20737 13 Mile Rd. Roseville, MI 48066

43570 Garfield Clinton twp., MI 48038

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Posts for: March, 2014

By David A.Susko DDS, PC
March 24, 2014
Category: Dental Procedures
Tags: root canal  
Top5ReasonsNottoDelayGettingaRootCanal

So you came in to the dental office for an exam, and now you’ve been told you need a root canal. But you’re wondering: Do I really have to do this? I’ve heard all sorts of things about the procedure. What if I wait a while — would that be so bad?

The answer is: It just might! Whenever we dentists recommend a root canal procedure, we have good reasons for doing so. Here are the top five reasons why you shouldn’t delay getting this important treatment.

  1. The tooth is infected and dying; a root canal stops the infection. While the outer layers of the tooth are hard, the inner pulp is made of soft, living tissue. This tissue sometimes becomes infected (through deep decay, cracks in the tooth surface, etc.), and begins to die. Once that happens, treatment is needed right away — to stop the pain, control the infection, and keep it from spreading.
  2. Root Canal Treatment Alleviates Pain. That’s right: Root canal treatment doesn’t cause pain — it relieves it. The procedure is relatively painless, despite the old stories you might have heard. In fact, it’s not unlike having a cavity treated, though it may take a little longer. So if you’re experiencing tooth pain (a major symptom in most cases of root canal trouble), remember that the sooner you get it treated, the sooner you’ll be pain-free.
  3. It won’t get better on its own… If you ignore some things, they will go away. Root canal problems aren’t one of those things. In some cases, if you wait long enough, the pain will go away. But that’s not a good sign, because the problem won’t go away on its own; it simply means that the nerves inside the tooth are all dead. The infection continues to smolder like glowing coals in a fire.
  4. …But it could get worse. Left untreated, bacteria from the infected tooth pulp can travel through the roots of the tooth and into the tissue of the gums and jaw. That can cause a painful, pus-filled abscess to form, which will require urgent treatment. In extreme cases, It can also result in increasing systemic (whole-body) inflammation, potentially putting you at risk for more serious conditions, like heart disease and stroke.
  5. Root Canal Treatment Can Save the Tooth. If you neglect treatment of a root canal problem long enough, you’re at serious risk for losing the infected tooth. And tooth loss, once it starts, can bring on a host of other problems — like an increased risk of tooth decay on remaining teeth, as well as gum disease, bite problems… and, as oral health problems escalate, even more tooth loss. Why put yourself at risk?

If you would like more information about root canal treatment, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “A Step-By-Step Guide To Root Canal Treatment” and “Tooth Pain? Don’t Wait!


By David A.Susko DDS, PC
March 21, 2014
Category: Oral Health
Tags: furcation  
BoneLossAroundRootFurcationsPosesTreatmentandCleaningChallenges

Although they may appear inert, teeth are anything but — they grow and change like other bodily tissues until complete maturation. Teeth roots are especially adaptable; teeth with multiple roots develop much like forks in a road as each root takes a different path toward the jawbone.

This fork where they separate is called a furcation. It’s normal for lower molars and premolars to have two furcations, while upper molars traditionally have three. Furcations pose difficulties for teeth cleaning and maintenance. If bone loss has occurred around them, a condition called a furcation invasion has occurred. This loss is most likely due to periodontal (gum) disease, an inflammation arising from bacterial plaque on the teeth that hasn’t been removed through proper oral hygiene.

We identify furcation invasions through x-ray imaging and tactile probing. They’re classified in three stages of development: Class I describes early onset in which marginal bone loss has occurred, exposing a groove that leads to the beginning of the furcation; Class II is moderate bone loss where a space of two or more millimeters has developed horizontally into the furcation; and, Class III, advanced bone loss whereby the bone loss has extended from one side of the tooth to the other, or “through and through furcation.”

Our first step in treatment is to remove any detectable plaque and calculus on the tooth surface, including the roots (known as scaling and root planing). These areas can be difficult to access, especially near furcations, and requires special instruments known as scalers or curettes. We may also employ ultrasonic scalers that use high-frequency vibrations coupled with water to break up and flush out the plaque and calculus.

We then apply antimicrobial or antibiotic medicines to further disinfect the area and inhibit bacterial growth while the affected tissues heal. As the infection and inflammation subsides, we then turn our attention during subsequent visits to address the bone loss around the furcation. This may involve surgical procedures to aid in re-growing gum tissue and bone and to create better access for cleaning and maintaining the area.

Finally, it’s important to establish good oral hygiene habits and regular checkups and cleanings to prevent further complications or a reoccurrence of the disease. Maintaining these habits will help you avoid tooth loss and other problems with your oral health.

If you would like more information on furcations, 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 “What are Furcations?


By David A.Susko DDS, PC
March 12, 2014
Category: Oral Health
Tags: oral cancer  
KickingtheTobaccoChewingHabitaMustforLong-TermHealth

Chewing tobacco, especially among young athletes, is considered fashionable — the “cool” thing to do. Many erroneously think it’s a safe alternative to smoke tobacco — it is, in fact, the source of numerous health problems that could ultimately lead to disfigurement or even death.

Chewing or dipping tobacco is especially linked with the sport of baseball. Its traditions in baseball go back to the late Nineteenth Century when players chewed to keep their mouths moist on dusty fields. The habit hit its greatest stride after the surgeon general’s warning on cigarettes in the late 1950s. Now, players wishing to emulate their major league heroes are prone to take up chewing tobacco at an early age.

But the habit comes with a price tag. Individuals who chew tobacco are more susceptible to oral problems like bad breath, mouth dryness, or tooth decay and gum disease. Users also increase their risk for sexual dysfunction, cardiopulmonary disease (including heart attack and stroke) and, most notably, oral cancer.

Derived from the same plant, chewing and smoke tobacco share a common trait — they both contain the highly addictive drug nicotine. Either type of user becomes addictive to the nicotine in the tobacco; and like smoking, a chewing habit can be very difficult to stop.

Fortunately, many of the same treatments and techniques for quitting smoking can also be useful to break a chewing habit. Nicotine replacement treatments like Zyban or Chantix have been shown effective with tobacco chewing habits. Substituting the activity with gum chewing (non-nicotine, and with the sweetener Xylitol), or even an herbal dip can also be helpful.

Like other difficult processes, it’s best not to try to quit on your own. You should begin your efforts to quit with a consultation with your doctor or dentist — they will be able to prescribe cessation medications and provide other suggestions for quitting. You may also find it helpful to visit a behavioral health counselor or attend a tobacco cessation support group.

Rather than just one approach, successful quitting usually works best with a combination of techniques or treatments, and perhaps a little trial and error. The important thing is not to give up: the improvements to your dental health — and life — are worth it.

If you would like more information on quitting chewing tobacco, 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 “Quitting Chewing Tobacco.”


By David A.Susko DDS, PC
March 04, 2014
Category: Oral Health
Tags: dental injuries  
GivingaKnockedOutToothaSecondChance

It can happen in an instant — your child takes a hard hit to the mouth while playing football, basketball or some other contact sport. Suddenly, he or she faces the severest of dental injuries: a knocked out tooth.

There's both good and bad news about this situation. First, the good news: the knocked out tooth can be reinserted into its socket and take root again. The bad news, though, is that the tooth has only the slimmest of chances for long-term survival — and those chances diminish drastically if the reinsertion doesn't take place within the first five minutes of the injury.

Outside of the five-minute window, it's almost inevitable that the tooth root won't reattach properly with the tiny fibers of the periodontal ligament, the sling-like tissue that normally holds the tooth in place to the jawbone. Instead, the root may fuse directly with the bone rather than via the ligament, forming what is called ankylosis. This will ultimately cause the root to melt away, a process known as resorption, and result in loss of the tooth.

Of course, the resorption process will vary with each individual — for some, tooth loss may occur in just a few years, while for others the process could linger for decades. The best estimate would be four to seven years, but only if the tooth receives a root canal treatment to remove any dead tissue from the tooth pulp and seal it from possible infection. Over time the tooth may darken significantly and require whitening treatment. Because the tooth may be fused directly to the jawbone it can't grow normally as its neighbor teeth will and thus may appear uneven in the smile line. From a cosmetic point of view, it may be best at that time to remove the tooth and replace it with an implant or other cosmetic solution.

In many ways the longevity of the tooth post-injury really depends on time — the time it takes to reinsert the knocked out tooth into its socket. The quicker you take action, the better the chances the tooth will survive.

If you would like more information on treating a knocked out tooth, 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 “Knocked Out Tooth: How Long Will a Tooth Last After Replantation?




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