20737 13 Mile Rd. Roseville, MI 48066

43570 Garfield Clinton twp., MI 48038

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Posts for: December, 2013

By David A.Susko DDS, PC
December 23, 2013
Category: Oral Health
Tags: gum disease  
AdvancedPeriodontalDiseaseRequiresanAggressiveTreatmentStrategy

Periodontics is a branch of dentistry that specializes in the supporting structures around the teeth, including the gums and bone, as well as the ligaments that join these structures to the tooth roots. From the Latin peri (“around”) and the Greek odont (“tooth”), periodontics serves one purpose: to keep these supporting structures healthy.

This specialty is critical when it comes to periodontal disease. The term actually refers to a category of inflammatory diseases that affect the periodontal tissues. The inflammation arises from the body's response to bacterial plaque that has collected at the gum line because of poor oral hygiene. It begins as gingivitis (inflammation of the gums), but if left untreated can develop into periodontitis, which results in bone loss. If left to continue, eventual tooth loss occurs.

Proper oral hygiene and regular cleanings are your best defense against developing periodontal disease in the first place. Once the disease gains a foothold in the area below the gum line, routine brushing and flossing will not be enough. To defeat the disease will require more aggressive treatment.

This usually begins in our office with oral hygiene instruction, scaling and root planing or debridement to rid the root surfaces of plaque and calcified deposits, also referred to as tartar or calculus. This may be followed up with a surgical procedure to remove any remaining pockets that were too deep to resolve with conservative treatment.

Another option we may add to your oral hygiene routine is the use of an anti-microbial mouthrinse, usually containing a 0.12% solution of chlorhexidine. We may also prescribe the use of a topically-applied antibiotic such as tetracycline to stop the infection and promote tissue healing.

Once the disease is arrested, it's important that you continue good oral hygiene practices. Vigilance and prevention are critical to keeping these all important structures around your teeth healthy and functioning.

If you would like more information on the diagnosis and treatment of periodontal 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 David A.Susko DDS, PC
December 20, 2013
Category: Oral Health
Tags: oral hygiene   oral cancer  
TheImportanceofOralHygieneDuringCancerTreatment

You're probably aware of some of the adverse side effects of treatment for cancer. Unfortunately, one of these side effects is the health of your mouth. In fact, more than one third of people treated for cancer develop oral side effects.

Cancer treatments, such as chemotherapy and radiation, attack cancer cells, but normal cells are also affected. Chemotherapy can affect the lining tissues of the mouth and the salivary glands, and radiation treatment can affect all tissues in its path, which will put you at higher risk for dental diseases, such as tooth decay and gum disease. You may also develop painful mouth sores as well as dry mouth.

The best approach to take when it comes to protecting yourself from these potential side effects is prevention. Here are a few steps you can take to defend yourself:

  • Get a Comprehensive Dental Examination. While in the planning stages for your cancer treatment, you should schedule an appointment with our office for a complete dental exam. We will ensure that you oral health is optimal before you undergo treatment. We will also provide detailed instructions on how to care for your teeth during treatment and how to recognize the problem signs. Some solutions we may recommend are a fluoride treatment or antibacterial rinse.
  • Keep up with your Oral Hygiene Routine. While cancer treatment may cause you to feel fatigued, it will be more important than ever for you to take good care of your teeth. Remember to brush twice daily with a soft brush and fluoride toothpaste. You should also floss once a day to clean between your teeth.
  • Keep your Mouth Moist. Dry mouth is a common side effect of radiation and chemotherapy, and along with dry mouth comes a higher risk for tooth decay. We may recommend salivary stimulating medications to fight against this condition. You should also avoid mouth rinses with alcohol, which tend to further dry out your mouth. Make sure to drink plenty of water and consider chewing gum with xylitol, which promotes salivation and actively prevents tooth decay.
  • Remain Alert. Throughout treatment, you should continue to look for signs of oral discomfort in the teeth, jaws and lining of your mouth. Notify both your oncologist and our office if you experience any side effects involving your mouth.

If you would like more information about oral health and cancer treatment, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Oral Health During Cancer Treatment.”


By David A.Susko DDS, PC
December 12, 2013
Category: Dental Procedures
FAQsAboutCalmingYourFearsWithOralSedationDentistry

What is oral sedation dentistry? If you become frightened and anxious when facing a dental appointment or procedure, sedatives (also called “anxiolytics” meaning they dissolve anxiety), can completely transform the experience. Oral sedatives (taken by mouth) allow you to relax your mind and body so that you feel comfortable while in the dental chair.

How does anxiety affect my pain response? When you are afraid, your pain threshold is reduced. You experience a rush of adrenalin and you tense your muscles. As a result you end up in a state of heightened sensitivity. With sedation this sensitivity to pain vanishes along with your fear and anxiety.

What are some of the oral sedatives that my dentist may use? Most of the medications used in oral sedation dentistry belong to a class of medications called benzodiazepines, tried and tested over decades to be safe and effective. They are used in the treatment of anxiety, insomnia, and agitation. They include Valium®, Halcion®, Ativan®, and Versed®.

I'd just like to forget the experience after it is over. Can oral sedation help? Some of the medications prescribed as oral sedatives have amnesic properties (“a” – without; “mnesia” – memory). This means you will have little memory of the time in the dental chair when your procedure is finished.

What does my dentist need to know in order to prescribe the right oral sedation? We need a thorough medical and dental history, including all medical conditions you may have, and all medications you are taking — both prescription and over-the-counter (including allergies, alternative medications and even herbal supplements). We will also ask you whether you eat certain foods that could interfere with a sedative's effects.

How are the oral sedatives administered? Oral medications are either placed under the tongue (sub-lingual), and allowed to dissolve and then swallowed, or they may be swallowed whole. They are safe, effective, and fast acting. After the sedation takes effect, it will be easier to experience injections of local anesthesia if needed to numb your gums for the dental procedure.

What do I need to do before and after my appointment? Follow all directions we give you about restricting food and drink before your appointment. Until the medication wears off you may not be able to drive, operate heavy machinery or work so be sure to make arrangements to take time off and to have someone drive you to and from the appointment.

Contact us today to schedule an appointment to talk about any fears you may have about dental treatments. Using oral sedation, we can make sure that you have a relaxing experience. Oral sedation allows you to relax both your mind and body, and focus on feeling peaceful rather than anxious. You can learn more about oral sedation dentistry in the Dear Doctor magazine article “Oral Sedation Dentistry.”


By David A.Susko DDS, PC
December 04, 2013
Category: Oral Health
Tags: gummy smile  
TreatingaGummySmileDependsonitsCause

Something about your smile isn’t quite right. It’s too “gummy” — too much of the upper gum line is visible and it looks out of proportion to your teeth and lips. Most dentists identify a smile as too gummy if four millimeters or more (approximately an eighth of an inch) of the gum tissue is visible at a full smile.

Fortunately, there are ways to minimize this effect. It’s important, though, to first determine the true cause before we embark on any treatment plan.

Your teeth may be the actual cause. As we mature, teeth “erupt” through the gums and the supporting bone and appear in the mouth. They continue to erupt until meeting their “antagonists,” the opposing teeth from the opposite jaw. In addition, the gums go to the proper position where the root meets the enamel of the teeth around late adolescence. The normal result is a length of the crown (the visible portion of the tooth) of approximately 10 mm.

If the teeth don’t erupt fully or the gums don’t go to their proper position, the teeth appear shorter and the gums more prominent. Using a surgical technique called crown lengthening, we remove excess gum tissue and, if necessary, reshape the underlying bone to reveal the proper amount of tooth length. Teeth also shorten due to excessive wear; the teeth continue to erupt to compensate for the wear that occurs over time. The attached gum tissue follows with the tooth. This can be corrected with orthodontic treatment (for bite correction) and porcelain veneers.

Two more causes of a gummy smile are when a person has a hyper-mobile upper lip — the upper lip can raise too much lift when smiling — and an upper jaw length that appears too long for the face. If lips rise higher than the normal 6-8 mm when we smile, too much of the gum line appears. This can be treated temporarily with Botox injections to reduce the mobility of the muscles, or there is a surgical procedure that reduces the mobility of the upper lip. For an elongated upper jaw, orthognathic (“to straighten the jaw”) surgery relocates the jaw to a more upward position that diminishes the amount of gum tissue that shows during smiling.

Treatments for a gummy smile range from simple techniques to more complex surgical procedures. Only a thorough dental exam will reveal the best treatment path to follow.

If you would like more information on treatments for “gummy” smiles, 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 “Gummy Smiles.”




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(586) 294-7810

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