Invisalign in Rockville, Maryland

Get the smile you’ve always wanted with Pike District Smiles. Dr. Samia Nikkhah and her team at Pike District Smiles are among the leading providers of the Invisalign in Rockville, Maryland. From minor corrections to more extensive support, Dr. Nikkhah is adept at utilizing Invisalign technology to transform smiles. Are you struggling with misaligned teeth and an uneven bite? Invisalign may be the best option to correct the alignment of your teeth. Invisalign is a revolutionary technology that utilizes a set of clear dental retainers to straighten teeth – also know as clear braces or invisible orthodontics.

Invisalign pioneered this process in 1999 and has successfully treated hundreds of thousands of patients wanting to straighten their smiles. Although there are competitors, Invisalign is the name brand for discreet, effective invisible braces. Their research and development has lead to many new advancements in smile correction systems and sets them above the rest. Invisalign treatment times vary, but the average span is 12 months and requires a few short dental office visits. Dr. Nikkhah is ready with the experience and skill you need to determine whether or not Invisalign in Rockville, Maryland is the best smile correction option for you.


Gum Recession in North Bethesda

Have you looked closely at your smile lately and noticed that your teeth look longer than you think they should? A smile that looks “toothy” can be a sign of gum recession, a common condition that affects millions of adults. When gums lose their snug attachment to the neck of the teeth, they can start to recede — eventually exposing the yellowish cementum, the surface layer of the tooth’s roots. Not only does that look unsightly, especially in highly visible areas of the mouth, but it can also cause discomfort. If you are worried that you have gum recession in North Bethesda, we welcome you to contact our office today.

Gum disease is a major cause of gum recession. However, recession can happen even in a healthy mouth, especially in people who have thin gum tissue. The type of gum tissue a person has — thin or thick — is determined by genetics. Thin gum tissue recedes more easily since it is more vulnerable to wear and tear — especially as we age. On the other hand, thicker gum tissue is more robust and less likely to be damaged by trauma and inflammation. Severe gum recession can make it harder for you to smile, talk, and eat with confidence and comfort; fortunately, there are many effective ways to treat it.

Many people may not even be aware that their gums are receding until some of these concerns show up. Your North Bethesda dentist can identify why this is happening, and then address the factors that are causing recession.

One of the main culprits is gum disease, which if left untreated, can wreak havoc on the supporting tissues of teeth. Gum disease is a bacterial infection that eventually causes bone loss. As the bone in your jaw is lost, the gums pull away from teeth, creating small spaces or pockets. These in turn harbor more bacteria, which cause further damage to gums and bone — and potentially more noticeable gum recession.

Poor oral hygiene is a major factor in gum disease. When teeth and gums aren’t properly cared for — with brushing, flossing, and regular professional cleanings — a sticky deposit of bacteria-laden plaque remains on the teeth. Plaque contains various toxins produced by the bacteria which promote infection, inflammation and chronic disease. In the absence of good oral hygiene, it can harden into a mineralized deposit called tartar (or dental calculus), which you can’t remove at home.

Ironically, overzealous hygiene habits can also cause problems; in fact, it is probably the most common cause of gum recession. Aggressively brushing your teeth in a sawing motion can wear away enamel, irritate or inflame the gum tissue, and eventually lead to gum recession. Remember that good brushing should not hurt! If over-aggressive brushing is an issue, try using a soft bristle or electric toothbrush with gentle circular motions.

There are several other habits that can lead to oral health problems: tobacco use (especially chewing tobacco), picking at the gum line, pricking it with sharp objects, and introducing foreign objects in the mouth, like oral piercings. All of these can damage gums and cause recession.

Finally, gum recession may be caused by a tooth that has simply erupted (emerged) in the wrong place: not in the center of the jaw’s bony ridge, as it ideally should. When this occurs, some areas on the root may have inadequate bone support, and consequently little or no gum tissue protection. This may happen naturally, or in some cases because of orthodontic treatment.

Fortunately, Pike District Smiles is equipped to combat unsightly gum recession in North Bethesda. Give our office a call today at (301) 679-0398 to schedule your comfortable and convenient appointment.

Teeth Grinding In Rockville

Life is stressful in the DMV!  Many of our patients complain of teeth grinding due to stress and we often see uncommon wear on teeth that indicates grinding as well.  Teeth grinding is a serious problem that your dentist can help with. If you are experiencing teeth grinding in Rockville or North Bethesda, Maryland, we encourage you to take the first step to treatment by contacting our office.

Teeth grinding, also known as bruxism, is a condition with multiple causes — that’s why there is no single treatment that can be counted on to stop it. However, there are a number of approaches that often prove effective. For the most part, successful management of bruxism focuses on eliminating factors that can trigger the behavior, practicing techniques to relieve stress, and using dental devices and treatments to reduce or eliminate its adverse effects.

Since the use of illicit drugs, alcohol and tobacco have been associated with bruxism, it makes sense to forego these substances. Sometimes this involves a lifestyle change, which can be a challenge. There are many resources available to those who want to make healthy changes in their lives; your healthcare providers can be a good source of information. Occasionally, prescription medications may cause bruxism as an unwanted side effect. In that case, your medical professionals may need to review the drugs your currently take, and determine if any adjustments or alternatives could help.

Stress reduction techniques address the psychological side of the bruxism. There are a number of simple techniques that can help you relax and get a good night’s sleep — and many of them can be effective at reducing teeth grinding at night. Taking a warm bath, creating a soothing environment for relaxation and keeping work-related tasks (and laptop computers) out of the bedroom can help you decompress and unwind more easily at night. Other stress-reduction practices, including meditation, mindfulness and biofeedback, can be used at any time. Many people report that these techniques have helped, though at present there is little hard evidence.

A number of dental treatments can help keep your teeth from being damaged by excessive grinding. The most common is an appliance called an “occlusal guard” or night guard. This is a comfortable, custom-made device that is most often worn over the top teeth. Made of laboratory-processed acrylic resin, a high impact plastic, the device keeps the teeth from actually coming into contact, and can prevent damage to teeth, fillings, crowns and other dental work. This treatment is often considered the best option since it is usually less costly than crowns or orthodontics, and is conservative: no teeth need to be altered, and the treatment is fully reversible. Dental researchers have found that hard night guards provide more stability and more relief of bruxism symptoms than soft occlusal guards. Regardless of the type of occlusal guard a patient receives, the general consensus is that the guard will sustain the wear and tear rather than the patient’s teeth.

In conjunction with an appliance, dentists sometimes recommend a “bite adjustment.” This typically involves removing a small amount of enamel from a tooth to keep it from projecting farther than it should. A tooth that “sticks out” in the bite is more likely to be damaged (or cause damage to other teeth) than a bite where all teeth are even. Occasionally, if a serious malocclusion is found, additional treatments such as orthodontics may be recommended. There have been many reports that once an adult corrects his or her bite with orthodontics, bruxism is reduced or fully eliminated. However, it’s generally worth trying a more conservative approach before considering any additional treatments for bruxism.

In many situations, teeth grinding is accepted as a normal behavior in response to stress. But when it begins to have negative consequences for your health, it’s time to seek treatment. Although the exact nature of bruxism isn’t fully understood, there are a number of ways to reduce its potentially harmful effects — starting with awareness of the problem, and possibly leading to positive lifestyle changes. If teeth grinding is causing problems for you, don’t just “grit your teeth and bear it;” ask your dentist how you can start controlling it.

Dental X-rays in Rockville Maryland


Many of our dental patients have questions about the x-rays they receive in our Rockville dental office. In this article, we will discuss dental x-rays in Rockville Maryland, and specifically, bitewings, which all patients should receive.

The name derives from the small tabs upon which a patient bites to hold the x-ray film or sensor in place. Bitewing radiographs are among the easiest and most accurate to take, giving distortion-free results necessary for the accurate assessment and diagnosis of dental decay between the teeth. In children and adolescents, they also show developing permanent teeth.  Bitewing images usually consist of four films, two on each side, which are necessary to capture all the back teeth — premolars and molars. Often only one bitewing image per side is required in smaller children.

Safety First

Bitewing x-rays carry little risk for you and your children when appropriate precautions are taken. Body parts other than the teeth being examined are carefully safeguarded: Lead collars and aprons are worn to protect and shield the neck and the rest of the body. The x-ray machine’s beam is collimated (produced in a narrow column) — designed to minimize the area of exposure, keeping it focused on the teeth. The use of today’s high-speed film and digital sensor technology has significantly reduced radiation exposure, while increasing accuracy.

When And How Often

The frequency with which bitewing x-rays should be taken is not one-size-fits-all; it is a clinical decision that should be made by you and your dentist after evaluating the risks, benefits and alternatives. It will dependent upon a number of factors including: age, which in the case of children and adolescents will reflect the stage and state of development of the teeth; and the risk of tooth decay, in itself part of a number of other clinical factors. From a periodontal standpoint, it will also include periodic monitoring and evaluation of bone levels in the assessment of periodontal health.

It is not uncommon practice to have bitewing radiographs taken as often as every six to twelve months during childhood or adolescent development, or for adults with high decay rates. The alternative is that tooth decay can go undetected and progress rapidly, requiring extensive repair or even tooth loss. And that will warrant more x-ray exposure (beyond bitewings) necessary to facilitate even more extensive assessment and diagnosis necessary for tooth replacement. Longer intervals between bitewing x-ray examinations are indicated when the risk of caries (tooth decay) and periodontal disease is low.

Dentist in Rockville, Maryland

We encourage you to contact us today to discuss your dental needs and to schedule your comfortable and convenient dental appointment and our dental office in Rockville, Maryland. Dr. Samia Nikkhah is your family dental expert in Rockville and North Bethesda who will give you a Hollywood smile!

Periodontal Disease | Dentist in Rockville Maryland

You may have been told that you have periodontal disease, but aren’t sure what that means.  Our dentist in Rockville discusses below what periodontal disease is and how it’s treated.  Periodontal disease, also known as gum disease, affects millions of people all over the world. It is the number one cause of adult tooth loss, and has been linked to a host of other ailments like diabetes, heart disease and problems in pregnancy. Nearly half of adults age 30 and older have some degree of gum disease, and the percentage increases with age. However, because the symptoms can be very subtle, many don’t realize they have gum disease until it starts to take a serious toll. Healthy gums are vital to a beautiful smile and to overall oral health — yet, when gums are not healthy, they not only look less appealing, but can also lose their tight attachment to the teeth.

One of the chief signs of gum disease is the presence of periodontal pockets — that is, spaces around the teeth, below the gum line, that have become infected. Pockets provide an ideal environment for bacteria to grow, and may spread infection to the structures that keep teeth anchored in the mouth. Although periodontal pockets are invisible to the eye, they can be detected during an oral exam, when the space between the gums and teeth is measured.

During a comprehensive examination, your dentist or hygienist may probe your gums and read off numbers like “three-two-three…four-three-three…” These numbers indicate whether periodontal pockets are present, and how deep they are. Taken together, they can give your dentist an accurate picture of the health of your gums.


Getting rid of plaque bacteria (also called biofilm) and tartar is the first step in keeping gum disease from getting worse. In the case of inflamed gums with no bone loss, even a pocket depth of 4 mm or 5 mm may be treated with professional cleanings to remove the causes of the inflammation, along with an enhanced at-home oral care regimen. This will likely include, at minimum: brushing your teeth twice a day with a soft toothbrush and fluoride toothpaste; flossing daily to remove plaque between the teeth where your brush can’t reach; and using an oral rinse if recommended by your dentist.

If more severe periodontal disease is present, a procedure called scaling and root planing may be recommended. This thorough cleaning procedure not only removes the plaque and tartar, but also smooths the root surface so the gum tissue can reattach to the tooth, shrinking the pocket.

Sometimes, antibiotics may be used to reduce inflammation and help control bacteria underneath the gum line. Antibiotics can be given in pill form, but most often are directly applied inside the periodontal pocket.

If a pocket is too deep to be treated with non-surgical procedures, surgery may be recommended to reduce the size of the pocket. This procedure is often done by a periodontist — a dentist who specializes in the treatment of the gums and other supporting structures of the teeth — and may be performed with standard surgical tools or with laser instruments.

At home, good oral hygiene plays a huge role in preventing periodontal disease.  Brushing twice a day and flossing daily will go a long way toward providing a healthy mouth.  Some of our patients in our Rockville dental office find that a waterpik or water flosser is a great way to keep your pearly whites fresh and clean.  If you have been told you have periodontal disease, give our dentist in Rockville a call for a free second opinion consultation.

Loose Teeth in North Bethesda

If you have loose teeth in North Bethesda, you will want to contact our dental office as soon as possible.  Tooth looseness more often than not is a fairly late sign and symptom of periodontal (gum) disease. Untreated, this inflammatory disease caused by dental plaque destroys the supporting structures of the teeth, most importantly, bone. As bone is progressively lost, teeth gradually become loose and are unable to withstand normal biting forces. Inevitably, as the disease progresses, unabated and untreated, the teeth become so loose and uncomfortable they will be lost.

It is not inevitable that you will lose your teeth, but looseness is not a good sign. The problem of loose teeth is complex but treatable. You should see your general dentist in North Bethesda immediately for a complete and thorough examination to determine the cause and severity of your condition and what can be done to save your teeth.

Pike District Smiles can help you with your loose teeth in North Bethesda.  Our highly educated and trained dentist and staff will work with you to provide custom solutions for your dental problems.  We can help you achieve oral health and find your Hollywood smile!  Contact us online today or give us a call to set up your convenient and affordable appointment today.

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