Posts for: June, 2015
There are a number of teeth whitening options to put the brightness back into your smile — from professional dentist office applications to over-the-counter products for home use. But before you decide on an option, you should first consider whether whitening is right for you and to what extent.
Here are 3 questions to ask yourself — and us — before undergoing a whitening treatment.
Do I have any dental problems that make whitening problematic? The underlying cause of the staining may stem from decay, root canal problems or other dental issues; in these cases the underlying cause needs to be treated first, because whitening would only mask the actual problem. You also may not want to whiten your teeth for aesthetic reasons: people with certain features like short teeth or gummy smiles may find these features become more prominent after teeth whitening. It might be more advisable in these cases to consider other cosmetic options first.
How much whitening do I really need to improve my smile? One of the biggest myths about teeth whitening is the brighter the shade the more attractive the smile. A truly attractive tooth color, however, is more nuanced, and every person’s ideal color is different. The most attractive and natural color is one that matches the whites of your eyes.
What effect will whitening have on existing dental work I already have? In most cases, none — and that could be a problem. Composite resins or ceramic dental material have their color “baked in” and bleaching chemicals used in whitening have no effect on them. The concern then is whether whitening nearby natural teeth may produce a color mismatch between them and the dental restorations, resulting in an unattractive appearance.
Before you decide on teeth whitening, visit us first for a complete exam and consultation. We’ll discuss whether whitening is a good option for you, or whether there are other issues we should address first. We can also advise you on products and techniques, and how to get the most from your whitening experience.
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 “Important Teeth Whitening Questions…Answered!”
Considering the costs, many people view replacing a back tooth as less important than a more visible front tooth. They’re rarely seen, so who will notice?
You might, eventually. A missing back tooth can set off a chain reaction of problems that can affect your overall dental health. Besides playing an important role in chewing food, back teeth also redistribute most of the chewing force away from the front teeth. Their absence can also affect the bite: adjacent teeth to the missing one will tend to migrate toward the open space, causing them to tip and rotate into an improper position. This can cause an increase in tooth mobility, excessive wear and erosion, and endanger their survival in the long run.
To avoid these and other problems you should consider some form of replacement. Most dentists prefer a dental implant for its life-like appearance and durability, and because its titanium post has a natural affinity with bone. Bone cells will grow around and permanently adhere to the implant, which may stop and even reverse bone loss in some cases.
Implants, though, require a certain amount of bone structure initially to anchor and position properly. If you have inadequate bone and don’t want to bone graft the area, the next best option is a fixed bridge, in which the missing tooth is replaced with an artificial crown known as a pontic. The pontic is fused between two support crowns that are permanently affixed to the natural teeth on either side of the missing tooth (also known as abutments). While fixed bridges restore function and inhibit tooth migration, they require the natural tooth supporting the bridge to be reduced to accommodate the crowns placed on them. This permanently alters them and places them at higher risk for future nerve damage, gum disease and decay.
One final option is a removable partial denture (RPD). Although RPDs restore function and improve appearance, their movement within the mouth may place additional stress on the teeth that hold them in place. This movement over time could damage or loosen them.
We can discuss which option is best for you after a complete dental exam. The important thing, though, is to replace the back tooth as soon as possible — doing nothing could cost you much more in the long run.
If you would like more information on tooth replacement, 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 “Replacing Back Teeth.”
For a predictable outcome, a dental implant should be placed as soon as the bone and gum tissues following a tooth extraction have healed. But what happens if the tooth has been missing for months or years? You might then run the risk of not having enough bone to properly place an implant.
This can happen because of a disruption in the growth cycle of living bone tissue. As older bone cells dissolve (resorption), new bone develops to take its place. This is a dynamic process, as the amount and exact location of the new growth is in response to changes in the mouth, particularly from forces generated by the teeth as we chew. If, however, this stimulation transmitted to the bone no longer occurs because the tooth is missing, the bone will tend to dissolve over time.
In fact, within the first year after a tooth loss the associated bone can lose as much as a quarter of its normal width. This is why we typically place bone grafting material in an empty socket at the same time as we extract the tooth. This encourages bone growth during the healing period in anticipation of installing a dental implant or a fixed bridge. If, however, the bone has diminished to less than required for a dental implant, we must then use techniques to encourage new bone growth to support a future implant.
One such technique for restoring bone in the back of the upper jaw is to surgically access the area through the maxillary sinus (a membrane-lined air space within the bone structure of the face) positioned just over the jawbone to place grafting material. During surgery performed usually with local anesthesia, the surgeon accesses the sinus cavity, lifts the tissue membrane up from the sinus floor and applies the grafting material on top of the bone. Eventually, the new bone growth will replace the grafting material.
If successful, the new bone growth will be sufficient to support an implant. Thanks to this renewed growth, you’ll soon be able to enjoy better function and a transformed smile provided by your new implant.
If you would like more information on forming new bone for implants through sinus surgery, 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 “Sinus Surgery.”
Children losing their primary (“baby”) teeth is both natural and necessary. So, is it really that much of a concern if they lose one early?
The answer is yes — premature primary tooth loss could have long-term consequences for the permanent teeth as they develop within the jaw before eruption. Primary teeth play a crucial role in this development: as the permanent teeth form and grow the primary teeth serve as placeholders until they’re ready to erupt. A natural process then takes place in which the primary tooth’s roots dissolve (resorb) to allow them to fall out. Once they’re out of the way, the permanent teeth can then erupt.
If, however, they’re lost before the permanent teeth are ready, it leaves a space in the child’s bite. The dynamic mechanism between teeth and the periodontal ligament causes adjacent teeth to move or “drift” into the space. This can crowd out the permanent tooth intended for the space, causing it to come in improperly forming a malocclusion (bad bite), or it may become impacted and remain partially or fully below the surface of the gums.
This poor dental development could lead to extensive orthodontic treatment later in life, which is why we seek to preserve even decayed primary teeth for their entire natural lifespan. If the tooth is lost, however, we need to take action to preserve the space for the permanent tooth and avoid costly treatment later.
This usually calls for a “space maintenance” appliance — a type of orthodontic “retainer” — worn by the child to prevent other teeth from drifting into the space. Designed by your orthodontist, the appliance can also perform a cosmetic and social function by causing the space to appear unnoticeable.
Maintaining that space requires monitoring — especially by an orthodontist — and continued dental hygiene and care both at home and at the dentist’s office. The extra care preserving the space caused by premature tooth loss will help to ensure your child’s dental structure develops properly and their future smile will be an attractive one.
If you would like more information on the care and treatment of primary teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Early Loss of Baby Teeth” and “Losing a Baby Tooth.”