20737 13 Mile Rd. Roseville, MI 48066

43570 Garfield Clinton twp., MI 48038

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Posts for: December, 2014

By David A.Susko DDS, PC
December 30, 2014
Category: Dental Procedures
ldquoPreplessrdquoPorcelainVeneersAreTheyRightForYou

Designing a better smile sometimes requires a change in the size, shape, or color of your teeth. Porcelain laminate veneers (thin layers of dental ceramic material) enhance your appearance by replacing the natural enamel on the outside of your teeth. A veneer is physically bonded to the surface of a tooth, in essence, becoming part of it.

Traditionally, a small amount of the natural tooth enamel is drilled away to allow room for the veneer. But today, in some circumstances, it is possible to use an approach where enamel reduction or preparation is not necessary because the veneers can be bonded directly onto the tooth's natural surface. These are called “Prepless” or “No-prep” veneers, and are used to create aesthetically pleasing and natural looking restorations. An advantage of the prepless procedure is that the process is reversible so that you can give your new smile a “test drive.”

You may be a good subject for Prepless veneers if:

  • Your smile is narrow because the teeth in the sides of your smile are positioned inward and do not show from a frontal view.
  • There is spacing between your teeth, and the teeth appear too small.
  • You have a fairly common genetic condition in which one or both of the teeth directly next to the two upper front teeth are very small and peg-shaped.
  • There is an imbalance between the size of your lips and teeth (large lips and small teeth), which are not in proportion to show off your best smile.

Prepless veneers are probably not for you if:

  • Your teeth are not aligned properly in your bite.
  • Your teeth are very crowded, resulting in poor facial profile.
  • Your teeth are already relatively large or positioned forward.

In these cases you may need to have some form of orthodontic treatment to move your teeth into better position. Sometimes veneers can be used to create an illusion of proper tooth alignment, but some amount of tooth reduction may be required.

We can assess whether prepless veneers are right for you. There is no substitute for an expert dentist's talent and expertise with the various cosmetic techniques available today. These skills combined with a thorough diagnostic evaluation, and a clear understanding of your goals, are the keys to providing you with a successful and beautiful smile.

Contact us today to schedule an appointment or to discuss your questions about cosmetic dentistry. You can also learn more about prepless veneers by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”


By David A.Susko DDS, PC
December 22, 2014
Category: Oral Health
Tags: gum disease  
AssessingYourRiskforSevereGumDisease

We’re all susceptible to gum disease when we fail to practice effective daily brushing and flossing. But you may have a greater risk of gum disease (and more severe forms of it) if any of the following categories pertain to you:

Aging. Gum disease risk naturally increases with age. We can lower the risk with an effective daily hygiene regimen, along with a minimum of two office cleanings and checkups each year. Brushing and flossing removes bacterial plaque and food particles which accumulate on tooth surfaces. The longer plaque remains in contact with gum tissues, the greater the chances of infection.

Pregnancy. Although women tend to take better care of their teeth than men, they still face unique issues that increase their risk. During pregnancy, for example, certain hormone levels rise, which cause the gums to become more responsive to bacteria. Other hormonal fluctuations throughout a woman’s life, including taking certain drugs for birth control or during menopause, can cause similar situations.

Family History. You could be at higher risk if members of your immediate family have a history of gum disease. Researchers estimate that 30% of the U.S. population has a genetic predisposition to the disease; it’s also possible for family members to transfer bacteria to other family members by way of saliva contact or shared eating utensils.

Smoking. Nicotine, the active ingredient in tobacco smoke, causes changes in the blood vessels of the mouth that could inhibit the flow of antibodies (produced by the body to fight infection) in the bloodstream. As a result, smokers experience more rapid disease development and greater detachment between teeth and gums than non-smokers.

Other Inflammatory Conditions. A number of studies indicate people with other inflammatory conditions like heart disease, arthritis or diabetes have a higher risk for gum disease. Some researchers have even suggested that bacteria associated with gum disease pass into the blood stream and threaten other parts of the body — an added incentive to seek treatment and stop the disease’s advancement.

If you fall into any of these risk categories, it’s even more urgent that you practice effective daily hygiene with regular office checkups. Additionally, if you begin to notice bleeding gums, tenderness and swelling, or loose teeth, contact us as soon as possible for an evaluation.

If you would like more information on the diagnosis and treatment of 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 “Assessing Risk for Gum Disease.”


By David A.Susko DDS, PC
December 19, 2014
Category: Dental Procedures
BoneGraftingcanputImplantsBackonYourOptionsList

A dental implant can permanently restore the form and function of a missing natural tooth. But there’s an important prerequisite for this smile-transforming therapy — you must have enough bone remaining at the implant site to securely anchor the implant and ensure proper crown placement for the most natural looking result.

Patients who don’t meet this prerequisite may need to consider other restorative options. In some cases, however, we may be able to encourage sufficient bone growth to support an implantation through a technique called bone grafting.

Bone grafting involves opening the gum tissues at the intended implant site to expose the underlying bone. We then place the grafting material (usually a processed material) around the bone, sometimes with collagen membranes that serve as subterranean band-aids to guide bone growth. In most cases, the graft is actually a scaffold for the natural bone to grow upon; the natural bone will eventually replace the graft material. The procedure is normally performed with local anesthesia to minimize discomfort.

While bone grafting is a fairly routine procedure, it shouldn’t be undertaken unless there’s a firm prognosis it can successfully support a future implant. We must therefore determine if anything else in your oral health would disqualify you as an implant candidate, even if sufficient bone existed or not. We must also determine if there’s enough remaining bone currently at the site to even attach a bone graft.

Once we’re satisfied that bone grafting would be both possible and helpful, we must then consider what type of grafting material to use. If we’re only replacing one tooth we may choose to use an autograft, bone material taken from another area of your own body. Although autografts have advantages because of their regeneration ability, it does involve creating another surgical site within the body. In most cases we may use processed materials, for example allografts, material that originates from another human being; xenografts, taken from another species of animal; or synthetic (man-made) materials. Regardless of the source, these materials are first processed to be safe for human use.

If successful, the regeneration process will result in enough new bone structure to make dental implants a reality. Your mouth will be healthier — and your resulting smile will be more beautiful than ever.

If you would like more information on bone grafting, 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 “Can Dentists Rebuild Bone?


By David A.Susko DDS, PC
December 11, 2014
Category: Oral Health
Tags: oral hygiene   oral health  
HelpTeensMaintainGoodOralHealth

Kids do lots of changing in the teen years, as bodies and minds begin the process of becoming more “grown up.” By now, parental reminders to brush teeth and go easy on sugary snacks might be met with rolled eyes and a groan. But there are still several ways that parents can help their teens to maintain good oral health.

1) Make sure kids get — and wear — a professionally made, custom-fitted mouthguard when playing sports.

The American Dental Association says athletes are 60 times more likely to suffer dental injury if they don't wear a mouthguard. These devices also protect the jaw, lips, cheeks, and tongue — not just the teeth. A mouthguard that's custom-made from a model of your child's teeth costs a little more, but offers greater protection than an off-the-shelf model.

2) Talk to your teens about the dangers of oral piercings.

Like tattoos and iPods, piercings are probably a sign of the times. But that doesn't make them harmless. Installing tongue and lip bolts creates a risk for the teeth and soft tissues that are nearby. Tooth chipping, sensitivity and pain, along with gum recession and infection, are some of the issues that may accompany an oral piercing. Remind teens that future dental problems may be a high price to pay for a fleeting fashion statement.

3) Get professional help if you — or your teen — develop an addiction to tobacco, alcohol or drugs, or an eating disorder.

Nobody wants to admit they aren't in control. But peer pressure, body image concerns and a host of other issues may lead teens into dangerous behaviors. The negative effect of various addictions on one's general health is well-documented; with respect to oral health, there are particular concerns. Tobacco not only stains the teeth, but causes changes in the mouth that can lead to oral cancer. Erosion of the tooth enamel is both a diagnostic signal of a potential eating disorder, and a problem that needs treatment. Don't hesitate to ask questions, particularly when an examination reveals a potential problem, and be sure to seek professional help when needed.

If you would like more information about helping your teen maintain good oral health, 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 “How to Help Your Child Develop the Best Habits for Oral Health.”


By David A.Susko DDS, PC
December 01, 2014
Category: Oral Health
Tags: gum disease   diabetes  
ManagingDiabetesandGumDiseaseTogetherwillLessentheEffectofBoth

Periodontal (gum) disease is a progressive bacterial infection caused primarily by bacterial plaque on tooth surfaces not adequately removed by daily oral hygiene. In fact, nearly all of us will develop gingivitis (inflammation of the gum tissues) if we fail to clean our teeth and gums for an extended period of time.

Some people, however, have a greater susceptibility for developing gum disease because of other risk factors not related to hygiene. Patients with diabetes are at particular high risk for acute forms of gum disease.

Diabetes is a chronic condition in which the body can’t adequately regulate the bloodstream’s levels of glucose, the body’s primary energy source. Type 1 diabetes is caused by inadequate production in the pancreas of the hormone insulin, the body’s primary glucose regulator. In Type 2 diabetes the body develops a resistance to insulin’s effects on glucose, even if the insulin production is adequate. Type 1 patients require daily insulin injections to survive, while most Type 2 patients manage their condition with medications, dietary improvements, exercise and often insulin supplements.

Diabetes has a number of serious consequences, including a higher risk of heart disease and stroke. Its connection with gum disease, though, is related to how the disease alters the body’s response to infection and trauma by increasing the occurrence of inflammation. While inflammation is a beneficial response of the body’s immune system to fight infection, prolonged inflammation destroys tissues. A similar process occurs with gum disease, as chronic inflammation leads to tissue damage and ultimately tooth loss.

Researchers have found that patients with diabetes and gum disease may lessen the effects of inflammation related to each condition by properly managing both. If you’ve been diagnosed with either type of diabetes, proper dental care is especially important for you to reduce your risk of gum disease. In addition to effective daily brushing and flossing and a professional cleaning and checkup every six months (more frequent is generally better), you should also monitor your gum health very closely, paying particular attention to any occurrence of bleeding, redness or swelling of the gums.

If you encounter any of these signs you should contact us as soon as possible for an examination. And be sure to inform any dental professional that cares for your teeth you’re diabetic — this could affect their treatment approach.

If you would like more information on dental care for patients with diabetes, 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 “Diabetes & Periodontal Disease.”




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(586) 294-7810

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228-2460