Mitchell V. Karl, DDS, FAGD, maintains his own dental practice located in East Brunswick, New Jersey. Dr. Karl offers many services to his patients, including patients with TMJ/TMD dysfunction, headaches and migraines. Dr. Karl is dedicated to staying up-to-date with his technologies and procedures and has completed the Dawson Occlusal/Function program in St. Petersburg, Florida; as well as the Perfect Bite Therapy program in Utah. The specialized programs Dr. Karl attends are in addition to the annual University of Pennsylvania continuing education program that he has taken over the past 25 years at Jersey Shore Medical Center. As well as serving his patients at his practice, Dr. Karl is an affiliate at Robert Wood Johnson University Hospital in New Brunswick.
Education and Training
New York University College of Dentistry
Dr. Mitchell V. Karl D.D.S.'s Expert Contributions
Most people have experienced a "toothache" at one time or another. Have you ever wondered why some aches seem to go away and others do not? How can you determine when it is wise to seek professional help, versus waiting to see if the pain goes away as quickly as it came? The answer to these...
All bleach formulations that are FDA approved are safe to use. The only real side effects are some temperature sensitivities. These are not experienced by most people, but they are also not uncommon. They usually resolve after stopping the bleaching process. In our office we prefer to use the at-home bleach procedure exactly for this reason. The patient has full control of how often and how long to use the bleach. There are also desensitizing agents available to help with those who may develop some temperature sensitivity. Otherwise, there are really no other known side effects that are detrimental. You should not hesitate to bleach your teeth under the supervision of a dentist. READ MORE
Most causes of bad breath are a result of either bacterial material lodging in the tongue, or from an acid or substance coming up from the esophagus. Try to determine the source of the odor, and then remedies can be offered. Do you possibly have less than a normal salivary flow due to medications? Possibly try a different mouthwash rinse as well. Try to brush your tongue, and rinse with something that can destroy bacteria and their odors. READ MORE
The possibilities range from an inflammatory problem of his own gum tissues, through medications that could have that same affect on the gingival tissues. He should present for an examination to try to figure out the "puzzle". Too many possibilities exist to actually formulate a list. He could also be experiencing an allergic reaction to a food or drink substance. READ MORE
There usually would be no direct affect on your teeth, unless you were to be drinking an acidic formulation. The acid could erode the enamel. So try to do some research about what exactly the liquids on your diet contain. READ MORE
A metallic taste may be the result of something that is being released from your own teeth due to clenching and/or grinding. But it can also be related to a medical issue. You should be seen by either a dental professional or medical doctor to further look into what the source of your metallic taste is coming from. READ MORE
Medications alone usually do not stain teeth. But that's not to say that you are having a unique reaction to one or more of the medications that you are taking. You can mention to the physician that prescribed the medication about your concerns, and/or possibly see a dentist to see exactly what type of stain you are actually experiencing. Need to recheck about the iron tablets. READ MORE
The causes of sensitivity are very broad. The best way to begin to find the answer is to schedule yourself for a complete dental examination to zero in on the possibilities. Some possibilities include clenching/grinding, erosion, dental infection of the nerves of the teeth, or even an incorrect bite. They are all very different, but they also could lead to the same symptoms of sensitivity as an end result. READ MORE
Leaving food between the teeth is inviting both dental decay and periodontal disease to attack your dentition. You should try your best to remove any and all food particles from between your teeth after each meal and/or snack. If your teeth are not contacting each other correctly, and the spaces are allowing food to get packed between them, then you may need some dental treatment to repair that problem. READ MORE
You need to see a dentist as soon as possible because your "boil" may be the result of a dental infection. This will not resolve on its own. There are different sources for the swelling to occur, and your dentist should be able to help you to determine the source. READ MORE
Mostly it’s the gums in a pregnant woman that show signs of inflammation. Some women find more bleeding when brushing, flossing, or using a rubber tip stimulator. Some of the reasons are probably hormonal, and you can only try to control the inflammation as best as possible. The gums themselves are usually not detrimentally affected by the pregnancy. Best of luck to you and your baby. READ MORE
Rusting if metal braces is not common. You may be developing plaque and tartar accumulation on the brackets. Or you may have been treated with a defective set of brackets. Either way, you should visit your dentist for him/her to check out what you are seeing. READ MORE
It’s a bit delayed as compared to average. But it doesn’t necessarily mean that there are no tooth buds waiting to erupt. Just s but later than expected. However, the possibility exists that no baby and/or permanent teeth exist as a result of an abnormality during pregnancy. A dental radiograph can confirm the presence or absence of teeth for your child. You may want to consider some type of x-ray for peace of mind. Good luck. READ MORE
My initial feeling is that tap water has no effect upon discoloring teeth. However, anything is possible. You should find out the chemical constitution of your water supply. Then be sure to analyze whether you had coincidentally begun any new medications or anything new or different from your past routines. We sometimes find out some very surprising answers when we take the time to closely analyze our routines and habits. READ MORE
Most probably yes, but try not to make a habit of ingesting anything that is not meant to be ingested. There are usually warning remarks on the label of the product that explains if swallowing it is dangerous. Some are meant for only external use and sores. READ MORE
There are various causes of erosion. We usually separate them into intrinsic and extrinsic categories. Extrinsic refers to things that are placed into the mouth from outside, such as lemons, carbonated sodas, highly acidic foods and drinks. Intrinsic refers to acids that are produced by the body, such as acid reflux, vomiting and regurgitation. You need to examine if you can identify which, if any, of the two categories that you may fall. Then you can take measures to prevent what may be causing the erosion. Some people can be brushing with very abrasive toothpastes, or using a hard-bristled toothbrush too vigorously. Any and all of the above can attribute to erosion and loss of enamel. READ MORE
Does she drink a lot of sugared drinks? Does she suck on sugared candy? She must be getting sugar attacks from somewhere. Does she leave much food on her teeth and not brush effectively before bedtime? Cavities need a source from which to form. I suggest to examine carefully her habits and try to find the answer to the puzzle. READ MORE
My first thought is if the sores might be connected to your menstrual cycle. Or is there any coincidence with stress? There are prescription medications that may help you. The location of the sores are also important in order to know if we are dealing with a recurrent herpes type virus, or aphthous ulcers, typically known as cold sores. READ MORE
Your decay in one tooth will not be directly transmitted to an adjacent tooth. So no worries there. However, are you certain that the adjacent teeth have been properly and recently examined by a dentist? You should also plan to “fix” or restore the decayed tooth as soon as possible to avoid allowing the decay to go deeper into the tooth. If untreated, the decay process will continue, leading to possible root canal treatment or extraction. READ MORE
Nothing that great really exists. The creams/meds used do not really shorten the time that the lesion will remain. Depending upon what type of canker sore you have, some subscription meds may be effective. READ MORE
Daily is usually recommended. I prefer using a rubber tip between the teeth because it’s easier to do, and just as effective, if not more so for the health of your gums. READ MORE
I’m not sure what else can actually be used for the all-on-4 technique. Just remember, you get all-on-4, but “none on 3.” If all 4 don’t work together, the entire case is lost. READ MORE
If you have never had a detrimental response to local anesthetic, chances are VERY slim that one would ever occur. Some patients get a faster heart rate IF epinephrine gets into the bloodstream directly. Talk about your concerns, but they sound as if fabricated by yourself for whatever the reason. READ MORE
Best thing to do is to see a dentist, or the hygienist that works in their office. READ MORE
This does occur often. Depending upon the source of the space, the repair options will vary. Some options would include perio tissue removal if indicated, bonding, or crowns and/or veneer laminates. READ MORE
Most likely due to either a tongue thrust habit that recently developed, or a bite discrepancy with clenching and/or grinding. Gum disease and mobile teeth may also lead to a space between the 2 front teeth. See your dentist for a proper diagnosis and treatment options. READ MORE
Raisins may be considered a “healthy” snack; but anything that has sugar and also sticks to the teeth, can increase the risk of getting decay in the teeth. Hope that helps. READ MORE
Those liquids could definitely cause tooth discoloration over time. A dental cleaning would be best BEFORE using a store-bought or office directed bleaching kit. READ MORE
You probably have an inflamed or infected area of gum disease. But other diagnoses are also possible. Not possible to diagnose properly without being seen in person at the dental office. READ MORE
Some may, and some contain abrasive substances that may not be Healthy for your enamel. Ask your dental office about the products you are referring to. READ MORE
It all depends upon if the black area is just stain, calculus, or decay. It needs to be seen by your Dental professional. READ MORE
Possibly, yes. However, there may be underlying problems causing the filling to dislodge. You may be a very heavy grinder, your bite may be off, or the tooth may not have enough structure around it in order to hold a filling in place. In that instance, a crown may be indicated. These are questions that your dentist should be able to answer and explain to you. READ MORE
Sounds like it requires something! Your bite may be off and a simple adjustment may resolve your issue. The nerve inside of the tooth my have been traumatized, and it will either resolve on its own, or possibly need root canal treatment. Definitely call to see your dentist ASAP because the longer you wait, the more potential damage can be done. You should not be having pain as a result of placing a new crown. You need to be seen for a proper diagnosis to be made. READ MORE
Your situation does not sound "completely normal". I would see your dentist again in order to see why you are having this delayed pain. There are various possibilities, but a visual examination is necessary in order to properly diagnose what your problem stems from. READ MORE
You need to see a dentist in order to properly answer that question. Depending upon the circumstances, your treatment might require either a very simple bonding repair, versus root canal therapy, versus extraction. Since the possibilities are so variant, examination and discussion of the pros and cons of all potential treatments is the first step that must be taken. A dental x-ray will also most likely be necessary. READ MORE
Definitely go back to the dentist as soon as possible. You may need a simple bite adjustment, or you may have a reinfection of the tooth. Your situation may not improve with time, so I suggest being seen as soon as feasible. READ MORE
Simply put, dental plaque needs to be physically disturbed and removed. That is accomplished with proper brushing of the teeth, and using something like floss and/or a rubber tip stimulator to remove plaque build up between the teeth. Some people accumulate plaque at a much faster rate than others, usually as a result of salivary content. If you are one of those folks, then you will need to work that much harder to try to control your plaque accumulation as compared to individuals that do not tend to build it up either so quickly or so heavily. Good luck. Seek out the proper techniques for brushing, flossing, and rubber tip use from your dental professional or hygienist. I recommend automatic brushes for those who cannot easily or effectively manipulate the manual brush for whatever reason. READ MORE
As long as your infection is now under control, there is no magic time period that needs to be met for the next appointment. We usually wait a minimum of 7-10 days, and not longer than necessary beyond that. Waiting for months is not recommended. READ MORE
No need to panic. Average tooth eruption is exactly that: “average”. There are many children that get their teeth much earlier or later than the “average” time schedule. Your child is still within the time frame of not needing to be concerned. If another 6 months go by without any tooth eruption, then something out of the ordinary is probably occurring. READ MORE
That does seem to be a rather long time. But as long as no infection exists, it could be a very slow healing site for whatever reason. I would suggest having the surgeon evaluate that area to confirm that there is nothing “abnormal” occurring. READ MORE
It really depends upon the source of the irritation. The only way to assess that is to have an examination and verbal discussion as to your specific circumstances. There are many possible reasons and causes of your sensitivity. Some are more easily resolved than others. READ MORE
Some of the more common possibilities include plaque or calculus accumulation, intrinsic stain not seen previously due to minor gingival recession, or even the development of decay. Visual exam is necessary to determine the difference between the various options of diagnosis. READ MORE
We actually suggest to bleach your teeth first, before making the crown. Then the shade for the crown can be selected based upon the new bleach shade. A crown does not respond to bleach as natural teeth do. And certain bleach techniques MAY even be able to bleach out the broken tooth to “catch up” to the adjacent teeth with regards to shade. READ MORE
Too many possible reasons to list. You should be checked by a dentist, probably sooner than later. READ MORE
Some OTC bleach products do indeed work. Some have limitations as to how many teeth are covered, and some just simply work as well as others. I only “recommend” self treatment if I have already cleared the patient for safe bleaching. Be aware that if you proceed without being checked by your dentist first, you are doing it at your own risk. There can be unforeseen consequences as with any unsupervised “treatment“. READ MORE
The course of treatment depends upon the severity of the disease process. Some people will only require deep cleanings and proper home care. Others may require surgical intervention. And some people may need some extractions if the tooth or teeth are beyond saving. You can always obtain a second opinion if you have doubts regarding the course of treatment that your dentist proposed or recommended. READ MORE
It very well may be. You should seek the advice and assistance of a Dental professional. When you say the infection keeps coming back despite treatment, that leads me to believe that you are currently under the care of a dentist. If you are, and your dentist cannot provide either the appropriate treatment to resolve the issue, or an acceptable explanation as to the cause of your issue, then I would seek a second opinion from another dentist. READ MORE
It’s all a matter of degree of severity. Usually a single tooth out if position does not indicate a “need” for braces. It also depends upon how your teeth meet together when you bite. A single “crooked” tooth may just be a cosmetic concern, but it depends upon what else is going on at the same time. READ MORE
You should have an X-ray taken as a means of comparison of the tooth between now and in the future. You may need a temporary splint to allow the tooth to firm up and stabilize. If pain persists, you need to be diagnosed for a possible fracture of the root, or for irreversible trauma that might require root canal treatment. Only a qualified dentist can make these evaluations and diagnoses for you. So, call and get seen as quickly as possible. Good luck, and definitely do not try to self-diagnose yourself. Mitchell Karl, DDS READ MORE
Yes it is possible. But it is even more possible that another reason may be the source behind your sensitivity. A knowledgeable dental professional needs to be consulted. You may have an incorrect bite that causes trauma to your teeth, making them sensitive to temperature changes. You also might be either clenching and/or grinding your teeth either at night when sleeping, or even during the day. You can try the toothpaste first, but if symptoms persist, seek out a dentist who can diagnose these issues. READ MORE
Very simply, red puffy gums is the first sign of gum disease and infection. The gums should always look pink and firm. There should be no bleeding at all when either brushing, flossing, or using any other interdental device. Sure, anyone can accidentally cut the gums, and that would bleed for a few days, but anything more constant could be signs of a potential problem. READ MORE
Many different possibilities are behind tooth sensitivity. One may be neural pain that usually is continuous. Root canal therapy may be necessary. Occlusal trauma is also a possible cause of tooth sensitivity. Another reason could be that you have a loose or leaking old restoration. You need to see a dentist in order to determine the true source of your dental sensitivity. Good luck! READ MORE
Any infection in the body can spread elsewhere. if untreated. Be sure to treat any known infections without delay to avoid the spread of any infections and/or inflammations. READ MORE
If you are only 27 years old, you should probably get some custom fit bleach trays made, and bleach as necessary to maintain the shade that you are happiest with. The home bleaching regimen is the most cost effective option, and it also allows you to maintain control of the final shade. Good luck, M. Karl READ MORE
I have some issues with what you were told. First, our main concern about patients brushing too hard with a stiff brush, is the potential to wear away some of the thinner enamel that exists near the gum line. The gum line does not usually recede as a result of scrubbing or brushing too vigorously. Gum recession is usually more related to either gum disease or occlusal trauma from an uneven bite. With regards to the electric brush, I strongly recommend them to people with manual dexterity issues. But the manual brush can accomplish the same affects as the electric brush if used properly. You should always use a brush with soft bristles, and gently brush both the teeth and the gums where the teeth emerge from. READ MORE
It sounds as if you have a chronic swelling from continued biting of the affected cheek area. There may have been some shifting or movement of the teeth that would lead to this problem. It may be possible to reshape some of the teeth that are causing you to bite your cheek. We would try to have the cheek deflect off of the teeth, instead of getting caught between them. Good luck with your treatment. Mitchell Karl READ MORE
You basically have three options. One would be to extract the third molar, thus eliminating the problem completely. The second option is to remove the flap of gum tissue under which the food gets lodged. This may or may not grow back over time. So it is not as predictable as the extraction option. Lastly, depending upon how often and to what degree the food collection occurs, you could try debriding the area with instruments like a rubber tip and/or water pik, and then select one of the other options if your problem continues. One last thing, you should allow your dentist to visually check the area to confirm that a gum infection has not developed as a result of the food impaction. READ MORE
Water flossing is effective to remove large particles of food from between the teeth. It does not effectively remove the plaque layer that flossing can physically remove. I prefer to use a rubber tip stimulator between the teeth to both remove the plaque layer AND stimulate the gum tissues simultaneously. Also, only one hand is needed to use the tip, versus two hands to use conventional flossing techniques. The use of floss picks help to resolve this issue, but I still prefer the use and advantages of using the rubber tip. READ MORE
There may be many different reasons for your tooth sensitivity. A complete dental history and examination would be needed in order to answer your question with any degree of accuracy and to offer meaningful suggestions. Feel free to contact our office if you want to pursue this further. Thanks. READ MORE
It is one of several options of "normal" things to do. You can also seek the expertise of a dentist trained with TMJ/TMD experience. You can read our web page for more information as to how we handle jaw popping, clicking, and pain. Good luck. READ MORE
You should call your dental office to be seen again. It is not possible to diagnose your situation without a visual exam. The list of possible reasons are too broad to give an answer that has any real accuracy. So call your dental office and request to be seen. READ MORE
Areas of expertise and specialization
Professional Society Memberships
- American Dental Association, New Jersey Dental Association
What do you attribute your success to?
Paying Attention to Detail and Individual Patient Needs, Staying Up to Date, and Continuing his Education
Hobbies / Sports
- Golfing, Golden Retrievers
- Robert Johnson University Hospital
Dr. Mitchell V. Karl D.D.S.'s Practice location
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Patient Experience with Dr. Karl
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