My Blog
By Michael S. Mullaney, D.M.D.
March 12, 2018
Category: Dental Procedures
Tags: oral health   x-rays  

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 Michael S. Mullaney, D.M.D.
March 04, 2018
Category: Oral Health

Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.

As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.

Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.

Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.

Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”

By Michael S. Mullaney, D.M.D.
February 17, 2018
Category: Oral Health

If you’ve lost some teeth you may eventually want to replace them with dental implants. Implants by far are the restoration of choice due to their life-likeness and durability. But those advantages don’t come cheaply — implants can be expensive especially for multiple teeth.

If you’re forced to wait financially for implants, you still have other intermediary options like a removable partial denture (RPD). The conventional RPD has a rigid acrylic base colored to resemble gum tissue supported by a metal frame with attached prosthetic (false) teeth at the missing teeth locations. They’re held secure in the mouth through metal clasps that fit over the remaining teeth.

But these conventional RPDs can sometimes be uncomfortable to wear and don’t always cover the bottom of the gum completely. If this is a concern, you might consider an alternative: flexible RPDs. The base of this RPD is made of a form of flexible nylon rather than acrylic plastic. They’re much more lightweight but still fit securely in the mouth with thin plastic extensions rather than metal clasps. The base can also be more easily formed to cover areas where gum tissue may have receded.

While flexible RPDs hold up better to wear and tear than their conventional counterparts, they must still be maintained like any other appliance. They can accumulate plaque (bacterial biofilm) responsible for tooth decay and periodontal (gum) disease, so daily thorough cleaning is a must. And if there fit becomes loose they can be more difficult to reline or repair than other types of dentures.

They also share a common weakness with other dentures — they can’t prevent and may even stimulate bone loss. As bone ages, old cells dissolve and new ones form to take their place. As we eat and chew our teeth transmit the forces generated through the teeth to the bone to stimulate it to grow. RPDs and other dentures can’t transmit this stimulus, so the bone replaces much slower to the point that the bone volume can diminish.

That’s why it’s best to consider any RPD as a temporary solution until you can obtain an implant for a more permanent and bone-friendly option. In the meantime, though, an RPD can provide you with a great solution for both form and function for missing teeth.

If you would like more information on RPD choices, 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 “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”

By Michael S. Mullaney, D.M.D.
February 02, 2018
Category: Dental Procedures
Tags: loose teeth  

During your lifetime you’ll eat thousands of meals — and generate a lot of force from chewing over the years. But thanks to a support system of gum tissues and bone, your teeth can normally handle it.

What your teeth can’t handle, though, are higher than normal chewing forces on a continual basis. This can happen if you grind your teeth, which can produce 20-30 times the normal force. The habit often arises in adults because of high stress and often occurs during sleep.

These abnormal forces can stretch the periodontal ligaments that hold teeth in place, cause the teeth to become loose and at increased risk for loss. The best treatment strategy is to reduce clenching with, for example, muscle relaxants or anti-inflammatory drugs or lower the effects with a mouth guard that won’t allow the teeth to make solid contact during clenching.

Your teeth can also become loose even with normal chewing forces if you have advanced periodontal (gum) disease. Gum disease arises from dental plaque, a thin film of bacteria and food particles left on teeth due to poor oral hygiene. As it builds up, it causes inflammation of the gum tissues resulting in bone loss and causing the gums to detach from the teeth, increasing pocket depth.

Our first step in this case is to treat the gum disease by removing plaque and calculus (tartar) from all tooth and gum surfaces. This includes infected areas below the gum line and around the roots, a circumstance that could require surgical access.

As treatment progresses in either of these scenarios the gum tissues heal and often regain their attachment to the teeth. But that can take time, so we may need to stabilize any loose teeth in the short term. The most common way is to splint them to other secure teeth. This is done by using a clear acrylic bonding material to join the loose teeth together with a strip of metal or other rigid material (like joining pickets in a fence).

When symptoms arise, quick action is the key to preventing lost teeth. If you notice swollen, painful or bleeding gums or especially loose teeth, don’t delay — contact us so we can begin treatment as soon as possible.

If you would like more information on the causes and treatments for 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 Michael S. Mullaney, D.M.D.
January 18, 2018
Category: Oral Health
Tags: oral health  

Did you make any New Year's resolutions this year? For many of us, these pledges reflect a sincere desire for self-improvement—whether it's in terms of our career, our personal lives, or our health. Yet it isn't always possible to keep every promise we make…and while exercising every day and cutting out desserts are worthwhile goals, they may also be very difficult to maintain. Fortunately, when you resolve to improve your oral health, there are some simple things you can do to help keep your smile looking healthy and bright.

Get Into the Oral Hygiene Habit

Got a minute? How about two minutes, twice a day? If so, you have time to brush your teeth properly. According to the American Dental Association (ADA), brushing twice daily with a soft-bristled brush that fits comfortably in your mouth—and replacing that brush every three to four months—is essential to good oral hygiene. The ADA also recommends flossing once a day to clean all the places where your brush can't reach—like in between teeth and under the gum line. Brushing and flossing are the best ways to maintain good oral hygiene at home.

Think Before You Drink

Here's another way to make a big difference in your oral health: Pass up those sugary and acidic drinks, and choose plain, refreshing water instead. We're talking about regular and diet soda, as well as fruit juice and those so-called “sports” or “energy” drinks. The sugar and acid in these drinks can spell disaster for your teeth: Sugar promotes the growth of bacteria that can cause tooth decay, while acid softens the hard enamel covering of your teeth, allowing cavities to get started. Water, on the other hand, satisfies your body's need for hydration without adding calories or harmful ingredients. That what makes it the best drink for your diet—and your oral health.

See Your Dentist Regularly

There are some jobs best left to the pros—like removing the hardened deposits called “tartar” from your teeth, and checking for tooth decay, gum disease and other oral health problems. We'll take care of all that at your routine dental checkup. Plus, you'll get a thorough cleaning and a chance to “brush up” on oral hygiene techniques that can help you keep your mouth healthy throughout the year.

If you have questions about improving your oral hygiene, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Daily Oral Hygiene” and “Think Before You Drink.”

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