There are many reasons why teeth may need a whitening treatment to achieve an appealing brightness: what we eat and drink, natural aging, genetics, and the lack of dedication to oral hygiene can all play a role in how we look.
For vital (living) teeth, there are basically three different options for teeth whitening, and we’d be happy to help you decide which is right for you:
- In-office tooth whitening: The fastest way to get your smile radiant. A high concentration of a peroxide gel solution is applied directly to the tooth surface. Gums and other soft tissues are completely protected for your safety. This technique is excellent for whitening deep surface stains as well as general tooth whitening. This professional treatment requires the least amount of time to achieve the desired whiteness.
- The professional take-home option: Custom-made bleaching trays are prepared by our office. This technique is convenient and less expensive, but the desired whiteness will take longer to achieve than the in-office option.
- Over-the-counter products: These offer the least expensive option but use weaker whitening agents. For example, whitening strips, like the ones advertised on television, are popular and easy to use but will generally take the most time to achieve the desired success. Also, even agents that are not the strongest available may cause damage to teeth if used inappropriately and without professional supervision.
While there are normally no serious side effects after professional whitening treatments, there is a potential risk of tooth sensitivity and gum irritation. If either one or both of these occur, it should disappear within a few days.
It should come as no surprise that bleaching is not permanent. The whiteness will fade eventually depending on your diet, habits, hygiene, etc., but it usually will last at least six months — more often up to two years. Obviously, if you avoid drinking coffee, tea, or red wine, don’t smoke, and have a diligent oral hygiene routine your results may last longer.
Advertisements for teeth-whitening products are everywhere. If you have any questions about what you see, or simply want to do a reality check on their claims, please contact us or schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine articles “Teeth Whitening: Brighter, Lighter, Whiter...,” and “Important Teeth Whitening Questions Answered.”
At your child's latest dental visit, you found out one of their primary (“baby”) teeth has become decayed and in danger of loss. Of course, you may think, it's only a primary tooth — it's going to come out sooner or later.
But a primary tooth lost “sooner” rather than “later” can create long-term negative consequences for your child's dental health. For the sake of the future permanent tooth, the best treatment strategy could be to put forth the effort and expense to save it.
Besides its role in eating and chewing, a primary tooth's most important function is as a “trailblazer” for the permanent tooth developing below it. A primary tooth doesn't normally loosen and let go until the new permanent tooth is ready to erupt. Until then they hold the new tooth's space in the jaw.
But if the primary tooth is lost prematurely, nearby teeth can drift into and crowd the space so that the permanent tooth comes in out of position. This can result in a malocclusion, or poor bite.
Depending on the state of your child's jaw development, it may be advisable to attempt saving the tooth through a filling or, in the case of deep decay, a modified root canal treatment. If the tooth can't be saved, then placing an orthodontic appliance known as a space maintainer might be necessary. Cemented to a tooth next to the empty space, this appliance has a looped band of metal that butts against the tooth on the other side of the gap, and prevents both teeth from drifting into the space.
Intervening for a decayed primary tooth can seem a waste of time and money since it has a limited lifespan to begin with. But for the health of its companion permanent tooth, as well as possibly avoiding orthodontic treatment, it could be well worth it for your child's long-term dental health.
If you would like more information on dental care for your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Importance of Baby Teeth.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
We most often associate plastic surgery with cosmetic enhancements to our outer appearance. While this is their primary purpose, some forms of reconstructive surgery restore lost function and health as well as improve appearance. A classic example is cosmetic periodontal (gum) surgery that restores receded gum tissues that have exposed more of the tooth than is visually appealing.
Gum recession occurs primarily because of excessive brushing (too hard or for too long) or because of periodontal (gum) disease, a bacterial infection that ultimately causes gum tissue to detach and pull away from the teeth. Gum recession not only affects the appearance of the teeth, it can expose the tooth’s root surface to further infection and decay. Without treatment, the disease could progress causing further damage with the potential for the tooth to be eventually lost.
In conjunction with plaque removal to stop gum disease and possibly other treatments like orthodontics to correct misaligned teeth, cosmetic gum surgery is used to rejuvenate lost gum tissues around teeth through tissue grafting. In these procedures, a combination of surgical approaches and/or grafting materials are attached to the area of recession to stimulate the remaining tissue to grow upon the graft and eventually replace it.
Donor grafts can originate from three sources: from the patient (an autograft); another person (an allograft); or another animal species, usually a cow (a xenograft). Tissues from outside the patient are thoroughly treated to remove all cellular material and bacteria to eliminate any possibility of host rejection or disease transmission.
Depending on the nature of the gum recession and tooth condition, the procedure can take different forms. It could involve completely detaching the graft tissue from the host site and re-attaching it to the recipient site. But if more of the tooth root is exposed, the surgeon may cover the graft with tissue adjacent to the host site to supply blood to the graft, and affix the loosened pedicle to the graft site. While any technique requires advanced training and experience, the latter procedure involves microsurgical techniques that require the highest levels of technical skill and art.
Cosmetic gum surgery can result in healthier gum tissues and teeth that are less susceptible to infection and loss. No less important, though, these procedures can return a more natural look to your teeth and gums — and a more pleasing smile.
If you would like more information on gum tissue reconstruction, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Plastic Surgery.”
September is National Gum Care Month, an ideal time to talk about how to keep your gums healthy. Unfortunately, nearly half of adults have gum disease, which can damage the soft tissue and bone supporting the teeth. In fact, advanced gum disease is the number one reason for tooth loss among adults, and it’s associated with other health problems, including cardiovascular disease, diabetes and pregnancy complications. But there’s good news—gum disease is preventable and, in its early stages, even reversible. Here are some tips for taking care of your gums:
Keep up a good oral hygiene routine
Gum disease begins with plaque buildup, so attack the plaque in your mouth with good dental hygiene. Spend two minutes morning and night brushing all surfaces of your teeth, and floss once a day to get rid of plaque that forms between teeth.
Use a soft toothbrush
The American Dental Association recommends brushing gently with a soft toothbrush. Hard bristles can damage your gums and cause them to pull away from the teeth.
Swish with a mouth rinse
Consider using a mouth rinse. Over-the-counter and prescription oral rinses are available to help wash away food debris, reduce plaque and fight gum inflammation.
Say no to tobacco
Smoking is one of the biggest risk factors for developing gum disease. And it’s not just cigarettes but all forms of tobacco, including e-cigarettes, pipes and chewing tobacco, that raise your risk of gum disease.
Eat a healthy diet
For the best gum health, avoid refined carbohydrates (sugary and starchy foods) and make sure you are getting enough vitamin C, vitamin D and antioxidants (found in berries and green tea, for example). In addition, studies suggest that a diet rich in omega-3 fatty acids may reduce your risk of gum disease and other inflammatory conditions. These healthy fats are found in many fish, nuts, seeds, soy products and vegetable oils.
Come in for regular cleanings
Professional dental cleanings can remove plaque from the tiny spaces that are difficult to reach by simply brushing and flossing. And once plaque hardens to form calculus (tartar), it cannot be removed during your regular oral health care routine at home. Further, at the dental office we can detect gum disease in its early stages—and the earlier gum problems are caught, the more easily they can be reversed.
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