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

Posts for: December, 2014

By Dr. Mark Shulman
December 30, 2014
Category: Oral Health
ThumbSuckingandyourChildsBite

You've probably heard that thumb sucking can be harmful to your child's mouth, but do you know why?

Keep in mind that thumb sucking is completely normal in children up to a certain age. In fact, 95% of babies suck their thumb! This is because it provides them with a sense of security and a way to test and learn about their new world. The American Academy of Pediatric Dentistry recommends that parents and caregivers encourage children to cease this habit by age three.

Many children stop sucking thumbs by themselves between the ages of two and four. However, if you are having issues getting your child to stop after this point, you should inform us at your next appointment. Thumb sucking can actually block your child's front teeth from fully erupting and can also push the teeth forward. The number of hours per day and how much pressure your child applies will affect how far out of position the teeth end up. Excessive thumb sucking can also cause your child's jaw to develop incorrectly. This is why it is so important to stop sucking habits before permanent teeth start to erupt.

There are many creative ways that you can help your child cut back and eventually stop sucking his or her thumb. You might try to implement some behavioral management techniques, such as offering rewards after your child goes a length of time without thumb sucking. If your child is old enough to understand consequences, you can simply try explaining what will happen if he or she keeps up with this habit. If you continue to have trouble, speak with us at your next appointment and we can discuss other options, such as a mouth appliance that blocks this habit.

If you would like more information about thumb sucking, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”


By Dr. Mark Shulman
December 22, 2014
Category: Oral Health
TheImportanceofBabyTeeth

Ah, the baby teeth: those cute little pearl buttons that start to appear in a child’s mouth at around 6 to 9 months of age. Like pacifiers and bedtime stories, they’ll be gone before you know it — the last usually disappear by age 10-13. So if the dentist tells you that your young child needs a root canal, you might wonder why — isn’t that tooth going to be lost anyway?

The answer is yes, it is — but while it’s here, it has some important roles to play in your child’s development. For one thing, baby teeth perform the same functions in kids as they do in adults: Namely, they enable us to chew, bite, and speak properly. The primary teeth also have a valuable social purpose: they allow us to smile properly. If a baby tooth is lost prematurely at age 6, the child may suffer detrimental effects for five years or more — and that’s a long time for someone so young!

Even more important, baby teeth have a critical function in the developing mouth and jaw: Each one holds a space open for the permanent tooth that will eventually replace it — and it doesn’t “let go” until the new tooth is ready to come in. If a primary (baby) tooth is lost too soon, other teeth adjacent to the opening may drift into the empty space. This often means that the permanent teeth may erupt (emerge above the gum line) in the wrong place — or sometimes, not at all.

The condition that occurs when teeth aren’t in their proper positions is called malocclusion (“mal” – bad; “occlusion” – bite). It can cause problems with eating and speaking, and often results in a less-than-perfect-looking smile. It’s the primary reason why kids get orthodontic treatment — which can be expensive and time-consuming. So it makes sense to try and save baby teeth whenever possible.

Procedures like a root canal — or the similar but less-invasive pulpotomy — are often effective at preserving a baby tooth that would otherwise be lost. But if it isn’t possible to save the tooth, an appliance called a space maintainer may help. This is a small metal appliance that is attached to one tooth; its purpose is to keep a space open where the permanent tooth can come in.

If your child is facing the premature loss of a primary tooth, we will be sure to discuss all the options with you. It may turn out that preserving the tooth is the most cost-effective alternative in the long run. If you have questions about your child’s baby teeth, please contact us or schedule an appointment for a consultation.


By Dr. Mark Shulman
December 19, 2014
Category: Oral Health
Tags: gum disease   loose teeth  
DeterminingtheCauseofToothLoosenessKeytoEffectiveTreatment

A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.

Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.

Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.

Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.

In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.

If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.

If you would like more information on loose teeth, 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 “Loose Teeth.”


By Dr. Mark Shulman
December 11, 2014
Category: Dental Procedures
Tags: dental implants   dentures  
AnImplant-SupportedDentureOffersaNumberofAdvantages

If you’ve had the misfortune of losing all or most of your teeth (a condition called edentulism), you still have effective options for restoring lost form and function to your mouth. There is, of course, the traditional removable denture that’s been the mainstay for edentulism treatment for decades. If you haven’t experienced significant bone loss in the jaw, though, a fixed bridge supported by titanium implants could be a better choice.

But what if bone loss has ruled out an implant-supported fixed bridge? There’s still another option besides traditional dentures — a removable “overdenture” that fits “over” smaller diameter implants strategically placed in the jaw to support it.

A removable, implant-supported bridge offers a number of advantages for edentulism patients with significant bone loss.

Speech Enhancement. Any denture or bridge supported by implants will have a positive impact on speech ability, especially involving the upper jaw. But patients who’ve previously worn removable dentures may not see a dramatic difference but will still be able to benefit from the greater stability of the denture, particularly if the dentures were previously unstable.

Hygiene. A removable denture allows better access to implant sites for cleaning. Better hygiene reduces the risk of gum disease and further bone loss.

Long-Term Maintenance. Regardless of which type of implant supported restoration is used, it will eventually require some maintenance. A well-designed removable overdenture can make any future maintenance easier to perform.

Aesthetics. For personal satisfaction, this is often the ultimate test — how will I look? As a product of the evolving art of facial aesthetics, removable dentures supported by implants can replace lost tissues and restore balance to the face, and often produce a remarkable smile “makeover.”

To find out which restoration option is best for you, you should first undergo a thorough examination to determine the status of your facial and jaw structures, particularly the amount of bone mass still present. Ultimately, though, the decision should be the one that best fits your functional needs, while fulfilling your desires for your future smile.

If you would like more information on tooth restoration options, 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 “Fixed vs. Removable: Choosing Between a Removable Bridge and a Fixed Bridge.”


Sports-RelatedDentalInjuriesmdashDeterminingYourRisks

A recent study revealed that on average there are 22,000 dental injuries in children under the age of 18. This alarming reality makes it clear that parents, caregivers, and coaches need to understand the risks for dental injuries so that they are best equipped to prevent them...or at least be prepared to manage one should it occur. The four most common categories for measuring risks associated with sports injuries are:

  • Age: Age is an important factor when accessing risk. Sports-related dental injuries tend to spike during the teenage years. Recent research shows that children under the age of 13 tend to not be injured as often.
  • Gender: Gender is probably the second most influential factor. The facts are that males top the list for experiencing dental injuries during sports or vigorous activities. However, more and more females are playing highly competitive and contact sports or activities; thus, their risk of injury is increasing.
  • Shape and position of your teeth: Both the condition and positions of the teeth affect their risk of injury. More prominent or “buck” teeth are considered a higher risk for injury than teeth in a more normal position. Furthermore, 80% of all dental injuries involve the upper front teeth.
  • Sports type: This last category is the one most often asked about, as parents, caregivers and athletes want to know which sports or activities have the highest risks for dental injuries. And while baseball and basketball top the list, the American Dental Association (ADA) has put together a comprehensive list of sports and activities. To review this list, read the Dear Doctor article, “Athletic Mouthguards.” The ADA also urges athletes to wear professionally-fitted mouthguards to protect against dental and facial injuries.

Knowing the above categories can help you assess your risk for a dental injury while playing in a sport or recreational activity. To learn more about sports-related dental injuries, read, “An Introduction To Sports Injuries & Dentistry.” Or if you have a traumatized, damaged, chipped or missing tooth from a sports or any other type of injury, contact us to discuss your situation or to schedule an appointment.




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