By James E. Mikula D.D.S., P.C.
November 28, 2018
Category: Oral Health
Tags: oral health   shingles  
BesidesYourHealthShinglesCouldAffectYourDentalCare

If you had chicken pox as a child, you're at higher risk for a painful viral infection later in life called shingles. Besides a painful skin rash and other symptoms that can develop, shingles could also affect your dental care.

About 90% of children contract chicken pox, a disease caused by the varicella zoster virus (VZV), which usually clears up on its own. But later in life, usually after age 50, about a quarter to a third of chicken pox patients will develop shingles.

The onset of shingles usually produces an itching or burning sensation on the skin that's either numb or overly sensitive to the touch. A red rash may ensue with crusty lesions, accompanied sometimes by pain, fever and fatigue. The rash often forms a belt-like or striped pattern along one side of the face or body.

For most patients this painful rash is the extent of their symptoms. But women who are pregnant, patients undergoing cancer treatment or people with compromised immune systems are at risk for more serious complications if they contract the disease. It's important for these at-risk patients to obtain a vaccination, as well as avoid contact with anyone with shingles.

Which brings us to your dental care: in its early stages shingles can be contagious, the virus passing to others through skin contact or by airborne respiratory secretions. That's why it's important if you're currently experiencing a shingles episode that you let us know before undergoing any kind of dental work.  Even a routine teeth cleaning with an ultrasonic device could disrupt the virus and increase the chances of it spreading to someone else. We may need to postpone dental work until the virus is under control.

Antiviral drugs like acyclovir or famciclovir are highly effective in bringing the disease under control, especially if treatment starts within three days of the onset of symptoms. And don't forget the shingles vaccination: the U.S. Center for Disease Control recommends it for anyone 60 or older regardless of a past history with chicken pox.

See your physician as soon as possible if you begin to notice symptoms. Don't let shingles interfere with your life — or your dental care.

If you would like more information on the impact of shingles and similar viruses on dental care, please contact us or schedule an appointment for a consultation.

By James E. Mikula D.D.S., P.C.
November 18, 2018
Category: Uncategorized
BaseballsFranciscoLindorShinesasMrSmile

At the first-ever Players Weekend in August 2017, Major League Baseball players wore jerseys with their nicknames on the back. One player — Cleveland Indians shortstop, Francisco Lindor — picked the perfect moniker to express his cheerful, fun-loving nature: “Mr. Smile.” And Lindor gave fans plenty to smile about when he belted a 2-run homer into the stands while wearing his new jersey!

Lindor has explained that he believes smiling is an important part of connecting with fans and teammates alike: “I’ve never been a fan of the guy that makes a great play and then acts like he’s done it 10,000 times — smile, man! We’ve got to enjoy the game.”

We think Lindor is right: Smiling is a great way to generate good will. And it feels great too… as long as you have a smile that’s healthy, and that looks as good as you want it to. But what if you don’t? Here are some things we can do at the dental office to help you enjoy smiling again:

Routine Professional Cleanings & Exams. This is a great place to start on the road toward a healthy, beautiful smile. Even if you are conscientious about brushing and flossing at home, you won’t be able to remove all of the disease-causing dental plaque that can hide beneath the gum line, especially if it has hardened into tartar, but we can do it easily in the office. Then, after a thorough dental exam, we can identify any problems that may be affecting your ability to smile freely, such as tooth decay, gum disease, or cosmetic dental issues.

Cosmetic Dental Treatments. If your oral health is good but your smile is not as bright as you’d like it to be, we can discuss a number of cosmetic dental treatments that can help. These range from conservative procedures such as professional teeth whitening and bonding to more dramatic procedures like porcelain veneers or crowns.

Tooth Replacement. Many people hide their smiles because they are embarrassed by a gap from a missing tooth. That’s a shame, because there are several excellent tooth-replacement options in a variety of price ranges. These include partial and full dentures, bridgework, and dental implants. So don’t let a missing tooth stop you from being Mr. (or Ms.) Smile!

If you’d like more information about oral health or cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”

By James E. Mikula D.D.S., P.C.
November 08, 2018
Category: Dental Procedures
Tags: dental implants  
ScreworCementWhichisBestforAttachingYourImplantCrown

If you’re in the initial planning stages for a dental implant, you may already be encountering a number of options to consider. One that may come up is how the visible crown will attach to the metal implant imbedded in the bone.

Generally speaking, implants are composed of two parts: a metal post most often made of titanium placed into the bone that serves as the “root” for the new tooth; and a visible, life-like crown made of dental porcelain that attaches to an abutment on the titanium post. The crown can be attached in one of two ways: either with a small screw through the biting surface of the crown into a receiving hole in the abutment or cemented to it.

The major advantage of a screwed crown is that it allows for easy removal of the crown if needed. While the titanium post can often last a lifetime, porcelain crowns more often need repair or replacement since they receive the brunt of the biting forces in the mouth. A screw-attached crown is much easier to remove than a cemented one.

On the other hand, screwed crowns have a small access hole that must be restored with a tooth-colored filling to help the crown appear natural. This isn’t too great an issue with back teeth but does make achieving a natural appearance in the front more difficult. Cemented crowns look more like a natural tooth and are thus more flexible in achieving the desired appearance.

Besides the possibility the cement may cause gum inflammation or bone loss, the chief detraction from cemented crowns is the difficulty in removing them. Crowns are often damaged in this process so it’s highly likely it will have to be replaced rather than repaired. It’s possible to use weaker cement, but this raises the risk of the crown coming loose at some point from the abutment.

As we plan for your implant, we’ll discuss which type of attachment will work best for you, depending on the tooth to be replaced and other conditions with your oral health. The end result, though, should be the same — a new, natural-looking tooth that serves you well for many years to come.

If you would like more information on dental implants, 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 “How Crowns Attach to Implants.”

By James E. Mikula D.D.S., P.C.
October 29, 2018
Category: Oral Health
Tags: tmj disorders   jaw pain  
TrytheConservativePathtoJawPainReliefFirst

If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.

The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.

Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.

TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.

It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.

By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.

TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.

If you would like more information on managing chronic jaw pain, 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 “Seeking Relief from TMD.”

By James E. Mikula D.D.S., P.C.
October 19, 2018
Category: Dental Procedures
Tags: bonding  
3AdvantagesforImprovingYourSmilewithCompositeResins

Are you embarrassed by your front teeth? Maybe it’s just moderate defects—a chipped tooth here, an irregularly shaped tooth there—but it’s enough to make you less confident to smile.

There are a number of ways to transform your teeth’s appearance like porcelain veneers or crowns. But a relatively inexpensive method that’s less involved is to bond dental material called composite resin to your teeth to correct defects. Made of synthetic resins, these restorative materials can mimic your own natural tooth color. We can also artistically shape them to create a more natural look for an irregular tooth.

If you’re looking to change the way your front teeth look, here are 3 reasons to consider composite resins to restore them.

They can be applied in one office visit. Although effective, veneers, crowns and similar restorations are typically outsourced to dental labs for custom fabrication. While the results can be stunning, the process itself can take weeks. By contrast, we can colorize, bond and shape composite resins to your teeth in just one visit: you could gain your “new smile” in just one day.

They don’t require extensive tooth alteration. Many restorations often require tooth structure removal to adequately accommodate them, which can permanently alter the tooth. Thanks to the bonding techniques used with composite resins, we can preserve much more of the existing tooth while still achieving a high degree of artistry and lifelikeness.

Composite resins are stronger than ever. Over the years we’ve learned a lot about how teeth interact with each other to produce the forces occurring during chewing and biting. This knowledge has contributed greatly to the ongoing development of dental materials. As a result, today’s composite resins are better able to handle normal biting forces and last longer than those first developed a few decades ago.

Composite resins may not be suitable for major cosmetic dental problems, but you might still be surprised by their range. To learn if composite resins could benefit your situation—even a large defect—see us for a complete examination.

If you would like more information on composite resin restorations, 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 “Artistic Repair of Front Teeth with Composite Resin.”





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Livonia, MI 48154
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