Invisalign Now Available

We have been providing clear aligners for many years at The Baltimore Center for Laser Dentistry. We are pleased to announce that we are now an Invisalign Provider. The recent advances in clear aligner technology that Invisalign has developed make them the best choice for invisible braces treatment. 

Our practice has always been focused on minimally invasive dental techniques. Clear aligners like Invisalign are the least invasive way possible to achieve a beautiful smile. Patients often undergo aggressive and expensive veneer procedures without considering the orthodontic options. Straightening teeth combined with whitening such as KoR can achieve an esthetic and long lasting result without grinding away precious enamel for veneers. And it is less expensive and the maintenance is simply wearing retainers and occasional whitening boost. Veneers need replacement after a number of years or can lead to needing crowns as they fail. An improved bite is functionally better, looks great, and can last a lifetime with proper care. 

Visit our website for more information.

Treating Cavities Without a Filling

Cavities caught early can now be treated chemically instead of an invasive filling. Silver Diamine Fluoride (SDF) has been used in Europe for many years and is now available in the United States. When applied to tooth decay SDF sterilizes the cavity and immediately hardens it against further decay. The cavity will turn darker so it is not indicated for esthetic areas.

Here is a case of a five year old boy who presented at his check up with a small cavity on the biting surface of one of his primary molars. The Diagnodent laser decay detector indicated an active cavity with a reading of 34 (anything above 30 usually needs a filling). The cavity was treated for one minute with SDF and he was seen a month later. You can see the cavity darkened some but is now reading much lower and a filling is not needed.

This next case is an early decay spotted between adult teeth on a check up x-ray. The SDF is being applied with Super Floss and then a fluoride varnish is applied to accentuate the effect. This approach has been shown to eliminate the need for a filling about eighty per cent of the time. 

The Baltimore Center for Laser Dentistry is committed to using the least invasive treatments when managing your oral problems. Silver Diamine Fluoride is a non invasive treatment that can help preserve your teeth for a lifetime. For more information on our minimally invasive approach to treating decay visit our website.

Our logo in a cool 3D animation.

My Two Root Canals

It all started during the Christmas holidays last year. I began getting a headache and radiating pain on the right side that felt like it was a TMJ episode or maybe my sinuses acting up. A few days later I noticed swelling in the gum around my upper right first molar. I immediately knew that that tooth had died and abscessed. A few months earlier it had been cold sensitive but an x-ray revealed no decay. I went to one of my trusted colleagues who specializes in root canals and he did a great job.

A few months later I was out to dinner with some of my dental laser training colleagues and noticed a lower left molar was extremely sensitive to cold and started to hurt when I bit on it. That tooth had been occasionally sensitive to biting hard foods for years. I knew it had a small crack in it but it only had a small filling and no active decay, so I lived with it. I knew right away I needed root canal number two for the year. I almost never get cavities, brush and floss like a pro, and get regular check ups. So..... why did I need two root canals within a few months? The answer is the destructive sleep habit known as Nocturnal Bruxism.

 I have been very lucky to have a low decay rate. Except for some small fillings when I was a teenager I have hardly a cavity in decades. I do, however, clench and grind my teeth while sleeping. I did not realize this until I was in dental school and learned about nocturnal bruxism, which is the non-functional grinding of teeth while asleep. In recent years I have tried to wear my night guard regularly but would forget sometimes.

Bruxism can damage the teeth in many ways. It causes an insidious loss of tooth enamel that over time can destroy far more tooth structure than decay in most patients. It also can contribute to gum recession as the excess forces cause the supporting bone and gingiva to slowly drop down the root surface of the tooth. People who primarily clench such as myself can develop vertical cracks in the teeth. Over time these cracks can make their way into the dental pulp (the "nerve") and become a passage for bacterial infection.
In my case I had two teeth develop infections completely due to these cracks caused by clenching and grinding in my sleep. Much of the damage had been done before I regularly wore a night guard and reared its ugly head years later. I was lucky, however. These cracks can be so bad the the tooth needs to be extracted.

If your dentist diagnoses that you grind your teeth it is very important that you start wearing a night guard. The long term effects of bruxism include not only cracked teeth, but also severe loss of enamel, aesthetic problems, TMJ disorder, gum recession, and can make periodontal disease worse.

For more information follow these informative links to our practice website...
www.laserdentistbaltimore.com/teeth-grinding-bruxism
www.laserdentistbaltimore.com/tmj-disorder
www.laserdentistbaltimore.com/laser-assisted-root-canals-with-pips

CPAP Alternative-Oral Appliance Therapy

CPAP is the gold standard for treatment of Obstructive Sleep Apnea. If one can tolerate the CPAP mask it is extremely effective. However, studies have shown that up to 40% of patients will quit using CPAP within the first six months. The reasons are many and include...

• Discomfort of the nose and upper lip
• Claustrophobia
• Unconsciously removing the CPAP while sleeping
• Nasal Dryness
• CPAP machine noise interrupts sleep
• Leaky mask
• Discomfort caused by straps and headgear

For those patients that can not tolerate CPAP, Oral Appliance Therapy is a safe and effective alternative. Oral appliances are recognized by the Academy of Sleep Medicine. They work by pulling the lower jaw forward which helps keep the throat from collapsing allowing air to reach the lungs. In addition, Oral Appliance Therapy is usually covered by your medical insurance. 

We have been providing Oral Appliance Therapy at the Baltimore Center for Laser Dentistry for over a decade. We also work with a billing company to ensure maximum medical insurance coverage available under your plan. 

If you would like to consult with us regarding Oral Appliance therapy for Sleep Apnea give us a call today at 410-789-4999. Also visit our website www.laserdentistbaltimore.com. 

What is TMJ Disorder?

TMJ Disorder is a common affliction that often goes undiagnosed. The discomfort can range from the mildly annoying to debilitating. Early diagnosis and treatment is the key as it is with many medical problems. Simply put,TMJ Disorder is the presence of pain and/or loss of function in the joints and muscles of the jaw. Below is a list of common symptoms that may indicate a TMJ Disorder problem...

• Jaw pain and/or stiffness

• Headaches, usually at the temples and side of head

• Vague tooth soreness or toothaches which often move around the mouth

• Sensitive teeth

• Painful or tender jaw joint

• Difficulty opening jaw

• Pain and fatigue when eating hard or chewy foods

• Clicks, pops, or grinding sound in jaw joint

• Ear pain

• Cervical neck tension and pain

• Tooth wear

• Awareness of grinding/clenching teeth while sleeping or awake (Bruxism)

• A pattern of breaking or cracking teeth with no other cause, i.e. tooth decay or trauma

• History of medically diagnosed migraine headaches (common incidence of concurrent TMD)

Having any of these symptoms may indicate the presence of a TMJ problem that should be evaluated by your dentist. The good news is that most TMJ Disorder problems can be managed effectively with a combination of bite splints and physical therapy. At the Baltimore Center for Laser Dentistry we often prescribe the NTI device which is a cost effective solution that yields results in the great majority of cases. For more in depth information visit our TMJ Disorder webpage at http://www.laserdentistbaltimore.com/tmj-therapy/.

Dr. Pohlhaus is Interviewed About the Dentist's Role in Treating Snoring and Sleep Apnea.

Dr Pohlhaus was recently on WBAL TV discussing the dentist's role in treating snoring and sleep apnea. He also talks about the NightLase procedure. NightLase is a non surgical laser treatment of the soft palate that reduces snoring in 80 percent of the patients treated. For more information on NightLase and other snoring treatments visit The Baltimore Center for Laser Dentisrty's website at www.baltimorelaserdentist.com.