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Whitening a Discolored Tooth from the Inside Out

May 22, 2012 by DentalCMO

If you have discolored teeth, the cause is often staining on the enamel surfaces from foods, beverages, or smoking. But tooth discoloration may also originate deep within the root of a tooth. Sometimes this happens to a tooth that had to have earlier root canal treatment because of injury or decay.

In such cases the living pulp tissue and its blood vessels and nerves had to be removed from the root canals, resulting in the death of the dentin layer, which makes up most of the tooth’s body. Over time this caused the dentin to darken. The color may come from remains of blood that was left in the tissue, or from filling materials left in the root canal that are showing through.

Since these stains are caused internally (intrinsic) and not on the outside of the tooth (extrinsic) they must be whitened from the inside. This is usually done by putting a bleaching agent into the empty chamber from which the pulp was removed. Usually the bleaching agent is a substance called sodium perborate.

When it is mixed with a solution of hydrogen peroxide, sodium perborate slowly bleaches the color from the tooth’s internal material. It is considered to be safe and reliable for this use.

The work begins by taking x-ray images to make sure that the root canal is correctly sealed and the bone is healthy. After this, we will make a small hole in the back of the tooth through which the root canal space will be cleaned. The root canal space will be sealed and the bleach will be applied in a putty-like form and sealed off from the rest of your mouth. Every few days this procedure will be repeated until the bleaching reaches the desired level.

At this point a tooth-colored composite resin will be used to seal the small hole that was made in the dentin to insert the bleach. After the tooth has reached the level of whiteness that matches it to your other teeth, veneers or crowns must sometimes be used to repair the surface if it is chipped or misshapen, for example.

Contact us today to schedule an appointment to discuss your questions about whitening internally discolored teeth. You can also learn more by reading the Dear Doctor magazine article “Whitening Traumatized Teeth.”

Seven Easy Ways to Prevent Gum Disease

May 14, 2012 by DentalCMO

Periodontal (gum) disease can lead to serious infection and even loss of teeth; but it can easily be prevented. Here are seven things you can do to prevent gum disease — or stop it in its tracks if you already have it.

Understand the causes of gum disease. Diseases of periodontal (from the root words meaning “around” and “tooth”) or gum tissues start with bacteria collecting on your teeth, in the areas where the teeth and gums meet. The bacteria, called plaque or biofilm, irritate the surrounding tissues and cause them to become inflamed and swollen, and to bleed easily on contact. This condition is called gingivitis.
Brush correctly and effectively. Brushing twice a day is not just to polish your teeth to pearly whiteness. An important reason to brush is to remove the daily coating of plaque from your teeth. At your next dental appointment, ask me or our staff to show you the most effective way to brush.
Floss every day. Daily flossing removes the plaque that settles in between your teeth, in places where your brush can’t reach.
Have regular professional cleanings. Our hygienist will remove plaque that you missed by brushing and flossing. This plaque hardens into a material called calculus or tartar. In a professional cleaning your hygienist uses special tools to scrape these materials away. The hygienist also measures the distances between your gums and teeth to make sure that inflamed gums have not separated from the teeth, forming pockets in which the bacteria continue to grow.
Recognize the signs of developing gum disease. These signs include any of the following: gums that bleed easily when you brush or floss; bad breath; red or swollen gums; and sensitive teeth.
Stop smoking. If you haven’t stopped smoking for your heart or lungs, here is another reason to quit. Smokers are more likely to develop periodontal disease than nonsmokers. Smoking masks the effects of gum disease, so smokers are less likely to notice the symptoms, allowing the disease to progress to a greater degree before they seek help.
See our office right away if your teeth become loose or your gums become red and swollen. If inflamed gum tissues do not heal, the disease continues to progress. The tissues that attach your teeth to your bone, called ligaments, are lost as pockets deepen as the infection advances. Your gums may also become red, swollen, and painful. As the infection gets worse it eats away the bone around your teeth, causing the teeth to loosen and fall out.

So start with prevention and stop periodontal disease in its early stages.

Contact us today to schedule an appointment to discuss your questions about gum disease. You can also learn more by reading the Dear Doctor magazine article “Warning Signs of Periodontal (Gum) Disease.”

Veneers: Not Just for Woodworking

May 6, 2012 by DentalCMO

You may have heard the term “veneer” with reference to woodworking, where it means a thin layer of attractive wood that covers and enhances the surface of a piece of furniture. Exactly the same principle applies to porcelain veneers used in dentistry: A thin layer of ceramic material is used to cover parts of a tooth in order to improve its structure and appearance.

Porcelain is a non-metallic ceramic material that is fired in an oven at a high temperature to make it hard and durable. Dental porcelain veneers are thin layers of ceramic that can be applied to the outside of the tooth so that the end result mimics the natural color and translucency of tooth enamel. The underlying tooth structure has to be prepared by removing a small amount of the enamel, about 1 mm, which the veneer replaces. The veneer is then bonded to the prepared surface using a light-sensitive resin.

In woodworking, a veneer may be used to match the grain between the left and right sides of a piece of furniture, creating a beautiful effect on a curve, or simply to bring the appearance of expensive wood to a backing that is less expensive.

Just as a wood veneer improves the appearance of a dresser or table, porcelain laminate veneers may be used to improve teeth that have a number of cosmetic and functional problems. These include staining that cannot be removed by tooth whitening, teeth that are too small, misshapen, chipped or spaced too far apart. After an assessment of your teeth and your smile, we can create a mock-up using temporary tooth-colored materials so you can decide whether the suggested changes will work for you, or you can make suggestions for further improvements.

Porcelain laminate veneers may not be the best solution for you if your teeth are severely stained or damaged. In cases where a large proportion of the original tooth must be replaced, porcelain crowns may be the best solution. The crown is the part of the tooth that is visible above the gum line, and it can be covered with a porcelain crown that looks exactly like a tooth in shape and color. After studying your needs, together we can decide on the most satisfactory method to restore your most attractive smile.

Contact us today to schedule an appointment to discuss your questions about porcelain veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”

True or False

It is perfectly normal to experience tooth sensitivity to hot and cold foods for a few days after dental treatment.

If you experience sharp pain when biting down on foods, you should hold off on contacting us to see if the pain gets better on it own.

Tooth pain is caused by a reaction of nerves inside the tooth’s enamel with the severity of the pain dependant upon the type and degree of the stimulus

Generally speaking, pain is a protective response that ranges from minor to severe as a way of informing the body that something is wrong.

If a tooth’s root surface is sensitive, you should use a firm toothbrush to ensure that you are keeping the area clean by thoroughly removing dental bacterial plaque.

Lingering pain after eating hot or cold foods and liquids probably means that the pulp within your tooth is probably damaged or inflamed as a result of deep tooth decay or injury from a physical trauma.

Regarding tooth sensitivity, you should only contact us if the pain persists for several months because this is not likely to be anything serious.

If a tooth’s pulp becomes damaged or dies, you will need a root canal.

With tooth pain, knowing how long to wait before you contact us can save physical, financial and emotional stress.

People often confuse tooth and sinus pain because they both can feel the same — a dull ache with pressure in the upper teeth and sinus area on one or both sides of the face.

Answers:
1) True.
2) False. You should contact us asap for an examination before the pain worsens.
3) False. The nerves are located in the tooth’s pulp chamber.
4) True.
5) False. Use a soft bristled toothbrush not a firm one.
6) True.
7) False. While tooth sensitivity generally does not signal a serious issue, if it persist for days or worsens, contact us.
8) True.
9) False. Early interception is best.
10) True.

To learn more, continue reading the Dear Doctor magazine article “Tooth Pain? Don’t Wait!” Or contact us today to schedule an appointment to discuss your questions.

Millions of people suffer from mouth dryness, but most people just never talk about it. As your dental care providers, we don’t want you to keep it a secret anymore and mouth dryness really can be a problem.

Why? Saliva is a very important fluid that moisturizes, lubricates, and aids in the first stages of chewing and digestion. A normal flow of saliva provides antibacterial benefits that even protect against cavities by buffering the effects of acids. It can also make the surfaces of your teeth more vulnerable to abrasion and erosion. Without enough saliva, you may be especially at risk for not only tooth decay, but even yeast infections.

Causes of dryness include dehydration and even morning breath, both of which are normal. Smoking, alcohol and coffee drinking also cause dryness. It is also a side effect of many medications. Although mouth dryness is not a disease in itself, it could be a symptom of salivary gland or other systemic (general body) disease.

As a first step in the treatment, we will assess your situation by taking a detailed habit, diet, medical, and drug history to properly assess the cause and establish whether this is a local condition affecting only your mouth or an indication of a generalized bodily problem.

It’s always helpful to keep yourself well hydrated by simply drinking a sufficient amount of water every day and by using good daily oral hygiene to remove dental bacterial plaque. Chewing gum, especially containing Xylitol, will also help promote saliva flow and keep your mouth moist. Be careful not to suck on candy or mints, because they are likely to cause decay. There are also prescription medications that can be used to promote more saliva flow.

Contact us today to schedule an appointment or to discuss your dry mouth and what we can do to help. For more information read the article on Dry Mouth in Dear Doctor magazine.

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