21 Crossroads Drive #350, Owings Mills, MD 21117, 410-581-1411

  

   
  

By Andrew I. Pupkin, D.D.S., P.A.
January 15, 2015
Category: Dental Procedures
Tags: oral surgery   orthodontics  
ExposingandPreservingImpactedCanineTeeth

The final emergence of permanent teeth in late adolescence marks the end of a long process beginning in the womb with the formation of our primary or “baby” teeth. Permanent teeth form in a similar way as buds high in the jaw, continuing to grow until the primary teeth ahead of them fall away. The crowns of the new adult teeth eventually break through the gum tissue and emerge (erupt) into view.

At least, that’s normally what should happen; sometimes, though, a tooth may only erupt partially or not at all, a condition known as impaction. The crown remains partially or fully submerged below the gum line, causing the tooth to press against other teeth, potentially damaging them. It can also make periodontal (gum) tissues adjacent to the area more susceptible to disease. Wisdom teeth are especially prone to this kind of impaction, to the extent they’re often surgically removed (extracted) to avoid future problems to adjacent teeth or the bite.

Upper canines (the “eye teeth” normally located directly below the eyes) are also subject to impaction. But because of their highly visible position, extracting them could have an adverse impact on the patient’s smile. In this case, we often attempt instead to expose and ultimately save the tooth.

Before taking any action, however, an orthodontic examination is conducted first to pinpoint the exact position of the impacted tooth and determine how that position might affect moving teeth into a more desired alignment. If we find the impacted canine is in a workable position, the next step is to surgically uncover the tooth from the gum tissue (a minor procedure usually performed by an oral surgeon or periodontist). Once exposed, an orthodontic bracket with a small attached gold chain is bonded to the tooth. The gums are then sutured back into place with the chain exposed and allowed to heal.

At some future point an orthodontist will attach the chain to orthodontic hardware that will pull the impacted tooth into proper position over several months. As a result, the upper canine becomes “un-impacted”; the dangers to surrounding teeth and tissues are also reduced. And, just as important, we can preserve the tooth and with orthodontics achieve an attractive, normal smile.

If you would like more information on the effects and treatment of impacted 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 “Exposing Impacted Canines.”

By Andrew I. Pupkin, D.D.S., P.A.
December 31, 2014
Category: Oral Health
IronChefCatCoraProtectingYourChildrensTeethStartsEarly

When Cat Cora is not doing battle as the first female chef on the Food Network's hit series Iron Chef America, she is busy caring for the needs of her four active young sons. This includes monitoring the food they eat and their oral hygiene habits.

The busy chef, restaurateur, author, philanthropist and television personality recently revealed in an interview with Dear Doctor magazine that it all started when her four sons were little. She got rid of bottles and sippy cups as soon as possible to prevent tooth decay. She also started exposing her boys to a wide variety of spices and foods when they were infants — for example, by putting cinnamon in their baby cereal. Cat limits the amount of sugar in their diet by using fruit puree in baked goods and BBQ sauces, or the natural sugar substitute Stevia. Furthermore, Cat reports, “my kids have never had fast food.”

Cat is right on target with her approach to her children's oral health. In fact, we are often asked, when is the right time to schedule a child's first dental appointment? Our answer surprises some people — especially those expecting their first child.

The ideal time to take your child to the dentist is around age 1. Why so young? A baby's first visit to the dentist sets the stage for lifelong oral health. Besides, tooth decay can start very early. Baby Bottle Tooth Decay (BBTD), as the name suggests, impacts children who often go to sleep sipping a bottle filled with a liquid containing natural or added sugars, such as formula, fruit juice or a fruity drink mix. Another condition, Early Childhood Caries (ECC), is often found in children who continuously use sippy cups (again, filled with sugary liquids), children who breast feed at will throughout the night, children who use a sweetened pacifier, and children who regularly take sugar-based oral medicine to treat chronic illness.

To learn more about this topic, continue reading the Dear Doctor magazine article “Age One Dental Visit.” Or you can contact us today to schedule an appointment. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”

By Andrew I. Pupkin, D.D.S., P.A.
December 16, 2014
Category: Dental Procedures
Tags: x-rays   oral health  
ConeBeamX-RayscanImproveOutcomesinManyDentalSituations

For decades, dental x-rays have helped us accurately diagnose and treat a wide array of dental diseases and conditions. But even with recent advances in digital imaging, the traditional x-ray does have one drawback: its two-dimensional view doesn’t always provide the “big picture” that a three-dimensional viewpoint can provide.

But a new type of x-ray technology can do just that: known as cone beam computed tomography (CBCT), these machines record hundreds of digital images as a cone-shaped beam of x-ray energy is projected through a device that rotates around a person’s head. A computer then assembles the images into a single three-dimensional image that can be manipulated on screen to view from various angles. Not only does this provide greater context and detail, it does so with no more radiation exposure than a standard 20-film digital full-mouth x-ray series.

While CBCT hasn’t replaced the traditional x-ray, it’s making its mark in a number of specialized areas of dentistry. The following are just a few of the ways CBCT is improving both accuracy and treatment outcomes.

Orthodontics. CBCT can provide a much more detailed view of the entire jaw; this can help us determine the best locations for realigning teeth safely and effectively.

Dental Implants. With a CBCT scan we can precisely locate nerve canals, sinuses and adjacent teeth before implant surgery to locate the best position for the implant.

TMD Treatment. To help develop the best treatment approach for alleviating the pain and dysfunction of temporo-mandibular joint disease (TMD), a CBCT scan can provide us detailed information on how the disease is affecting a patient’s joints, teeth, sinuses and airway.

Impactions. An impacted tooth can exert damaging pressure against the roots of neighboring teeth. A CBCT scan allows us to observe the impacted tooth from various vantage points to determine the best treatment approach for neighboring teeth, nerve canals and sinuses.

If you would like more information on CBCT technology, 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 “Getting the Full Picture With Cone Beam Dental Scans.”

By Andrew I. Pupkin, D.D.S., P.A.
December 01, 2014
Category: Oral Health
CurtSchillingBlamesSmokelessTobaccoforHisOralCancer

For years, even as tobacco use began to decline and disappear in most settings, professional baseball seemed one of the few exceptions. Now, the tide is finally turning. Recently, the legendary right-hand pitcher Curt Schilling revealed that he had been treated for oral cancer — and said that his chewing tobacco habit was to blame. “I’ll go to my grave believing that was why I got [cancer],” Schilling told the Boston Globe.

Schilling isn’t the only former player whose oral cancer is blamed on smokeless tobacco. Tony Gwynn, Hall of Famer and beloved coach, recently passed away from oral cancer at the age of 54. His death led to players pledging to give up the habit. But many still use “dip” or “snuff,” thinking perhaps it’s not so bad after all.

In fact, nothing could be further from the truth. With nicotine as its active ingredient, chewing tobacco can be just as addictive as cigarettes. Not only is nicotine addictive, it also increases heart rate and blood pressure, constricts the arteries, and affects the body in other ways. In addition to nicotine, chewing tobacco contains about 30 other chemicals known to cause cancer.

Tobacco use of any kind is a major risk factor for oral cancer. While it isn’t as well-known as some other types of cancer, oral cancer can be just as deadly. About 43,000 people in the U.S. are diagnosed with it each year — and the 5-year survival rate is just 57%. One reason for the relatively low survival rate is that oral cancer isn’t usually detected until it has reached a later stage, when it’s much harder to treat.

What can you do to reduce your risk for oral cancer? Clearly, you should stop using tobacco products of any kind. Moderating your intake of alcohol, and eating more plant foods and less red meat can also have an impact. And don’t forget to have regular dental checkups: cancer’s warning signs can often be recognized in an oral examination — and early detection can boost survival rates to 80-90 percent.

How does Schilling feel about chewing tobacco now? “I lost my sense of smell, my taste buds for the most part. I had gum issues, they bled, all this other stuff,” he told the Globe. “I wish I could go back and never have dipped. Not once.”

If you have questions about oral cancer or cancer prevention, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Chewing Tobacco” and “Diet and Prevention of Oral Cancer.”

By Andrew I. Pupkin, D.D.S., P.A.
November 13, 2014
Category: Oral Health
TheParent-DentistPartnershipEstablishingBetterOralHealthforYourChild

As a parent, the task of guiding your children through their physical, mental and social development can sometimes seem overwhelming. That doesn’t have to be the case with their dental development — that’s because we’re one of your most reliable support partners for oral health. We’re available not only to treat problems as they arise, but to also offer expertise and resources that can help you help your children establish life-long oral health.

Here are just a few ways we can help guide you along the path to a brighter dental future for your children:

Age One Dental Visit. A healthy life is built on healthy habits — and there’s no better habit for great dental health than regular checkups. We recommend your child’s first visit with us around their first birthday. Beginning this early not only helps us identify any emerging dental problems, it can also help the child — and you — become more comfortable with visiting the dentist. As they grow older they’ll think nothing of their regular visits in the dentist’s chair.

Help! While your child’s first teeth coming in are exciting milestones, the teething process can be extremely frustrating. And, when those same primary teeth give way to their permanent versions, you’ll develop a new set of concerns about their development. By establishing a long-term trust relationship with us, we can offer a wealth of knowledge and tips (as well as needed reassurance) concerning the various stages of your child’s dental development.

“Do as I Do.” Dental visits are important — but the greatest contribution to long-term dental care is a daily habit of proper brushing and flossing, which should start as soon as your child’s first teeth begin to appear. “Modeling” is the best approach for instilling this habit in your child — performing hygiene tasks together and allowing them to learn how to do it from you. To be sure you’re passing on the proper technique, we’ll be glad to provide you with instruction on brushing and flossing — for your sake as well as theirs.

Although rewarding, raising a child is a tough job. When it comes to their oral health, though, we can help make that job a little easier.

If you would like more information on building the right foundation for your child's dental 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 “Dentistry & Oral Health for Children.”





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