You may have noticed, as you get older, that the enamel of your teeth is looking worn in certain areas. Sometimes tooth wear takes the form of a minor chipping or fracturing at the incisal (cutting) edges of the teeth, or a loss of tooth material from the area near the gum line. In more severe cases, worn teeth look quite a bit smaller than they used to. Why does this happen?

Some wear with age is natural. But too much wear can interfere with your bite, expose more sensitive inner parts of the tooth to decay, and give you a more aged appearance.

There are things you can control that affect wear:

Your habits: Clenching or grinding habits, also called “bruxism,” is a major cause of tooth wear. The motion of teeth sliding over each other with forces that are beyond what's normal for biting or chewing causes a mechanical removal of tooth enamel. This can happen during sleep or periods of high stress. In either case there are therapies available, such as a thin, professionally made mouthguard that prevents your teeth from coming into contact with each other. Holding foreign objects, such as nails and bobby pins, between your teeth can also cause wear.

Your diet: Tooth enamel can be eroded (dissolved away) by acidic beverages, such as sodas, sports drinks and juices. Frequent snacking on sugary foods encourages the growth of oral bacteria that produce acid as a byproduct — also leaving your teeth vulnerable to tooth decay. Your saliva can buffer the effects of the acid in your mouth in about half an hour; if you consume these types of foods and beverages continually, there won't be enough time for this to work.

We can restore the appearance and function of worn teeth in a variety of ways. Porcelain crowns and veneers, for example, can re-establish the normal thickness and length of teeth while improving their color and giving you a more youthful appearance.

If you have any questions about tooth wear, please contact us today to schedule an appointment for a consultation. You can learn more about tooth wear by reading the Dear Doctor magazine article “How And Why Teeth Wear.”

While the first recorded attempts at dental implant were recorded around 600 AD during the Mayan civilization, today they have become a normal and integral tool that we use to replace teeth and restore full functionality to dental and oral health. In fact, many dentists now refer to dental implants as a person's third set of teeth, and they are the optimal choice for permanently replacing missing adult (permanent) teeth.

To help you visualize, think of your teeth as having two main parts: the crown or the part that can be seen above the gum tissues and the root, the portion that is suspended in the bone by the periodontal (gum) ligament that keeps the tooth in place. A dental implant is actually a root replacement, but unlike a tooth's root, it is anchored in the jawbone. However, an interesting fact is that the dental implants being used today actually fuse with or integrate in to the bone to become one. This process is called “osseo-integration.”

For the most part, dental implants are made from commercial-grade, pure titanium. This metal is “osteo-philic” or literally a bone loving metal that has been used for many years by both the medical and dental professions because it is not rejected by the body. For these reasons, these dental implants are very successful and can last for a lifetime.

Implant placement is a surgical process that requires prior planning involving collaborative efforts between the implant surgeon, dentist, and a laboratory technician. Periodontists, oral surgeons, or general dentists with advanced training in implantology and surgery normally “place” them. To learn more about dental implants and the entire process, read, “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

If you cringe at the appearance of your less than pearly whites when you look in the mirror, you are not alone. A frequently requested cosmetic procedure, teeth whitening is a very successful and relatively inexpensive way to enhance your smile. We can determine which whitening treatment will work best for you after performing a basic oral examination in our office. When will it work and when won't it? Here's some background:

Teeth most commonly become stained or discolored due to surface (extrinsic) changes, the most common of which are dietary and smoking. Foods including red wine, coffee, and tea can cause extrinsic staining. Teeth can also commonly become discolored or stained due to intrinsic (internal) reasons, such as changes in the structure of enamel or dentin or by incorporation of chromogenic (color generating) material into tooth tissue during formation or after eruption.

1. Toothpastes that claim to whiten teeth are only effective in removing plaque and other surface stains. Although most of these products contain mild abrasives that remove the plaque, they aren't capable of changing the underlying color of stained teeth.
2. Tooth polishing by your dentist or dental hygienist is effective in removing superficial staining, but will not change tooth color.
3. Teeth whitening systems work by bleaching, generally with the use of hydrogen peroxide. Using bleaching gels in custom made trays or whitening strips can be done at home, but is slow and the changes are gradual. We can perform quicker and more effective “power bleaching” in our dental office when precautions can be taken to ensure safety due to the higher concentrations of bleaching gels used. Teeth with intrinsic (internal) staining may need internal bleaching to whiten them and this can only be done in the dental office.
4. Teeth whitening results fade over time, but optimally last from six months to two years. Taking care of your newly whitened teeth by avoiding the foods, beverages, and habits that cause staining will help them remain whiter for longer.
5. If you have had previous cosmetic dentistry performed, including the placement of composite restorations, porcelain veneers, or crowns, teeth whitening may not be for you. Bleaching agents have little to no effect at all on the materials used to create these restorative products.

If you would like to discuss whitening your teeth with us, call today to make an appointment. To learn more about the various teeth whitening procedures, read the Dear Doctor magazine article “Teeth Whitening: Brighter, Lighter, Whiter…”

When asked about her dazzling white smile, Cat Cora, the first female iron chef on the hit television series Iron Chef America, freely admits to maintaining the brightness of her smile with professional whitening sessions.

“With what I do, whitening your teeth is like getting your hair done, your nails done and everything else you have to do to be on television,” Cat recently told Dear Doctor magazine. However, she does have her limits. “I want my teeth to be white and healthy looking — but not stark white or looking like they could glow in the dark,” she said with a laugh.

Cat's perceptions and experiences with tooth whitening may accurately describe Hollywood, but through the power of media, celebrities and their respective fan bases, having attractive white teeth has become a goal for most people. This is because white teeth are subconsciously associated with youth and virility.

Here in the dental office, we can use professional-strength “power bleaching” to whiten teeth several shades in a single visit. To prevent irritation to the area surrounding the teeth being treated, we isolate the gums and skin of the mouth with a protective gel or a rubber barrier known as a dental dam. After the whitening solution is placed on the teeth, the process may be supplemented by heat or a light source to activate or enhance peroxide release.

For bleaching teeth at home, our office can make custom-fitted bleaching trays that you fill with a gel form of carbamide peroxide. Sometimes this whitening gel can cause a temporary tooth sensitivity to hot and cold, but this normally lasts for no more than four days after you stop bleaching your teeth.

To learn more about tooth whitening, you can continue reading the Dear Doctor magazine article “Teeth Whitening.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination and discuss what treatment options will be best for you. And to read the entire interview with Cat Cora, please see the article “Cat Cora.”

Creating a dental crown that looks good and wears well is not an easy achievement. It is the result of good communication you, the patient, have with us, your dental professionals, and that we have with the dental lab that manufactures the crown. In addition, it reflects the quality of work done by us and by the lab technician.

What is a dental crown?
A crown is a dental restoration that surrounds the remains of a damaged tooth or is attached to a dental implant so that it resembles a natural tooth as it extends above the gum line. The choice of materials and appearance of the crown depend upon many factors. One is the location of the crown. If it is in the back part of your jaw, strength and wear will be a major factor. If it is in the front, a life-like appearance will be important.

What goes into making a good-looking and functional crown?
Options for crown materials include porcelain, gold, porcelain fused to metal (called PFM) and some newer materials such as “pressed-ceramic” restorations and computer-milled-ceramics.

You as the patient can have a say in choosing the crown's color and appearance. Before it is cemented into its final position, make sure you are happy with the feel and appearance of your new crown.

Gold is often chosen for crowns on back teeth because of its superior wear qualities. Gold crowns have been known to last more than 50 years. They also cause minimal wear to the teeth that they touch on the opposing jaw.

Crowns made of porcelain (a glass-like substance fired in an oven at a high temperature) look good but may be too brittle to stand the wear and forces given to back teeth. Like glass, they can fracture under pressure. But because of their lifelike appearance they make a good choice for visible front teeth.

PFM (porcelain-fused-to-metal crowns) are a good combination of the best of gold and porcelain, but they sometimes lose the stains applied to make them look natural, and occasionally they fracture away from the metal.

A provisional crown can help you make sure you are getting a crown with the qualities you want. With the provisional crown all the details are worked out ahead of time, and you get a chance to try them out to make sure the crown looks good and that you can eat and talk normally. After you give your approval on the provisional crown, the final crown will be made to match it, in longer-lasting and better quality components.

Contact us today to schedule an appointment to discuss your questions about crowns and other dental restorations. You can also learn more by reading the Dear Doctor magazine article “Gold or Porcelain Crowns.”