20737 13 Mile Rd. Roseville, MI 48066

43570 Garfield Clinton twp., MI 48038

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Posts for: July, 2015

By David A.Susko DDS, PC
July 29, 2015
Category: Oral Health
Tags: gum disease  
KeepanEyeonyourGumstoCatchDiseaseEarly

You have a great smile: beautiful white teeth all perfectly aligned. But unbeknownst to you, periodontal (gum) disease might even now be damaging your gum tissues, setting the stage for future tooth and bone loss — and a ruined smile.

While it’s easy to miss the early stage of this disease caused by bacterial plaque on tooth surfaces, there are a few signs if you pay close attention. Bleeding gums after moderate brushing or flossing could indicate normally resilient gum tissues have begun to weaken. You may also notice a slight redness and swelling around the margins of the gums and a bad taste or breath. As it progresses, you may experience painful abscesses (infected pockets that develop between the gums and tooth) and loose teeth, a late sign of tissue detachment and bone loss. If you are a smoker, nicotine reduces swelling and bleeding of the gums, removing signs you have a disease. If you smoke, you need to see your dentist regularly.

While renewed daily oral hygiene is important for stopping gum disease, you may also need professional care to bring it under control. The main treatment calls for the manual removal of plaque and calculus (hardened deposits of plaque) that are sustaining the infection. Dentists and hygienists both can perform scaling, which removes plaque and calculus at or just below the gum line, and root planing to clean accessible root surfaces.

In more advanced cases, though, you may need the services of a periodontist, a specialist in treating diseased or injured gums, bone and other connective tissues that support the teeth. They’re also skilled in more advanced treatments like gum flap surgery that more fully exposes a tooth’s root area for plaque and calculus (or tartar) removal, or tissue grafting procedures that improve the health and appearance of damaged gums.

If you suspect you have gum disease, the place to start is with your family dentist. They can determine if your case will respond to basic scaling, root planing or antibiotic treatment. If the disease appears more advanced or with complications, they will most likely refer you to a periodontist for treatment.

If you’ve already seen bleeding, swelling or redness, see your dentist as soon as possible. The sooner you begin treatment for any case of gum disease, the less likely it will lead to the loss not only of your teeth but your beautiful smile.

If you would like more information on the treatment of 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 “When to See a Periodontist.”


CrownLengtheningOpensupNewTeethRestorationPossibilities

A crown — a life-like “cap” made of dental porcelain that permanently covers an existing tooth — is an effective way to restore a still-viable decayed or broken tooth’s appearance. Properly fitting the crown over the tooth requires some healthy tooth structure above the gum line.

But what if the tooth has broken down to the gum line? In this case, we would need to perform a common procedure known as crown lengthening to expose more of the tooth.

Crown lengthening is a minor surgical procedure performed with local anesthesia to numb the tooth, surrounding gum tissues and supporting bone. We first make tiny incisions inside the gum-line on both the cheek and tongue side of the tooth to expose the bone, and then carefully remove a small amount of bone from either side of the tooth; this will expose or “lengthen” the tooth. Once finished, we suture the gum tissue back into place with self-dissolving sutures against the bone and tooth.

Most procedures take only sixty to ninety minutes, and the mild discomfort afterward is usually managed with pain relievers like ibuprofen. While the gum tissues may appear to be healed after a week, we typically wait six to eight weeks to perform the final crown restoration to give the tissues time to fully mature.

Crown lengthening may not work in all situations, especially with a severely fractured tooth. In these cases, we may need to evaluate the long-term viability of the tooth and consider other restorative options. Depending on your bite, it may also be necessary to treat with orthodontics first: not only will the tooth move into a better position, but the treatment may move both the gum and bone down with the tooth. Subsequent crown lengthening will then only affect the intended tooth and not adjacent ones, resulting in a more even smile.

The first step is for us to decide after a thorough examination if you would benefit from crown lengthening. If so, this minor surgical procedure could pave the way for better mouth function and a more attractive smile.

If you would like more information on crown restorations, please contact us or schedule an appointment for a consultation.


By David A.Susko DDS, PC
July 13, 2015
Category: Dental Procedures
Tags: crowns  
CustomizedTemporaryCrownsHelpEnsureaSatisfyingPermanentSmile

Restoring missing or unattractive teeth can often be a lengthy process. Months may elapse between initial teeth preparation and final placement to allow time for tissue healing and permanent crown manufacturing. During that period you will likely wear temporary (provisional) crowns to protect the teeth while improving function and appearance.

In the past, provisional crowns were fairly uniform. Today, though, there are provisional crowns available that conform exactly to a patient’s individual mouth. These crowns not only enhance function and appearance, they’re an excellent way to “try out” your new smile before the permanent restoration.

Customized provisional crowns are part of a concept known as “smile analysis.” A new smile involves more than restoring affected teeth: we also consider the overall health of your mouth, the shape of your face, and your own desires and expectations. Your final smile design is a joint collaboration between you, our office and the dental laboratory that will fashion the final restoration.

There are a number of techniques for creating customized provisional crowns. Some techniques involve bonding tooth-colored materials like composite resin directly to the teeth. Others use impression models of your teeth to create an outline or shell that’s filled with an acrylic material and then affixed to your teeth. The aim with any of these techniques is to produce a provisional crown that accurately reflects the final crown’s appearance.

With these types of provisional crowns, we can see how the new teeth will look (their color, shading, shapes and proportions) against the gums, and if they appear to be in balance and harmony with the entire face, including your lips, jaws and facial contour. We can also evaluate how well the new teeth function as you chew, speak or smile.

It takes some extra effort to prepare customized provisional crowns rather than the more uniform version. But this effort is well worth it: by helping us anticipate more accurately how your new restorations will appear and function, customized crowns help ensure your new smile is an attractive and satisfying one.

If you would like more information on temporary restorations, 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 “Concepts of Temporary Restorations.”


By David A.Susko DDS, PC
July 12, 2015
Category: Oral Health
Tags: canker sore  
EasingthePainandDiscomfortofCankerSores

If you occasionally experience small sores in the softer tissues of your mouth, you may have aphthous ulcers or better known as canker sores. While rarely a health concern, they can be painful and annoying particularly when you’re eating and drinking.

These breaks in the skin or mucosa (the lining membranes of the mouth) usually occur in the thinner tissues found in the cheeks, lips, under the tongue or in the back of the throat. They tend to be most painful (especially while eating acidic foods like citrus or tomato sauce) between the first few hours of appearing and for a couple of days afterward, and will often occur during periods of anxiety, stress or after a minor injury. The sores will normally heal and fade within a couple of weeks.

Although occasional outbreaks of canker sores are quite common with most people, 20-25% of people (more often women) have a recurring form of painful outbreak known as recurrent aphthous stomatitis (RAS). Another variation called herpetiform aphthae, similar in appearance to herpes simplex virus sores, is characterized by smaller clusters of ulcers. While the specific causes for canker sores are still unclear, there’s some correlation between them and abnormalities with a person’s immune system, as well as with other systemic conditions like gastrointestinal disorders or vitamin deficiencies.

The basic treatment for canker sores is to first soothe the pain and promote quicker healing. Many over-the-counter medications are available for mild cases that numb the area temporarily and provide a protective covering while the sore heals. For more severe cases, there are also prescription medications (like steroids) that can be applied topically or through injection.

While canker sores are not contagious and usually benign, there are some situations that call for a dental examination: sores that haven’t healed within 2 weeks; increasing occurrences and severity of the sores; and never being completely free of a sore in the mouth. These may indicate some other condition, or be an occurrence of cancer or a pre-cancerous condition.

If you have any concerns, be sure to schedule a visit. We’ll be glad to evaluate any occurrence of the sores and recommend the best course of treatment to ease the pain and annoyance.

If you would like more information on canker sores or other types of mouth ulcers, 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 “Mouth Sores.”


By David A.Susko DDS, PC
July 04, 2015
Category: Oral Health
Tags: topical fluoride  
TopicalFluoridecanEnhanceYourChildsDentalCare

More than likely your child already receives fluoride from your drinking water or toothpaste. So, is it really necessary for them to receive topical fluoride during their regular office checkups?

We highly recommend they do. A naturally occurring chemical, fluoride has the ability to make enamel more resistant to acid attacks that lead to tooth decay. It’s most effective when it works its way into the structure of the enamel during early teeth development.

Both fluoridated drinking water and dietary fluoride supplements (recommended by a doctor or dentist) can be the vehicle for this to occur while the teeth are still forming in the jaw before eruption (when teeth become visible). After the teeth have erupted, fluoride applied directly to the enamel surface (topically) can become infused with it as it continues to develop during early growth.

But can’t fluoride toothpaste accomplish the same result? No — the fluoride added to toothpaste and other hygiene products is relatively low, and only strong enough to maintain and protect enamel. The fluoride levels in topical applications like gels, foam or varnishes are much higher (in the tens of thousands of parts per million) and remain in contact with the teeth during a treatment session for much longer. Some fluoride varnishes, in fact, will continue to leach fluoride into the tooth surface for a month or more.

Topical fluoride applications are especially beneficial for children who are growing up in an area without fluoridated drinking water or without the proper means for good oral care and hygiene. But even for children with access to fluoridated water and oral care, a topical application can still be helpful.

A topical fluoride treatment isn’t a stand-alone application, but a regular part of your child’s dental care of daily brushing and flossing and semi-annual dental cleanings and checkups. Topical fluoride enhances the care they already receive to help produce stronger enamel for future healthy teeth.

If you would like more information on topical fluoride applications, 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 “Topical Fluoride: How Fluoride will Benefit Your Child.”




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228-2460