How can we help you?
It's completely normal to have questions about your dental care and our practice! We encourage our patients to ask questions. After all, that's how you make informed decisions!
We'll always take the time to explain diagnoses and treatment options to you, and if there's ever anything you need more information on, don't hesitate to let us know!
We've collected some of the most commonly heard questions at our practice. Feel free to look through and see if your questions are answered here. If your question isn't here or you'd like more information, give us a call!
Sensitive teeth can seriously affect your quality of life. They can make it difficult to enjoy cold or hot foods as well as sweet foods. They may also create a deterrent to proper home care.
Fortunately, there are a number of solutions for sensitive teeth. The first step is to make an appointment at our Rockville dental office so we can get to the bottom of the problem.
Some common culprits that contribute to sensitive teeth include:
Gum recession and root exposure
Over-the-counter teeth whitening products
Clenching and grinding
Chips or small fractures
The good news is that treating sensitivity is often fairly simple. If you are experiencing decay, we can fill your cavity to repair your tooth. If gum recession is your problem, we can determine whether the problem is caused by periodontal disease or if there is a mechanical issue. For instance, you could be brushing your teeth too hard or using a toothbrush with bristles that are too firm!
In the meantime, there are a number of good kinds of toothpaste for sensitive teeth (such as Sensodyne) that can reduce your sensitivity and make eating, drinking, and brushing and flossing your teeth much more comfortable.
Don't ignore sensitivity! Give us a call to schedule an appointment.
Clean between your teeth and below your gum line
Your toothbrush is a fantastic tool for cleaning the surfaces of your teeth, but unfortunately, it's not nearly as effective at cleaning between your teeth and just below your gumline. Dental floss, on the other hand, is designed for precisely that! When you floss once a day, you remove plaque and other particles from the spaces between your teeth and your gumline.
Floss comes in a variety of thickness and styles, and we can recommend the one that's best for you. Generally speaking, a thicker floss that still slides comfortably between your teeth is often the best choice.
Proper Flossing Technique
Rather than "snapping" the floss between your teeth to dislodge bits of food, take your time and gently ease the floss between your teeth. Make sure to get both sides of each tooth, including the ones in the back! Using a gentle back-and-forth motion, work the floss along the side of the tooth and into the gum tissue. If you haven't been flossing properly for a while, you might experience some bleeding. Make sure to wind the floss so you are working with a clean area of the floss in each area.
The American Dental Association recommends that most patients have their teeth professionally cleaned two times per year (every six months), and we agree with this recommendation.
Why two cleanings a year?
Our ultimate goal is to protect your teeth and help you keep them for a lifetime. Regular visits for cleanings and examinations help us do that.
The fact is, no matter how diligently you brush your teeth, you simply aren't going to be able to remove every last trace of plaque. Over time, this plaque, a combination of food particles, saliva, and bacteria, sits on the surface of your teeth. Eventually, it hardens into tartar, which can't be removed by either a toothbrush or dental floss. Depending on the location of the deposit, the result will be either decay or gum irritation and recession (or both!).
Stay on top of your dental health with preventative care
Every six months, your dental hygienist will carefully assess your oral health and remove any build-up of plaque or tartar using their knowledge, their training, and their specialized instruments. This gives you a fresh start and prevents the damage that occurs from plaque and tartar that are allowed to remain on your teeth for an extended period of time. Additionally, your hygienist can notify your dentist if they notice anything that could indicate a problem, such as signs of decay or gum disease. This allows for prompt treatment early on.
Has it been a while since your last check-up and cleaning? Give us a call and we'll help you get back on track without any judgment! We want to help you get and stay healthy!
The age of your dental crown is really immaterial. Certain crowns can last for 30 years or more if they are well made and well maintained. However, older crowns that once were a nice match to the rest of your teeth may become mismatched with time, due to changes in the appearance of the other teeth, or gum recession that has exposed the margin of the crown. If crowns like these are holding you back from smiling your happiest smile, then they too should be replaced.
Repairing Broken Dental Crowns in Rockville
If you have a broken crown, you should see your dentist as soon as you can. Depending on just how broken the crown is, you may just need the fractured area re-contoured and polished. More severe fractures can result in exposed tooth structure or food impaction. Both of these conditions may be painful (though not always!), and can increase the likelihood of developing a cavity in either the tooth with the fractured crown or the tooth next to it.
The worst thing to do would be to ignore the problem because it’s not hurting you. Most of the time, cavities do not cause any pain whatsoever, so if you have a condition, such as a broken crown, that makes you more likely to develop a cavity, it needs to be addressed before a problem occurs. Waiting until the tooth is painful will lead to more costly and time consuming treatment - such as root canal treatment, or in more severe cases, extraction of the tooth and replacement with an implant.
Replacement of a broken crown is usually straightforward and predictable as long as the situation is addressed in a timely manner. So if you are concerned about one of your crowns, call us today to schedule an appointment.
As patients, we hear these terms all the time, but unless you’ve had personally experience with bridges and crowns, you might not know exactly what the difference is. But it’s actually very simple. A dental crown is a placed on a tooth in order to repair it from a fracture or to prevent a fracture, or in many cases, to resolve pain that a patient experiences when biting on a certain tooth. You can think of it as a helmet for your tooth, because it binds the remaining, healthy tooth structure together and protects the tooth from breaking catastrophically. It takes two appointments about one to two weeks apart to make a crown. At the first appointment, we prepare the tooth, place a temporary crown, and make a digital scan of the tooth which is sent to a lab. The lab then makes the crown using natural looking materials like porcelain or zirconia. At the second appointment, the crown is cemented to the tooth after we ensure that it has the desired fit and appearance.
Dental Bridge vs. Crown
Bridges are very similar, and we use many of the same techniques to make bridges as we do to make crowns. A bridge is used to replace a missing tooth, and uses the teeth next to the missing tooth in order to hold the bridge in place. In most cases, you can think of a bridge as three crowns connected together- the first one is placed on top of the tooth behind the missing tooth, the second one replaces the missing tooth, and the third one is placed on top of the tooth in front of the missing tooth. Bridges are great for replacing teeth when patients already have crowns or big fillings on either side of the missing tooth, or in situation where we can’t place dental implants. Like crowns, bridges also require two separate appointments.
It’s much easier to tell the difference in photographs. The first one is a crown, which fits over top of one tooth. The second one is a three-unit bridge, which replaces one missing tooth using the two teeth next to the missing one.
Custom Made Tooth Restoration in Rockville
Getting these restorations made requires two steps and two appointments.
At the first appointment, we'll prepare your tooth for the crown, shaping it so that the crown fits well among your existing dentistry for a natural appearance. We'll then take images and impressions, which will be sent with our doctor's precise instructions to the dental lab. You'll be fitted with a temporary crown to protect the shaped tooth and your comfort.
It will take a couple of weeks for the lab to create your crown and send it back to us. At this point, we will ask you to return to the office so that we can place your personalized crown. During this appointment, we'll look over the crown with you, then remove the temporary crown and check the fit. Once you and your doctor are both happy with the results, we will cement the permanent crown in place.
Quality, expert dental care is our goal in 20850
One of our goals is to provide each patient with customized dentistry that looks great, functions well, and lasts a long time. Using the best labs in the U.S. allows us to do precisely that. If you're in need of a crown, call our office today to schedule your appointment!
Sometimes, but not usually.
Most of us are familiar with the unpleasant, painful sensation of having a pointy piece of food, such as a tortilla chip, stab the roof of our mouths when we’re least expecting it. Even the smallest, most innocent parts of food can turn “violent” when they unexpectedly poke us or become temporarily lodged in our gums.
Thankfully, however, most such instances are not dental emergencies—just dental inconveniences.
If you injure yourself while chewing a piece of food, the best thing to do is to remove the food and inspect the area for damage gently. It’s common to have a small, blister-like bubble form around the injury, and you can expect the inside of your mouth to be tender and sensitive for several days. Sometimes, a simple painkiller such as Motrin can help alleviate this pain.
A situation with a tortilla chip or other food would only become a dental emergency if your mouth begins bleeding profusely or if you cannot remove the food from your gums.
In these instances, it’s always a good idea to call your Rockville emergency dentist so we can examine the area right away. Soft tissue injuries such as these aren’t usually permanent or threatening, but it’s always best to rule out infection or other damage.
The next time you have a painful run-in with a bite and food and wonder if you need emergency dentistry, contact Dr. Thomas Gladnick or Dr. Elizabeth Gladnick right away!
Pain-free, Carefully Done Extractions
When we take out teeth we do it in a specific, precise way that has been developed with years of training and experience. Without that training and experience and knowledge of dental anatomy, one might be tempted to just put a pair of pliers on a tooth and yank the thing out. During our time in dental school, we actually saw several cases of patients who did attempt to remove their own teeth, often with unhealthy consequences.
Instead of brute force and a pair of pliers, dentists first use instruments called elevators to apply pressure to specific areas of the tooth. This causes back and forth movement that breaks the ligament that holds the root of the tooth to the bone and gums. Once the tooth is very loose, special forceps that are adapted to teeth are used to gently remove the tooth. All of this is done under profound local anesthesia, so while patients may feel some pressure, they don’t feel any pain.
Not every tooth comes out easy. Some teeth break into multiple pieces, and others are firmly held in place by thick walls of bone. In these cases, it may be necessary to move the gum tissue out of the way in order to better visualize the surgical area. After that, bone can be removed as necessary, or the tooth can be split into fragments and removed piece by piece.
If you have any questions about extractions, please feel free to call us at (301) 963-0800, and we’ll be happy to tell you more.
There are many different types of extractions, but the two most common are the simple extraction and the surgical extraction.
The simple extraction usually takes much less time and is completed by using instruments known as elevators and forceps. These are straightforward procedures in which pressure is applied to specific areas on the tooth, gums, and bone in order to loosen the tooth and eventually remove it from the socket. Placement of a suture may be necessary.
A surgical extraction is a little more complicated and involves either removal of bone around the tooth, or the partitioning of the tooth into different pieces before the tooth is extracted. This is much more common with molars, which have multiple roots, and often need to be removed root by root. For these procedures, in addition to the elevators and forceps used in a simple extraction, the dentist may use a special drill in order to section the tooth. In this procedure, placement of sutures is almost always necessary.
Complications May Result In A Surgical Extraction
When you can see a lot of remaining tooth structure, usually a simple extraction is all that is needed to remove the tooth. However, if the tooth breaks during the extraction, it may necessitate the removal of the tooth piece by piece with the aid of a drill, making the procedure a surgical extraction. In cases where very little tooth structure is remaining, surgical extractions are more likely because there is less tooth structure to engage with our usual instruments, and the only way to remove the tooth is piece by piece.
This can be confusing to patients, and if you have any questions about your specific situation, please give us a call at (301) 963-0800, and we’ll be happy to talk to you!
Tooth Pain May Not Always Mean A Cavity
It would seem to make sense that a hole in your tooth would cause you pain!
The fact is, however, that your tooth's nerves are buried inside the tooth and the hard, outer shell – the enamel – has no nerves. If a cavity has gotten deep enough that you can feel it, that means that it's done a lot of damage to the structure of the tooth and it may need more than a simple filling to treat it!
This is actually one of the reasons why we recommend routine examinations. We would much rather catch problems early on when they are simpler to treat and long before they cause you any pain!
Preventive Care Can Prevent Cavities
Problems of this nature, such as cavities and even some infections, become visible on an x-ray or during an exam before they reach the nerve. At this stage, we can provide simple, conservative treatment to solve the problem and repair the tooth. In some cases, we can even minimize the problem by adding a product to your home care routine or helping you improve your technique.
Old retainers may still be usable
Anyone who has had orthodontic treatment, either with traditional braces or with clear aligner therapy (such as Invisalign), had a retainer made after treatment in order to keep the teeth properly aligned. Most patients that do not wear their retainers will soon discover that their teeth have shifted, and the old retainer might not fit anymore. Others may find that the old retainer still fits, but is very tight and uncomfortable.
If the retainer is tight, we recommend wearing it anyway, even if it makes your teeth a little sore at first. After a few successive nights of wear, patients will find that their retainer fits much better and isn't as uncomfortable. This is because the teeth are moving back into their ideal positions, as guided by the retainer.
A new retainer may be needed
If the retainer doesn't fit at all, a new one can be easily fabricated. The new retainer will keep the teeth where they are, but it will not be able to move the teeth where they are now, but it will not be able to move the teeth back to where they were at the moment the braces were removed. In order to properly align your teeth, additional braces or clear aligner therapy (such as Invisalign) would be necessary.
Root Canal Therapy
Does tooth pain always mean a root canal?
We get this question most frequently from patients that schedule emergency appointments because they’ve noticed some tooth pain. In most of these cases, patients don’t end up needing root canal therapy. Root canal therapy is only necessary when the nerve and blood vessels inside teeth are inflamed or infected. In these cases, the pain is often constant and severe, and occurs spontaneously, or even wakes the patient up at night.
Root canals are typically only necessary after a history of problems
In most cases, the nerves and blood vessels (also known as the pulp of a tooth) only get inflamed or infected after there has been a history of problems with the tooth. It is very rare for a tooth that has never had a deep cavity, a large filling, a crown, or trauma to end up needing root canal treatment. The most common cases of teeth that end up needing root canal treatment are the ones that have had cavities that were so deep that they were very close to the pulp, or even into the pulp. This is just one of the reasons why it is important to catch cavities when they are small and to stop them in their tracks before they become painful.
History of trauma to the tooth is also a common reason why root canal treatment may be necessary. If a tooth was fractured and the pulp was exposed, it is likely the pulp will become inflamed and painful. Even in cases in which the tooth does not break, but the root of the tooth is moved off its blood supply, over time the tooth will die because it is
no longer receiving nutrients from the blood. After the pulp dies, bacteria can invade and cause an infection. Sometimes a toothache won’t happen for years after the original incident.
If you're in pain or in need of a root canal, contact our office to schedule your appointment! We'd love to work with you and determine the best plan of action for your current situation.
Root Canal Therapy - Step By Step
The first step to most dental procedures is the administration of local anesthetic. It is very important that the patient is nice and numb and relaxed, and dentists have developed techniques for ensuring that the patient doesn’t feel anything painful. After the anesthesia takes effect, a rubber dam is placed over the tooth to isolate the rest of the mouth from the unhealthy tooth and from the disinfectants.
Root canal therapy is performed by accessing the middle of the tooth, where the infected or inflamed nerve and blood vessels are located. This is accomplished by a dentist using a specialized tiny drill, and removing tooth structure and filling material from the surface toward the center of the tooth, where the pulp is located. Then, the diseased nerve and blood vessels in the center of the tooth are removed with special instruments, and the dentist can see where the root canals themselves begin.
What is a root canal?
The root canals are the thin, cylinder-shaped spaces in the center of the roots of the teeth that extend from the tip of the root all the way to the middle of the tooth. These canals provide the pathway for the nerve and blood vessels to provide nutrients to the tooth. The dentist is able to access these canals with specialized files, which remove the diseased pulp as well as the affected tooth structure. The canal is then cleaned with disinfectants and antimicrobial agents and then filled with gutta-percha, a rubbery material that seals the canal from the outside environment.
After the canal is filled and sealed, a filling material must be placed to close up the access hole that was created at the beginning of the procedure. If the tooth that has been root canal treated is a back tooth, we recommend that a crown is placed to prevent the tooth from fracturing, due to the fact that root canal treated teeth are more prone to breaking.
If you believe you are a candidate for root canal therapy, or if you're experiencing intense dental pain, please contact our office in Rockville, MD to schedule your appointment today!
Professional Whitening May Be For You
Many people come to our practice unhappy with their smile and thinking that they need extensive cosmetic treatment. They are usually pleasantly surprised to find that all they need is a professional whitening treatment!
We are pleased to offer our patients both in-office whitening and take-home whitening kits, so you can choose the option that's most appropriate for your needs. In-office whitening costs more, but it's a great choice if you need your smile to look better right away. We often provide in-office whitening treatments for patients who are getting married soon or have an important job interview coming up!
Take-home Whitening Kits
While a take-home kit takes a bit longer, the results are comparable and the kit costs less. Take-home kits include trays that are made from impressions of your teeth for a customized fit, and we'll help you select a strength of whitening product that is appropriate for your needs. We'll tell you everything you need to know about using your kit, and, of course, we'll be here anytime you have any questions or concerns!
If you're frustrated with stains caused by foods, drinks, or even the aging process, talk to us. We can help you restore the youth and beauty of a naturally white smile.