6609 Park Heights Avenue
Baltimore, MD 21215
Tel: (410) 764-3400
Fax: (410) 764-3401
Dr. Lieder Baltimore Dentist: New Patient Forms

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Dr. Lieder's Dental Q&A

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  1. How often do I need to have my teeth cleaned?
  2. I usually don’t like to have x-rays. Must I have x-rays of my teeth?
  3. What is a panoramic x-ray and why do I need one?
  4. I was told by a previous dentist that I have periodontal disease. How does that affect my dental care?
  5. What is the difference between amalgam fillings and composite fillings?
  6. How quickly can I get my teeth bleached?
  7. My child has cavities but is terrified of going to the dentist to have them filled. What can you do for her?
  8. I’m under a lot of stress right now, and I’ve been grinding my teeth at night and waking up with aching muscles. Do you have any solution?
  9. I just had a crown done two years ago, and now I am told it needs to be replaced. Isn’t that too soon?
  10. I have a deep, very painful cavity in a tooth towards the front of my mouth. Is it possible to save this tooth?
  11. My tooth cracked. How soon do I need to see a dentist?
  12. Do you take care of all dental problems in your office?

How often do I need to have my teeth cleaned?

It is recommended that anyone over age 3 gets a dental cleaning every six months. Regular dental cleanings and exams save you from more costly and painful dental procedures down the road.

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I usually don’t like to have x-rays. Must I have x-rays of my teeth?

It’s important to have x-rays as well as a dental exam for early detection of cavities. X-rays can identify cavities between the teeth that the dentist might not otherwise find until the cavities become very deep. It is recommended that bitewing x-rays be taken once a year.

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What is a panoramic x-ray and why do I need one?

A panoramic x-ray takes one large picture of all the teeth and the surrounding jaw structures. Since they are taken from outside the mouth, panoramic x-rays are easier and more comfortable than full-mouth x-rays. Panoramic x-rays are valuable for identifying location and position of wisdom teeth as well as permanent teeth in children. They also can detect problems in the jaw or roots of the teeth before they become serious. It is recommended that panoramic x-rays be taken once every three years.

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I was told by a previous dentist that I have periodontal disease. How does that affect my dental care?

Patients with periodontal disease (shrinking of the bone that supports the teeth) require more frequent and extensive cleanings to keep their mouths healthy. During full dental examinations, we measure the gum levels to determine the frequency and type of teeth cleanings. These periodontal cleanings reduce the presence of bacteria that cause bone breakdown and periodontal disease.

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What is the difference between amalgam fillings and composite fillings?

Although composite (white) fillings are more cosmetically appealing than amalgam (silver) fillings, there are cases where amalgam fillings are superior to composite fillings in the back of the mouth. Amalgam fillings are very strong and durable; we all know people who have silver fillings in their mouths that have lasted for over 25 years. The FDA has concluded, after a review of over 200 studies, that the mercury in amalgam fillings does not pose any danger. I usually involve the patient in the decision as to what type of filling material to use, but there are some cases where only an amalgam filling will do the job.

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How quickly can I get my teeth bleached?

The one-hour teeth whitening that is offered by some dental offices may be quick and convenient, but it can be very painful both to the teeth and your wallet! Instead, I fabricate custom trays to be used with bleaching gel at night. In three to four weeks, you have a beautiful white smile with minimal tooth sensitivity. This is all done at a very reasonable price. We will work with you to make sure that you are satisfied with the results.

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My child has cavities but is terrified of going to the dentist to have them filled. What can you do for her?

For children or adults who are very anxious about dental work, nitrous oxide (laughing gas) sedation works wonders in calming them down during procedures. Nitrous oxide should be given on an empty stomach, so we will probably give your child an appointment first thing in the morning. In order to minimize your child’s anxiety, we will lend her a nitrous oxide mask in advance of her appointment so she can practice breathing through her nose with her mouth closed. I have found this to be an extremely successful technique, since the children come in well prepared for their appointments. Please note that nitrous oxide may be dangerous for fetuses, so pregnant mothers must stay out of the room when their children are getting nitrous oxide.

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I’m under a lot of stress right now, and I’ve been grinding my teeth at night and waking up with aching muscles. Do you have any solution?

A dental night guard can help relieve muscle tightness and generalized tooth sensitivity caused by nighttime teeth grinding. I always recommend first trying an over-the-counter do-it-yourself night guard, which can be purchased at a pharmacy. These night guards are bulky and do not fit well, but they are a good gauge of whether you can tolerate a night guard and whether the night guard helps relieve your symptoms. If you decide that a night guard is helpful for you, I will fabricate a custom-made night guard suitable for long-term use.

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I just had a crown done two years ago, and now I am told it needs to be replaced. Isn’t that too soon?

If a crown does not sit perfectly on its tooth or does not close the gap between teeth, over time, this results in decay under the crown. A properly fabricated crown that seals around the tooth, has proper contacts, and is well maintained by the patient should last for a long time. In our office, before a crown is cemented, we take an x-ray to confirm full and complete sealing of the crown. We also confirm that all the contacts of the tooth are correct. If there is any problem with the fit of the crown, we return the crown to the lab and a new one is made. This is true for bridges as well.

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I have a deep, very painful cavity in a tooth towards the front of my mouth. Is it possible to save this tooth?

When a tooth is badly decayed, there may be a choice between extracting the tooth or saving it with a root canal. Although root canals are more expensive than extractions, remember that preserving the natural tooth is very valuable. Missing teeth can lead to many problems with costly solutions, such as dental implants or dentures. After examining you and taking x-rays, I will discuss with you whether the best solution for your tooth is a root canal and a crown, or extraction and an implant. Although we usually prefer to preserve a natural tooth, sometimes an implant has a better long-term prognosis.

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My tooth cracked. How soon do I need to see a dentist?

If a tooth cracks, you should see a dentist within 24 to 48 hours. Pushing off seeing the dentist will only lead to more problems.

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Do you take care of all dental problems in your office?

Sometimes the best dental treatment requires a specialist. If this is the case, I will refer you to the specialist (pediatric dentist, periodontist, endodontist, orthodontist, or oral surgeon) who I feel will best suit your needs.

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