Whether performed in a dental office or using a home kit, teeth whitening applications are quite effective for bleaching exterior (extrinsic) stains on enamel surfaces. But what if your discoloration comes from inside the tooth? In this case, extrinsic teeth whitening won’t work — you’ll need to undergo an “internal bleaching” method, which can only be performed in a dentist's office.
There are a number of causes for “intrinsic” staining, including too much fluoride exposure or tetracycline use during childhood. One of the more common causes, though, occurs from root canal treatments used to remove the remnants of the pulp tissue inside a tooth’s pulp chamber and root canals. Certain cements used during the procedure to help seal in the filling material and leftover blood pigments can cause the tooth to darken over time.
To alleviate this discoloration, we use a bleaching agent, usually sodium perborate mixed with a diluted solution of hydrogen peroxide to achieve a safe, accelerated color change. After determining that the root canal filling is still intact and the bone is healthy, we create a small cavity in the back of the tooth to access the pulp chamber. The chamber is cleaned of any debris or stained material and then thoroughly irrigated. The original root canal filling is then sealed off to prevent leakage from the bleaching agent.
We then place the bleaching agent in the cleaned-out space with a cotton pellet and seal it in with a temporary adhesive. This step is repeated for several days until we achieve the desired shade of white. Once that occurs we then seal the dentin with a more permanent filling and then restore the cavity we created with a composite resin bonded to the enamel and dentin.
If we’re successful in achieving the desired color, intrinsic whitening could help you avoid more costly options like veneers or crowns for an otherwise healthy and attractive tooth. The end result would be the same — a beautiful smile without those unsightly stains.
If you would like more information on treating internal tooth stains, 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 “Whitening Traumatized Teeth.”
When you’re buying a tool or appliance, you compare brands for the best quality you can afford. There’s another important item that deserves the same level of scrutiny: your toothbrush. Choosing the right one for you can make a huge difference in your oral hygiene effectiveness.
But a visit to your store’s dental care aisle can dim your enthusiasm. You have plenty of options involving all manner of shapes, sizes and features. Perhaps too many: After a while, the sheer number of choices can paralyze your decision-making process.
You can streamline this selection process by concentrating on a few important toothbrush basics. First up for consideration: the bristles. While you may think a good stiff brush would be best, it’s actually the opposite—most dental professionals recommend softer bristles. That’s because hard bristles can potentially damage your teeth and gums over time.
Softer bristles are gentler on your teeth and just as effective for removing plaque, if you use the right technique and thoroughly brush all tooth surfaces. And look for rounded bristles, which are friendlier to your gums.
Next, look for a brush that feels right in your hand. If you have problems with manual dexterity, look for one with an oversized handle. Some brushes come with angled necks and tapered heads, which you may find effective in reaching less accessible back teeth. This might mean trying different brushes until you get one that’s right for you. Don’t worry, though, you’re not buying a brush for life—in fact, you should change out your brush every three to six months.
You’ll also rarely go wrong buying a toothbrush with the American Dental Association Seal of Acceptance on the packaging. This seal signifies the toothbrush has undergone testing and met the ADA’s standards for hygiene effectiveness. While some manufacturers of effective brushes don’t pursue this seal, you can be sure one with it has passed the test of quality.
It makes all the difference in the world having the right tool for the job. Be sure your toothbrush is the right one for you.
If you would like more information on toothbrushes and other dental care products, 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 “Sizing up Toothbrushes: How to Choose the Right Brush for Optimal Oral Health.”
Athletes in contact sports are at significant risk for traumatic injury to their teeth and mouth. It’s estimated 600,000 emergency room visits each year involve a sports-related dental injury.
Athletic mouthguards have become the premier safeguard against sports-related oral injuries. First worn by professional boxers in the 1920s, mouthguards are now required for use by various sports associations and leagues — from amateur youth to professional — for a number of sports. The National Collegiate Athletic Association (NCAA), for example, requires their use during play for hockey, lacrosse, field hockey and football. The American Dental Association recommends mouthguards for 29 sports or exercise activities.
But do mouthguards actually prevent injury? To answer that question in a scientific manner, the Journal of Sports Medicine published an evidence-based report in 2007 on mouthguard effectiveness for preventing or reducing the severity of oral-facial injuries and concussions. While the report objectively analyzed many of the problems and issues associated with mouthguards (like materials, design and durability), it concluded the risk of an oral-facial injury was nearly two times greater without the wearing of a mouthguard.
That being said, most dentists and other professionals in sports safety would advise not all mouthguards are alike. The stock, “off the shelf” mouthguard found in many retail stores with limited size offerings is the least expensive, but also least protective, of mouthguard types. Mouth-formed or “boil-and-bite” protectors, which are softened in boiling water and then bit down on by the player to form the fit, are better than the stock version — however, they often don’t cover all of the player’s back teeth.
The best option is a custom-designed guard made by a dentist for the individual patient. Although relatively expensive (costs range in the hundreds, compared with $25 or less for a stock guard), they provide the highest recognized level of mouth protection.
The bottom line: a mouthguard is a must-wear part of any uniform for any sport that involves contact or high velocity objects of play. If you or a family member is a contact sport athlete, it’s essential you protect your teeth and mouth with a custom-fit, high quality mouthguard.
If you would like more information on mouthguards, 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 “Athletic Mouthguards.”
Multi-platinum recording artist Janet Jackson has long been known for her dazzling smile. And yet, Jackson admitted to InStyle Magazine that her trademark smile was once a major source of insecurity. The entertainer said, “To me, I looked like the Joker!” It was only after age 30 that the pop icon came to accept her unique look.
Jackson is not alone. A study commissioned by the American Association of Orthodontists found that more than one third of U.S. adults are dissatisfied with their smile. But there’s good news—modern dentistry can correct many flaws that can keep you from loving your smile, whether you’re unhappy with the color, size, or shape of your teeth. Here are some popular treatments:
Professional teeth whitening: Sometimes a professional teeth whitening will give you the boost you need. In-office whitening can dramatically brighten your smile in just one visit.
Tooth-colored fillings: If you have silver-colored fillings on teeth that show when you smile, consider replacing them with unnoticeable tooth-colored fillings.
Dental bonding: If you have chipped, cracked, or misshapen teeth, cosmetic bonding may be the fix you’re looking for. In this procedure, tooth colored material is applied to the tooth’s surface, sculpted into the desired shape, hardened with a special light, and polished for a smooth finish.
Porcelain veneers: Dental veneers provide a natural-looking, long-lasting solution to many dental problems. These very thin shells fit over your teeth, essentially replacing your tooth enamel to give you the smile you desire.
Replacement teeth: Is a missing tooth affecting your self-confidence? There are several options for replacing missing teeth, from a removable partial denture to a traditional fixed bridge to a state-of-the-art implant-supported replacement tooth. Removable partial dentures are an inexpensive way to replace one or more missing teeth, but they are less stable than non-removable options. Dental bridges, as the name implies, span the gap where a tooth is missing by attaching an artificial tooth to the teeth on either side of the space. In this procedure, the teeth on both sides of the gap must be filed down in order to support the bridgework. Dental implants, considered the gold standard in tooth replacement technology, anchor long-lasting, lifelike replacements that function like natural teeth.
After coming to embrace her smile, Jackson asserted, “Beautiful comes in all shapes, sizes, and colors." If you don’t feel that your smile expresses the beauty you have inside, call our office to schedule a consultation. It’s possible to love your smile. We can help.
For more information, read Dear Doctor magazine article “How Your Dentist Can Help You Look Younger.”
While the prevention and treatment of tooth decay has improved dramatically over the last half century, it continues to be a major health issue, especially for children. One in four children 5 and younger will develop some form of the disease.
Although tooth decay in children stems from the same causes as in adults — the presence of decay-causing bacteria in plaque, unprotected teeth and the right mix of carbohydrates like sugar left in the mouth — the means by which it occurs may be different. We even define tooth decay differently in children as Early Childhood Caries (ECC), “caries” the dental profession’s term for tooth decay.
ECC highlights a number of cause factors specific to young children, such as: continuous use of a bottle or “sippy cup” filled with juice or other sweetened beverages; at-will breast-feeding throughout the night; use of a sweetened pacifier; or regular use of sugar-based oral medicine to treat chronic illness.
If you noticed sugar as a common denominator in these factors, you’re right. As a primary food source for bacteria, refined sugar is a major trigger for the disease especially if it constantly resides in the mouth from constant snacking or sipping. In fact, it’s the primary driver for a particular pattern of decay known as Baby Bottle Tooth Decay (BBTD). This pattern is specifically linked to sleep-time bottles filled with juice, milk, formula or other sweetened beverages, given to an infant or toddler to help soothe them through the night or during naps.
All these factors cause a cycle of decay. To interrupt that cycle, there are some things you as a parent should do: perform daily hygiene with your child to reduce decay-causing bacteria; reduce the amount and frequency of carbohydrates in the diet, particularly sugar; and protect the teeth by having us apply fluoride or sealants directly to the teeth.
Early tooth decay could affect your child's oral health for years to come. With a little care and vigilance, you improve your chances of avoiding that encounter.
If you would like more information on preventing tooth decay in children, 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 “Dentistry & Oral Health for Children.”
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