20737 13 Mile Rd. Roseville, MI 48066

43570 Garfield Clinton twp., MI 48038

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Posts for: September, 2014

By David A.Susko DDS, PC
September 29, 2014
Category: Dental Procedures
MakingtheRightChoicesWithRemovablePartialDentures

Removable partial dentures (RPDs) are a common replacement option for multiple lost teeth. However, they're not the best long-term option; in fact, one particular type of RPD could be a poor choice if you wish to wear them long-term.

Made primarily of plastic, these RPDs are sometimes referred to as “flippers” because of how the tongue can easily flip them out of the mouth. While some people see them as a permanent replacement for their lost teeth, in reality plastic-based RPDs are a transitional replacement — a stepping stone, if you will, to a permanent solution. They are most useful during healing following a periodontal procedure or during the waiting period after implant surgery.

However, they can pose problems to your long-term oral health if worn permanently. Because of the manner in which they fit to the gums and any remaining teeth, they tend to settle into and compress the gum tissues. If you have gum disease, they force infection deeper into the tissues. They also allow and promote bacterial plaque growth. This in turn may lead to increased incidences of decay and gum disease.

On the other hand, a metal RPD, ideally made of cast vitallium or gold alloy, fits more snugly and accurately in the mouth. They still can cause increased plaque and food retention, but if the wearer also adheres to sound daily oral hygiene practices, regular dental checkups and diligent care of the RPD, they can be used successfully for many years.

Although a metal RPD costs more than its plastic counterpart, they cost less than more permanent teeth replacements. They are lighter in weight than plastic RPDs and fit more securely to deflect the forces generated by biting.

In considering your options for replacing lost teeth, you should not view plastic transitional RPDs as a permanent solution, but rather as a temporary one until you can obtain a more permanent solution. And although not the most optimal choice, the metal RPD could be considered a more permanent cost-effective solution.

If you would like more information on your options regarding removable partial dentures, 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 “Removable Partial Dentures.”


By David A.Susko DDS, PC
September 26, 2014
Category: Oral Health
Tags: gum disease   loose teeth  
DeterminingtheCauseofToothLoosenessKeytoEffectiveTreatment

A loose permanent tooth isn’t normal — it represents a serious threat to the tooth’s survival. There may be a chance to save the tooth, however, if we can determine the cause of the looseness and treat it appropriately.

Teeth are normally held securely in place by the periodontal ligament, an elastic tissue that attaches to both the teeth and the bone. Certain conditions, however, can disrupt this attachment. The most common is advanced periodontal (gum) disease, an infectious condition caused by bacterial plaque. It can severely inflame and damage the surrounding gum tissues resulting in bone loss. As the bone is lost, the periodontal ligament is lost as they detach from the teeth. In fact, tooth looseness may be a fairly late sign of the disease.

Another major cause is teeth grinding (bruxism) and clenching habits that result in excessive biting forces. Usually stress-related, teeth grinding and clenching generate forces on the teeth outside of their normal range. As a result the periodontal ligament can become stretched, inducing tooth looseness.

Our treatment approach depends on which condition is causing the looseness, best assessed with a thorough dental examination. If gum disease is the culprit, the main treatment is to remove as much bacterial plaque and calculus (tartar) as possible using various techniques such as scaling or root planing (accessing and cleaning root surfaces). It’s also imperative for you the patient to start and maintain an effective hygiene regimen of daily brushing and flossing, along with professional cleanings every three to six months depending on your degree of vulnerability to gum disease. Subsequent healing will stimulate tissue reattachment to the teeth.

In the case of excessive biting forces, we primarily want to reduce their effect on the teeth. Treatment can include muscle relaxants or anti-inflammatory drugs, or a custom-fitted bite guard to minimize biting forces from teeth grinding during sleep. In some cases we may opt to reshape the biting surfaces of teeth through removal of small amounts of surface enamel: this will reduce the biting force by altering how the upper and lower teeth contact. It’s also possible to splint loose teeth to more stable teeth, joining them like pickets in a fence. This helps relieve the biting force on teeth with significant loss of bone support.

If you notice a loose tooth, you should make an exam appointment with us as soon as possible. The sooner we can diagnose the cause and begin treatment, the less chance you’ll lose your tooth.

If you would like more information on loose teeth, 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 “Loose Teeth.”


By David A.Susko DDS, PC
September 18, 2014
Category: Oral Health
Tags: oral health  
FindingtheRightBacterialBalanceforOptimumOralHealth

By the time you reach adulthood, roughly 100 trillion microscopic organisms will have taken up residence in and on your body, outnumbering your own cells 10 to 1. Most are bacteria, a domain of the animal kingdom considered synonymous with disease. But only a few of the thousands of bacterial species cause us harm; the rest are either benign or actually beneficial to our health, including in our mouths.

Dentistry pioneered much of our knowledge about bacteria, developing processes used to identify, classify and understand those species inhabiting our mouths. Science as a whole is catching up with the Human Microbiome Project (HMP) begun in 2007. Through HMP, researchers have catalogued and begun to study more than 10,000 bacterial species.

We’re finding that our bodies develop a symbiotic relationship with many of these creatures invisible to the naked eye. During our infancy the bacteria we ingest from birth and breast feeding begin to interact with our body’s immune system, “teaching” it to refrain from attacking friendly organisms that contribute to health and searching and destroying enemy species that cause disease.

We’re also learning that an imbalance with our individual population of bacteria has links with disease. Our digestive system is a prime example: bacteria related to obesity can overpopulate our digestive tract, while malnutrition can create an environment that produces too many bacteria that inhibit digestion of vitamins and other nutrients.

The same microbial imbalance can occur in the mouth. For example, our typical Western diet encourages the growth of bacteria most associated with tooth decay (Streptococcus mutans). We’re also finding that tobacco smoking creates a mouth environment more conducive to the bacteria that cause gum disease. Just by quitting smoking you can alter that environment to encourage growth of health-promoting bacteria and inhibit growth of malevolent species.

The desired outcome of this knowledge is to develop treatments that target disease-causing bacteria without harming those beneficial to us (as often occurs with traditional antibiotics). In dentistry, such possibilities could help stop the spread of tooth decay, gum disease or similar bacterial infections, while fostering a healthier oral environment that prevents disease and protects health.

If you would like more information on healthy aspects of bacteria, please contact us or schedule an appointment for a consultation.


By David A.Susko DDS, PC
September 10, 2014
Category: Dental Procedures
Tags: dentures  
SuccessfulOutcomesWithDenturesDependsonAttentiontoDetail

While dental implants are considered the gold standard for tooth replacement, removable dentures are still a viable choice, especially for patients with edentulism (complete tooth loss). Removable dentures have also undergone considerable advancement to improve their function, appearance and longevity.

But even with these advancements, dentures still require a fair amount of skill, experience and — of utmost importance — a sense of art. If you’re considering this option, long-term success depends on a careful process of construction, fit adjustment and regular checkups to maintain that fit.

Our first step is to determine exact tooth placement on each denture. Using facial features (or photos before tooth loss) we establish placement landmarks so that corresponding upper and lower teeth align properly. We also consider tooth size, their orientation in relation to the lip, and the needed space to leave between the upper and lower teeth when they are at rest. We make these determinations based on accepted standards of beauty, but also taking into account your particular comfort level with any features that might alter your appearance.

The denture’s gums must also look realistic when you smile, especially if your upper lip rises above the teeth to expose more gum tissue. We also want to match the color and texture of your natural gums, as well as incorporate palatal rugae, the little ridges behind the upper front teeth that aid with speech and chewing food.

When we first place the new dentures in your mouth, we may need to adjust them for balance between the upper and lower sets when they come together. An imbalanced fit could have an adverse effect on your ability to bite, chew and speak normally.

Your dentures should have a good, comfortable fit. Over time, however, you will encounter some degree of bone loss because you no longer have your natural teeth to stimulate bone growth and absorb the forces created during function when your teeth contact. This and other factors may cause your dentures to become loose and uncomfortable to wear. For that reason, it's important for you to visit us regularly to maintain that good fit and check the health of underlying tissues and bone.

Careful planning and denture construction help ensure your new dentures successfully restore form and function to your mouth. Regular monitoring will also ensure they continue to serve you well for as long as possible.

If you would like more information on removable dentures, 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 “Removable Full Dentures.”


By David A.Susko DDS, PC
September 02, 2014
Category: Oral Health
ExtendtheLifeofYourDentalApplianceWithProperCare

Your dental appliance plays a big role in restoring function and improving your appearance. Taking proper care of it will ensure it can do that for a long time.

Cleaning is a top priority. Though it might seem natural to use toothpaste, you should avoid using it on your appliance. The abrasives in toothpaste are necessary to break up plaque on natural teeth’s hard enamel surfaces, but will leave micro scratches on the surface of your appliance that eventually become havens for bacterial growth — a sure recipe for discoloration and unpleasant odors. If you plan to use boiling or hot water to disinfect your appliance, don’t. The heat distorts the plastic and can disrupt its precise mouth fit. You should also avoid using bleach because it can break down the composition of the plastic, can leave a strong odor, and can whiten the pink “gum tissue” areas of the denture.

Instead, use plain liquid detergent or hand soap with warm water to clean your appliance — and use a brush designed for it rather than your toothbrush. If you have a long-term appliance like a denture, you might consider investing in an ultra-sonic cleaner that uses high frequency sound vibrations to clean out small crevices a brush can’t reach.

Remember the old saying, “familiarity breeds contempt?” With dental appliances, too much time in the mouth breeds bacteria. Dentures, for example, should be taken out at night to allow saliva and its antibacterial capacity to work in your mouth. You also should be on the lookout for signs of infection — if anything appears amiss, contact us for an exam as soon as possible to minimize the effects of tooth decay or gum disease.

One final item: be careful where you place your appliance when it’s not in your mouth. Lying out in the open (like on a nightstand) is a tempting lure for the family pet or a curious child. Keep it in its case in accordance with the care instructions given you when you received your appliance.

Doing the right things — and avoiding the wrong things — when caring for your dental appliance will go a long way to increasing its life and reducing problems along the way.

If you would like more information on caring for your oral appliance, please contact us or schedule an appointment for a consultation.




Roseville Office
(586) 294-7810

Clinton Township Office
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228-2460