20737 13 Mile Rd. Roseville, MI 48066

43570 Garfield Clinton twp., MI 48038

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Posts for: July, 2013

By David A.Susko DDS, PC
July 29, 2013
Category: Oral Health
Tags: tooth pain  
ConfusingToothPain

Is it a root canal problem, a gum infection, or both?

Sometimes it's difficult to pinpoint the source of tooth pain; it can result from an infection of the tooth itself, or of the gum, or even spread from one to the other. Identifying the origin of a toothache is important, however, so we can choose the right treatment and do all that we can to save the tooth.

When a tooth becomes decayed, bacteria can infect the sensitive, living nerve tissue deep inside the tooth known as the root canal. This condition is called an endodontic (“endo” – inside; “dont” – tooth) problem. The infection inside the tooth can spread to the periodontal ligament (“peri” – around; “dont” – tooth) that encases the tooth and attaches it to the jawbone. Occasionally, infection of endodontic (root canal) origin can spread out from the end of the tooth root all the way up the periodontal ligament, and into the gum.

The reverse can also happen: dental pain can originate from periodontal (gum) tissues that have become diseased. Gum disease is caused by a buildup of bacterial biofilm (plaque) along the gum line. It results in detachment of the gums along the tooth surface. In advanced cases, this bacterial infection can travel into the nerve tissues of the dental pulp through accessory canals or at the end of a tooth.

To figure out where pain is coming from when the source is not obvious, we need to take a detailed history of the symptoms, test how the tooth reacts to temperature and pressure, and evaluate radiographs (x-ray pictures).

Unfortunately, once dental disease becomes a combined periodontal-endodontic problem, the long-term survival of the tooth is jeopardized. The chances for saving the tooth are better if the infection started in the root canal and then spread to the gums, rather than if it started as gum disease that spread into the root canal of the tooth. That's because in the latter case, there is usually a lot of bone loss from the gum disease. Effectively removing plaque from your teeth on a daily basis with routine brushing and flossing is your best defense against developing gum disease in the first place.

If you would like more information about tooth pain, gum disease or root canal problems, please contact us or schedule an appointment for a consultation. You can also learn more about this diagnostic dilemma by reading Dear Doctor magazine's article “Confusing Tooth Pain.”


By David A.Susko DDS, PC
July 19, 2013
Category: Oral Health
KidsandSportsPreventingDentalInjuryWithMouthguards

There's nothing quite like watching your son or daughter compete on the athletic field. It's a mixture of anticipation, pride — and occasionally, anxiety. Despite all the protective gear and training, kids are sometimes injured playing the sports they love. In fact, when it comes to dental injuries, teens are the most susceptible of any age group. Here's what you should know about preventing sports-related dental injuries in kids.

Of course you know that football and hockey players should always wear mouthguards, both at games and during practice. But don't forget about kids who play soccer, do gymnastics, wrestle or play basketball. According to the American Dental Association (ADA) these athletes — along with participants in about 20 other sports — also need to wear this important piece of protective gear. In fact, the ADA states that not wearing a mouthguard makes an athlete 60 times more likely to sustain dental injury!

In selecting a mouthguard, there are three basic options to choose from: the “off-the-shelf” type, the so-called “boil and bite” protector, and the custom-fitted mouthguard that we can fabricate. Let's look briefly at all three.

The first type, available at many sporting goods stores, comes in a limited range of sizes, and an unknown range of quality. It's the least expensive option, offering a minimal level of protection that's probably better than nothing.

The second type, although popular, is also limited in its protection. This one is designed to be immersed in hot water, and then formed in the mouth using finger, tongue and bite pressure. If it can be made to fit adequately, it's probably better than the first type — though it often lacks proper extensions, and fails to cover the back teeth. Also, upon impact, the rubber-like material will distort and not offer as much protection as you would like to have.

The third is a piece of quality sports equipment that's custom-made for your child's mouth (or your own). To fabricate this mouthguard, we first make a model of the individual's teeth, and then mold the protector to fit just right. Made from tough, high-quality material, it's designed to cover all teeth, back and front, without being excessively bulky. It can even be made to accommodate growing teeth and jaws. And, it's reasonable in cost.

To paraphrase the ADA's recommendation, the best mouthguard is the one you wear. A comfortable, correctly-fitted mouthguard is easy to wear — and it can help prevent dental injury, giving you one less thing to worry about. Now, if you could just get you child to keep her eye on the ball.

If you have questions about mouthguards or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”


By David A.Susko DDS, PC
July 08, 2013
Category: Dental Procedures
HowDoILookAfterMyNewPorcelainVeneers

You've just had porcelain laminate veneers placed on your teeth to improve their appearance, color and shape. Now what? How do you maintain them and keep them looking their best?

A dental porcelain veneer is a thin layer of porcelain that is bonded to a tooth, replacing the enamel (the outermost layer of a tooth). Dental porcelain is a glass-like substance that can be used to mimic natural tooth enamel perfectly because of its bright, reflective and translucent (see-through) qualities.

To look after your veneers, it is important to maintain the health of the teeth on which they were placed, and of the surrounding gums.

  • About a week after your veneers have been placed, return to our office so that we can check them to make sure they are functioning well.
  • Brush and floss regularly using non-abrasive fluoride toothpaste; make sure you remove biofilm, the film of bacteria that collects on the teeth, every day. Flossing or brushing will not harm your veneers.
  • We recommend regular dental checkups to review the state of your veneers and your dental health in general.

Porcelain is a ceramic glass-like material, and like glass it is strong but brittle and can fracture when placed under too much stress.

  • You can eat almost all foods without harming your veneers, but avoid biting into hard things like candy apples.
  • Many people habitually grind or clench their teeth. If you are one of them, let us know. We can make a protective bite guard that you can wear to reduce stress placed on your teeth (and your veneers) while you sleep.

With good dental hygiene, and regular dental check-ups porcelain veneers can last from seven to twenty years or even longer. This makes them a good solution that will improve your smile for years to come.

Contact us today to schedule an appointment or to discuss your questions about porcelain laminate veneers. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced with Porcelain Veneers.”




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