PikeDistrict Smiles

Invisalign in Rockville, Maryland

Invisalign in Rockville, MarylandGet the smile you’ve always wanted with Pike District Smiles. Dr. Samia Nikkhah and her team at Pike District Smiles are among the leading providers of the Invisalign in Rockville, Maryland. From minor corrections to more extensive support, Dr. Nikkhah is adept at utilizing Invisalign technology to transform smiles. Are you struggling with misaligned teeth and an uneven bite? Invisalign may be the best option to correct the alignment of your teeth. Invisalign is a revolutionary technology that utilizes a set of clear dental retainers to straighten teeth – also know as clear braces or invisible orthodontics.

Invisalign pioneered this process in 1999 and has successfully treated hundreds of thousands of patients wanting to straighten their smiles. Although there are competitors, Invisalign is the name brand for discreet, effective invisible braces. Their research and development has lead to many new advancements in smile correction systems and sets them above the rest. Invisalign treatment times vary, but the average span is 12 months and requires a few short dental office visits. Dr. Nikkhah is ready with the experience and skill you need to determine whether or not Invisalign in Rockville, Maryland is the best smile correction option for you.


Gum Recession in North Bethesda

Have you looked closely at your smile lately and noticed that your teeth look longer than you think they should? A smile that looks “toothy” can be a sign of gum recession, a common condition that affects millions of adults. When gums lose their snug attachment to the neck of the teeth, they can start to recede — eventually exposing the yellowish cementum, the surface layer of the tooth’s roots. Not only does that look unsightly, especially in highly visible areas of the mouth, but it can also cause discomfort. If you are worried that you have gum recession in North Bethesda, we welcome you to contact our office today.

Gum disease is a major cause of gum recession. However, recession can happen even in a healthy mouth, especially in people who have thin gum tissue. The type of gum tissue a person has — thin or thick — is determined by genetics. Thin gum tissue recedes more easily since it is more vulnerable to wear and tear — especially as we age. On the other hand, thicker gum tissue is more robust and less likely to be damaged by trauma and inflammation. Severe gum recession can make it harder for you to smile, talk, and eat with confidence and comfort; fortunately, there are many effective ways to treat it.

Many people may not even be aware that their gums are receding until some of these concerns show up. Your North Bethesda dentist can identify why this is happening, and then address the factors that are causing recession.

One of the main culprits is gum disease, which if left untreated, can wreak havoc on the supporting tissues of teeth. Gum disease is a bacterial infection that eventually causes bone loss. As the bone in your jaw is lost, the gums pull away from teeth, creating small spaces or pockets. These in turn harbor more bacteria, which cause further damage to gums and bone — and potentially more noticeable gum recession.

Poor oral hygiene is a major factor in gum disease. When teeth and gums aren’t properly cared for — with brushing, flossing, and regular professional cleanings — a sticky deposit of bacteria-laden plaque remains on the teeth. Plaque contains various toxins produced by the bacteria which promote infection, inflammation and chronic disease. In the absence of good oral hygiene, it can harden into a mineralized deposit called tartar (or dental calculus), which you can’t remove at home.

Ironically, overzealous hygiene habits can also cause problems; in fact, it is probably the most common cause of gum recession. Aggressively brushing your teeth in a sawing motion can wear away enamel, irritate or inflame the gum tissue, and eventually lead to gum recession. Remember that good brushing should not hurt! If over-aggressive brushing is an issue, try using a soft bristle or electric toothbrush with gentle circular motions.

There are several other habits that can lead to oral health problems: tobacco use (especially chewing tobacco), picking at the gum line, pricking it with sharp objects, and introducing foreign objects in the mouth, like oral piercings. All of these can damage gums and cause recession.

Finally, gum recession may be caused by a tooth that has simply erupted (emerged) in the wrong place: not in the center of the jaw’s bony ridge, as it ideally should. When this occurs, some areas on the root may have inadequate bone support, and consequently little or no gum tissue protection. This may happen naturally, or in some cases because of orthodontic treatment.

Fortunately, Pike District Smiles is equipped to combat unsightly gum recession in North Bethesda. Give our office a call today at 301-979-9071 to schedule your comfortable and convenient appointment.

Teeth Grinding In Rockville

Life is stressful in the DMV!  Many of our patients complain of teeth grinding due to stress and we often see uncommon wear on teeth that indicates grinding as well.  Teeth grinding is a serious problem that your dentist can help with. If you are experiencing teeth grinding in Rockville or North Bethesda, Maryland, we encourage you to take the first step to treatment by contacting our office.

Teeth grinding, also known as bruxism, is a condition with multiple causes — that’s why there is no single treatment that can be counted on to stop it. However, there are a number of approaches that often prove effective. For the most part, successful management of bruxism focuses on eliminating factors that can trigger the behavior, practicing techniques to relieve stress, and using dental devices and treatments to reduce or eliminate its adverse effects.

Since the use of illicit drugs, alcohol and tobacco have been associated with bruxism, it makes sense to forego these substances. Sometimes this involves a lifestyle change, which can be a challenge. There are many resources available to those who want to make healthy changes in their lives; your healthcare providers can be a good source of information. Occasionally, prescription medications may cause bruxism as an unwanted side effect. In that case, your medical professionals may need to review the drugs your currently take, and determine if any adjustments or alternatives could help.

Stress reduction techniques address the psychological side of the bruxism. There are a number of simple techniques that can help you relax and get a good night’s sleep — and many of them can be effective at reducing teeth grinding at night. Taking a warm bath, creating a soothing environment for relaxation and keeping work-related tasks (and laptop computers) out of the bedroom can help you decompress and unwind more easily at night. Other stress-reduction practices, including meditation, mindfulness and biofeedback, can be used at any time. Many people report that these techniques have helped, though at present there is little hard evidence.

A number of dental treatments can help keep your teeth from being damaged by excessive grinding. The most common is an appliance called an “occlusal guard” or night guard. This is a comfortable, custom-made device that is most often worn over the top teeth. Made of laboratory-processed acrylic resin, a high impact plastic, the device keeps the teeth from actually coming into contact, and can prevent damage to teeth, fillings, crowns and other dental work. This treatment is often considered the best option since it is usually less costly than crowns or orthodontics, and is conservative: no teeth need to be altered, and the treatment is fully reversible. Dental researchers have found that hard night guards provide more stability and more relief of bruxism symptoms than soft occlusal guards. Regardless of the type of occlusal guard a patient receives, the general consensus is that the guard will sustain the wear and tear rather than the patient’s teeth.

In conjunction with an appliance, dentists sometimes recommend a “bite adjustment.” This typically involves removing a small amount of enamel from a tooth to keep it from projecting farther than it should. A tooth that “sticks out” in the bite is more likely to be damaged (or cause damage to other teeth) than a bite where all teeth are even. Occasionally, if a serious malocclusion is found, additional treatments such as orthodontics may be recommended. There have been many reports that once an adult corrects his or her bite with orthodontics, bruxism is reduced or fully eliminated. However, it’s generally worth trying a more conservative approach before considering any additional treatments for bruxism.

In many situations, teeth grinding is accepted as a normal behavior in response to stress. But when it begins to have negative consequences for your health, it’s time to seek treatment. Although the exact nature of bruxism isn’t fully understood, there are a number of ways to reduce its potentially harmful effects — starting with awareness of the problem, and possibly leading to positive lifestyle changes. If teeth grinding is causing problems for you, don’t just “grit your teeth and bear it;” ask your dentist how you can start controlling it.

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.