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

Posts for: September, 2014

By Dr. Mark Shulman
September 29, 2014
Category: Oral Health
GumDiseaseASilentProblemYouShouldntIgnore

Because its symptoms can be easy to overlook, gum disease is sometimes called a “silent” malady. But don't underestimate this problem! Untreated periodontal disease can progress into a serious condition, possibly leading to tooth loss and even systemic (whole-body) health issues. With proper preventive measures and appropriate treatment, however, the disease can be controlled.

The root cause of periodontal disease — actually, a group of related diseases, all of which affect the tissues surrounding the teeth — is the buildup of bacterial plaque (also referred to as biofilm) around the gums. While hundreds of types of bacteria live in the mouth, only a comparatively few are thought to be harmful. But when oral hygiene (namely, brushing and flossing) is inadequate, the environment in the mouth becomes favorable to those harmful types.

The disease often begins with inflammation of the gums called gingivitis. It symptoms include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. However, in some people these early warning signs are ignored, or masked by the effects of harmful habits like smoking.

Gum disease is chronic; that means, if left alone, it will worsen over time. Periodontitis, as it progresses, causes damage to the ligament that helps hold the tooth in place, as well as bone loss. This may become increasingly severe, and ultimately result in the loss of the tooth. Severe periodontitis is also associated with whole-body (systemic) inflammation, which has been linked to an increased incidence of cardiovascular diseases, like stroke and heart attack.

But there's no reason to allow gum disease to progress to this stage! Prevention — that is, regular daily brushing and flossing as well as regular dental cleanings — is a primary means of keeping this problem at bay. Plus, every time you have a regular dental checkup, your gums are examined for early signs of trouble. Of course, if you notice the symptoms of gum disease, you should come in for a check-up as soon as you can.

There are a number of effective treatments for gum disease. One of the most conservative, routine ways are those regular dental cleanings we referred to earlier, usually called scaling and root planning. Using hand-held and ultrasonic instruments, the buildup of plaque (tartar) is carefully removed, sometimes under local anesthesia. A follow-up evaluation may show that this treatment, carried out on a regular schedule, is all that's needed. Or, it may be time for a more comprehensive therapy.

If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”


By Dr. Mark Shulman
September 26, 2014
Category: Oral Health
Tags: oral health  
FindingtheRightBacterialBalanceforOptimumOralHealth

By the time you reach adulthood, roughly 100 trillion microscopic organisms will have taken up residence in and on your body, outnumbering your own cells 10 to 1. Most are bacteria, a domain of the animal kingdom considered synonymous with disease. But only a few of the thousands of bacterial species cause us harm; the rest are either benign or actually beneficial to our health, including in our mouths.

Dentistry pioneered much of our knowledge about bacteria, developing processes used to identify, classify and understand those species inhabiting our mouths. Science as a whole is catching up with the Human Microbiome Project (HMP) begun in 2007. Through HMP, researchers have catalogued and begun to study more than 10,000 bacterial species.

We’re finding that our bodies develop a symbiotic relationship with many of these creatures invisible to the naked eye. During our infancy the bacteria we ingest from birth and breast feeding begin to interact with our body’s immune system, “teaching” it to refrain from attacking friendly organisms that contribute to health and searching and destroying enemy species that cause disease.

We’re also learning that an imbalance with our individual population of bacteria has links with disease. Our digestive system is a prime example: bacteria related to obesity can overpopulate our digestive tract, while malnutrition can create an environment that produces too many bacteria that inhibit digestion of vitamins and other nutrients.

The same microbial imbalance can occur in the mouth. For example, our typical Western diet encourages the growth of bacteria most associated with tooth decay (Streptococcus mutans). We’re also finding that tobacco smoking creates a mouth environment more conducive to the bacteria that cause gum disease. Just by quitting smoking you can alter that environment to encourage growth of health-promoting bacteria and inhibit growth of malevolent species.

The desired outcome of this knowledge is to develop treatments that target disease-causing bacteria without harming those beneficial to us (as often occurs with traditional antibiotics). In dentistry, such possibilities could help stop the spread of tooth decay, gum disease or similar bacterial infections, while fostering a healthier oral environment that prevents disease and protects health.

If you would like more information on healthy aspects of bacteria, please contact us or schedule an appointment for a consultation.


By Dr. Mark Shulman
September 18, 2014
Category: Oral Health
Tags: oral health   oral cancer  
StayAlerttoYourOralHealthDuringCancerTreatment

The weapons in the war against cancer are stronger and more effective than ever. But as in real war, those weapons can inflict harm on innocent bystanders — in the case of cancer treatment, other cells in your body. Your mouth in particular may develop side effects from these treatments.

The basic purpose of common cancer treatments like chemotherapy and radiation is to destroy and inhibit future growth of cancer cells. They're very effective to that end, but they can also destroy healthy cells caught in the “crossfire” with malignant cells or have an adverse effect on the body's immune system and its response to infection. Chemotherapy in particular negatively affects blood cells developing within bone marrow, which leads to lower resistance to infection.

These can have secondary effects on the mouth. Patients undergoing cancer treatment can develop painful ulcers and sores within the mouth cavity, and reduced immunity makes them more susceptible to tooth decay or gum disease (especially if risk factors were present before cancer treatment). Certain treatments may also cause dry mouth in some patients.

If you are being treated for cancer, or about to begin treatment, we can help mitigate these effects on your oral health. The first step is to perform a complete dental examination to identify any issues that may affect or be affected by the cancer treatment. We would then treat those conditions (if possible before cancer treatment begins).

We would also monitor your oral health during the treatment period and treat any complications that arise. Such treatments might include applications of high-potency fluoride to strengthen teeth against decay, anti-bacterial rinses to reduce the risk of bacterial growth, and medications to stimulate saliva if you should encounter dry mouth.

Fighting cancer will be your main priority. You should, however, remain aware of how cancer treatment may affect other aspects of your health. As your dentist, we will partner with you in seeing that your teeth and gums remain as healthy as possible during this process.

If you would like more information on caring for oral health during cancer treatment, 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 Health During Cancer Treatment.”


By Dr. Mark Shulman
September 10, 2014
Category: Oral Health
Tags: tooth decay  
DevelopaLong-TermStrategytoPreventToothDecay

Tooth decay (dental caries) is one of the world’s most common infectious diseases. Left untreated, it can lead to tooth loss. The best treatment strategy, of course, is to prevent it from occurring in the first place with a long-term approach that begins in early childhood and continues throughout our lifetime.

Here are some basic components for just such a prevention strategy.

Know your risk. We each don’t share the same level of risk for tooth decay, so it’s important to come to terms with any factors that raise your personal risk for the disease — your dental history, inadequate oral hygiene, absence of fluoride use, and lifestyle habits like smoking. Coming to terms with these and other factors — and altering those you can change — can lower your risk.

Reduce acid-producing bacteria in your mouth. Tooth decay usually arises from elevated acidic levels in the mouth caused by certain strains of oral bacteria. You can reduce these bacteria by removing plaque, a thin film of food particles that collect on tooth surfaces, with daily oral hygiene and regular cleanings in our office. In some cases, we may also recommend antibacterial mouthrinses like chlorhexidine to further lower the bacterial population.

Apply protective measures to teeth. Fluoride, a naturally occurring chemical, has been proven effective in strengthening tooth enamel and reducing tooth decay. In addition to fluoride found in many oral hygiene products and public water systems, children can also benefit from a direct application of fluoride to the enamel surface just after the teeth have erupted in the mouth. Many clinical studies have shown 99% cavity free results in over a thousand teeth receiving a fluoride application with sealants.

Control your diet. Bacteria ferment leftover sugars and other carbohydrates in the mouth; this creates acid, which can soften tooth enamel and lead to decay. You can limit this effect by eating more fresh fruits and vegetables and reducing your consumption of refined sugar. You should also limit between meal snacking — constant snacking prevents saliva, the mouth’s natural acid neutralizer, from effectively restoring the mouth’s pH balance.

A prevention strategy for tooth decay will help you avoid unnecessary pain and problems — physically and financially. You’ll also reap the rewards that come from a lifetime of good dental health.

If you would like more information on preventing tooth decay, 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 “Tooth Decay.”


HerbalRemedyHelpsAlleviatePainandSwellingAfterDentalProcedures

Alternative medicines — also known as herbal or homeopathic remedies — have grown in popularity in recent decades. Because they don’t think of these remedies as “medicines,” many people will try them based on their friends’ advice or an internet search — with or without a doctor’s advice. Any herbal remedy, though, should be viewed as a real drug with real, and often significant, side-effects.

With that said, many of these alternative treatments are safe and effective if taken in an appropriate manner. Arnica Montana, a member of the daisy family, is a good example: various preparations of this herb have been found to reduce pain and inflammation caused by sprains or bruising, as well as control infection by killing bacteria. It’s also one herbal application that’s finding a home in the field of dentistry.

You can find many products containing Arnica, particularly topical applications made from the herb’s roots and dried flowers. It’s common to find Arnica in tinctures (the herb mixed in with a gel), tea infusions and a variety of ointments; the best-selling topical product is a gel containing 8% of the Arnica herb.

Many dentists are now prescribing Arnica to patients following invasive procedures like gum surgery, root canal treatment, implant surgery or wisdom teeth extraction to help reduce swelling and bruising. In this case, topical applications won’t work: directly applying a topical treatment to open mouth wounds can cause mucositis (an irritation of the lining of the mouth) and reactions in people with allergies to plants related to daisies. Dentists prescribe a programmed capsule regimen taken orally for four days after the procedure. This has been shown to lessen the length and degree of recovery time.

Any medicine, whether traditional or non-traditional, can have unintended consequences. Know the facts about what you’re taking, and be sure you consult with your doctor or dentist before trying any herbal remedy.

If you would like more information on Arnica Montana and similar remedies, 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 “Herbal and Homeopathic Remedies.”




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