My Blog

By Dr. Steven L. Rattner DDS & Associates
April 02, 2020
Category: Dental Procedures
RemovingOneorMoreTeethCouldImproveOrthodonticOutcomes

Moving teeth through orthodontics may involve more than simply wearing braces. There are many bite conditions that require extra measures before, during or after traditional orthodontic treatment to improve the outcome.

One such measure is extracting one or more teeth. Whether or not we should will depend on the causes behind a patient's poor dental bite.

Here, then, are 4 situations where tooth extraction before orthodontics might be necessary.

Crowding. This happens when the jaw isn't large enough to accommodate all the teeth coming in. As a result, later erupting teeth could erupt out of position. We can often prevent this in younger children with space maintainers or a palatal expander, a device which helps widen the jaw. Where crowding has already occurred, though, it may be necessary to remove selected teeth first to open up jaw space for desired tooth movement.

Impacted teeth. Sometimes an incoming tooth becomes blocked and remains partially or fully submerged beneath the gums. Special orthodontic hardware can often be used to pull an impacted tooth down where it should be, but not always. It may be better to remove the impacted tooth completely, as well as its matching tooth on the other side of the jaw to maintain smile balance before orthodontically correcting the bite.

Front teeth protrusion. This bite problem involves front teeth that stick out at a more horizontal angle. Orthodontics can return the teeth to their proper alignment, but other teeth may be blocking that movement. To open up space for movement, it may be necessary to remove one or more of these obstructing teeth.

Congenitally missing teeth. The absence of permanent teeth that failed to develop can disrupt dental appearance and function, especially if they're near the front of the mouth. They're often replaced with a dental implant or other type of restoration. If only one tooth is missing, though, another option would be to remove the similar tooth on the other side of the jaw, and then close any resulting gaps with braces.

Extracting teeth in these and other situations can help improve the chances of a successful orthodontic outcome. The key is to accurately assess the bite condition and plan accordingly.

If you would like more information on orthodontic options, 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 “Removing Teeth for Orthodontic Treatment.”

By Dr. Steven L. Rattner DDS & Associates
March 26, 2020
Category: Oral Health
Tags: oral hygiene  

How your dentist in Gaithersburg, MD, can help you enjoy a healthy smile

Are you keeping good oral hygiene habits? If you are not brushing or flossing regularly, your health and your smile are at risk! In fact, according to the Mayo Clinic, an unhealthy smile can increase your risk of suffering from heart disease, endocarditis, diabetes, a stroke, and other serious medical conditions.

Fortunately, Dr. Steven L. Rattner of Grove Dental Arts in Gaithersburg, MD, offers comprehensive dental care, including preventive services to help you and your smile stay healthy.

The easiest most important way to maintain a healthy smile is to keep good oral hygiene habits. So, how do you do that? You need to:

  • Brush after meals and before you go to bed; brushing is one of the best ways to remove plaque and bacteria, which cause gum and periodontal disease. You can either use a manual toothbrush or an electric or sonic toothbrush. Brush in a gentle, circular motion, covering every tooth surface and along the gumline. Always use a toothpaste containing fluoride, to help harden tooth enamel.
  • Floss at least once each day; use either waxed or unwaxed floss and wrap around each tooth as you go down in between your teeth. By gently wrapping in a “C” shape around each tooth, you help ensure the floss stays next to the tooth surface and cleans effectively. If you have arthritis or dexterity issues, you can also use floss picks and other tools.
  • Visit your dentist regularly every six to twelve months; Your dentist will perform a thorough dental examination, including taking x-rays to diagnose dental issues while they are still small and easily treatable. Regular checkups help save you and your smile from needless tooth pain. Your dental hygienist can also perform a dental cleaning at this time, as well.

Keeping good oral hygiene habits are important to the health of your smile and the health of your body. To learn more about maintaining a healthy smile, call Dr. Steven L. Rattner of Grove Dental Arts in Gaithersburg, MD, at (301) 987-5527. Call now and protect your smile!

By Dr. Steven L. Rattner DDS & Associates
March 23, 2020
Category: Oral Health
3TipsforHelpingYourChildFeelMoreComfortableGoingtotheDentist

There’s really no secret to keeping your child’s teeth healthy — good, daily hygiene habits, regular dental visits and early treatment for emerging problems. It’s a lot easier for those things to happen if your child feels comfortable with dental care and visiting the dentist. Sadly, that’s not always the case: many children develop an unhealthy fear of the dentist because the initial relationship may have been mishandled.

Here, then, are 3 tips that will help you foster a healthy relationship between your child and their dentist.

Visit the dentist before their first birthday. From a health standpoint, dental visits should begin soon after your child’s first teeth emerge (erupt) in the mouth. Visiting the dentist by their first birthday also improves the chances they’ll develop a sufficient level of comfort with the visits, more so than if you waited a year or two longer.

Choose your dentist with your child’s sense of security and comfort in mind. When you’re looking for a dentist to care for your child, think of it as looking for a “new member of the family.” It’s important to find an office environment that’s kid-friendly and staff members that work well with children. Some dentists specialize in pediatric dentistry and many general dentists have additional training in working with children. The key is a dental team that has a good, trust-building rapport with children.

Set an example, both in the home and at the dentist. Children learn quite a bit watching what their caregivers say and how they react in potentially stressful situations. If dental care is important to you personally, it’s more likely to become important to your child. And when you visit the dentist with your child, be sure to project calm and a sense that it’s routine — if you display tenseness or nervousness your child may take that as a sign that visiting the dentist is something to fear.

You want your child to learn that the dentist is their friend who’s there to help them. That lesson should begin early with the right dental team — and by making dental care a priority in your own life.

If you would like more information on dental care for your child, 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 “Taking the Stress out of Dentistry for Kids.”

By Dr. Steven L. Rattner DDS & Associates
March 13, 2020
Category: Oral Health
Tags: oral hygiene  
SomethingBetweenYourTeethDontUseAnythingElsebutDentalFloss

As a saying, “Necessity is the mother of invention” is no more appropriate than when you have something caught between your teeth. And humans, as inventive and creative as we are, have used a weird assortment of items—usually within arms' reach—to dislodge a pesky bit of food.

According to a recent survey, more than three-fourths of Americans admit to using a number of “tools” to clean between teeth including twigs, nails (the finger and toe variety), business cards or (shudder!) screwdrivers. And it's one thing to do this alone, but among dinner companions and other folk it's a definite faux pas.

Usually, it's smarter and more economical if you can use a particular tool for many different applications. But when it comes to your teeth, you should definitely go with a “unitasker” designed specifically for the job: dental floss. It's not only the safest item you can use to clean your teeth, it's specifically designed for that purpose, especially to remove disease-causing plaque from between teeth.

Of course, the reason many of us use alternate items for cleaning between teeth is that they're the closest ones at hand. You can remedy this by keeping a small spool (or a short length) of dental floss or floss picks handy for those moments you encounter a wedged piece of food. In a pinch, you can use a rounded toothpick (better for your gums than the flat variety).

At home if you find flossing difficult, consider using a water flosser. This handheld device emits a pulsating stream of pressurized water that loosens and flushes away plaque and bits of food remnant. It's ideal for people who have a hard time maneuvering floss or who wear braces, which can block regular floss thread from accessing between teeth as fully as possible.

In any case, use the other “tools” at hand for whatever they're intended. When it comes to what's best for your teeth, use floss to keep the in-between clear and clean.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation.

By Dr. Steven L. Rattner DDS & Associates
March 03, 2020
Category: Dental Procedures
ADifferentKindofChipShotforProGolferDanielleKang

While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.

“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.

Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.

Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).

For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.

Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.

If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”





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