20737 13 Mile Rd. Roseville, MI 48066

43570 Garfield Clinton twp., MI 48038

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Posts for: August, 2014

By David A.Susko DDS, PC
August 29, 2014
Category: Oral Health
OurArsenalofWeaponsintheWarAgainstGumDisease

Advanced periodontal (gum) disease is a chronic, progressive condition characterized by bacterial infection and inflammation. Without proactive treatment, gum disease can cause extensive damage to the various tissues that hold teeth in place, and lead eventually to tooth loss.

As every war has its tactics, so the war against advanced gum disease is no different. Here’s a few of the approaches and treatments we use to stop the disease and promote healing to damaged tissues.

A Change in Behavior. Regardless of other risk factors, a film of bacterial plaque on tooth surfaces caused by a neglect of proper oral hygiene is the main culprit behind progressive gum disease. Your first step is to form new hygiene habits — brushing and flossing — that will need to be performed daily to be effective. It’s also time to end some old habits like smoking that are contributing to your gum disease.

Total Plaque Removal. Although your renewed efforts at oral hygiene are essential, it’s just as important for us to use our expertise to remove the hard deposits of plaque (known as calculus) you can’t reach with brushing and flossing. Clinging stubbornly below the gum line, these deposits will continue to be sources of infection until they’re removed. Using techniques known as scaling or root planing, we employ ultrasonic or manual instruments to access and remove as much of the offending deposits as possible. This essential step may require more than one visit to give time for inflammation to subside, and may be followed with antibiotic therapy as well.

Surgical Treatments. Although quite effective in most cases of gum disease, scaling or root planing may not be adequate in more severe cases. We still have other weapons in our arsenal, though — there are a number of surgical procedures we can use to eliminate hidden pockets of infection, or repair and regenerate damaged tissues and bone. These procedures not only help restore you to better oral health and function, but also establish a more conducive environment for maintaining future care.

Using these and other techniques, we can reduce the infection and inflammation associated with gum disease. This sets the stage for healing and renewed health, both for your mouth and your entire body.

If you would like more information on treatment for periodontal gum 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 “Understanding Periodontal Disease.”


TakingPrecautionsBeforeDuringandAfterImplantsWillHelpEnsureSuccess

One of the many reasons for dental implant popularity is their reliability — studies have shown 95% of implants still function well after ten years. Still, on rare occasions an implant will fail. We can minimize this risk by taking precautions before, during and after installation.

Long-term success begins with careful planning before surgery. We thoroughly examine your teeth and jaws, using x-rays or CT scanning to map out the exact location of nerves, sinus cavities and other anatomical structures. Along with your medical history, this data will help us develop a precise guide to use during implant surgery.

We’ll also assess bone quality at the intended implant site. The implant needs an adequate amount of bone for support — without it the implant will not be able to withstand the biting force of normal chewing. It may be possible in some cases to use bone grafting or similar techniques to stimulate growth at the site, but sometimes other restoration options may need to be considered.

The surgery can also impact future reliability. By precisely following the surgical guide developed during the planning stage, the oral surgeon can increase the chances of success. Still, there may be an unseen variable in play — a pre-existing or post-operative infection, for example, that interferes with the integration of the implant with the bone. By carefully monitoring the healing process, we can detect if this has taken place; if so, the implant is removed, the area cleansed and the implant (or a wider implant) re-installed.

Even if all goes well with the implantation, there’s still a chance of future failure due to gum disease. Caused mainly by bacterial plaque, gum disease infects and inflames the supporting tissues around the teeth; in the case of implants it could eventually infect and weaken the surrounding bone, a condition known as peri-implantitis. This calls for aggressive treatment, including plaque and infected tissue removal, and possible surgery to repair the bone’s attachment to the implant. Without treatment, the implant could eventually detach from the weakened bone.

Maintaining your implants with good oral hygiene and regular dental checkups is the best insurance for long-term reliability. Taking care of them as you would natural teeth will help ensure a long, happy life for your “third set” of teeth.

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 “Dental Implants.”


By David A.Susko DDS, PC
August 15, 2014
Category: Oral Health
MinimizingX-RayExposureRisksinChildrentoMaximizeBenefits

X-ray diagnostics have revolutionized our ability to detect early or hidden cavities, paving the way for better dental care. But x-ray exposure also increases health risks and requires careful usage, especially with children.

A form of invisible radiation, x-rays penetrate and pass through organic tissue at varying rates depending on the density of the tissue. Denser tissues such as teeth or bone allow less x-rays to pass through, resulting in a lighter image on exposed film; less dense tissues allow more, resulting in a darker image. This differentiation enables us to identify cavities between the teeth — which appear as dark areas on the lighter tooth image — more readily than sight observation or clinical examination at times.

But excessive exposure of living tissue to x-ray radiation can increase the risk of certain kinds of cancer. Children in particular are more sensitive than adults to radiation exposure because of their size and stage of development. Children also have more of their lifespan in which radiation exposure can manifest as cancer.

Because of these risks, we follow an operational principle known as ALARA, an acronym for “As Low As Reasonably Achievable.” In other words, we limit both the amount and frequency of x-ray exposure to just what we need to obtain the information necessary for effective dental care. It’s common, for example, for us to use bitewing radiographs, so named for the tab that attaches the exposable film to a stem the patient bites down on while being x-rayed. Because we only take between two and four per session, we greatly limit the patient’s exposure to x-rays.

Recent advances in high-speed film and digital equipment have also significantly reduced x-ray exposure levels. The average child today is exposed to just 2-4 microsieverts during an x-ray session — much less than the 10 microsieverts of background radiation we all are exposed to in the natural environment every day.

Regardless of the relative safety of modern radiography, we do understand your concerns for your child’s health. We’re more than happy to discuss these risks and how they can be minimized while achieving maximum benefits for optimum dental health. Our aim is to provide your child with the highest care possible at the lowest risk to their health.

If you would like more information on the use of x-rays in dentistry, 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 “X-Ray Safety for Children.”


By David A.Susko DDS, PC
August 04, 2014
Category: Oral Health
HatsOfftoEtherandEvenBetterAnesthetics

The next time you’re visiting Boston, why not make time for a stroll in the city’s renowned public garden? It’s got a little something for everyone: acres of greenhouses and formal plantings, a picturesque pond where you can go for a paddle in swan-shaped boats, and the first (and perhaps the only) statue dedicated to an anesthetic gas.

Yes, the Ether Monument (also called “The Good Samaritan”) is a vaguely Moorish-looking sculpture that commemorates the first use of anesthetic in a medical procedure. This ground-breaking event took place at nearby Massachusetts General Hospital in 1846. But if it seems that perhaps the park designers were feeling a bit light-headed when they commissioned this statue* then just think of what it would have been like to have a tooth drilled without it!

Today, of course, ether is no longer used for anesthesia; that’s because medical science has developed far better ways to make sure you don’t feel pain when you’re having a procedure. However, we do still use a gas for people who need a little more help relaxing during dental treatment. It’s called nitrous oxide, but sometimes goes by the nickname “laughing gas.”

This sweet-smelling gas, mixed with oxygen, is often administered in a process called inhalation conscious sedation. It doesn’t put you to sleep — you can still follow directions and respond to verbal cues — but it makes you very comfortable, and may even induce a slightly euphoric feeling, which wears off quickly when the gas is stopped. That’s what makes it ideal for some dental procedures: It’s quite effective for people who might otherwise have a great deal of dental anxiety, yet it’s quick, easy and safe to administer — and you can usually drive yourself home afterward.

Sometimes, however, you may need even more relaxation — for example, if you’re having multiple wisdom teeth extracted. In this case, it may be best to use intravenous (IV) conscious sedation. Here, the precise amount of medication you need is delivered directly into your bloodstream via a tiny needle. As with nitrous oxide, you’ll remain conscious the whole time, but you won’t feel any pain — and afterward, you probably won’t remember a thing.

Sedation dentistry has come a long way since the days of ether… but making sure you don’t feel pain or anxiety remains a critical part of what we do. Before a procedure, we’ll talk to you about what type of anesthesia is best — and if you have any questions or concerns, we’ll work with you to make sure you have the best experience possible. If you would like more information about sedation dentistry or relieving dental anxiety, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Sedation Dentistry” and “Sedation Dentistry For Kids.”


By David A.Susko DDS, PC
August 01, 2014
Category: Oral Health
Tags: gummy smile  
FrequentlyAskedQuestionsaboutGummySmiles

Q: What is a gummy smile? I’ve never heard that term before.
A: You may not have heard the phrase, but you’ve probably noticed the condition. A “gummy smile” occurs when too much gum tissue (in technical terms, over 4 millimeters, or about one-eighth of an inch) is visible in the smile. Different people have different ideas about when this issue becomes a problem… but if you feel it detracts from your appearance, there are several ways dentists can treat a gummy smile.

Q: What can cause a smile to appear “gummy”?
A: A number of factors can contribute to this perception. One is simply that an excess of gum tissue is covering up the teeth. Another is that the teeth themselves are relatively short; this can be a natural anatomical feature, or it can result from the teeth being worn down by a grinding habit or another cause. In some cases, the problem is that the upper lip is hypermobile, meaning it rises too high when you smile. And in rare instances, the upper jaw is proportionately too long for the face, making the gums and teeth extend down too far.

Q: What’s the best way to fix this condition?
A: It all depends on what is causing the smile to appear gummy. If it’s too much gum tissue, a periodontal procedure called “crown lengthening” can be used to remove the excess tissue and reveal more of the teeth. If the teeth themselves are responsible, they can be crowned (capped), or covered by porcelain veneers. A hypermobile lip can be controlled temporarily with Botox injections, or permanently with a minor surgical procedure. Jaw problems present the most complex condition, but can be successfully treated with orthognathic (jaw-straightening) surgery. Orthodontic treatment may also be recommended in conjunction with these therapies.

Q: I’m unhappy with the way my smile looks, but I’m not sure exactly what’s wrong. What should I do?
A: A great-looking smile comes from the harmonious dynamic between teeth, lips and gums. If you feel your smile could use a little improvement, we can help you identify the things you like about it, and point out the things that need improvement. Working with an experienced cosmetic dentist is the best way for you to get the smile you’ve always dreamed about.

If you’d like more information about cosmetic gum treatments or cosmetic dentistry in general, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Gummy Smiles.”




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(586) 294-7810

Clinton Township Office
(586)
228-2460