Call Us:(410) 260-0790


At The Mugford Center, we perform a wide variety of services to help you get the smile you deserve. By leveraging today's advanced techniques and technology, your Crofton periodontists Dr. Mugford and Dr. Sfondouris can restore your beautiful smile to help you maintain your youthful appearance.

Tap the links below to learn more about some of the services we provide. (Tap again to close.)

► Bone Grafting
Bone grafting is a surgical procedure that is used to fix problems associated with the bone or joints. It involves transplanting bone tissue, and in the field of dentistry, it is most commonly completed so that there is enough bone available to support dental implants.

Major Bone Grafting

Bone grafting is essential in repairing implant sites to contain adequate bone structure. This may be needed due to tooth loss, previous extractions, trauma, or gum disease. The bone will either be harvested from somewhere else in your body, such as the tibia, hip or jaw, or it can be taken from a cadaver or animal source. Special membranes are also used to encourage bone regeneration and bone grafts, and the most successful regeneration efforts will occur when using live bone from your own body.

Major bone grafting is usually performed in order to repair jaw defects. These may have resulted from congenital defects, tumor surgery, or some type of traumatic injury. The largest defects are typically corrected using the patient's own bone, and the procedures are generally performed in an operating room and may require an overnight hospital stay.

Benefits of Bone Grafting

Bone grafting will be done to restore the bone in your jaw to its previous form, and it may also be used to maintain the existing bone structure after you have had teeth extracted. These activities are important for several reasons. First, dental implant placement will require that the bone of the jaw is as close to the original dimensions as possible in order to achieve optimal results. Additionally, the jaw and facial bones will support the muscles and skin that make up your facial shape and appearance, and without this underlying support, your face may look prematurely aged.

Preparing for Your Bone Grafting Procedure

Prior to the surgery, you'll need to go through a periodontal treatment known as scaling and root planing. You should also be sure to care for you teeth properly by brushing and flossing twice per day.

Anesthesia will be used during the procedure, so it is important that you follow the steps outlined by your dentist or surgeon in order to prepare for the procedure. This will likely involve avoiding food and beverages for six hours prior to your appointment, not smoking, and taking other precautions. Our team will outline all of the preparation steps you need to take prior to your appointment.

After Your Bone Grafting Procedure

Following your bone grafting procedure, you'll likely be prescribed pain medication to help with your discomfort. Be sure to follow your surgeon's instructions regarding how often and when to take any medications that you are prescribed. Swelling is also common, and you can use an ice pack placed on the outside of your mouth to help with this.

It is important to keep your mouth as clean as possible as you heal. Be sure to brush and floss the unaffected portions of your mouth normally. Your surgeon or dentist will provide additional tips on how to safely keep the rest of your mouth clean.

► Ridge Augmentation
Sometimes, due to tooth loss or extraction, the bone underlying the gums will start to recede. This bone loss frequently results in the sinking of the ridge of the gums. The pocket that the tooth used to fill in the gums will widen and deepen as the bone continues to recede which can leave a large indentation where the tooth once was.

Ridge augmentation is a great solution to the issue of unsightly pockets in the gums that can give bacteria a place to build up. In addition to the potential health risk of bacteria formation, deep recesses in the gums can be unsightly and make it impossible to place needed dental implants. Implants have the ability to look and act just like a real tooth, which can prevent changes in your bite and bone loss, and restore function/esthetic appeal to your mouth.

Ridge augmentation may also be needed to restore gum tissue in your mouth to give your teeth a more natural look. When gums recede they can leave teeth looking too tall, and often unsightly. This procedure is a fabulous answer to the problem of gum recession.

How is ridge augmentation accomplished?

The process used to accomplish ridge augmentation depends upon where the issue lies—in the bone or the soft tissue (gum). If bone loss is the cause of the issue, hard tissue augmentation is required, which is often called a bone graft. If the gums themselves are receding the solution is a soft tissue augmentation, which is referred to as a gum graft.

As mentioned before, soft tissue augmentation is usually only performed to improve the look of the gums and teeth. Soft tissue augmentation starts with the retrieval of a tissue graft, usually from the roof of the mouth and numbing the area to be grafted. The graft is then placed and attached with sutures.

Hard tissue augmentation is done with the intent of restoring bone to a site that has experienced bone loss. The procedure is accomplished in much the same way a gum graft is accomplished. The site is numbed and an incision is made to lift the gum away from the bone. The bone graft will then be placed in the incision and attached with sutures.

Occasionally both soft and hard tissue augmentations are performed at the same time, depending on the situation and the patient’s needs. A recovery time of four to six months is needed to allow the augmentation to take and heal properly.

We are excited to help remedy any dental issues you may be experiencing and encourage you to give us a call at (410) 260-0790 today to setup an appointment!

► Sinus Lift
Tooth loss often leads to bone loss in the jaw. A dental implant needs a solid foundation of bone to support it, and bone loss is a common issue when teeth have been missing for a significant period of time. When bone loss occurs in the upper premolar or molar areas the sinus can fill in the gap left by the receding bone. No harm is caused by the sinus filling in the gap left by receding bone, but if dental implants are desired a sinus lift may be necessary.

The upper premolar and molar teeth’s roots can sometimes occupy the sinus cavity or be positioned very close to it. As a result, it is common for the bone loss associated with tooth loss to affect the sinus cavity. In circumstances such as these, before placing implants we will perform a sinus lift/augmentation.

What is involved in the procedure?

Before we start the procedure we prepare by taking x-rays of the jaw and sinus area so we know exactly what must be done. If the patient has seasonal allergies we strongly recommend that this procedure not be done while they are active.

Local anesthetic is applied to numb the site then a small incision in the bone where the tooth used to be is made. We use this hole to gain access to the bottom of the sinus cavity (Schneiderian membrane). The sinus is carefully pushed up into a higher position in the cavity. The result is a free space between where the bone ends and the sinus begins, which encourages the bone to naturally grow and fill in that space. A bone graft will be placed into the space created by this procedure to prevent the sinus from falling back into its original position and to encourage bone growth.

When the graft is in place we suture the gum tissue closed and the site is allowed to heal for anywhere from four to nine months. The long recovery time allows the graft to meld with the jaw and varies depending on how much material needed to be placed.

Following Sinus Augmentation

Recovery from the procedure is typically uneventful. Saline solution is prescribed for the patient to help mitigate dry nasal tissue. Blowing of the nose ought to be avoided and nosebleeds are common following sneezes.

At The Mugford Center we are committed to your health and are proud to offer the best care available. Please give us a call at (410) 260-0790 to setup your appointment today!

► Tooth Extraction
Tooth Extraction patient in Crofton, MDAt The Mugford Center, we are always looking out for the best interest of your mouth. It is a rare thing, but occasionally one of our patient’s tooth will have suffered so much damage due to trauma or decay that it will need to be removed. Extractions are also commonly performed on wisdom teeth. Whatever the reason, extractions are a standard procedure that we frequently perform and with fantastic results.

Reasons Teeth Are Extracted

There are some reasons teeth might need to be extracted which include:
•  Extreme decay
•  Gum disease that has resulted in bone loss
•  Traumatic fracturing of the tooth
•  A tooth that will be impacted upon eruption
•  Teeth that are non-functional or in the way of what will be a more functional bridge or implant

There are two classifications of a tooth extraction – simple and surgical. A simple extraction does not require us to make any incisions in the soft tissues of the mouth whereas a surgical extraction does.

The Tooth Extraction Procedure

The process to remove a tooth with a simple extraction procedure is, as you might guess, simple. Every procedure starts with a numbing of the site and any anesthesia that you request. Once we are certain of your comfort, we will employ the use of a tool called an “elevator” that grips the crown of your tooth. Once the elevator has established a firm grip on your tooth, we will rock it gently back and forth to loosen it to the point where it can be lifted out of its socket.

When we remove a tooth using a surgical procedure, we will usually need to make incision in your gums to get better access to the tooth. Sometimes we can remove the tooth using a similar method to that of the elevator method described above. Other times we may need to split the tooth into halves or quarters to be more easily removed piece by piece. Once the tooth has been fully removed we will suture the site closed and apply gauze to the surgery site to encourage a blood clot to form.

Post-Operative Tooth Extraction Instructions

Whenever you have a tooth extracted the most important piece of advice that we can give you is to keep gauze on it for at least an hour, and once a clot forms, protect it. The blood clot that forms in the extraction site is critical to the quick recovery of your mouth. To protect the clot, the following points are important:
•  No sucking motions with your mouth (straws, cigarettes)
•  No tobacco use
•  No alcohol use
•  Plenty of cold compresses to bring down swelling
•  Do not brush or floss the extractions site

Bleeding in your mouth ought to slow dramatically after the first hour and stop completely roughly 8-12 hours after the procedure. You may notice a bit of a pinkish discharge, which is to be expected. Brushing should be done with care, and special caution should be taken to avoid the site. It is fine to take a mild analgesic like Tylenol, Advil or Aleve to manage pain. If we send you home with a prescription of any kind, please follow all dosing instructions

Call us today at (410) 260-0790 to learn more or schedule an appointment.

► Sleep Apnea

Sleep Apnea in Crofton, MD

Everyone has the occasional bad night of sleep. However, for millions of Americans, every night is a bad night of sleep. No matter what you do, you wake up morning after morning feeling completely exhausted, like you never went to sleep in the first place. This is a condition known as sleep apnea. With diagnosis and proper treatment, your sleep quality, and quality of life can be restored. The Mugford Center is here to help.

What is Sleep Apnea?

When you have sleep apnea, your breathing is interrupted for several seconds several times while you sleep. When you stop breathing, you wake up, even if you are unaware of it. This disrupts your sleep cycles, forcing you to restart them all over again each time. Not only does sleep apnea impact your sleep, leaving you exhausted, it can also affect your mental and physical health as well.

Sleep apnea is a condition that affects how you breathe when sleeping. During sleep, normal breathing can be interrupted for 10 seconds or more hundreds of times during a single night. Untreated sleep apnea prevents you from getting enough deep, restorative sleep. Without enough deep sleep you may be sleepy, lack mental sharpness and be less productive. Long term health effects can be serious, including weight gain, high blood pressure, heart disease and diabetes.

What are the Causes and Symptoms of Sleep Apnea?

In order to diagnose sleep apnea, you should schedule a consultation with Dr. Mugford.

Sleep Apnea Causes

There are three different types of sleep apnea, obstructive sleep apnea, central sleep apnea, and mixed sleep apnea. Mixed sleep apnea, also called complex sleep apnea syndrome, is a mixture of obstructive sleep apnea and central sleep apnea.

Obstructive sleep apnea is the most common type of sleep apnea. This particular type of sleep apnea occurs when your airway becomes blocked, either by your tongue or other intraoral tissues. When your airway is blocked by these tissues, it can interfere with your breathing.

Sleep Apnea Symptoms

•  Loud, chronic snoring
•  Insomnia
•  Breathing pauses for long periods
•  Waking up often at night
•  Forgetfulness, irritability, depression

Read more about sleep apnea causes and symptoms

How is Sleep Apnea Diagnoses and Treated?

Sleep Apnea Diagnosis

Diagnosing sleep apnea is typically done through a sleep study, which is performed in a sleep clinic. During your sleep study, which is called a polysomnogram, you are attached to machines that monitor and record different information while you sleep. Your heart rate, breathing, brain activities, blood oxygen levels, and the movements of your arms and legs are all monitored. After your sleep study is complete, the next day, the recorded information is read by a sleep specialist, who can interpret the results and diagnose sleep apnea or other sleep-related issues and prescribe you with appropriate treatment.

Sleep Apnea Treatment

There are a number of different treatments that may be recommended for sleep apnea.
•  Specialist: Talk to a doctor trained in sleep apnea. Come visit Dr. Mugford today to start the process.
•  Oxygen Aid: Use supplemental oxygen while sleeping. This will help treat the symptoms, but it may not address any underlying issues.
•  C-PAP Machine: A C-PAP (Continuous Positive Airflow Pressure) machine is a machine that delivers a constant flow of air through a small mask that is worn over your nose. This helps to keep your airway open while you sleep.
•  Oral Appliance: This treatment involves the use of a custom fit guard similar to a mouth guard that is worn while you sleep. These oral appliances, made by Dr. Mugford's office, help your airway to stay open by keeping your lower jaw forward and preventing soft tissues from falling into your airway.
•  Oral Surgery: In some cases, surgery may be required. There are a few different types of procedures that may be performed, including removing excess oral tissue or moving your lower jaw forward.

Read more about sleep apnea diagnosis and treatment

What are the Types of Sleep Apnea?


Obstructive Sleep Apnea

Obstructive sleep apnea, commonly abbreviated as OSA, is the most common type of sleep apnea. This particular sleep apnea is caused by a partial or full blockage of your airway.

Central Sleep Apnea

Central sleep apnea, or CSA, is a type of sleep apnea that is much less common than OSA. It occurs when your brain temporarily fails to signal to the muscles that control your breathing that you need to breathe.

Complex Sleep Apnea Syndrome

Complex sleep apnea syndrome, also referred to as mixed sleep apnea, is a type of sleep apnea that is a mix of both obstructive and central sleep apnea.

Read more about sleep apnea types

Schedule Your Sleep Apnea Consultation Today

The proper diagnosis and treatment of sleep apnea can help you to get the sleep you need, restoring your quality of life. For more information or to schedule your consultation, call The Mugford Center today at (410) 260-0790. We can help identify and diagnose the severity of the sleep apnea and discuss the best treatment options for your unique situation. For more information about our practice, see our office information page.

► TMJ Dysfunction
Woman experiencing TMJ in Crofton, MDIf you are experiencing jaw pain or discomfort, The Mugford Center has experience treating issues that affect the alignment of your jaw and temporomandibular joint (TMJ).

Dr. Mugford will examine your TMJ for irregularities during your comprehensive or periodic exam in order to detect signs of temporomandibular joint dysfunction (TMD).

What Does the Temporomandibular Joint Do?

The purpose of your TMJ is to allow your mouth to move both up and down and side to side. When it is properly aligned, your teeth meet in their optimal bite position, allowing regular functions such as chewing and speaking to occur properly and without discomfort.

Normal TMJ function is essential not only for chewing and speaking, but for overall comfort in your jaw. When your TMJ is misaligned, you may experience headaches, extreme pain in the jaw, and ear or sinus infections. We can identify and treat these alignment issues so that you do not experience additional concerns associated with TMD.

There are several treatment methods available to treat TMD.

Custom created mouthguards are crafted using a special machine that tracks the movements of your jaw. While you sleep, the mouthguards work at realigning your jaw and over time, they can permanently align your jaw to its optimal position. Full mouth restoration is an option for some patients. Full mouth restoration may be best suited for patients whose TMD cannot be treated with traditional mouthguards, or who have additional cosmetic concerns.

Dr. Mugford has extensive experience in helping to reduce pain and perfect your smile. We will work closely with you to determine the treatment plan that is most ideally suited to your individual needs.

► Crown Lengthening
Crown Lengthening at The Mugford CenterCrown lengthening (AKA: "crown-elongation" or "crown-extension") is a surgical procedure that is done when the tooth is too short to provide adequate retention for a restoration (usually a crown).

When a tooth has a deep cavity, a crown and buildup are usually needed to restore the tooth. If the cavity extends too far below the gums, it becomes impossible to predictably make a crown that will last for any length of time. Performing crown lengthening where indicated improves the prognosis for the tooth.

Crown lengthening nearly always involves removing and recontouring some of the bone around the tooth. This results in more tooth structure above the gums and smooth flowing gum contours. Not every tooth that needs a crown also needs crown lengthening surgery, it is only necessary when a deep cavity or crack is present.

Reasons for Crown Lengthening

•  To be able to keep a tooth that would otherwise be removed
•  Provide gum contours that make the tooth easy-to-clean again
•  Improve the appearance of the gum line (in some cases)
•  Provide a restored tooth that lasts longer

What Does Crown Lengthening Involve?

First, the dentist or periodontist will thoroughly numb the tooth or teeth needing crown lengthening. During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. After the procedure your dentist can now prepare the tooth for a functional, long lasting crown. As always, proper brushing and flossing is key to insuring the maximum life of your new crown.

► Scaling & Root Planing
Scaling and root planing is a special type of treatment that goes deeper BELOW the gum line to remove contaminated debris and bacteria, most often performed on patients with active periodontitis.

This seems to be a procedure that causes much confusion for patients trying to understand the difference between "just a cleaning" and scaling and root planing, and the need/reason for this procedure.

A professional polishing or prophy removes only the soft sticky plaque and hard crusty calculus that is ABOVE the gum line on the crown of the tooth. Scaling and root planing is done to remove soft sticky plaque and hard crusty calculus that is loaded with bacteria, around and BELOW the gum line on root surfaces. It is a method of treating gum disease when pockets formed around the teeth have a measurement of greater than 3mm and there is evidence of bleeding and tissue attachment loss.


Scaling is a procedure that meticulously removes contaminated biofilm, plaque, calculus, microorganisms and toxins from around the gum line down to the bottom of each periodontal pocket, in order to obtain a healing response.

Root Planing

Root planing involves smoothing the root surfaces of your teeth with thin instruments so gum tissue can more firmly reattach to roots that are clean and smooth, to prevent tooth loss and sensitivity problems. This procedure makes it more difficult for plaque, calculus and bacteria to accumulate along these root surfaces.

Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take one to six visits to complete. Depending on the extent of the disease, you may need one or more quadrants of the mouth to be treated with scaling and root planing.

Some Reasons Why Root Planning May Be Necessary

•  To control the growth of harmful bacteria
•  Help the pocket wall reattach firmly to the clean root surface
•  Prevent further bleeding of the gums from disease
•  Reduce inflammation
•  Reduce discomfort
•  Prevent bone loss
•  Prevent gum disease related tooth loss
•  Reduce systemic disease

Periodontal Maintenance

A periodontal maintenance procedure (PMP) is defined as a procedure that is recommended following periodontal treatment (such as scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of Dr. Mugford.

These intervals can be as frequent as every two months and they can be extended as long as six months, depending on the patient. Keeping up your PMP interval is important because periodontal disease can recur without adequate follow-up.

PMP includes removal of plaque and tartar above and below the gums, scaling and root planing of specific areas, and polishing. PMP is always completed following active periodontal treatment such as scaling and root planing or more extensive gum surgery.

Home Care After Root Planing and Scaling

Rinse with warm salt water every few hours (1/2 tsp. salt in 8 oz. water) for the remainder of the day to encourage healing and sooth discomfort. Be careful not to bite or chew your lip, cheek or tongue while they are numb. Avoid chewing for 2 hours after this procedure or until numbness has worn off. Keep your fingers and tongue away from the areas that have been treated. Take Tylenol or ibuprofen according to directions on the manufacturers label for a couple of days to help with the discomfort; do NOT take aspirin because it may prolong bleeding.

Rinse your mouth with Closys or Chlorohexidine, if prescribed by your dentist, to reduce oral bacteria. Do not smoke or chew tobacco for 72 hours after the procedure to allow for healing. Gently brush and floss your teeth after each meal. How you care for your teeth and gums at home after treatment is critical to reducing the risk of recurring periodontal disease.

► Soft Tissue Grafts
When you are suffering from advanced gum disease, you may notice that your gums start to pull away from your teeth. This can lead to increased sensitivity and a host of other problems, so you will need to work with Dr. Mugford to treat the issue before it can progress.

Treating Your Gum Recession

There are several ways that your gum recession can be treated. First, a professional cleaning can be used to stop the recession. This procedure is known as scaling and root planing, and it can help the gums to heal so that they don't recede further.

If you need more extensive treatment, a gum graft is often recommended. According to the American Academy of Periodontology, this option can repair the wounded areas where recession has occurred, and it can also help to prevent future infections.

Types of Grafts

There are several different types of gum grafts available if this is the treatment option that you need to pursue, and your periodontist will help you to choose the right option:
•  Connective tissue grafts. This is the most common grafting procedure, and it takes tissue form the roof of your mouth before stitching it over the exposed root.
•  Free gingival graft. Similar to the connective tissue grafts, this option involves taking tissue directly from the palate.
•  Pedicle graft. This option uses tissue found next to the tooth that needs a repair in order to perform the graft.

Benefits of Gum Grafting

There are a few great benefits associated with gum grafting:
•  Improved appearance of your smile. Root exposure and receding gums can make your teeth look longer than normal, giving you a "toothy" grin. Grafting can improve this issue, making your smile look more symmetrical.
•  Better oral health. Gum disease can destroy your gum tissue quite quickly, but grafting can halt bone and tissue loss. This can prevent against future problems.
•  Reduced sensitivity. When the roots of the teeth are exposed, it can be pretty painful to drink or eat foods that are especially hot or cold. Grafting can cover the exposed root permanently, helping with your discomfort

Are you concerned that your gums might be receding? Call our office at (410) 260-0790 about ways to treat the problem.

► Frenectomy & Fiberotomy
Image of patient's tongue extended supported by fibrous muscle.There are several connection points in our mouth to attach our tissues, assisting in the function in our mouth. When this connective tissue is abnormally long, or tight, this can impede your function or cause your teeth to shift out of alignment. A frenectomy or fiberotomy are two procedures that allow our team, at The Mugford Center to surgically correct this potential area of trouble. Our dentists, Dr. Mugford will evaluate your needs and help create a treatment plan that is right for you.

What is a Frenectomy?

Between your upper front teeth or under your tongue is a fibrous muscle known as the frenum, this muscle connects your upper lip to your upper jaw or your tongue to your lower jaw. For some patients, this muscle can interfere with your oral health, pushing your front teeth, and neighboring teeth, from their position, even after the patient has worn braces, or it can impede your speech or ability to use your tongue. We want to help your orthodontia work be more successful, and help the positioning and function of your bite.

A frenectomy is the removal of the frenum, which is the thin muscle tissue found connecting your upper lip to your upper jaw, or your tongue to your lower jaw. This is a simple procedure that patients who have had orthodontic work find necessary to help prevent their front teeth from forming a gap, moving out of their new position, and removing the progress that was achieved from wearing braces.

In a frenectomy, we snip the troublesome tissue, then stitch it up with dissolvable sutures. This is a mostly painless procedure, due to a local anesthetic, and recovery is easy, most patients only require an over the counter pain relief medication the first couple of days following.

It is normal for patients to have a frenum, but it is considered troublesome if the frenum is so long or tight that it pulls on the gum. This pull will create gaps, or cause recession to occur. If we see indications of pulling, it is best to have the frenum surgically released from the gum with a frenectomy.

What is a Fiberotomy?

A fiberotomy is the removal of gingival fibers that surround a tooth and its connection to the bone. This is done to remove the natural elastic fibers that will work to pull a tooth, or multiple teeth, back into the original position. A fiberotomy is usually performed close the end of a patient’s orthodontic treatment. A fiberotomy is a very simple, and painless, procedure, which requires no stitches. Patients often report no healing discomfort, though an over the counter pain relief medication may be taken as needed.

Protecting your orthodontic work with a frenectomy or fiberotomy is important to your long term bite and overall dental health. This simple procedure can save you money and time in a dental chair.

Our team at The Mugford Center can help. For more information on frenectomy and fiberotomy, contact our Crofton front office.

► Gingivectomy
When a patient needs to have a portion of soft gum tissue, not bone, removed, this procedure is known as a gingivectomy, not crown lengthening. At The Mugford Center we can help you have healthy teeth and gums, decreasing the incidence of periodontal disease, or gum disease, by removing the places that bacteria can hide. Excessive gum tissue can create flaps helping food debris and tartar to hide; our goal is to set our patients up for success with regular brushing and flossing, removing those flaps.

What is a gingivectomy?

A common dental condition that many patients have to deal with is what is known as a gummy smile; this means that the patient has excessive gum tissue that hangs over their teeth. This may be caused by various problems, including medications, gum inflammation, or due to bone growth abnormalities. Patients who have this problem need to take extra caution to brush along the edge of their teeth, under this flap of excess tissue to remove all bacteria. When a patient has braces, this can be even more difficult. Most often a gingivectomy is performed for patients with braces.

A gingivectomy is the removal of this excessive tissue. We will create some small cuts to remove the tissue, being sure to create a smooth look, and contouring the surface to appear natural. This process will help shrink deep gum pockets, decreasing the places that bacteria can rest.

Gingivectomy Process

The gingivectomy process begins with Dr. Mugford anesthetizing the area, this means that the patient will feel little or no discomfort. We will then remove the excess tissue; the entire process should take under 30 minutes. In most cases, there are no stitches required. Following your gingivectomy procedure, you may experience some soreness for a day or two, but it should be easily alleviated with an over the counter pain relieving medication.

In most cases, a gingivectomy is usually done before the patient has experienced problems with gum disease damaging their bone that supports their teeth. By decreasing the size of the patient's gum pockets, we hope to promote their dental health. For some patients, we may prescribe an antibiotic, to prevent or minimize infection. Please take the antibiotics as instructed by Dr. Mugford until the medication is completed.

If you have been instructed to wear a clear stent or an upper denture to cover your gums, Do Not Remove the device for at least 24 hours - even if the device appears to be pooled with blood. We will give you care instructions to swoosh using a Chlorhexidine rinse or lukewarm salt water. Our team at The Mugford Center will be sure to give you clear instructions for your situation. These instructions may include not drinking from a straw for the next 24 hours because this can induce bleeding, and to keep your fingers away from the surgical site to reduce the transfer of bacteria.

Our team at The Mugford Center wants to promote your oral health and decrease the incidence of gum disease. For more information on a gingivectomy, contact our Crofton front office.

► Biopsy / Oral Pathology
Dentist performing oral pathology cancer screening and exam.Part of every oral examination with Dr. Mugford is an oral cancer screening. We want to catch anything unusual or out of the ordinary sooner than later. Oral cancer can be a very serious medical condition if left untreated. Studies have shown that dentists catch more symptoms of oral cancer than anyone else. This is why we have made it part of our routine exam at The Mugford Center.

During your screening, we will thoroughly evaluate the anatomy of the patient’s mouth, examining the soft tissues such as the lips, the tongue, inner and outer cheeks, gums and the uvula. If we spot something during this exam that appears abnormal, we may examine it further with x-rays and request a biopsy to gain more information.

During my oral cancer screening, what would be unusual?

Dr. Mugford will look for a variety of potential hazards or abnormalities, this includes:

•  Open Mouth Sores:A common indication of a problem is a sore that does not seem to heal. We may ask how long you have had the sore, or if it has had a problem healing, continuously reopening. Sores that do not seem to heal can be an indication of a bigger problem, or can be due to another medical disorder including diabetes or because the patient smokes tobacco.
•  Spots that are white or red:There can be many reasons that a patient has spots, most of these reasons are nothing to worry about. There are also spots that can be a signal to a larger problem. White and red spots can potentially be an indication of oral cancer growth. We will want to be aware and evaluate their progress.
•  Hard Lumps:We will take note of any unexplained hard lumps either inside or outside your mouth. Lumps tend to be an indication of infection, though they could be an indication of a larger issue. We may ask to examine your lump with a dental x-ray or ask to take a sample for biopsy. We will review your information during your evaluation and discuss what steps should be taken.
•  Roughened Texture of your soft tissues:A signal to a possible problem may be patches of skin that feel rough to the touch. We will want to review your medical history and possible psoriasis before discussing a biopsy.

Oral cancer can be a potentially large problem, and it is best caught early. Dr. Mugford will want to gather all necessary information when examining a potential problem to help make a complete diagnosis. Part of gathering information will include knowing and understanding your medical history, any medications you are taking, reviewing x-rays, pathology reports, blood tests, and a biopsy report.

This complete medical workup will help us decide the next course of action and in creating a treatment plan that is right for you if any at all.

What is a biopsy?

A biopsy is a simple procedure, done in our office. We want to take a sample of the area that seems questionable. This will mean the removal of a sample of tissue. Removing a tissue sample is a quick and mostly painless process.

Using a local anesthetic, we will remove a piece of, or possibly even all of, the specified area and then send the tissue to a pathology lab for examination. Some patients may require a few sutures be placed following the removal of tissue. Once the numbness from the anesthetic wears off, the area may be sore for a few days. For most patients, over-the-counter pain relief medication is all that is necessary, for a small percentage of patients, we may find it necessary to prescribe pain relief medication. This will be done under the direction of Dr. Mugford.

After 1-2 weeks, we should have received the results of your biopsy from the pathology lab, and contact you regarding the results of the tests. If a problem has been discovered, we will make arrangements for follow-up care and create a treatment plan.

Dr. Mugford is happy to offer more information if needed.

► Orthodontic Tooth Uncovering
Beautiful African American woman in Orthodontic braces-laughing.As we grow from children into adults, new teeth will erupt into the mouth during certain ages. One such occurrence is the eruption of the canine teeth, which typically takes place between the ages of 11 and 13 years of age. When the canines—or other teeth—begin to come in, if they do not properly erupt through the gum they may remain fully or partially buried beneath the gum tissue. This condition can lead to a wide array of problems, from excruciating headaches to improperly spaced and aligned teeth to infections and swelling. To correct this, we perform a procedure known as orthodontic tooth uncovering.

What is orthodontic tooth uncovering?

Orthodontic tooth uncovering is the process by which we first uncover a tooth that is either fully or partially buried beneath the gum line, and then move it into the proper position in your mouth. It is sometimes necessary to assist your teeth in their proper development and spacing and, although it may be unpleasant for a short while, it is highly preferable to leaving the tooth as it is.

How does the process of orthodontic tooth uncovering work?

We know that you may be nervous about the process, and we want you to fully understand everything involved before we begin. First, we will make sure to completely numb the area using an anesthetic onto the soft tissue around the area. You should not feel any discomfort during the procedure.

Once we are satisfied that the area is adequately numbed, we will push the gum tissue away from the impacted tooth. Depending on the position and orientation of the tooth, we may remove some of the bone around the tooth to give it the room it needs to properly erupt into place in your mouth.

Following the exposure of the tooth, we will use a specialized bonding agent to attach an orthodontic bracket to the tooth. This bracket grips the tooth and allows us to begin manipulating it and guiding it into the proper position.

We will attach a small chain to the bracket and use this chain to pull on the tooth and guide it into place. Of course, this will not happen immediately, as the tooth will slowly move from its impacted position into its proper position in the mouth.

Does it hurt?

Orthodontic tooth uncovering should not cause any pain during the procedure itself, as we will first make sure the area is thoroughly anesthetized. However, after the anesthesia has worn off, you may experience a little bit of discomfort. You can probably address this using simple painkillers; however, we will talk with you before and after the process to give you specialized instructions. Remember that every patient is unique and you may have certain options for pain management that are not available to everyone.

We will give you detailed aftercare instructions to make sure you heal properly and the tooth moves into its new place. Follow them carefully, and as always, you are free to call if you have any questions or concerns.

► Perioscopy
Brushing and flossing are a vital part of your dental hygiene routine. However, brushing and flossing alone are inadequate to completely clean your teeth. Remember, your teeth extend down below the gum line and into your jawbone. These areas are hidden from view and cannot be reached by brushing and flossing alone. That’s why we perform perioscopy as part of our regular preventive maintenance on patients.

What is perioscopy?

Perioscopy is a procedure that involves using a miniaturized tool called an endoscope. The endoscope is inserted below the gum line and uses a tiny light and camera to send us a picture of the hidden pockets next to your tooth root. This lets us spot any trouble areas where bacteria are collecting.

Once we find pockets of bacteria we use probes (called micro ultrasonics) to clean the tooth root completely. During the procedure, we display a video feed on a monitor so you can see what we are doing.

Why would I consider perioscopy?

Perioscopy has a number of advantages over other traditional methods of cleaning below the gum line such as periodontal surgery. For one thing, it is minimally invasive, meaning that the experience is less traumatic to you, and recovery time will be much faster. For another, because we are able to put a camera down under the gum line, we can identify the bacterial pockets faster; in addition, using the camera, we can avoid hitting the root of your tooth any more than necessary, decreasing the chances of you becoming overly sensitive in the tooth. Finally, because we have the video feed from the camera, we are able to identify other dental conditions that might have been missed in the past, leading to better overall preventive dentistry.

Is it expensive?

No! Actually, compared to more traditional methods of treating periodontitis such as surgery, perioscopy is actually significantly cheaper—sometimes costing as little as 1/3 of what other treatment options might cost. This, in addition to the other benefits noted above, makes it an ideal option for many patients.

Does perioscopy cause significant pain?

Compared to traditional methods of cleaning out significant bacteria pockets, perioscopy can actually be less painful. Certainly, it is less painful than outright surgery, and traditional methods of cleaning below the gum line where the dental professional inserts a pick and operates blindly can be more traumatic than a perioscopy. We have anesthesia available for your comfort if you find the process too discomforting, but we believe you will be happy with how easily it goes.

Is perioscopy right for me?

As with any dental or medical procedure, there are a number of factors to consider when determining whether perioscopy is the right treatment option for you. We are here to help you figure out the best treatment option for you, and we are happy to spend some time with you answering your questions and making recommendations in light of your specific situation. Call us today and we’ll be happy to set up a time to talk with you.

► Pocket Reduction
gum disease diagram showing pocket reduction needGum disease is a devastating problem that starts in your gums. Gingivitis, the earliest stage, is an infection in the gums, can easily go undiagnosed, as many people never notice the redness and swelling of the gums associated with it. Gingivitis is easily reversible, but once it progresses into more severe stages, periodontal disease, more intervention than a dental cleaning is required. Periodontal maintenance can often help to heal the gums and prevent infections and other health issues, but if the pockets in your gums become too deep, pocket reduction surgery may be required.

Periodontal Disease

A more advanced stage of gum disease, periodontal disease affects more than just your gums. The plaque on your teeth hardens into tartar, which cannot be removed by simply brushing your teeth. Tartar pushes up against your gums, causing irritation and inflammation. Bacteria can easily fall below the gum line, feeding on lost food particles and multiplying. Bacteria can also cause infection under your gums and in the roots of your teeth. These infections can get into your jawbone and then into your bloodstream, spreading throughout your body and potentially leading to such issues as heart disease, diabetes and stroke.

Periodontal disease often requires periodontal maintenance, scheduled cleanings that include scaling and root planing. These processes are a deep cleaning of your teeth, removing plaque and tartar buildup as well as infection causing bacteria. These cleanings can help in the healing of your teeth and gums. While maintenance is usually a great help to those with periodontal disease, in some situations it may not be effective.

Pocket Formation

One major issue caused by periodontal disease is the formation of pockets in your gums. When your gums are healthy, the tissue fits snug around your teeth, sealing out bacteria. When your gums succumb to disease, this tissue begins to deteriorate and recede, forming pockets, gaps, in which bacteria can fall. Normally, these pockets and be kept clean by means of periodontal maintenance, or regularly scheduled deep cleanings of disease ridden teeth and gums, but when they become too deep, their ability to be kept clear of bacteria becomes difficult, if not impossible, therefore requiring surgery.

Pocket Reduction Surgery

Pocket formation in the gums is cyclical. Bacteria causes pockets, which allows more bacteria in, worsening the pockets, which allow in even more bacteria. Pocket reduction surgery, or osseous surgery puts an end to this cycle.

During this surgery, gum tissue is folded back and bacteria is removed. Occasionally, damaged bone may need to be smoothed out to prevent hiding places for bacteria. The tissue is then secured back in place and allowed to heal.


Benefits of pocket reduction surgery include:
•  Preventing damage from periodontal disease.
•  Restoration of a healthy smile.
•  Reduces bone loss.
•  Reduces the ability for bacteria to get below the gums and then into the bloodstream, which prevents infections from spreading throughout the body.
•  Helps make periodontal maintenance easier.
•  Makes at home oral maintenance easier.

If periodontal disease has wreaked havoc on your gums, causing pockets too deep to be cleaned by regular periodontal maintenance, pocket reduction surgery can help start the healing process. For more information, or to schedule an appointment, call the experts at Implant and Periodontal Associates Northwest. Don't let periodontal disease continue to ruin your health. Let us provide you with the quality care you deserve. Call today!

Office Hours
Monday: 8am - 5pm
Tuesday: 8am - 5pm
Wednesday: 8am - 3pm
Thursday: 8am - 5pm
Friday: 8am - 3pm

Saturday: Closed
Sunday: Closed

1660 Village Green
Crofton, MD 21114

(410) 260-0790