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

Posts for: October, 2015

By Dr. Mark Shulman
October 27, 2015
Category: Dental Procedures
Tags: dental implants   diabetes  
DentalImplantsandDiabetes

Today, dental implants are an increasingly popular option for replacing lost teeth — an issue faced by many older Americans. It’s not hard to see why these high-tech prosthetic teeth are preferred: They look, “feel” and function just like natural teeth… and with proper care they can last the rest of your life. Unfortunately, many people who could benefit from implants also face an additional health problem: diabetes, a metabolic disease that can affect many different parts of the body, sometimes severely.  Uncontrolled diabetes can lead to nerve and tissue damage, and may adversely impact your oral health. So if you have diabetes, does it mean you won’t be able to get dental implants? 

The short answer is no — but there are some considerations that diabetics (and their health care providers) need to keep in mind. For example, it has been demonstrated that wounds in diabetics tend to heal more slowly, and are more prone to infection than those in non-diabetics. Also, people with diabetes sometimes experience a chronic inflammatory response, which can eventually lead to tissue damage or other problems.

Because the placement of dental implants requires minor surgery, dentists and researchers have questioned whether people with diabetes are good candidates for implants. Now there’s encouraging news: Several recent studies have come to the conclusion that many diabetics can indeed undergo an implant procedure without undue risk.

One key consideration is how well an individual can control his or her blood glucose levels. Researchers have found that diabetics with good blood glucose control, those with poor glucose control, and non-diabetics all have similar implant success rates (above 95%). However, in diabetics with poor glucose control, more time may be needed for the jawbone to heal in the area where the implant procedure was done. That doesn’t by any means rule out the placement of a dental implant — but it does mean that special considerations apply to individuals in this situation.

So if you are considering an implant procedure but have trouble controlling your blood glucose levels, ask us how we can help. Just remember that in most cases, having diabetes doesn’t mean you won’t be able to enjoy the benefits of dental implants. If you have additional questions, contact us or schedule an appointment.


LimitAcidicBeveragestoProtectYourChildsToothEnamelfromErosion

Tooth enamel erosion is a serious issue for many children that can result in permanent impairment of oral health. The problem isn’t just bacterial acid that causes tooth decay — it’s also the high acid content of sodas, energy and sports drinks widely popular among children and teenagers today.

Enamel is made of the strongest substance in the human body, which enables it to shield the inner layers of the teeth from disease and other environmental factors. Its chief nemesis, though, is acid: when enamel interacts with high concentrations of acid for a prolonged time, its mineral content will begin to soften and dissolve, a process known as de-mineralization. Saliva is the enamel’s main protection against acid with the ability to neutralize (or buffer) acid and restore some of the enamel’s mineral content, usually within thirty minutes to an hour after we eat.

The high acid content of many popular beverages, however, can overwhelm saliva’s buffering ability, especially if a person is sipping for an extended time on an acidic drink. This kind of exposure is different from acid produced by bacteria that causes tooth decay: bacterial acid tends to concentrate in specific areas of the teeth, while the constant wash from acidic beverages will have a more generalized eroding effect on teeth.

This level of enamel loss is irreversible, which can leave a tooth in peril of decay and ultimate loss — and increase long-term dental care and costs. The best strategy is to have your child stop or significantly curtail drinking highly acidic beverages. Rather than drink sports beverages for hydration, substitute water, nature’s hydrator. Milk can also be a viable beverage substitute.

If you do allow some acidic beverages, try to limit them to mealtimes and discourage extended sipping. Look for drinks with added calcium as this can reduce the beverage’s erosive potential. The goal is to reduce the amount and duration beverage acid is in contact with tooth enamel.

Making these changes will help greatly to protect your child’s tooth enamel, and give saliva a chance to do its job protecting it. Your efforts will also increase your child’s chances of better dental health in the future.

If you would like more information on dental erosion, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Erosion.”


FAQsKeepingYourMouthHealthyAfterGumDiseaseTreatment

Surgical treatment for periodontal (gum) disease can go a long way toward restoring your mouth to good health; however, it does not change your susceptibility to the disease. That’s why we recommend that you come in regularly for periodontal cleanings after your treatment. Here are some frequently asked questions about keeping your mouth healthy after gum disease treatment.

How often do I have to come in for periodontal cleanings?
There’s no “one-size-fits-all” answer to that question: It really depends on your individual situation. For example, some individuals may have a more aggressive form of periodontal disease that requires more frequent periodontal maintenance (PM) treatments to maintain control. Others may have greater success controlling the buildup of disease-causing plaque with at-home oral hygiene measures, and therefore need PM less often. However, for people with a history of periodontal disease, getting PM treatments at a three-month interval may be a good starting point.

What happens at a periodontal maintenance appointment?
A thorough cleaning of the crown and root surfaces of the teeth, aimed at removing sticky plaque and hardened dental calculus (tartar), is a big part of PM treatments — but there’s much more. You’ll also receive a thorough clinical examination (including oral cancer screening), a review of your medical history, and x-rays or other diagnostic tests if needed. The status of any ongoing periodontal disease will be carefully monitored, as will your success at maintaining good oral hygiene. Decisions about further treatment will be based on the results of this examination.

What else can I do to keep gum disease at bay?
Keeping your oral hygiene in top-notch condition — which includes effective brushing and flossing every day — can go a long way toward controlling gum disease.  In addition, you can reduce risk factors by quitting tobacco use and eating a more balanced diet. And since inflammatory conditions like diabetes, arthritis and cardiovascular disease can make periodontal disease worse (and vice versa), keeping these conditions under control will greatly benefit both your oral health and your overall health.

If you have additional questions about maintaining oral health after gum disease treatment, contact us or schedule an appointment.


PreventiveCareforYourChildisaPartnershipbetweenYouandYourDentist

Like the rest of their bodies, children’s teeth and mouth are on a rapid development track. By the time they’re young adults, they will have had two sets of teeth, extensive bone growth and a noticeable change in their features. The natural process is truly amazing.

But dental disease can easily derail their development, with tooth decay the most common problem children encounter. More than at any other time of life, preventive dental care is a top priority.

True preventive care for your child includes the entire mouth, not just the teeth. Our main focus, of course, is to head off tooth decay before it develops, including the application of topical fluoride or sealants when appropriate. But we also monitor bite development and provide protection against sports injuries or other forms of trauma with customized mouth guards.

You also have a part to play in your child’s preventive dental care. It begins when your child’s first teeth begin to emerge in the mouth — the point when you should begin brushing them. You can also reduce the risk of dental disease by providing a nutritious diet that’s high in fresh fruits and vegetables and low in sugar, especially between-meal snacks.

You should also start regular dental visits around their first birthday. This is not only the best time to begin professional care, but your child will also have an easier time at this age becoming comfortable with visiting the dentist than waiting until they’re older.

Taking care of your child’s teeth is a working partnership between you and us: we provide the professional care your child needs to develop properly, while you look to their daily hygiene and nutrition, which is just as important for your child’s healthy development. Through our partnership, we can ensure your child is getting the very best start toward a lifetime of healthy teeth and gums.

If you would like more information on preventive dental care for your child, please contact us today to schedule an appointment for a consultation.


By Dr. Mark Shulman
October 02, 2015
Category: Dental Procedures
Tags: gum recession  
YouMayNeedSurgerytoRepairtheDamageofGumRecession

Gum recession is an all too common problem for millions of people that if left untreated could lead to tooth and bone loss. But the good news is not only can the process be stopped, much of the damage can also be repaired through periodontal plastic surgery.

Gum recession occurs when the gum tissue protecting the teeth detaches and draws back to expose the root surface. This exposure may result in a range of effects, from minor tooth sensitivity to eventual tooth loss. There are a number of causes for gum recession, including overaggressive brushing or flossing, biting habits or badly fitting dentures or appliances.

The most prominent cause, though, is periodontal (gum) disease, a bacterial infection triggered by plaque buildup on tooth surfaces due to poor oral hygiene. Fortunately, early gum disease is highly treatable by thoroughly cleaning tooth, root and gum surfaces of plaque and calculus (hardened plaque deposits), along with possible antibiotic therapy, to reduce the infection and promote tissue healing.

Unfortunately, advanced cases of gum recession may have already resulted in extensive damage to the tissues themselves. While disease treatment can stimulate some re-growth, some cases may require reconstructive surgery to repair and further rebuild the tissues.

There are several techniques periodontists (specialists in gums, bone and other dental support structures) or dentists with advanced training can perform to “re-model” recessed gum tissues. One of the major areas is placing tissue grafts (either from the patient or a human donor) at the site to encourage further tissue growth. Properly affixing a graft requires a great deal of training, skill and experience, especially in cases where the graft may need to be connected with adjoining tissues to establish a viable blood supply for the graft.

In skilled hands, a periodontal surgical procedure is fairly predictable with minimal discomfort afterward. And the lasting effects are well-worth it — not only will your health benefit from restored gum tissue and greater protection for your teeth, you’ll also enjoy a more attractive smile.

If you would like more information the treatment of gum recession, 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 “Periodontal Plastic Surgery.”




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