Dentist - Towson
8600 LaSalle Rd. Suite 406 Severn Bldg.
Towson, MD 21286
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Posts for: July, 2018

CleanYourImplantsJustLikeyouCleanYourNaturalTeeth

Dental implants to replace teeth are a popular choice as much for their durability as their life-likeness. Most implants last for decades, which can result in lower long-term maintenance costs than other replacement options.

But to achieve this longevity, you must take care of your implants. You should brush and floss them daily right along with your remaining natural teeth — and continue regular semi-annual dental visits for cleanings and checkups.

You may be wondering, though: if they're made of inorganic materials, why worry with brushing them? It's true that bacterial plaque, the thin film of food particles most responsible for dental disease, doesn't affect them.

Your implants, though, don't exist in a bubble: they're imbedded in real bone, surrounded by real gum tissue and placed next to real teeth. All these other living tissues are susceptible to infection caused by plaque, even from plaque on non-organic implants.

The bone and tissues around an implant can even have a higher susceptibility to infection. This is because an implant's attachment in the jaw differs from that of natural teeth. An implant is imbedded directly into the bone; a natural tooth, on the other hand, maintains its hold through an elastic gum tissue between it and the bone called the periodontal ligament. Tiny fibers from the ligament attach to the tooth on one side and to the bone on the other.

Besides holding the tooth in place, the ligament also contains blood vessels that supply the tooth and surrounding tissues not only with nutrients but also antibodies that help fight infection. Due to the absence of a ligament connection, an implant doesn't enjoy the same level of protection from infection.  It's much easier for tissues and teeth around an implant to become infected, and harder to stop it.

That's why prevention through daily hygiene is so important. So, be sure to brush and floss all your teeth — including implants — every day, and keep up your regular dental visits. And at the first sign of a possible infection — swollen, red or bleeding gums — see us as soon as possible for an examination.

Consider your implants a long-term investment in both your smile and dental health. Taking care of them will pay dividends for many years to come.

If you would like more information on taking care of your dental implants, 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 “Dental Implant Maintenance.”


By Dr. Mark Shulman
July 21, 2018
Category: Uncategorized
Tags: gum recession  
GumRecessionCouldShortentheLifeofYourTeeth

Your teeth are meant to last a lifetime. Even with wear and tear from years of eating and biting they can continue to function properly and look attractive well into your senior years.

Teeth are resilient thanks in part to enamel, the hardest substance in the human body. But the gums also contribute to this resilience: besides attractively framing the teeth, they protect the dentin and roots below the enamel covering.

Unfortunately, the gums can shrink back or “recede” from their normal place. Not only does this look unattractive, the recession can also expose teeth to disease and cause tooth sensitivity to temperature changes or biting pressure.

There are a number of causes for gum recession, some of which you may have little control over. If, for example, your teeth come in off center from their bony housing, the gum tissues may not develop around them properly. You might also have inherited a thinner type of gum tissue from your parents: thinner tissues are more delicate and susceptible to recession.

But there are other causes for which you have more control. Over-aggressive brushing (too hard for too long), ironically, does more harm than good as it can injure your gums and cause them to recede. More likely, though, your recession is a direct result of neglecting proper hygiene for your teeth and gums.

When teeth aren't properly cleaned through daily brushing and flossing, a thin film of bacteria and food remnant called plaque builds up on tooth surfaces. This can trigger periodontal (gum) disease, which subsequently causes the gum tissues to detach from the teeth and often recede.

To reduce your risk of gum disease, you should gently but thoroughly brush and floss daily, and visit us for cleanings and checkups at least twice a year. If you have a poor bite (malocclusion), consider orthodontic treatment: malocclusions make it easier for plaque to accumulate and harder to remove.

Above all, if you begin to see signs of gum problems — swelling, bleeding or pain — see us promptly for an examination and treatment. Dealing with these issues early is the best way to ensure your gums continue to do their jobs for the long-term.

If you would like more information on the treatment and prevention of gum disease, please contact us or schedule an appointment for a consultation.


TeenagerswithMissingTeethUsuallyNeedaTemporaryRestoration

Anyone at any age, including older children and teenagers, can lose or be born missing a permanent tooth. And while those missing teeth can be restored, replacing them in patients who haven’t yet reached adulthood can be tricky.

That’s because their dental and facial development isn’t finished. This is especially problematic for dental implants because as the jaws continue to grow, a “non-growing” implant could eventually appear out of alignment with the surrounding natural teeth. That’s why it’s often better to install a temporary restoration until the jaws fully mature in early adulthood. Two great choices are a removable partial denture (RPD) or a bonded (“Maryland”) bridge.

While “dentures” and “teens” don’t seem to go together, an RPD in fact can effectively restore a teen’s lost dental function and appearance. Of the various types of RPDs the one usually recommended for teens has a hard acrylic base colored to resemble the gums, to which we attach prosthetic (“false”) teeth at their appropriate positions on the jaw.

Besides effectiveness, RPDs are easy to clean and maintain. On the downside, though, an RPD can break and—as a removable appliance—become lost. They can also lose their fit due to changes in jaw structure.

The bonded bridge is similar to a traditional fixed bridge. But there’s one big difference: traditional bridges crown the natural teeth on either side of the missing teeth to secure them in place. The supporting teeth must be significantly (and permanently) altered to accommodate the life-like crowns on either end of the bridge.

Instead, a bonded bridge affixes “wings” of dental material extending from the back of the bridge to the back of the natural teeth on either side. While not quite as strong as a regular bridge, the bonded bridge avoids altering any natural teeth.

While a fixed bridge conveniently stays in place, they’re more difficult than an RPD to keep clean. And while less prone to breakage, they aren’t entirely immune to certain stresses from biting and chewing especially in the presence of some poor bites (how the upper and lower teeth come together).

Choosing between the two restorations will depend on these and other factors. But either choice can serve your teen well until they’re able to permanently replace their missing teeth.

If you would like more information on dental restorations for teens, please contact us or schedule an appointment for a consultation.


EnsuretheBestOutcomewiththeRightCareforaTeensMissingTooth

While it's possible for a teenager to lose a tooth from decay, it's more common they'll lose one from an accidental knockout. If that happens to your teenager, there are some things you should know to achieve a good outcome.

Our top concern is to preserve the underlying bone following tooth loss. Like other tissues, bone has a life cycle: older cells dissolve and are absorbed by the body (resorption), then replaced by new cells. The biting pressure generated when we chew helps stimulate this growth. But bone around a missing tooth lacks this stimulation and may not keep up with resorption at a healthy rate.

This can cause a person to lose some of the bone around an empty tooth socket. To counteract this, we may place a bone graft at the site. Made of bone minerals, usually from a donor, the graft serves as a scaffold for new bone growth. By preventing significant bone loss we can better ensure success with a future restoration.

Because of its lifelikeness, functionality and durability, dental implants are considered the best of the restoration options that can be considered to replace a missing tooth. But placing an implant during the teen years is problematic because the jaws are still growing. If we place an implant prematurely it will appear to be out of alignment when the jaw fully matures. Better to wait until the jaw finishes development in early adulthood.

In the meantime, there are a couple of temporary options that work well for teens: a removable partial denture (RFP) or a fixed modified bridge. The latter is similar to bridges made for adults, but uses tabs of dental material that bond a prosthetic (false) tooth to the adjacent natural teeth to hold it in place. This alleviates the need to permanently alter the adjacent natural teeth and buy time so that the implant can be placed after growth and development has finished.

And no need to worry about postponing orthodontic treatment in the event of a tooth loss. In most cases we can go ahead with treatment, and may even be able to incorporate a prosthetic tooth into the braces or clear aligners.

It's always unfortunate to lose a tooth, especially from a sudden accident. The good news, though, is that with proper care and attention we can restore your teenager's smile.

If you would like more information on how to treat lost teeth in teenagers, 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 “Dental Implants for Teenagers.”


By Dr. Mark Shulman
July 06, 2018
Category: Oral Health
Tags: oral health  
GetYourVitaminstheNaturalWayforOptimumDentalHealth

Along with daily oral hygiene and regular dental visits, a balanced and nutritious diet is another key part of great oral health. The foods you eat can have a profound impact on how well your teeth and gums withstand diseases like tooth decay and periodontal (gum) disease.

At the heart of proper nutrition are organic compounds called vitamins. Along with trace minerals, vitamins help the body convert food into energy, repair cellular and tissue damage and protect against environmental toxins. When you don’t receive an adequate amount of each vitamin your health can suffer; in terms of dental health, your teeth and gums can weaken and become more susceptible to disease.

Vitamins play a wide variety of roles, including within the mouth. The Vitamins A and C contained in fruits and vegetables and Vitamin E in vegetable oils are antioxidants that protect cells and their DNA from destructive elements in the environment. As such, they’re a major prevention factor against tooth decay and gum disease. Vitamin D, found in dairy products, eggs or certain seafood, is used by bone and teeth to absorb calcium. Without sufficient calcium, teeth and bone lose vitality and strength.

This recognized power of vitamins for optimum health has also fueled the multi-billion dollar nutritional supplement industry. But studies show that your best source for vitamins are the foods you eat—and the more natural foods and less processed products you eat, the better your vitamin and mineral intake. Taking supplements isn’t necessarily wrong—but it’s not in your best interest health-wise to depend on them for vitamins and minerals at the expense of healthier eating.

So in all you do to prevent dental disease, don’t overlook your diet. The vitamins and minerals you receive from foods in their most natural state will help you keep your teeth and gums healthy and your smile beautiful.

If you would like more information on the role of nutrition in dental 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 “Vitamins & Dietary Supplements.”




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