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By David A.Susko DDS, PC
September 15, 2021
Category: Oral Health
Tags: oral hygiene   toothpaste  
HeresWhatsinYourToothpasteforKeepingYourTeethandGumsHealthy

We're all interested in how our toothpaste tastes, how it freshens breath or how it brightens teeth. But those are secondary to its most important function, which is how well our toothpaste helps us remove dental plaque, that thin bacterial film on teeth most responsible for both tooth decay and gum disease.

Daily brushing and flossing clear away dental plaque, resulting in a much lower risk for dental disease. But while the mechanical action of brushing loosens plaque, toothpaste helps complete its removal. It can do this because of two basic ingredients found in nearly every brand of toothpaste.

The first is an abrasive (or polishing agent), a gritty substance that boosts the effectiveness of the brushing action (which, by the way, alleviates the need for harmful aggressive brushing). These substances, usually hydrated silica, hydrated alumina or calcium carbonate, are abrasive enough to loosen plaque, but not enough to damage tooth enamel.

The other ingredient, a detergent, works much the same way as the product you use to wash greasy dishes—it breaks down the parts of plaque that water can't dissolve. The most common, sodium lauryl sulfate, a safe detergent found in other hygiene products, loosens and dissolves plaque so that it can be easily rinsed away.

You'll also find other ingredients to some degree in toothpaste: flavorings, of course, that go a long way toward making the brushing experience more pleasant; humectants to help toothpaste retain moisture; and binders to hold bind all the ingredients together. And many toothpastes also contain fluoride, a naturally-occurring chemical that strengthens tooth enamel.

You may also find additional ingredients in toothpastes that specialize in certain functions like reducing tartar buildup (hardened plaque), easing tooth or gum sensitivity or controlling bacterial growth. Many toothpastes also include whiteners to promote a brighter smile. Your dentist can advise you on what to look for in a toothpaste to meet a specific need.

But your first priority should always be how well your toothpaste helps you keep your teeth and gums healthy. Knowing what's in it can help you choose your toothpaste more wisely.

If you would like more information on oral hygiene products and aids, 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 “Toothpaste: What's in It?

By David A.Susko DDS, PC
September 10, 2021
Category: Dental Procedures
TemporarySmilesforTeensWaitingonDentalImplants

Here's some good news: Teenagers are less likely than adults to lose teeth to dental disease. But there's also a flip side. Teens can still lose teeth, more likely from traumatic injury.

Fortunately, there are several options for replacing lost teeth like dentures or bridges. But the choice considered best by most dentists and patients is a dental implant. An implant tooth looks and functions like the real thing—and it's durable, capable of lasting for years, if not decades.

But there's a hitch with teens getting an implant: Even though they may have all their permanent teeth by adolescence, their jaws are still growing and developing. Natural teeth, with their attachment to the jaws by way of a periodontal ligament, can keep pace with this growth—but implants can't.

That's because an implant doesn't have this attachment to gum tissue like natural teeth, but to the jawbone alone. Hence, an implant tooth can't keep up with jaw development, and may eventually look like it's "sunk" into the gums in relation to the teeth around it.

It's best, then, to wait until a teen's jaws have fully developed before attempting an implant. In the meantime, though, they don't have to endure a smile marred by missing teeth, but can replace them with a temporary restoration. The two most common options are a partial denture or a modified bridge.

The partial denture is a lightweight version that's quite affordable. Although not as durable as other types of dentures, the appliance is only intended to last until the patient is old enough for a permanent implant.

The modified bridge is a prosthetic tooth with strips of dental material extending behind it that are bonded to the backs of the teeth on either side to hold it in place. It's likewise not as durable as a traditional bridge, but it can fill the bill until time to place an implant.

Although this adds an additional step in a teen's restorative journey after losing a tooth, it's necessary—waiting to place an implant after jaw maturity will help ensure a long-lasting result. In the meantime, a temporary tooth replacement will help them to enjoy a normal smile.

If you would like more information on dental restorations for teens, 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 David A.Susko DDS, PC
September 05, 2021
Category: Dental Procedures
Tags: dental implants  
DentalImplantsCouldHelpPreserveBoneAfterToothLoss

Losing teeth can make it more difficult to eat, not to mention the effect it can have on your smile. But that could be just the beginning of your problems. Missing teeth can contribute to extensive bone loss within your jaws and face. Here's why.

Bone is like any other living tissue—cells develop, function and eventually die, and new cells take their place. Forces generated during chewing stimulate this new growth, helping the jawbone maintain its normal volume and density.

But you lose this stimulus when you lose teeth. This can cause a slowdown in bone cell regrowth that can eventually diminish bone volume. And it can happen relatively quickly: you could lose a quarter or more of jawbone width around a missing tooth within a year.

As this loss continues, especially in cases of multiple missing teeth, the bone can eventually erode to its base level. This loss of dental function can make chewing more difficult, place more pressure on the remaining teeth and adversely affect facial appearance. It could also prevent an implant restoration to replace missing teeth.

Dentures and other forms of dental restoration can replace missing teeth, but not the chewing stimulus. Dentures in particular will accelerate bone loss, because they can irritate the bony gum ridges they rest upon.

Dental implants, on the other hand, can slow or even stop bone loss. Implants consist of a metal post, typically made of titanium, imbedded into the jawbone at the site of the missing tooth with a life-like crown attached. Titanium also has a strong affinity with bone so that bone cells naturally grow and adhere to the implant's surface. This can produce enough growth to slow, stop or even reverse bone loss.

This effect may also work when implants are combined with other restorations, including dentures. These enhanced dentures no longer rest on the gums, but connect to implants. This adds support and takes the pressure off of the bony ridge, as well as contributes to better bone health.

If you've lost a tooth, it's important to either replace it promptly or have a bone graft installed to help forestall any bone loss in the interim. And when it's time to replace those missing teeth, dental implants could provide you not only a life-like solution, but a way to protect your bone health.

If you would like more information on 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 “The Hidden Consequences of Losing Teeth.”

By David A.Susko DDS, PC
August 31, 2021
Category: Dental Procedures
Tags: tooth decay  
FrequentSinusInfectionsTakeaTriptoYourDentist

If you suffer frequent sinus infections, you might want to see a dentist. No, really—your recurring sinusitis might stem from a decayed tooth.

Tooth decay can start as a cavity, but left untreated can advance within the tooth and infect the pulp and root canals. If it reaches the end of the root, it can cause the root tip and surrounding bone to break down.

A severe toothache is often a good indicator that you have advanced tooth decay, which can usually be stopped with a root canal treatment.  But a decayed tooth doesn't always produce pain or other symptoms—you could have a “silent” infection that's less likely to be detected.

A symptomless, and thus untreated, infection in an upper back tooth could eventually impact the maxillary sinus, a hollow air-filled space located just above your back jaw. This is especially true for people whose tooth roots extend close to or even poke through the sinus floor.

That “silent” infection in your tooth, could therefore become a “loud” one in the sinuses causing chronic post-nasal drip, congestion and, of course, pain. Fortunately, a physician or an ear, nose and throat (ENT) specialist might suspect a dental origin for a case of recurring sinusitis, a condition known as maxillary sinusitis of endodontic origin (MSEO).

Antibiotic treatment can clear up sinusitis symptoms short-term. It's unlikely, though, it will do the same for a dental infection, which may continue to trigger subsequent rounds of sinusitis. The best approach is for a dentist, particularly a specialist in interior tooth disease called an endodontist, to investigate and, if a decayed tooth is found, treat the source of the infection.

As mentioned earlier, the solution is usually a root canal treatment. During this procedure, the dentist completely removes all infected tissue within the pulp and root canals, and then fills the empty spaces to prevent future infection. In one study, root canal therapy had a positive effect on alleviating sinusitis in about half of patients who were diagnosed with a decayed tooth.

If your sinusitis keeps coming back, speak with your doctor about the possibility of a dental cause. You may find treating a subsequently diagnosed decayed tooth could alleviate your sinus problem.

If you would like more information on how your dental health could affect the rest of your body, 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 “Sinusitis and Tooth Infections.”

By David A.Susko DDS, PC
August 26, 2021
Category: Dental Procedures
Tags: gum recession  
GumRecessionDoesntHavetobePermanent

The worst outcome of periodontal (gum) disease is tooth loss—but it isn't the only form of misery you might suffer. One of the more troublesome results associated with gum disease is gum recession.

Normal gum tissue covers teeth from just above the visible crown to the roots, providing protection against bacteria and oral acid similar to the enamel on the crown. But advanced gum disease can weaken these tissues, causing them to pull away or recede from the teeth.

Not only can this diminish your smile appearance, but the exposed areas are more susceptible to further disease and painful sensitivity. And it certainly can accelerate tooth loss.

But there are some things we can do to reduce the harm caused by gum recession. If we're able to diagnose and treat a gum infection early while the gums have only mildly receded, the tissues could stabilize and not get worse.

The chances for natural regrowth are unlikely, especially the more extensive the recession. In such cases, the gums may need some assistance via plastic periodontal surgery. Surgeons reconstruct gum tissues by grafting like tissues to the area of recession. These grafts serve as a scaffold for new tissues to gradually grow upon.

There are two general types of grafting procedures. One is called free gingival grafting. The surgeon completely removes a thin layer of skin from elsewhere in the mouth (such as the palate), then shapes and attaches it to the recession site. Both the donor and recession sites heal at approximately the same rate, usually within 14-21 days. This procedure replaces missing gum tissue, but doesn't cover exposed tooth roots to any great extent.

In cases of root exposure, dentists usually prefer another type of procedure, known as connective tissue grafting.  The donor tissue is usually taken again from the palate, but the design of the surgery is different. A flap of tissue at the recipient site is opened so that after the connective tissue from the palate is placed at the recipient site to cover the exposed roots, the flap of tissue covers the graft to provide blood circulation to the graft as it heals.

Both kinds of procedures, particularly the latter, require detailed precision by a skilled and experienced surgeon. Although they can successfully reverse gum recession, it's much better to avoid a gum infection in the first place with daily oral hygiene and regular dental care.

If you would like more information on treating 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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