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Posts for: August, 2014

HomevsProfessionalTeethWhitening-WeighingYourOptions

If you’re considering tooth whitening, you may be torn between using a home product and undergoing a professional application in our office. Here’s a brief comparison of both approaches to help you in your decision process.

It helps first to know what we’re trying to correct — that dull, discolored tooth stain. Tooth staining comes in two varieties: intrinsic, which occurs deep within the tooth and can be caused by aging, old root canal treatments, tetracycline antibiotic use or excessive fluoride intake during childhood development; or extrinsic, which occurs mainly on the tooth surface and is caused by substances like coffee, tea, wine or tobacco. Intrinsic stains can only be treated through an in-office procedure — the comparison we’re making between home and professional whitening refers only to extrinsic staining.

Whitening, then, is the use of a chemical agent to bleach those stains. The majority of both home and professional products use hydrogen peroxide or carbamide peroxide (which also contains hydrogen peroxide) as its primary bleaching agent. Depending on the application, either of these chemicals can effectively bleach extrinsically stained teeth. The two approaches differ, however, in the strength of the bleaching agent: home products usually contain a 10% or less concentration, while professional solutions usually contain between 15% and 35%. As a result, the home application takes longer than a dentist’s treatment to achieve desired results — two to three weeks as opposed to one or two office visits.

Whichever option you choose, remember teeth whitening isn’t a permanent solution. The brightness will fade over time — six months to a year if you restrict foods and habits that stain teeth. You can also receive a touch-up once or twice a year to help extend brightness.

There’s also a middle of the road option — you can use a home application with guidance from our office. It’s also a good idea to visit us for an examination beforehand — we can then advise you on what options will work for your particular type of staining and teeth condition.

If you would like more information on teeth whitening 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 articles “Teeth Whitening” and “Tooth Staining.”


By Roya Levi, DDS
August 15, 2014
Category: Dental Procedures
AWorld-ClassSmile

He’s the world’s highest-paid soccer player: a forward on the Spanish club Real Madrid, and captain of the Portuguese national team. His super-toned body is featured in a series of advertisements, and he’s regularly seen with a supermodel on his arm. So would it surprise you to know that it took a bit of dental work to help Cristiano Ronaldo get a world-class smile?

You might never guess it to look at him now — but when he was 18 years old, and just starting his professional career with Manchester United in England, Ronaldo wore ceramic braces to correct a set of teeth that were quite a bit… off-sides. (As pictures from that time show, his teeth were out of alignment and had irregular spacing.) Yet in a relatively short time, his smile was completely transformed.

Ceramic braces are the treatment of choice for many sports stars and celebrities — and plenty of “regular” folks too. They work just like traditional all-metal braces, exerting a gentle force that slowly moves the teeth into better positions. But they have one major difference: They’re a good deal harder to notice.

That’s because instead of having brackets made of metal, this style of braces uses a high-tech ceramic material to attach the archwire to the teeth. The brackets blend right in with the natural shade of the tooth, so all you can see from a distance is the thin metal wire. That makes them a great orthodontic option for image-conscious celebs (like Tom Cruise and Faith Hill, who both wore them) — as well as anyone who may be concerned that traditional metal braces don’t fit in with their “look”.

In addition to ceramic braces, there are other, less-visible orthodontic treatments that can work just as well in many situations. One is lingual braces, which are similar to traditional braces — except they are applied on the tongue-side of the teeth, making them truly invisible. Another is clear aligners, a series of transparent plastic trays that are worn 22 hours a day and gradually move the teeth into more pleasing positions. What’s the best way to know which system is right for you? Come in and talk to us about your options!

Besides braces, did Cristiano Ronaldo have other cosmetic dental work (like teeth whitening) done? It’s possible, but he’s not saying exactly. Yet, as he told a Portuguese magazine, “I feel good about myself and that’s the most important thing.”

If you would like more information about ceramic braces or other orthodontic treatments, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”


AlternativestoRootCanalTreatmentCanSaveanInjuredImmatureTooth

When a permanent tooth has been injured, our first priority should be to save it. A root canal treatment (where the interior pulp of the tooth is removed and the pulp chamber and root canals are filled and sealed) is usually the best approach for tooth preservation.

An immature permanent tooth, however, presents a different challenge. While the pulp is less essential to a mature tooth’s vitality, it serves a critical purpose in the tooth’s early development before early adulthood. The pulp produces layers of dentin necessary for the tooth’s root system development. Completely removing the pulp at this stage may retard root development and cause the tooth to eventually weaken, and become brittle and darkened.

For younger teeth, we should therefore use alternative techniques that preserve as much healthy pulp as possible. One of these alternatives is Indirect Pulp Therapy, used when the pulp hasn’t been exposed by the trauma. With this technique we remove as much damaged dentin as possible while preserving the harder dentin closer to the pulp. After applying an antibacterial agent to protect against infection, and then filling and sealing the tooth, the pulp can continue to produce dentin in a normal way.

If pulp exposure has occurred, some form of pulpotomy — the partial removal of any damaged or infected pulp — would be in order. Our goal here is to leave as much of the pulp as possible, and then apply substances that stimulate the remaining pulp to create dentin. The most common type of growth substances are calcium hydroxide or mineral trioxide aggregate (MTA).

If the pulp isn’t at all salvageable, we may then turn to a procedure known as apexification. After removing the pulp we insert MTA at the root end of the tooth, then fill and seal the remaining interior as in a regular root canal treatment. The MTA will help the surrounding bone to heal and continue to grow around the root to further support the tooth.

Recent research into pulp stem cells promises further advances in this area. The regenerative qualities of stem cells could eventually help us “engineer” root development. Until then, there are still effective ways to give a young, damaged tooth a fighting chance to survive.

If you would like more information on preserving injured 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 article “Saving New Permanent Teeth After Injury.”