it, the pain may (or may not) eventually cease: This signals that the nerves have died — but the disease still persists. Eventually, it may lead to further infection… a pus-filled abscess… even tooth loss. And that’s a truly bad outcome.

It’s normal to feel a little apprehension before any medial procedure. But don’t let faded myths about the root canal procedure keep you from getting the treatment you need. Remember, root canal treatment doesn’t cause pain — it relieves it!

If you would like more information about root canal treatment, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “A Step-By-Step Guide To Root Canal Treatment” and “Tooth Pain? Don't Wait!




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