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

Posts for: October, 2016

TreatingGumDiseaseImportanttoSavingtheUnderlyingBone

If you've had periodontal (gum) disease, you've no doubt experienced gum inflammation, bleeding or pain. But your gums may not be the only mouth structures under assault — the disease may be damaging the underlying support bone.

Although easing soft tissue symptoms is important, our primary focus is to protect all your teeth's supporting structures — the gums, the attaching ligaments and, of course, the bone. To do so we must stop the infection and reduce the risk of reoccurrence.

Stopping gum disease depends on removing its source — plaque, a thin biofilm of bacteria and food particles accumulating on tooth surfaces, due to poor oral hygiene. We must remove it mechanically — with hand instruments known as scalers or ultrasonic equipment that vibrates the plaque and calculus (hardened plaque deposits) loose.

It's not always a straightforward matter, though, especially if the diseased gum tissues have pulled away from the teeth. The slight natural gap between teeth can widen into voids known as periodontal pockets; they fill with infection and can extend several millimeters below the gum line. We must thoroughly cleanse these pockets, sometimes with invasive techniques like root planing (removing plaque from the roots) or surgical access. You may also need tissue grafting to regenerate gum attachment to the teeth.

One of the more difficult scenarios involves pockets where roots divide, known as furcations. This can cause cave-like voids of bone loss. Unless we treat it, the continuing bone loss will eventually lead to tooth loss. Besides plaque removal, it may also be prudent in these cases to use antimicrobial products (such as a mouthrinse with chlorhexidine) or antibiotics like tetracycline to reduce bacterial growth.

Perhaps the most important factor is what happens after treatment. To maintain gum health and reduce the chances of re-infection, you'll need to practice diligent daily hygiene, including brushing, flossing and any prescribed rinses. You should also keep up a regular schedule of office cleanings and checkups, sometimes more than twice a year depending on your degree of disease.

If you would like more information on treatments for gum disease, 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 “Treating Difficult Areas of Periodontal Disease.”


By Dr. Mark Shulman
October 20, 2016
Category: Dental Procedures
Tags: braces   tooth extraction  
ExtractingCertainTeethcanBoostOrthodonticEffectiveness

We treat most malocclusions (bad bites) with braces or clear aligners. But not all malocclusions are alike — some can require extra procedures to achieve successful results.

One such example is when incoming teeth crowd other teeth and cause them to erupt abnormally. The crowding also reduces the space needed to move the misaligned teeth to better positions. To make more room we'll often remove some of the teeth before undertaking orthodontics.

The key is to extract the right teeth. The best candidates are those whose absence will have minimal effect on both appearance and dental function. That's commonly the bicuspids, located right on the edge of the “smile zone” (the teeth most visible when we smile) between the cuspid (eye) teeth and the back molars.

Once we choose and remove the teeth our next concern is to protect the bone at the extraction site. The bone in our jaws benefits from the pressure created when we bite or chew. This stimulates new bone cells to form and replace older cells. Without it, as when we have a missing tooth, the amount of bone can diminish over time and affect the success of any future orthodontics.

To prevent this, we take care not to damage the gums and bone removing the tooth. We may also install a graft under the empty socket to encourage bone growth.

If we've removed teeth outside the smile zone, the resulting orthodontics will move teeth into the opened space. In the end, you won't even notice they're gone. Teeth lost or congenitally missing in the smile zone, though, may eventually require a replacement tooth. A dental implant is the best choice, but it should be put on hold for a younger person until their jaw has fully developed.

In the meantime, we can install a spacer or a temporary restoration to hold the empty space and prevent other teeth from drifting into it. This can be incorporated into braces or aligners, or with a removable partial denture or a temporary modified bridge.

Extracting teeth to aid orthodontics first requires a well-laid plan that could encompass several years. The end result, though, can be well worth the time and effort — better function and a new, attractive smile.

If you would like more information on the process of straightening 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 “Tooth Removal for Orthodontic Reasons.”


4BigBenefitsforBeginningEarlyDentalVisitsforYourChild

Your child's dental health is just as important as any other aspect of their physical development. That's why we recommend beginning regular dental visits around their first birthday.

Besides getting them used to and comfortable with visiting the dentist, there are other solid reasons for starting this habit by age one. Here are 4 benefits for regular early childhood dental visits.

Disease prevention. Children's teeth are just as susceptible to tooth decay as adults. Even primary (baby) teeth need protection so they can fulfill their role as guides for incoming permanent teeth. Besides monitoring and treatment for decay, we can also perform measures to protect teeth (especially in children at high risk) through topical fluoride applications or sealants.

Bite development. We can get early clues that a child's teeth are not erupting properly and are on the way to developing a poor bite (malocclusion). If so, we can initiate measures to lessen the impact of a developing malocclusion, like installing spacers to help guide an erupting permanent tooth. Early intervention can lessen the extent and cost of later orthodontic treatment.

Accident prevention. Disease isn't the only danger your child's teeth and mouth face. Even young toddlers can suffer mouth injuries falling onto furniture while playing or learning to walk. And the risk doesn't diminish as they get older, especially if they're active in sports. We can advise you on accident prevention tips and help fashion a custom mouth guard for that budding athlete in your family.

Caregiver assistance. The most important aspect of children's dental care is what happens every day at home. We can serve as your dental “coaches” to help you get on the right track with daily brushing and flossing, as well as give you helpful tips on good dietary habits that promote nutrition and deter dental disease. We'll also help you work through other childhood issues like teething, thumb sucking or teeth grinding.

Think of us as your partners when it comes to your child's dental care. We'll do our part, and help you do your part too.

If you would like more information on children's preventive care, please contact us or schedule an appointment for a consultation.


By Dr. Mark Shulman
October 04, 2016
Category: Oral Health
Tags: nutrition   sugar  
ReduceSugarConsumption-foraHealthierMouthandBody

Tooth decay doesn't appear out of nowhere. It begins with bacteria, which produce acid that softens and erodes tooth enamel. Without adequate enamel protection, cavities can develop.

So, one of our prevention goals is to decrease populations of disease-causing bacteria. One way is to deprive them of carbohydrates, a prime food source, most notably refined sugar. That's why for decades dentists have instructed patients to limit their intake of sugar, especially between meal snacks.

Ironically, we're now consuming more rather than less sugar from a generation ago. The higher consumption impacts more than dental health — it's believed to be a contributing factor in many health problems, especially in children. Thirty years ago it was nearly impossible to find a child in the U.S. with type 2 diabetes: today, there are over 50,000 documented juvenile cases.

Cutting back isn't easy. For one thing, we're hard-wired for sweet-tasting foods. Our ancestors trusted such foods when there was limited food safety knowledge. Most of us today still have our "sweet tooth."

There's also another factor: the processed food industry. When food researchers concluded fats were a health hazard the government changed dietary guidelines. Food processors faced a problem because they used fats as a flavor enhancer. To restore flavor they began adding small amounts of sugar to foods like lunch meat, bread, tomato sauce and peanut butter. Today, three-quarters of the 600,000 available processed food items contain some form of added sugar.

Although difficult given your available supermarket choices, limiting your sugar intake to the recommended 6 teaspoons a day will reduce your risk for dental and some general diseases. There are things you can do: replace processed foods with more fresh fruits and vegetables; read food labels for sugar content to make better purchasing decisions; drink water for hydration rather than soda (which can contain two-thirds of your daily recommended sugar allowance), sports drinks or juices; and exercise regularly.

Keeping your sugar consumption under control will help you reduce the risk of tooth decay. You'll be helping your overall health too.

If you would like more information on the effect of sugar on 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 “The Bitter Truth about Sugar.”




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