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

Posts for: April, 2015

By Dr. Mark Shulman
April 22, 2015
Category: Dental Procedures
Tags: extractions  
SimpleToothExtractionsareaCommonDentalProcedure

When a tooth is beyond repair due to disease or injury, it may be necessary to remove it. A “simple” tooth extraction is among the most common in dentistry and certainly not the agonizing procedure depicted in common lore.

They’re referred to as simple extractions because the shape of the tooth and root allows for a fairly straightforward and uncomplicated removal. An example would be the normally cone-shaped upper front tooth that doesn’t offer a lot of resistance during the extraction process.

The process itself is fairly straightforward. Teeth are held in place by the periodontal ligament, an elastic tissue made of tiny fibers that attaches the tooth to the supporting bone. These fibers can be dislodged from the tooth with some careful manipulation — in the hands of an experienced dentist there’s a deft “feel” to the fibers loosening. Once they’ve detached, it requires little effort to remove the tooth; with the aid of local anesthesia, you won’t feel anything but a little pressure.

Immediately after the tooth is removed, we commonly insert bone grafting material in the socket to minimize bone loss until a permanent replacement like a dental implant can be installed after tissue healing. We then place sterile gauze over the site for a few minutes to control bleeding and, depending on the size of the wound opening, we may also place a few stitches to close it. We then give you instructions for caring and cleaning the site over the next few days, and prescribe antibiotics to reduce the chance of infection and anti-inflammatory drugs for any discomfort.

Although a simple extraction is a routine procedure, it’s important to perform a proper assessment of the tooth and the surrounding bone beforehand, including x-rays to determine the tooth’s exact shape and position. If we discover a complication that makes a simple extraction impractical (like multiple roots at acute angles), we may then refer you to an oral surgeon for a more complicated surgical extraction.

It’s our hope you’ll have your natural teeth for as long as you live. But if you must have one removed, you can rest assured it’s a common — and uneventful — experience.

If you would like more information on tooth extraction, 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 “Simple Tooth Extraction.”


DentalAmalgamFillingsRemainaSafeandReliableToothRestorationOption

Metal amalgam fillings for dental caries have been used since the mid 19th Century. Although newer, “natural color” filling materials have become available, amalgam remains a standard choice among dentists.

Dental amalgam is a metal alloy created by carefully combining exact proportions of mercury, silver, tin and copper. Though quite pliable when first mixed, the alloy eventually sets into a very hard substance that stands up well against the forces produced by the mouth’s natural chewing function. The presence of mercury, however, has raised concerns for some that the metal’s toxic properties pose a risk to the patient’s health.

But after decades of research, the American Dental Association and other health organizations have concluded that dental amalgam “is a safe, reliable and effective restorative material.” Studies have determined that any free molecules of mercury that could potentially enter the bloodstream are trapped in the set amalgam. And although the amalgam can release mercury vapor during chewing, the amounts are well below the levels considered harmful.

Dental amalgam has proven to be versatile, effective and economical. It doesn’t create an allergic reaction, is quite durable, and doesn’t interfere with normal chewing function. It does, however, have its drawbacks. Its use can require more tooth material to be removed to keep the fillings in place, and they can increase temperature sensitivity during the initial four to six weeks. And, of course, their metallic appearance, especially when used in more visible front teeth, reduces their aesthetic appeal.

Other, more cosmetically appealing types of filling material have been developed over the years. These include composite resin fillings, a mixture of glass or quartz in a resin medium; glass ionomers, made of acrylic acids and fine glass powders and best used in areas not subject to heavy chewing; and resin ionomers, similar to glass ionomers but with the addition of acrylic resin. Each of these has their advantages and disadvantages (as well as cost considerations), but they’re main advantage over amalgam is their mimicry of natural tooth color.

The choice of either dental amalgam filling or one of the tooth-color alternatives depends on what you may need and can afford. Rest assured, though, that if the choice is dental amalgam, this restoration workhorse can provide you years of safe and effective service.

If you would like more information on your options for tooth fillings, 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 “Silver Fillings.”


CosmeticQuestionstoAsktoGetYouontheRightPathtoaBetterSmile

For some time now, you’ve noticed things about your teeth and gums — your overall smile — that you would like to change. But you’re in unfamiliar territory: you don’t know where to begin.

Here, then, are a few basic cosmetic dentistry questions you should ask yourself and us to get you moving in the right direction.

Am I a candidate for cosmetic dentistry? Invariably, the answer is yes — there’s always a way to enhance your appearance, starting with basic hygiene or whitening. But whether you’re a candidate for a particular procedure will depend on a full examination of your mouth — a “smile analysis” — to assess its current condition and needs, and what cosmetic options would best fit those needs.

Are my expectations realistic? That will first depend on what we find with your smile analysis. It will, however, also include studying the bigger picture — how certain changes might affect not only your smile but your overall facial appearance. Your wants and desires are extremely important in this process, but they should also be balanced with a dose of reality — some things may not be in your best interest health-wise to undertake, or are not in keeping with basic aesthetic principles of beauty.

Will I be able to have an idea beforehand how the changes will look? We’ve come a long way in providing patients ways to preview their new smile before undertaking a procedure. It’s often possible to “see” your proposed smile through computer simulation, or in some cases “test drive” it with temporary (provisional) crowns or veneers. For restorations involving porcelain crowns, it may be possible to take your input and fine-tune the shape and color of the permanent crown before it’s completed.

What will it cost? This will depend on the treatment plan we develop. Some treatments like teeth whitening are relatively inexpensive, while procedures like dental implants or orthodontics are major investments. You should also consider the costs to your time — some treatments require only a single visit, while others may take months or even years to complete. Depending on your financial means and comfort level, cost will need to be factored into the final plan, as well as your expectations.

If you would like more information on cosmetic dentistry, 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 “Cosmetic Dentistry: A Time for a Change.”


By Dr. Mark Shulman
April 03, 2015
Category: Dental Procedures
Tags: wisdom teeth  
GettingSmartAboutWisdomTeeth

Wisdom teeth are the third set of molars that erupt in the late teens or early twenties — so-called because they come in around the age of maturity or “wisdom.” While teeth are designed to last a lifetime, wisdom teeth are often problematic requiring early removal because they frequently become impacted, meaning they are not able to erupt fully through the gums to become healthy functioning teeth. However, not all wisdom teeth need to be removed if they are fully erupted and functional.

Prevention: Having a tooth submerged below the gum, pressing on the roots of neighboring teeth can cause damage and decay even though you may not be feeling any discomfort. By the time the tooth becomes painful, significant damage may already have occurred. In addition, the ability of the body to heal following oral surgery tends to decrease with age. A recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation strongly recommends that wisdom teeth be removed in young adulthood in order to prevent future problems and to ensure optimal healing.

Reasons for Removal: If your wisdom teeth are impacted against (pressing on) the roots of other teeth, damage can occur. To prevent infections, gum disease, decay, or damage to other permanent teeth, our office may recommend removal of your wisdom teeth.

What to Expect: If wisdom teeth removal is recommended, it can generally be done in the dental office as a surgical procedure with local anesthesia and conscious sedation (twilight sleep). After the surgery, you may experience some moderate discomfort and swelling depending on the degree of impaction and difficulty. Taking non-steroidal anti-inflammatory medication like ibuprofen, or prescription medication for several days after surgery will provide pain relief and control swelling.

Contact us today to schedule an appointment to discuss any questions you may have regarding removal of your wisdom teeth. Read more about this topic in the Dear Doctor magazine article “Wisdom Teeth: To Be Or Not to Be?




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