PikeDistrict Smiles

Dental X-rays in Rockville Maryland

Many of our dental patients have questions about the x-rays they receive in our Rockville dental office. In this article, we will discuss dental x-rays in Rockville Maryland, and specifically, bitewings, which all patients should receive.

The name derives from the small tabs upon which a patient bites to hold the x-ray film or sensor in place. Bitewing radiographs are among the easiest and most accurate to take, giving distortion-free results necessary for the accurate assessment and diagnosis of dental decay between the teeth. In children and adolescents, they also show developing permanent teeth.  Bitewing images usually consist of four films, two on each side, which are necessary to capture all the back teeth — premolars and molars. Often only one bitewing image per side is required in smaller children.

Safety First

Bitewing x-rays carry little risk for you and your children when appropriate precautions are taken. Body parts other than the teeth being examined are carefully safeguarded: Lead collars and aprons are worn to protect and shield the neck and the rest of the body. The x-ray machine’s beam is collimated (produced in a narrow column) — designed to minimize the area of exposure, keeping it focused on the teeth. The use of today’s high-speed film and digital sensor technology has significantly reduced radiation exposure, while increasing accuracy.

When And How Often

The frequency with which bitewing x-rays should be taken is not one-size-fits-all; it is a clinical decision that should be made by you and your dentist after evaluating the risks, benefits and alternatives. It will dependent upon a number of factors including: age, which in the case of children and adolescents will reflect the stage and state of development of the teeth; and the risk of tooth decay, in itself part of a number of other clinical factors. From a periodontal standpoint, it will also include periodic monitoring and evaluation of bone levels in the assessment of periodontal health.

It is not uncommon practice to have bitewing radiographs taken as often as every six to twelve months during childhood or adolescent development, or for adults with high decay rates. The alternative is that tooth decay can go undetected and progress rapidly, requiring extensive repair or even tooth loss. And that will warrant more x-ray exposure (beyond bitewings) necessary to facilitate even more extensive assessment and diagnosis necessary for tooth replacement. Longer intervals between bitewing x-ray examinations are indicated when the risk of caries (tooth decay) and periodontal disease is low.

Dentist in Rockville, Maryland

We encourage you to contact us today to discuss your dental needs and to schedule your comfortable and convenient dental appointment and our dental office in Rockville, Maryland. Dr. Samia Nikkhah is your family dental expert in Rockville and North Bethesda who will give you a Hollywood smile!

Periodontal Disease | Dentist in Rockville Maryland

You may have been told that you have periodontal disease, but aren’t sure what that means.  Our dentist in Rockville discusses below what periodontal disease is and how it’s treated.  Periodontal disease, also known as gum disease, affects millions of people all over the world. It is the number one cause of adult tooth loss, and has been linked to a host of other ailments like diabetes, heart disease and problems in pregnancy. Nearly half of adults age 30 and older have some degree of gum disease, and the percentage increases with age. However, because the symptoms can be very subtle, many don’t realize they have gum disease until it starts to take a serious toll. Healthy gums are vital to a beautiful smile and to overall oral health — yet, when gums are not healthy, they not only look less appealing, but can also lose their tight attachment to the teeth.

One of the chief signs of gum disease is the presence of periodontal pockets — that is, spaces around the teeth, below the gum line, that have become infected. Pockets provide an ideal environment for bacteria to grow, and may spread infection to the structures that keep teeth anchored in the mouth. Although periodontal pockets are invisible to the eye, they can be detected during an oral exam, when the space between the gums and teeth is measured.

During a comprehensive examination, your dentist or hygienist may probe your gums and read off numbers like “three-two-three…four-three-three…” These numbers indicate whether periodontal pockets are present, and how deep they are. Taken together, they can give your dentist an accurate picture of the health of your gums.

Getting rid of plaque bacteria (also called biofilm) and tartar is the first step in keeping gum disease from getting worse. In the case of inflamed gums with no bone loss, even a pocket depth of 4 mm or 5 mm may be treated with professional cleanings to remove the causes of the inflammation, along with an enhanced at-home oral care regimen. This will likely include, at minimum: brushing your teeth twice a day with a soft toothbrush and fluoride toothpaste; flossing daily to remove plaque between the teeth where your brush can’t reach; and using an oral rinse if recommended by your dentist.

If more severe periodontal disease is present, a procedure called scaling and root planing may be recommended. This thorough cleaning procedure not only removes the plaque and tartar, but also smooths the root surface so the gum tissue can reattach to the tooth, shrinking the pocket.

Sometimes, antibiotics may be used to reduce inflammation and help control bacteria underneath the gum line. Antibiotics can be given in pill form, but most often are directly applied inside the periodontal pocket.

If a pocket is too deep to be treated with non-surgical procedures, surgery may be recommended to reduce the size of the pocket. This procedure is often done by a periodontist — a dentist who specializes in the treatment of the gums and other supporting structures of the teeth — and may be performed with standard surgical tools or with laser instruments.

At home, good oral hygiene plays a huge role in preventing periodontal disease.  Brushing twice a day and flossing daily will go a long way toward providing a healthy mouth.  Some of our patients in our Rockville dental office find that a waterpik or water flosser is a great way to keep your pearly whites fresh and clean.  If you have been told you have periodontal disease, give our dentist in Rockville a call for a free second opinion consultation.

Loose Teeth in North Bethesda

If you have loose teeth in North Bethesda, you will want to contact our dental office as soon as possible.  Tooth looseness more often than not is a fairly late sign and symptom of periodontal (gum) disease. Untreated, this inflammatory disease caused by dental plaque destroys the supporting structures of the teeth, most importantly, bone. As bone is progressively lost, teeth gradually become loose and are unable to withstand normal biting forces. Inevitably, as the disease progresses, unabated and untreated, the teeth become so loose and uncomfortable they will be lost.

It is not inevitable that you will lose your teeth, but looseness is not a good sign. The problem of loose teeth is complex but treatable. You should see your general dentist in North Bethesda immediately for a complete and thorough examination to determine the cause and severity of your condition and what can be done to save your teeth.

Pike District Smiles can help you with your loose teeth in North Bethesda.  Our highly educated and trained dentist and staff will work with you to provide custom solutions for your dental problems.  We can help you achieve oral health and find your Hollywood smile!  Contact us online today or give us a call to set up your convenient and affordable appointment today.

Teeth Whitening in Rockville, Maryland

Teeth Whitening in RockvilleWhen you are deciding to get teeth whitening in Rockville, Maryland, the first step in deciding whether or not to whiten teeth should always be a proper dental examination — with x-ray pictures — to determine the cause of the tooth discoloration. This is the best context in which to explore whitening options, with the person who is in the best position to advise you: your dentist. The optimal, most natural-looking tooth shade is always the one that creates a match between the whiteness of the teeth and the whites of a person’s eyes.

The pre-bleaching exam may reveal a need for a particular treatment, before or even instead of bleaching. For example, there are several causes for discoloration — abscessed teeth, decay, and root canal problems, to name a few — for which bleaching will mask but not resolve the problem. There are also some aesthetic considerations, such as how much of your teeth and gums show when you smile. Typically, short teeth and a gummy smile do not look better with bleaching because whiter teeth will accentuate the gummy smile. Also, exposed tooth roots don’t bleach, so if you have root exposure, your results won’t be ideal. In either of these cases, you may want to consider other cosmetic options.

For teeth whitening, there are three basic options: in-office whitening (done by a dentist), at-home bleaching with custom-made flexible plastic trays (called nightguard bleaching), and over-the-counter products. Within each of these methods the technique can vary, as does the concentration of bleaching solutions and duration of treatment. The in-office bleaching solutions are the strongest, so precautions must be taken by the dentist to protect the gums from coming in contact with them. To compare the three options to achieve a six-shade change: three in-office applications; one week of whitening solution used at home nightly in a custom-made tray; or 16 daily applications of solution on a strip. Your own preferences, lifestyle, and finances will come into play when making a treatment choice. It’s important to keep in mind that all three of these options should eventually achieve the maximum whiteness allowed by the tooth given enough time to work.  Working together with your dentist in Rockville, Maryland, you’ll be able to achieve your teeth whitening goals!

We are always accepting new patients in our beautiful dental office in North Bethesda, Maryland.  Schedule an appointment today online or give us a call at 301-979-9071 to discuss your teeth whitening options.

Invisalign in North Bethesda

invisalign in north bethesdaIf you have a minor imperfection in your smile, such as a crooked tooth or gap, you are most likely a prime candidate for Invisalign in North Bethesda.  Minor or simple movements mean the teeth don’t have to be moved very far, maybe a millimeter or two, just like in your case of closing a small gap between two front teeth. It also means that the appliances used are relatively simple in design and because the movements are minor the procedure generally takes months, not years.

There are a few important things that our comfortable Invisalign dentist in North Bethesda will observe to make sure that these minor movements can be carried out simply safely. As with everything in dentistry, correct assessment or diagnosis of the problem is essential to correct treatment. For instance, with a small gap between your front teeth:

  • Is there enough room to close the space without creating a bite problem with the lower teeth?
  • Are the roots of the teeth in reasonably good position to allow for minor tooth movement to close the space? Radiographs (x-rays) will be essential to assess this and models may also be necessary for study purposes.
  • Is there an involuntary tongue habit that has pushed the teeth forward and created the gap? — This could be difficult or impossible to fix.
  • Is there a large “frenum” the little frond of tissue that runs between the teeth and up into the lip causing the teeth to separate? This may require a very minor and routine surgery to remove it and allow the teeth to stay together after space closure.
  • Are the surrounding gum tissues and the bone healthy?

Dr. Samia Nikkhah, who has taken advanced training in Invisalign, will answer these and other questions and carry out the minor tooth movement safely and uneventfully.

Depending upon the assessment, and bearing in mind that each person’s diagnosis is individual, Invisalign clear retainers are typically the best option for minor tooth movement treatment.  If you are interested in fixing your smile with Invisalign in North Bethesda, please contact our office today to get more information and to schedule your free consultation.

Veneers in Rockville, Maryland

veneers in rockvilleIf your teeth are discolored, there are several ways to combat the effects, including over-the-counter and professional whitening systems.  Some people may be surprised to find out that veneers in Rockville, Maryland are also a good solution. In cases of severe tooth discoloration which are generally caused by “intrinsic” staining (staining to the tooth structure itself), discoloration caused by fillings, tetracycline antibiotic staining and other reasons, Dr. Samia Nikkhah, your dentist in Rockville, Maryland may recommend that your teeth be whitened as best as possible before applying the veneers to enhance the result.

When our dentist in Rockville recommends veneers, we have decided that the teeth cannot be evenly whitened or matched by other means. Porcelain veneers are among the most aesthetic ways of creating a more pleasing and beautiful smile. They allow for the alteration of tooth shape, size and in this case, color. They require a minimal amount of tooth preparation and are, therefore, a more conservative restoration than crowns, which requires significant removal of healthy tooth structure. Although not the only alternative for all aesthetic abnormalities, they are truly a remarkable restoration when they are indeed the treatment of choice. Simply stated, a veneer is a thin layer of dental restorative material, usually made of porcelain, that replaces enamel and which is bonded on to the remaining underlying tooth.

Dr. Nikkhah will create a mock-up smile made of wax on models of your teeth. This is used to make temporary veneers at the preparation appointment. These temporary veneers in Rockville, a plastic or composite material, are a real benefit of this technique because they can last for a few weeks to several months if necessary, creating, in effect, a “trial smile” so that you can see and evaluate changes before the final result. The provisional stage allows the exciting prospect of visualizing and trying the changes before they’re made permanent. You should always provide to Dr. Nikkhah feedback before deciding upon the final veneer restorations and participate in choosing colors and shapes. Our dental technicians will replicate the provisional teeth in the porcelain veneers. Veneers can make for wonderful tooth imitations by mimicking tooth enamel perfectly.

If you are interested in dental veneers in Rockville, Maryland, we encourage you to contact us today to learn more and to schedule your free veneer consultation.  Pike District Smiles serves dental patients in the Rockville and North Bethesda communities.

Wisdom Teeth – Coming of Age May Come With a Dilemma

For some, it is said, wisdom comes with age; for others, age comes by itself. Yet there’s one thing almost everyone can count on when they reach adulthood: the arrival of the third molars, commonly known as “wisdom teeth”.  This set of teeth (generally four, but sometimes more or less) most often appears between the ages of 18 and 24 years.  They are the farthest back in the jaw and the last to come in, completing the process of dental development that began in infancy.

Unfortunately, the appearance of wisdom teeth may be accompanied by dental problems.  Trouble is more likely to occur when the teeth are impacted – that is, they are developing in a way that makes it impossible for them to erupt (emerge from under the gums) and take their expected places in the jaw without affecting nearby healthy teeth.  Impacted teeth generally result from from one or more of the following: a lack of sufficient space in the jaw (crowding); an obstruction (such as another tooth in the way); or an abnormal  position in the mouth.  It’s not certain how many people are affected by this issue, but one recent study showed that 7 our of 10 people in their twenties had at least one impacted wisdom tooth.

Frequently, the solution to potential problems with impacted wisdom teeth is removal (extraction) – even before symptoms are noticed.  In fact, this is a very common procedure for many dentists.  Yet many people have questions about when – or if – this surgical procedure is needed.  For example, if a wisdom tooth isn’t causing pain or disease now but might create problems later, should it be removed as a preventive measure?

Pike District Smiles should be your first call for wisdom teeth information in North Bethesda, Maryland.  Contact us today to learn more and schedule your comfortable and convenient appointment.

Root Canal Safety

A patient recently stated that they read on the internet that root canals cause cancer.  Is there any validity to that?

Unfortunately, sources that rank high on search engines do not always rank high on truth.  So let’s set the record straight:  Root canal treatment does not cause cancer or any other disease.  The fact is that root canal treatment – performed 25 million times every year by skilled dental professionals – stops infection and saves teeth.  Let’s take a closer look at what root canal treatment is, why it’s needed and where these discredited theories come from.

A smile reveals the pearly-white crowns of your teeth.  But each tooth also has one ore  more roots that extend down into the bone beneath your gums.  In addition, there is a hollow space in the center of each tooth called the “pulp chamber” that contains living tissue (pulp).  The nerves and blood vessels of the pulp pass through narrow spaces called canals which branch from the pulp chamber and out through the root tip.  Once outside the tooth, they connect with the rest of the body.

Now let’s go back to that pearly-white tooth surface you can see.  This is enamel, the hardest substance in your body.  It protects teeth from damage and harmful bacteria.  But sometime a tiny hole (cavity) or a crack develops in the enamel that allows bacteria to get in and begin eroding the tooth.  If left alone, these bacteria may reach the pulp tissue, causing tooth destruction, inflammation and pain.

If this inflammatory process remains untreated, the pulp tissue can die off – leading to bacterial infection.  An infection inside the tooth may pass through the root canals into the surrounding tissues, bone and supporting structures.  This infection can result in a painful jaw abscess, and in rare cases may be life-threatening.  In some cases the pain may eventually subside or go away.  However, the infection won’t – even with the use of antibiotics.  Removing the infection is necessary to safeguard your oral health and even your general health.

In the 20th century, a dentist believed that leaving a “dead” organ in the body (in this case the tooth) leads to numerous seemingly unrelated issues.  Yet getting rid of dead tissue is exactly what root canal treatment does – with the significant bonus of keeping the tooth!

If you have tooth pain in Rockville, Maryland, call your Rockville dentist today to find relief today!

Hey Millennials: Pick Up That Toothbrush!

The population of millennials – people who are reaching adulthood in the early 21st century – will soon be greater than that of any other adult generation.  But there’s one thing that’s not so great about this generation: their oral hygiene habits.

A recent survey of 2,000 millennials found that 3 in 10 brush their teeth only once a day.  Many go without brushing for over two days at a time!  And while 56% are concerned about losing their teeth, over half reported being afraid to see the dentist.

What’s wrong with this picture?  For one thing, to keep your oral health in good shape, the ADA recommends brushing twice a day with fluoride toothpaste, and flossing once a day.  Proper brushing and flossing are the two most important things you can do every day to maintain good oral hygiene – and having good oral hygiene is the best way to keep your teeth throughout your whole life.

But even if you brush and floss as recommended, you still need to see your dentist in North Bethesda, Pike District Smiles, for regular checkups and cleanings.  That’s because it’s almost impossible to completely remove decay-causing plaque at home……especially between teeth and under the gums.  A professional cleaning, however can effectively remove stubborn plaque.  Plus a routing checkup includes a complete evaluation of your oral health.  That’s significant, because untreated tooth decay is prevalent among millennials, affecting 1 in 3 people between the ages of 18 and 34.

Your dentist in North Bethesda, Pike District Smiles, is available for your next comfortable and convenient dental appointment!  Contact us today to so schedule your appointment with our caring North Bethesda dentist and staff!

Dental Health While Pregnant

Women who are pregnant, planning to get pregnant or nursing should heed the advice of their dentists when it comes to dental health. And virtually all dentists agree there are some general rule-of-thumb guidelines women of child-bearing age should follow. To make sure you’re aware of the risks associated with poor dental health during pregnancy or while breastfeeding, we’ve compiled a list of some easy tips and warnings.

Brush/Floss Regularly
Many new moms find it difficult to adjust to the schedules of their babies, which is why they tend to delay or forget basic dental hygiene. So if you’re a new mom, make sure you make it a point to brush those pearly whites and floss daily.

Prevent Teeth Grinding
The stresses of motherhood frequently cause women to suffer from teeth grinding or jaw clenching overnight. The easiest solution is to have your dentist fit you with a custom mouthguard that provides a protective layer between the teeth.

Hydration Is Important
A dry mouth can pose all kinds of problems, including gum disease and cavities. And new moms have a habit of putting their needs last. This is why women who are pregnant or nursing should be making sure they are properly hydrating themselves.

Medication Complications
Having dental work done while you’re pregnant or breastfeeding can be a bit tricky. To avoid any type of complications and to make sure the medications you’ll be taking won’t harm your baby, it’s best to consult with your dentist beforehand. He or she will be able to help come up with a plan that protects both you and your child.

Dental health and hygiene is crucial for women who are pregnant, breastfeeding or planning to conceive. If you have any questions or concerns, do not hesitate to contact us or stop by our office to get the answers you deserve!