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

Posts for: August, 2014

By Dr. Mark Shulman
August 29, 2014
Category: Dental Procedures
Tags: dental implants  
FrequentlyAskedQuestionsaboutFixedDentures

Q: Is there much of a difference between fixed and removable dentures?
A: There’s a BIG difference! Removable dentures are the type your grandparents might have had — and possibly their grandparents, too. They work well enough after you get used to them, but there’s always the issue of slippage, poor fit, limited function… and potential embarrassment. Modern fixed dentures, however, get their stability from today’s state-of-the-art system for tooth replacement: dental implants. They won’t loosen or slip, they function and “feel” like your own natural teeth, and they can last for years and years to come.

Q: How are fixed dentures supported?
A: Each arch (set of teeth comprising the top or bottom jaw) of a fixed denture is anchored into the jaw bone by four or more dental implants. These small screw-like devices, made of titanium metal, are placed into the jawbone in a minor surgical procedure. Once set in place, they remain permanently attached by both mechanical forces and osseointegration — the process in which living bone cells actually become fused with the metal implants themselves.

Q: What is the procedure for getting dental implants like?
A: Before having any work done, you will receive a thorough examination and have a set of diagnostic images made. Implant surgery is normally performed in the dental office, using local anesthesia or conscious sedation. If any failing teeth must be extracted (removed), that will be done first. Next, small openings are made in the gums and the jawbone, and the implants are placed in precise locations. Sometimes, a set of temporary teeth can be attached to the implants immediately; other times, the implants will be allowed to heal for a period of time.

Q: Besides added stability, are there other advantages to fixed dentures?
A: Yes! As they become integrated in the jaw, dental implants actually help preserve the quantity and quality of bone in the jaw; removable dentures, on the other hand, decrease bone quantity and quality. This is important because the jawbone plays a vital role in supporting facial features like lips and cheeks. When the facial features lose support, it can make a person look prematurely aged. Also, people who wear removable dentures often have trouble eating “challenging” foods like raw fruits and vegetables (which are highly nutritious), and opt for softer, more processed (and less nutritious) foods. With fixed dentures, however, you can eat the foods you like.

Q: Aren't fixed dentures with dental implants more expensive?
A: Initially, the answer is yes — but in the long run, they may not be. Unlike removable dentures, which inevitably need to be re-lined or remade as the jawbone shrinks, fixed dentures can last for the rest of your life. They don’t require adhesives or creams, and you will never have to take them out at night and clean them. In fact, you can think of them as a long-term investment in yourself that pays off with a better quality of life!

If you’d like more information on fixed dentures, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Dental Implants: Your Best Option for Replacing Missing Teeth.”


By Dr. Mark Shulman
August 20, 2014
Category: Oral Health
Tags: geographic tongue  
WhatintheWorldisGeographicTongue

Picture this: You’re feeling some mild irritation in your mouth, which seems to be coming from the area near your tongue. You go to the mirror, open wide… and notice a series of red patches on the tongue’s surface, which are surrounded by whitish borders. Should you drop what you’re doing and rush to get medical help right away?

Sure, a visit to the dentist might be a good idea to rule out more serious problems — but first, sit down and relax for a moment. Chances are what you’re experiencing is an essentially harmless condition called “benign migratory glossitis,” which is also known by its common name — geographic tongue. While it may look unusual, geographic tongue isn’t a serious condition: It’s not cancerous or contagious, and it doesn’t generally lead to more severe health problems. However, it can make your tongue feel a bit more sensitive, and may occasionally lead to mild sensations of burning, stinging or numbness.

The appearance of reddish patches on the tongue results from the temporary loss of structures called papillae: tiny bumps which normally cover the tongue’s surface. These patches may appear or disappear over the course of days — or even hours — and sometimes appear to change their shape or location.

What causes geographic tongue? Several factors seem to be responsible for setting off the problem, but as of yet the actual cause of the disease is unknown. Among these triggers are emotional stress and psychological upsets, hormonal disturbances, and deficiencies in zinc or vitamin B. The condition, which affects between one and three percent of the population, is seen more frequently in non-smokers, in women, and in those with a family history of the problem. It is also associated with people who suffer from psoriasis, a common skin condition, and those who have a fissured (deeply grooved) tongue.

Unfortunately, there is no “cure” for geographic tongue — but the good news is that treatment is usually unnecessary. If you’re experiencing this condition, it may help if you avoid foods with high levels of acidity (like tomatoes and citrus fruits), as well as hot and spicy foods. Alcohol and other astringent substances (like some mouthwashes) may also aggravate it.

While geographic tongue isn’t a serious condition, it can cause worry and discomfort. That’s why it’s a good idea for you to come into the office and have it checked, just to make sure. A thorough examination can put your mind at ease, and rule out other conditions that may be more of a concern. We may be also able to help you manage this condition by prescribing anesthetic mouth rinses, antihistamines, or other treatments.

If you would like more information about geographic tongue, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Geographic Tongue.”


ProtectYourVeneersWithaFewCommonSensePrecautions

Porcelain veneers are a proven way to achieve a new smile. Composed of thin layers of dental porcelain and other materials laminated together to form one life-like unit, veneers are applied to the outside of a prepared natural tooth to enhance its appearance. Given the right circumstances, they’re an excellent solution for correcting mild to moderate spaces between teeth, slight deviations in tooth position, and problems with the color and shape of a tooth.

Veneers are very strong and can resist most of the forces you generate when you chew your food. But dental porcelain is also a form of glass — strong but not indestructible. Following a few maintenance guidelines will help you avoid damaging a porcelain veneer and incurring additional dental care costs.

Practice daily oral hygiene. Although veneers aren’t subject to disease or decay, the tooth structure they cover and the surrounding gum tissues are. You should, therefore, brush and floss veneered teeth just as you would any other tooth. And, there’s no need for specially formulated toothpastes — any non-abrasive fluoride brand will work.

Avoid excessive biting or chewing. While it’s a good practice for natural teeth to avoid applying too much biting force to hard materials, it’s especially important for veneers. Attempting to open hard-shell nuts with your teeth or chewing on bones, pencils and other hard objects are just a few of the activities that could lead to a shattered veneer.

Use a bite guard for clenching habits. People who excessively grind or clench their teeth (a condition called bruxism) can also put undue stress on their veneers. We can help alleviate some of this stress by fashioning a bite guard you wear at night. The guard will help protect your veneers from teeth grinding while you sleep.

Limit foods and drinks that cause staining. Tea, coffee, wine and similar substances can leave teeth stained and dingy. Although your new veneers won’t typically stain, the natural teeth around them can — the brighter veneers would then stand out prominently from the dingier natural teeth.

Porcelain veneers are proven “smile changers.” Taking care of them with a few common sense precautions will ensure the change is long-lasting.

If you would like more information on porcelain veneers, 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 “Smile Design Enhanced With Porcelain Veneers.”


By Dr. Mark Shulman
August 04, 2014
Category: Oral Health
Tags: oral health   oral cancer  
OvercomeOralCancerWithScreeningsandLifestyleChanges

Baseball legend Babe Ruth, President Ulysses S. Grant and George Harrison of the Beatles — these three notable people from different backgrounds and historical eras have a sad commonality — they all died from oral cancer. They are a reminder that regardless of one’s wealth or fame, no one is immune from oral cancer and its deadly effects.

Like other cancers, oral cancer is characterized by abnormal cell growth capable of spreading into nearby tissue or other parts of the body. Although oral cancer accounts for less than 3% of all occurring cancers, it’s among the most deadly: only 58% of oral cancer patients survive five years after treatment. This is mostly due to the difficulty of detecting oral cancer in its early stages; in fact, 30% of oral cancers have already spread (metastasized) when they’re finally diagnosed.

Early detection through careful monitoring is the best strategy for defeating oral cancer. If you have a predisposing factor like a family history of oral cancer, then regular screenings during dental checkups are a must. During an exam we may be able to detect abnormalities (like unusual white spots on the gums or jaws) that may signal a cancer in a pre-cancerous or early stage. You also should be on the lookout for a persistent sore throat or hoarseness, lingering mouth pain, a painless lump in the mouth or on the neck, or ear pain on only one side.

There are also conditions or behaviors that may increase your risk for oral cancer, like using tobacco (both smoke and smokeless) or consuming alcohol. If you use tobacco you should consider quitting it altogether; you should consider cutting back on alcohol consumption if you’re a moderate to heavy drinker. You should also avoid sexual behaviors that increase your chances of viral infection — research has found a link between oral cancer and the viral infection caused by the sexually-transmitted human papilloma virus (HPV 16).

Improving your nutrition can also reduce your cancer risk. A diet rich in fresh fruits and vegetables supplies the body with cancer-fighting nutrients, including antioxidants that protect cells from damage caused by carcinogens. Studies have shown this kind of diet consistently lowers the risk of oral and throat cancer, as well as cancers of the esophagus, breast, prostate, lung and colon.

If you would like more information on oral cancer, 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 “Oral Cancer.”


GumDiseasemayAffectOtherConditionsintheBody-andViseVersa

As we continue to learn about the delicate balance between the body’s various organ systems, we’re discovering what affects one part of the body may affect other parts. This is particularly true for patients with periodontal (gum) disease and one or more other systemic diseases — researchers have identified a number of possible links between them.

Here’s a snapshot of three such diseases and how patients who suffer from them and gum disease may be affected.

Diabetes. Both diabetes (caused by the body’s inability to produce insulin that regulates blood sugar levels) and gum disease can trigger chronic tissue inflammation. Because of inflammation, diabetics are more prone to infectious diseases like gum disease. From the other perspective, uncontrolled gum disease and its resultant inflammation can worsen blood sugar levels. Some research has shown treatments that reduce oral tissue inflammation in diabetics with gum disease may also help bring their blood sugar levels into normal range.

Cardiovascular Disease. Diseases of the heart and blood vessels can eventually lead to heart attacks and strokes, the world’s leading causes of death. There’s evidence that some types of bacteria that cause gum disease may also contribute to higher risks for cardiovascular disease. Reducing the levels of these bacteria in the mouth through periodontal treatment can help lower the risk of cardiovascular disease.

Osteoporosis. Like gum disease, osteoporosis causes acute bone loss, although from a hormonal imbalance rather than as the result of bacterial infection. The major link between the two conditions, though, relates to their treatments. On the positive side, the antibiotic doxycycline has displayed positive effects on both conditions when administered in low doses. On the other hand, a class of drugs known as bisphosphonates used to treat osteoporosis may limit bone regeneration after tooth extraction and could have implications for using dental implants to replace extracted teeth.

There’s still more research needed on the relationship between gum disease and these and other systemic conditions. There’s widespread optimism, though, that such research could yield new treatment approaches and procedures that bring better healing to the mouth as well as the rest of the body.

If you would like more information on the connection between oral and general health, 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 “Good Oral Health Leads to Better Health Overall.”




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