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Posts for category: Dental Procedures

HomeWhiteningKitsareSafeandEffectiveifUsedtheRightWay

You’re satisfied with your smile appearance except for one thing — your teeth aren’t as white and bright as you wish they could be. So, you’ve decided to do something about their dull yellow color.

You’re also thinking about buying a whitening product you can use yourself rather than a professional application. But you still want the answers to two questions: are home whitening kits safe? And, are they effective?

By and large the answer to the first question is yes — if you use it as directed. The whitening agents in FDA-approved products are in safe proportions to other ingredients and won’t cause any major health issues. That said, if you go beyond the instructed dosage you could damage your teeth, especially your enamel, and cause long-term problems with your dental care.

In addition, if you (or a family member) are still in your early teens, you may want to wait until you’re older. Although most permanent teeth have come in by puberty, their enamel still needs to mature. The chemicals in a whitening kit could be too strong for their under-developed enamel. It’s best to get our advice on whether your teeth are mature enough for whitening.

As to their effectiveness, home whitening kits should perform as their labeling indicates. But there are some differences in effects between a home kit and a professional application.

Although a home kit usually uses the same whitening agents (like carbamide peroxide), its strength is much lower than a professional treatment — about 10% of volume compared to around 30% in clinical solutions. This means it will take much longer to achieve the desired whitening effect that a professional application can in fewer sessions, and with less precision. In addition, home kits are only effective on surface staining of the enamel — discoloration within a tooth requires treatment by a dentist.

You can get satisfactory results from a home whitening kit. But before you make a purchase, consult with us first — we can advise you on what to look for in your purchase, as well as determine if your teeth can benefit from whitening at home.

If you would like more information on teeth whitening, 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 “Tooth Whitening Safety Tips.”

ConsideranEffectiveandAffordableRPDforTeethReplacement

If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.

RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.

The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.

Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.

RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.

A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.

If you would like more information on teeth replacement options, 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”

ADifferentKindofChipShotforProGolferDanielleKang

While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.

“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.

Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.

Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).

For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.

Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.

If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”

TechniquesforKeepingImpactedCanineTeethfromSpoilingYourSmile

Although usually an orderly process, some permanent teeth don't come in as they should. In fact, they may not come in at all and remain hidden in the gum — a situation called impaction. This creates multiple problems for function, health and, in the case of front canines, appearance.

Canines are the longer and more pointed teeth on each side of the front-most incisors. They help tear and cut food during chewing, a function impaction eliminates. Besides a higher risk for developing abscesses (isolated areas of infection) and cysts, they can also put pressure on neighboring teeth and damage their roots or cause them to erupt abnormally.

Dentists often remove impacted wisdom and other back teeth to lessen these potential problems. Removing canines, though, has additional considerations: besides compromising ideal chewing function, missing canines often create an unattractive smile.

But before considering removal, there's another technique we might be able to use to save the canines and actually draw them down through the gums to their correct position. It's usually part of an overall orthodontic plan to correct a poor bite (malocclusion).

After pinpointing their exact position with x-rays or CT scanning, a surgeon surgically exposes the impacted canines' crowns through the gums. They then bond small brackets to the crowns and attach a small gold chain to each bracket. They fasten the other end of the chains to orthodontic hardware that exerts downward pressure on the impacted teeth. Over several months this pressure can help move the teeth into their normal positions.

Unfortunately, this technique isn't always advisable: one or more of the impacted teeth may be in a difficult position to attempt it. It's usually best in these situations to remove the teeth, usually sooner rather than later for the sake of neighboring teeth.

Fortunately, with today's advanced restorative techniques, we can eventually replace the canines with dental implants, although that's best undertaken after the patient enters adulthood. In the meantime, we can utilize orthodontic means to preserve the open space and provide a temporary restorative solution.

Whatever route taken, these teeth don't have to become a source of problems, especially for your appearance. Whether through orthodontics or restorative dentistry, impacted canines don't have to ruin your smile.

If you would like more information on various orthodontic procedures, 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 “Exposing Impacted Canines.”

By Picture Perfect Smiles
February 27, 2019
Category: Dental Procedures
Tags: local anesthesia  
LocalAnesthesiaTakesthePainOutofMostDentalWork

Long ago dental work could be painful and stressful—often for both patient and practitioner. Thankfully, that time is long past: today, most procedures are painless in large part due to local anesthesia.

Local anesthetics are numbing substances applied to specific areas of the body like the teeth and gums to temporarily block pain during a procedure. And because they only affect a localized area of the body, you remain conscious and alert throughout the procedure.

To achieve the level of numbing necessary for dental work, we often need to deaden the gums using a needle to deliver the anesthetic. But then this poses a secondary pain concern—the needle stick itself.

Again, topical anesthesia comes to the rescue in the form of a swab, patch or spray applying an anesthetic directly to the top layer of the gums at the injection site. This numbs the area and prevents you from feeling the needle stick. It's highly probable, therefore, that from start to finish you won't feel any discomfort during your dental work except perhaps for a little pressure.

Local anesthesia truly is a game changer for dental care—and not just for the patient. A dentist who's concerned about their patient's comfort level may work hurriedly to complete a procedure. But if their patient is relaxed, the dentist can work calmly and methodically. The result is better, more focused care.

For all its improvements in the patient experience, though, there has been one consistent complaint—the numbness that often lingers for a while after the procedure is over. But there have been advances in recent years that have helped reduce this irritation: new anesthetic agents (even some that can reverse the anesthetic effect) and fine-tuned dosages can help keep residual numbing to a minimum.

Not all procedures like routine teeth cleanings or enamel shaping require anesthesia. But when it's appropriate, local anesthesia can make your next dental visit much more pleasant.

If you would like more information on how anesthesia benefits your dental care, 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 “Local Anesthesia for Pain-Free Dentistry.”