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The Perio Page Blog
By Towson Center for Dental Implants and Periodontics
October 19, 2021
Category: Oral Health
Tags: oral hygiene  
IfYouFindFlossingTooDifficultTryaWaterFlosser

Dental plaque, that gritty bacterial film coating your teeth, is the top cause for tooth decay and periodontal (gum) disease. You can see and feel a lot of it—but not all of it. Some deposits can lodge snugly between your teeth, and can cause dental disease just as much as what's out in the open.

The problem with between-teeth plaque is that even a solid brushing habit might not effectively remove it. That's why you flossing should also be part of your daily oral hygiene.

If the thought of flossing, however, causes you to let out an audible sigh, we understand. Flossing typically engenders less enthusiasm than brushing, mainly because many find flossing time consuming and difficult to do.

If traditional flossing isn't your bag, we may have a reasonable alternative. Oral irrigation is a hygiene method for removing plaque between teeth using a pressurized water spray. You direct the water spray between your teeth using a handheld wand (which somewhat resembles a power toothbrush) and small hose attached to a countertop pump appliance.

A mainstay in dental offices, oral irrigators (or water flossers) have been available for home use since the 1960s. They're ideal for people who have problems with manual dexterity or who may not want to contend with flossing thread. They also make it easier for patients wearing braces to clean between their teeth, a monumental task using regular floss.

As to effectiveness, oral irrigation appears to match that of regular flossing, especially for orthodontic patients. Clinical studies in the early 2000s compared patients with braces using oral irrigation with those who were brushing only. Those using irrigation were able to remove five times as much plaque as the other group.

There are a number of comparable oral irrigation brands on the market from which to choose, and your dentist can advise you on features to look for when purchasing one. Just be sure you're using some method, oral irrigation or traditional flossing, to remove disease-causing plaque from between your teeth—either will go a long way in keeping your teeth and gums healthy.

If you would like more information on flossing methods, 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 “Cleaning Between Your Teeth.”

By Towson Center for Dental Implants and Periodontics
October 09, 2021
Category: Dental Procedures
Tags: dental implant  
ShouldYouTakeanAntibioticBeforeImplantSurgery

Although getting an implant requires surgery, it's usually a minor affair. Chances are good that after just a few days recuperation you'll be back completely to your normal activities.

But like many other minor surgeries, an implant procedure does pose a slight risk of post-op infection. That's especially so with any dental procedure like implant surgery, since the mouth harbors numerous strains of bacteria that could escape into the bloodstream. For most people, though, a post-op infection doesn't pose a major problem since their immune system kicks in immediately to defeat it.

But some patients with less than robust immune systems or other health problems can have serious complications from an infection. Among other things, infected tissues around an implant may not heal properly, putting the implant at significant risk for failure.

If you have a condition that makes a post-op infection problematic, your dentist or physician may recommend you take an antibiotic before your procedure. Known as prophylactic (preventive) antibiotic treatment, it's intended to give a weakened immune system a head-start on any potential infection after a procedure.

Using antibiotics in this way has been a practice for several decades, and at one time were recommended for a wide list of conditions. That's changed in recent years, though, as evidence from numerous studies seems to show the risk to benefit ratio isn't significant enough to warrant its use in all but a handful of conditions.

Both the American Dental Association and the American Heart Association recommend prophylactic antibiotics for patients with prosthetic heart valves, past infective endocarditis, a heart transplant and some congenital heart conditions. Some orthopedists may also recommend it for patients with prosthetic joints.

Even if you don't fall into these particular categories, prophylactic antibiotics may still be beneficial if you have a compromised immune system or suffer from a disease like diabetes or lung disease. Whether or not a prophylactic antibiotic is a prudent step given your health status is a discussion you should have with both your physician and your dentist.

If they feel it's warranted, it can be done safely in recommended doses. If your health isn't as robust as it could be, the practice could give you a little added insurance toward a successful implant outcome.

If you would like more information about dental implant surgery, 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 “Implants & Antibiotics.”

By Towson Center for Dental Implants and Periodontics
September 29, 2021
Category: Oral Health
Tags: loose tooth  
YouNeedtoActFasttoSaveaLooseTooth

Some things in life are almost guaranteed to make you go, "Uh, oh"—your car won't start, your a/c goes out, or, worse yet, you get an unexpected letter from the IRS.

Here's another: One of your teeth is loose. And, if you don't act quickly, that loose tooth may soon become a lost tooth.

But first, we need to find out why it's loose. It's usually due to one of two types of injury related to your bite. One type is called primary occlusal trauma. This results from your teeth encountering higher than normal biting forces. This often happens if you habitually gnash or grind your teeth together outside of normal functions like eating or speaking.

The other type is secondary occlusal trauma. In this case, the supporting gum tissues and bone have been weakened or lost by disease, with the gum tissues possibly becoming detached. Without this support, even normal biting forces could loosen a tooth.

Our treatment approach for a loose tooth may differ depending on which of these is the cause. For primary occlusal trauma, we want to reduce the biting forces that have contributed to loosening the tooth. One way to do this is to create a mouthguard that when worn prevents teeth from making solid contact during grinding episodes.

For secondary trauma, we want to first focus on treating any gum disease responsible for weakening the gum tissues. Once we have it under control, the gums and bone tissues can heal and possibly regain and strengthen their attachment with the tooth.

At the same time, we may also need to stabilize a loose tooth to prevent its loss. This usually involves splinting, whereby we use neighboring healthy teeth to support the loose tooth. One way to do this is to attach a metal strip across the backs of the loose tooth and its more stable neighbors, or by way of a channel cut through the top biting surfaces of the teeth.

If a loose tooth regains its attachment with the gums and bone, it may stabilize and any splinting can be removed. If not, splinting may become a permanent solution. Either way, prompt treatment can help us save your loose tooth.

If you would like more information on treating 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: Biting Forces Can Loosen Teeth.”

By Towson Center for Dental Implants and Periodontics
September 18, 2021
Category: Dental Procedures
Tags: celebrity smiles   crowns  
HowCelineDionOvercameHerSmileObstacle

For over three decades, Celine Dion has amazed audiences and fans with her powerful singing voice. Best known for her recording of "My Heart Will Go On," the theme song for the movie Titanic, Dion has amassed global record sales topping 200 million. In her early singing days, though, she struggled with one particular career obstacle: an unattractive smile.

The Canadian-born performer had a number of dental defects including crooked and discolored teeth, and—most prominent of all—abnormally large cuspid or "canine" teeth (located on either side of the four front incisors). They were so noticeable that one Quebec celebrity magazine gave her the unflattering nickname "Canine Dion."

This isn't an unusual problem. Since human canines are already the longest teeth in the mouth, it doesn't take much for them to stand out. Our ancient hunter-gatherer ancestors needed these large, pointed teeth to survive. But with the evolution of agriculture and industry, canine teeth have become gradually smaller—so much so that when they're abnormally large, they don't look right in a smile.

So, what can be done if your canines embarrassingly stand out from the rest? Here are some of the options to consider.

Reduce their size. If your canines are just a tad too long, it may be possible to remove some of the enamel layer in a procedure called contouring. Using this technique, we can reduce a tooth's overall size, which we then re-shape by bonding composite resin to the tooth. It's only a good option, though, if your canines have an ample and healthy layer of enamel.

Repair other teeth. The problem of prominent canine teeth may actually be caused by neighboring teeth. When the teeth next to the canines are crooked, the canines can appear more prominent. Alternatively, other teeth around the canines may be abnormally small. Braces or clear aligners can correct crooked incisors, and applying porcelain veneers to smaller teeth could help normalize their length.

Apply dental crowns. In some instances, we can reduce the canines in size and then bond porcelain crowns to them. This is the option that Dion ultimately chose. The natural teeth are still intact, but the crowning process transforms them into properly proportioned, life-like teeth. There is, however, one caveat: The alteration to these teeth will be permanent, so they will need a crown from then on.

Besides crowning her canine teeth, Dion also underwent other dental work to straighten and whiten her other teeth. As a result, this superstar performer now has a superstar smile to match and so can you if your teeth are less than perfect. These or other cosmetic enhancements can give you the look you truly desire. All it takes is an initial visit with us to start you on the road to a transformed smile.

If you would like more information about various cosmetic solutions for your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Dental Crowns.”

By Towson Center for Dental Implants and Periodontics
September 08, 2021
Category: Dental Procedures
TemporarySmilesforTeensWaitingonDentalImplants

Here's some good news: Teenagers are less likely than adults to lose teeth to dental disease. But there's also a flip side. Teens can still lose teeth, more likely from traumatic injury.

Fortunately, there are several options for replacing lost teeth like dentures or bridges. But the choice considered best by most dentists and patients is a dental implant. An implant tooth looks and functions like the real thing—and it's durable, capable of lasting for years, if not decades.

But there's a hitch with teens getting an implant: Even though they may have all their permanent teeth by adolescence, their jaws are still growing and developing. Natural teeth, with their attachment to the jaws by way of a periodontal ligament, can keep pace with this growth—but implants can't.

That's because an implant doesn't have this attachment to gum tissue like natural teeth, but to the jawbone alone. Hence, an implant tooth can't keep up with jaw development, and may eventually look like it's "sunk" into the gums in relation to the teeth around it.

It's best, then, to wait until a teen's jaws have fully developed before attempting an implant. In the meantime, though, they don't have to endure a smile marred by missing teeth, but can replace them with a temporary restoration. The two most common options are a partial denture or a modified bridge.

The partial denture is a lightweight version that's quite affordable. Although not as durable as other types of dentures, the appliance is only intended to last until the patient is old enough for a permanent implant.

The modified bridge is a prosthetic tooth with strips of dental material extending behind it that are bonded to the backs of the teeth on either side to hold it in place. It's likewise not as durable as a traditional bridge, but it can fill the bill until time to place an implant.

Although this adds an additional step in a teen's restorative journey after losing a tooth, it's necessary—waiting to place an implant after jaw maturity will help ensure a long-lasting result. In the meantime, a temporary tooth replacement will help them to enjoy a normal smile.

If you would like more information on dental restorations for teens, 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 for Teenagers.”





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