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…”

Even with all the medical know-how we possess at the dawn of the 21st century, complete tooth loss is still a big problem. In this country, more than a quarter of all adults between ages 65 and 74 have lost all of their teeth. For these individuals, removable full dentures are often still used as an affordable and effective way to replace missing teeth.

Success with dentures originates from a collaboration among dentist, laboratory technician, and, of course, the denture-wearer. Creating false teeth that look natural is as much an art as it is a science. We take a number of steps to make sure you will get the best results. These include:

• Positioning the teeth. Using facial landmarks and photographs of how you used to look before your teeth were lost helps us determine where to place each tooth and how the upper and lower teeth should line up in relation to each other. For example, we will consider what size the teeth should be; how close to the lip they should be; and how much space should exist between the upper and lower teeth when they are at rest.
• Simulating natural gums. If you are someone with a “high lip dynamic” (a lot of gum shows when you smile), it is particularly important to simulate real gum tissue in a set of full dentures. Fortunately, there are many colors and textures available to create a realistic effect. Again, photographs can be helpful in achieving this.
• Balancing the bite. We must make sure that your upper and lower dentures come together in a way that facilitates normal biting, chewing, and speech.

As a denture wearer, you will need to visit our office regularly to make sure the gum tissue and bone upon which your dentures rest stay healthy. It's common to see a gradual loss of bone in people who wear dentures at a rate that varies from person to person. This bone loss can affect the fit of your dentures and lead to other health problems, which we can address if we are monitoring you on an ongoing basis.

If you have any questions about dentures, please contact us or schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “Removable Full Dentures.”

As a successful author, interior design guru (with 127 makeovers in eight years on The Oprah Winfrey Show), and host of his own television program, The Nate Berkus Show, Nate Berkus understands the important role a beautiful smile plays in one's life and career. In a recent interview with Dear Doctor magazine, Nate discussed his oral health history. Berkus credits his all natural smile — no cosmetic dentistry here — to the treatments he received as a child from his dentist. “I'm grateful for having been given fluoride treatments and sealants as a child.” He then added that, “healthy habits should start at a young age.”

Dental sealants are important because they help protect developing young teeth until the enamel has matured. Without dental sealants, the newly erupted immature enamel of teeth is more permeable, meaning that the acids produced by bacteria in the mouth can damage these teeth more easily. This makes the teeth less resistant and thus more susceptible to tooth decay.

Regardless of how much your children brush their teeth, the reality is that toothbrush bristles cannot reach down to clean out the crevices found in the deep grooves (“pits and fissures”) of teeth. And if not removed, the bacteria found in these grooves produce decay-causing acids as a byproduct of metabolizing sugar. However, when sealants are used in combination with fluoride, good hygiene and nutrition (including lower sugar consumption), the odds of having tooth decay is dramatically reduced.

We refer to dental sealants as “pit and fissure” sealants because they protect the grooves found in the top of back teeth and the back of front teeth. Sealants also may reduce the need for subsequent treatments as your child grows older — just as it did for Nate Berkus. For these reasons, sealants are definitely something that all parents and caregivers should consider for their young children.

To learn more about dental sealants, contact us today to schedule an appointment so that we can conduct a thorough examination, discuss any questions you have as well as what treatment options will be best for you or your child. Or to learn more about sealants now, you can continue reading the Dear Doctor magazine article “Sealants for Children.” And to read the entire interview with Nate Berkus, please see the Dear Doctor magazine article “Nate Berkus.”

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.”

Dentistry has ventured into the new area of sleep medicine by helping snorers — and their exasperated sleeping partners — with custom-made anti-snoring devices. These oral appliances, which resemble orthodontic retainers or sports mouthguards, keep the snorer's airway clear and the bedroom quiet. To see how they work, you have to understand the mechanics of snoring.

Snoring occurs when the upper airway (back of the throat) becomes blocked by the tongue or other soft-tissue structures, such as large tonsils or a long soft palate. The vibrating of these obstacles creates the sound we call snoring.

Snoring is often worse when sleeping on one's back because that position encourages the lower jaw to fall back and the tongue to close off the airway. This is where Oral Appliance Therapy comes in. These custom-fitted devices are designed to keep the upper airway open during sleep by pulling the lower jaw forward, which in turn brings the tongue away from the throat. Dentists, and our office in particular, are the only source for Oral Appliance Therapy.

People who snore should have a thorough examination to rule out Obstructive Sleep Apnea (OSA), a potentially dangerous condition in which airflow can be cut off completely for 10 or more seconds (“a” – without; “pnea” – breath), reducing blood-oxygen levels. Chronic, loud snoring is a common finding with OSA.

Please remember that sleep is an integral part of health and well-being. In fact, we spend about a third of our lives doing it. If you are snoring or have any sleep-related breathing disorders that are waking you or your bed partner, be sure to tell our office. There are plenty of examples of the havoc wreaked by sleep-deprived individuals. Remember the Exxon Valdez?

If you have any questions about Oral Appliance Therapy, please contact us or schedule an appointment for a consultation.

To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Supermodel Christie Brinkley has a one-in-a-million smile, but she is just one of millions who have benefited from today's preferred tooth-replacement technique: the dental implant. In a wide-ranging interview, Brinkley told Dear Doctor magazine about a helicopter accident she suffered while back-country skiing.

“I fractured two molars in the back of my mouth and I had to get two dental implants,” Brinkley told the magazine. “I am grateful for the dental implant technology that feels and looks so natural.”

You might think it serves little purpose to replace a missing back tooth that was barely visible in your smile to begin with — especially if you don't spend a lot of time posing for magazine covers. But this is actually not the case. Your molars are extremely important for chewing and even for maintaining a more youthful appearance.

Dentists generally agree that losing posterior (back) teeth can have many consequences for the remaining teeth and their surrounding structures, i.e., bone and gums. If back teeth are missing, the front teeth end up bearing more stress than they were built for. And there are certain things that happen when any tooth is lost, whether front or back, that can affect function and appearance.

For one thing, when a tooth is lost the adjacent teeth tend to drift into the empty space or tip towards it. This can adversely affect your bite. Too much shifting can render a tooth basically useless and also leave it more vulnerable to gum disease.

Another complication is the loss of tooth-supporting bone that inevitably occurs when teeth are lost. When a tooth comes out, the bone under it actually begins to melt away. Since back teeth support the vertical dimension of the face, their loss can cause what's known as “bite collapse” — a reduction in facial height that becomes increasingly noticeable over time and can make you look older.

A dental implant can prevent all of these things, while providing you with a replacement that looks and feels just like the tooth you lost.

If you are interested in learning more about implants, please contact us or schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Christie Brinkley, please see “The Secret Behind Christie Brinkley's Supermodel Smile.” Dear Doctor magazine also has more on “Replacing Back Teeth.”

On the day when braces come off, most people feel that their orthodontic treatment is over. When they are then asked to wear retainers, they may wonder what this additional requirement will accomplish. Wasn't the work of moving their teeth to desired positions already completed? To understand the answer to this question, you need to understand how orthodontics works.

How does orthodontic treatment remodel your smile?

Although they give the appearance of being stable and unmoving, teeth and their surrounding structures (gums, jawbones, and ligaments) are living tissues and are actually in a constant state of change.

Teeth are rooted in bone and are attached by a fibrous tissue called the periodontal ligament (from peri meaning around and odont meaning tooth). One side of the ligament attaches to the cementum (part of the tooth's root) and the other side is attached to the bone, with the tooth suspended in between.

These tissues are constantly remodeling themselves, but pressure from the lips and cheeks on one side and from the tongue on the other create a balance that keeps the teeth suspended in the same location. When mild forces are placed on the teeth, such as the forces from the wires used in orthodontic treatment, the tissues slowly adapt and rebuild, resulting in a new position for the teeth.

What are retainers?

Orthodontic retainers are devices usually made of a clear plastic section that is fitted to the roof of the mouth, with thin wires that fit over the teeth.

What is the purpose of retainers?

The remodeling process keeps going after the orthodontic treatment stops, so time is needed for the teeth to reach a new balanced state. The retainer stabilizes them in their new position so that bone and ligament can reform around the teeth and hold them there. This works well for adolescents, whose jaws are in a state of growth, but adults may need outside assistance to stabilize their teeth for a longer time. They may be asked to wear retainers indefinitely to make sure their teeth do not move from their new positions.

What happens if you don't wear your retainers?

If you don't wear your retainers, your teeth are likely to return to the positions they had prior to your orthodontic treatment. This can happen fairly rapidly, underscoring the importance of wearing retainers as instructed.

What are the different types of retainers?

Most retainers are removable devices as described above. For people who require long-term use of retainers, thin retainer wires can be bonded to the inside surfaces of their front teeth. Such wires are usually left in place for several years, relieving them of the need to remove and replace their retainers.

Contact us today to schedule an appointment to discuss your questions about orthodontics and retainers. You can also learn more by reading the Dear Doctor magazine article “Why Orthodontic Retainers?”

While the goal of restorative dentistry is to return all of the destroyed or lost dental tissues of the teeth to full form (shape) and function, when you blend this goal with the artistry of cosmetic dentistry, the results can be dazzling. Today's modern techniques and materials enable replacement of missing tooth structure that allows bonding directly to the tooth so that it not only is an exact color match but also actually strengthens the tooth. And tooth-colored fillings are not just for front teeth. They can dramatically improve the appearance of all teeth — even your back molars — so that it appears you've never had tooth decay at all!

All of this is accomplished through the use of either tooth-colored dental porcelain or composite resins. Porcelains are a form of ceramic material formed by the action of heat. They are available in many colors and shades made from a powder corresponding to the primary color of the natural tooth structure that is mixed with water and placed into an oven for firing (hence their ceramic nature). When built up in layers by highly trained dental ceramicists, they can be made to mimic the exact natural translucency, staining and contours of tooth enamel.

Dental composite resins are the most common materials used for tooth-colored adhesive restorations today and have properties similar to tooth structure. They consist of resin or special plastics and fillers that are made of silica, a form of glass. The fillers give the composites wear resistance and translucency (see through properties).

It is important to note that besides providing the appearance of beautiful teeth, properly restored teeth function and wear better. But most important to you, they appear indistinguishable from natural teeth! Furthermore, scientific studies and clinical experience have validated their use as both safe and predictable. In fact, these techniques are also suitable for children's teeth and can incorporate fluoride to reduce decay. Together, all of these changes have so significantly impacted the way modern dentistry is practiced that many believe we may have entered into the so-called “post-amalgam (silver metal-colored dental fillings) era.”

Contact us today to schedule an appointment to discuss your questions about tooth-colored fillings. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is an interesting condition because it can be hard to diagnose and often mimics many other conditions. It arises when there are problems inside the temporomandibular joint, and the muscles attached to it, causing pain. When treating TMD, we typically start by relieving the symptoms of pain and discomfort with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. We feel that it is critical to address your pain issues as soon as possible before preceding any further with treatment.

Once we have provided some pain relief and after having completed a thorough history and examination, we can move to the next phase of treatment. This may include the introduction of a bite guard or some form of oral appliance therapy. A bite guard is an unobtrusive yet rigid plastic horseshoe-shaped appliance that fits snuggly over the biting surfaces of the upper teeth. When in place and properly adjusted, this custom-made appliance allows your muscles and therefore jaw joints to relax. And it will prevent you from grinding your teeth, another contributing factor to TMD. We will probably ask you to wear it when sleeping or in times when you are feeling stressed when clenching or grinding habits may be active. We may also suggest that you obtain some relaxation therapy and/or biofeedback from a licensed therapist, as this can prove helpful in treating TMD.

If you have suffered from frequent jaw pain in the past and suspect that you may have TMD, please let us know so that we can address it at your next appointment. Or if you are currently in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

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.”

Worldwide it is generally accepted that the best method for permanently replacing a missing tooth is with a dental implant. However, one fact that can affect the timing of placement of dental implants is that the person should be fully mature. In this case, it means that growth is complete, in particular the jawbones have completed growing. And while we are sensitive to teens who may beg for a dental implant to replace a missing, damaged or traumatized tooth, parents or caregivers should know that research and experience have shown that it is better to wait.

The main reason it is best to wait is because natural teeth grow and move with the jaws as they mature whereas implants don't. Natural teeth change positions and move with the jaws as the jaws grow, implants don't. They are fused to the bone in one position and as the jawbone grows, they get left behind and appear to sink as the adjacent teeth and jawbone grow in harmony.

Although it is not really possible to determine exactly when a person has finished growing, it is generally best to wait until the jaw is fully matured and developed. However, we are the most qualified, along with our orthodontic colleagues to “guesstimate” based on family history, age and genetics. Specialized radiographs (x-rays) of the skull and jaws may also be helpful in determining the timing of jaw growth completion and when implants can be placed.

Dental implants are a permanent solution to a dental problem and thus should not be used until all growth is complete. Think about it. Your young child gets a beautifully restored smile through a dental implant...and for a year or two it looks fantastic. However, as your child's jaws continue to grow, everyone begins to notice gaps between the implant and adjacent teeth. So it makes sense to avoid this eventuality; by just waiting until late teens when beautifully restored crowns on properly positioned dental implants should last for many many years.

To learn more on this subject, read the Dear Doctor article, “Teenagers & Dental Implants.” You are also welcome to contact us to discuss your questions or to schedule an appointment.

When you have your teeth bleached in a dental office, the results almost seem like magic. Let's push aside the magician's cape and see what is really happening in professionally-applied, in-office tooth whitening.

How do teeth become discolored?
A tooth's enamel covering is mostly composed of mineral crystals. At a microscopic level, you can see a framework or matrix of organic (living) matter interspersed between the crystals of enamel creating a very irregular surface capable of retaining stains. Chromagenic (color generating) organic compounds can become part of this organic matrix resulting in tooth staining. They can be bleached without affecting the mineral structure of the tooth's enamel.

As people get older and their teeth wear, the enamel loses its youthful translucency and the underlying layer, called dentin, thickens and becomes more yellow. Such changes to the actual tooth structure are called intrinsic staining. Other causes of intrinsic discoloration are exposure to high levels of fluoride or tetracycline antibiotic administration during childhood, tooth decay, or root canal problems, among others. Discoloration can also be caused by external staining from certain foods, drinks, or tobacco products. Such surface stains are called extrinsic staining.

Behind the Magic
Materials used for tooth bleaching are hydrogen peroxide and carbamide peroxide. Peroxides are commonly used as bleach, and you may have seen them used as hair bleaches, for example. Hydrogen peroxide is a strong oxidizing agent that attacks the organic molecules responsible for tooth discoloration, bleaching them until they lose their color. Carbamide peroxide also contains urea, which is a compound that permits the peroxide to remain in contact with the teeth for longer amounts of time without harming them.

Often called power bleaching, the in-office technique uses a high concentration of peroxide solution (35-45% hydrogen peroxide), placed directly on the teeth in the form of a gel. A heat or light source may enhance the peroxide release. The gel is applied with trays custom fitted to your mouth, and specific barriers are applied to protect sensitive gum tissue from the solution. Results show teeth becoming up to ten shades lighter in about an hour.

In-office bleaching under the supervision of my staff and me is recommended if you have severely stained teeth, and particularly if you are about to have veneers or crowns made. It's a way to rediscover the pearly translucency of your youthful smile.

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

Before determining if a bridge or an implant will work best for you, here is some useful background information. There are two main parts to a tooth; the crown or part that you see above the gum line and the root portion that is below the gum line and encased in bone — the part that is replaced by a dental implant.

A dental implant is inserted into the jawbone during a surgical procedure. The implant is actually a titanium screw-like device that is placed in contact with the bone. During a 3 to 6 month healing period, it subsequently fuses to the bone. A crown made from dental porcelain, gold or a combination of both is then attached to the implant to mimic a healthy, normal tooth.

There are two critical reasons why implants are the preferred method for permanently replacing an adult tooth. The first is that they are less susceptible to gum disease and they are not subject to tooth decay. The second is that because they attach to the jawbone and not to the adjacent teeth. And while an implant may cost a little more initially, when compared to the longevity and replacement cost of bridgework over a lifetime, they may cost less.

By contrast, a fixed bridge is also a non-removable restoration or prosthesis (replacement part) that is held in place by attaching it to your natural adjacent teeth. The treatment gets its name from the French word for bridge, “pont,” as the tooth being replaced is called a pontic. Before placing a bridge, the teeth on either side of the missing tooth must be prepared by removing layers of tooth enamel. Three new teeth are then crafted as a single unit from dental porcelain and/or precious metals with crowns on either side of the pontic. The pontic is held in place when the crowns are placed. Bridgework is at risk for gum disease and tooth decay and requires careful maintenance.

As with most dental procedures you have options and choices. Luckily, when it comes to determining whether a bridge or an implant will work best for you, you can rely upon our expertise. However, by having a clear understanding of these two options you are now better prepared for working with us should you require this treatment option. To learn more read the article, “Implants Vs. Bridgework.” Or, contact us to discuss your questions or to schedule an appointment.

Can chewing gum prevent cavities? Yes! It can if the gum is sweetened with xylitol.

What is xylitol?
Xylitol is a type of “sugar alcohol,” similar to sorbitol and mannitol, sugar replacements that are used in many low calorie foods. Xylitol occurs naturally in many fruits and vegetables and is obtained from the bark of birch trees, coconut shells and cottonseed hulls. It looks and tastes like sugar and is a diabetic-safe, low-calorie carbohydrate.

How does xylitol stop cavity formation?
Decay starts when certain bacteria break down sucrose (regular table sugar) and produce acids that dissolve the minerals in the enamel, the outer protective layer of your teeth. When the decay-causing bacteria try to consume xylitol, they are unable to break it down, and instead they begin to starve.

A normal mouth contains a large population of bacteria, and it is better for your teeth to have more “good” bacteria of the kind that do not cause cavities. Xylitol also stops your saliva from becoming acidic, so your mouth becomes a better environment for the “good” bacteria.

Chewing xylitol gum also increases your flow of saliva. Saliva contains calcium and fluoride and helps give these minerals back to your teeth (re-mineralization), undoing some of the effects of the cavity-causing bacteria. This makes chewing xylitol gum a particularly good solution for people who suffer from dry mouth.

How much xylitol do you need to prevent cavities?
We recommend that you chew or suck on two pieces of xylitol gum or two pieces of xylitol candy for five minutes following meals or snacks, four times daily — if you are at moderate to extreme risk for cavities. The target dose of xylitol is 6 to 10 grams (one or two teaspoons) spread throughout the day. Prolonged gum chewing is not advised, so most xylitol-sweetened products contain flavor that only lasts a short time to discourage excessive chewing. The only side effect of too much xylitol ingestion is that it may have a mild laxative effect.

I don't like chewing gum. Is there another way to get xylitol?
People who don't like to chew gum have the option of using xylitol in mints, candies, mouthwash, toothpaste, or mouth sprays. For these individuals, a minimum dose is 5 to 6 grams (one teaspoon) three times per day.

So now you can add xylitol to the list of ways to fight cavities: daily brushing and flossing, and regular professional cleanings — and chewing xylitol gum.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”

Nearly everyone is familiar with snoring, having either been awakened by a snoring, sleeping partner or by snoring so loudly that you wake yourself up. As if the sounds emanating from snoring weren't bad enough, snoring is no laughing matter and should never be ignored. And why? It can be a sign of other health issues.

Snoring occurs when the soft tissue structures of the upper airway (the back of your throat) collapse onto themselves, the tongue drops back and air is blocked in its movement through the mouth and nose into the lungs. These obstacles cause a vibration that produces the snoring sound. Snoring can also be caused by large tonsils, a long soft palate, a large tongue, the uvula (the tissue in the back of the throat that dangles like a punching bag), and/or fat deposits.

If snoring is more severe, it may denote a medical condition called Obstructive Sleep Apnea (OSA; or just “sleep apnea”). It occurs when the upper airway collapses causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more and can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. But have no fear; you are not alone, as millions of people worldwide have been diagnosed with this condition. There are also numerous treatment options that we can discuss with you — should you be diagnosed with this problem.

You can learn more about sleep apnea by reading the Dear Doctor article, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule a consultation.

The much anticipated day has arrived: your child's braces have been removed. You are really happy with the way your son's or daughter's smile looks now. All the time, money, and discomfort of having teeth straightened have been well worth it.

But did you know that the teeth could relapse into their old positions if your child doesn't wear a retainer every night?

Why is wearing a retainer necessary?
It is important for both you and your child to understand the reason for wearing a retainer. It has to do with how orthodontia works in causing teeth to move to more satisfactory positions.

The reason that orthodontia (“ortho” – straight, “odont” – tooth) works is that the tissues holding teeth in place are living and keep remodeling themselves. Teeth are suspended in the jawbone by the periodontal ligament (“peri” – around, “odont” – tooth), which suspends the tooth by extending from the cementum of the tooth on one side into the bone on the other. Cementum is the thin layer of calcified tissue covering the dentin of the root. When light forces are placed on it, the periodontal ligament can reform itself and adapt to the pressures it is under.

Orthodontists know how to keep the pressures during orthodontic treatment light enough to cause movement that is slow and steady but not so strong that the tissues are damaged. If too much force is applied, the process can cause damage to the periodontal tissues and tooth roots.

When the teeth have moved to their desired positions, they will continue slowly moving. The purpose of a retainer is to stabilize the teeth in their “finished” position. They must be retained in this position long enough that the bone and ligament can completely re-form around them, a process that can take several months.

Make it clear to your child that a retainer won't have to be worn forever. Once your child understands that it is very important to wear the retainer for a few months in order to stabilize that attractive new smile, it should be easy to convince him or her to use it nightly.

Contact us today to schedule an appointment to discuss your questions about retainers. You can also learn more by reading the Dear Doctor magazine article “Why Orthodontic Retainers?”

Of all the teeth in the mouth, the ones receiving the most discussion and controversy would have to be the wisdom teeth or third molars. And this is not just a recent phenomenon, as people have been discussing them for centuries! See how much you really know about wisdom teeth by taking our quick and easy true/false self test.

1. Third molars received their name, “wisdom teeth,” because a moderate amount of wisdom is supposedly achieved in life about the time they appear.
   True or False
2. Wisdom teeth and all of their associated problems are commonplace in the practice of dentistry.
   True or False
3. Because wisdom teeth are so unpredictable, they typically make their appearance between the ages of 17 and 25.
   True or False
4. The most common consequence of impacted wisdom teeth is gum (periodontal) disease.
   True or False
5. If wisdom teeth are not removed, they will become impacted or cause crowding. This is why so many people require orthodontic treatment (braces).
   True or False
6. While most people have four wisdom teeth, having more (supernumerary teeth) or less (hypodontia) is possible.
   True or False
7. Through dental x-rays and routine check-ups, we can predict the timing and way in which wisdom teeth become visible (erupt).
   True or False
8. An impacted wisdom tooth, by definition, is a third molar that is colliding with or jammed against another important structure, such as an adjacent tooth, the gums or other important soft tissues in the mouth, or nerves and blood vessels.
   True or False
9. The primary symptom for indicating you have an impacted wisdom tooth is pain.
   True or False
10. If wisdom teeth need to be removed, it is best to remove them at a younger age rather than waiting until periodontal disease has started.
    True or False

Answers: 1) True. 2) True. 3) True. 4) True. 5) False. While wisdom teeth can be a factor in crowding, some people have no issues with these teeth. For them, they grow into proper position and are healthy teeth. 6) True. 7) False. Unfortunately, it is not possible to predict the way wisdom teeth will erupt. 8) True. 9) False. In some scenarios, impacted wisdom may cause no pain. 10) True.

To learn more about wisdom teeth and in particular, impacted wisdom teeth, continue reading the Dear Doctor magazine article “Wisdom Teeth.” Or you can contact us today to schedule an appointment to discuss your questions.

Snoring and other sleeping disorders impact between 50 and 70 million Americans each year. However, did you know that our office can help when it comes to diagnosing and treating sleeping disorders? For this reason, we have put together this list to highlight how we can have a positive impact on your snoring.

1. Many people are surprised to learn that physician training is lacking and very slowly evolving in the area of sleep related breathing disorders. Therefore, there is limited public and medical awareness. The American Academy of Sleep Medicine (AASM) has acknowledged that properly trained dentists are the first line of therapy for treating mild to moderate sleep apnea effectively.
2. Because we see our patients on a more regular basis than many primary-care physicians, we dentists are in a unique position to identify and/or detect a SRBD. However, for us to accomplish this, you must share the facts about your sleeping habits and issues related to breathing. In other words, do not be embarrassed to let us know that your spouse, sleeping partner or family complain to you about your snoring!
3. When it comes to treating complications associated with Oral Appliance Therapy (OAT) used in managing Sleep Related Breathing Disorders (SRBD), dentists are the primary professionals who are specifically trained to create, fit, adjust, monitor and treat any complications associated with a mouthpiece (oral appliance).
4. Did you know that dentists help identify the approximately 90% of misdiagnosed cases of patients suffering from a SRBD? Well, it is true. We play a critical role in diagnosing and treating these patients.
5. Another reason why it is much easier for us to diagnose and treat these problems is because the core of our training is centered upon the oral cavity, mouth and parts of the upper airway — the very areas where your snoring and SRBDs occur.

If you suffer from snoring or any other Sleep Related Breathing Disorder, it is imperative that you seek and obtain treatment. Ignoring these problems can lead to issues such as: an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease as well as strokes and impotence. Contact us today to discuss your questions about snoring or to schedule an appointment. You can also learn more about snoring and sleep disorders when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

1. Xylitol is a kind of sugar.
   True or False
2. Xylitol is made from
   1. Bark of birch trees
   2. Coconut shells
   3. Cottonseed hulls
   4. All of the above
3. Xylitol is a natural “sugar alcohol” similar to other so-called sugar alcohols such as mannitol and sorbitol.
   True or False
4. Xylitol is broken down by decay-causing bacteria to produce acid.
   True or False
5. Decay-causing bacteria are transmitted from a parent to a child through oral contact such as a simple lip-to-lip goodnight kiss.
   True or False
6. Researchers have found no difference in prevention of tooth decay in gum made from xylitol compared to gums containing sorbitol/xylitol and sucrose.
   True or False
7. Other xylitol products such as mints, candy and cookies also seem to decrease the incidence of tooth decay.
   True or False
8. Xylitol products increase salivary flow and allow saliva to neutralize acids in your mouth.
   True or False
9. The only side effect of too much xylitol ingestion is a possible mild laxative effect.
   True or False
10. The target dose of xylitol is one to two teaspoons spread throughout the day.
    True or False

1. True. Xylitol is a kind of sugar that does not contribute to tooth decay.
2. All of the above. It is also found naturally in some fruits and vegetables.
3. True. The others, mannitol and sorbitol, are used as sugarless sweeteners.
4. False. Unlike sucrose (table sugar), xylitol is NOT broken down by bacteria to produce acid. Xylitol also stops saliva from becoming acidic so your mouth becomes an unfriendly environment to acid-producing bacteria.
5. True. However, xylitol inhibits growth and attachment of the bacteria to your teeth, so it also inhibits transmission to your children.
6. False. Systematic use of xylitol chewing gum significantly reduces the relative risk of caries (tooth decay) when compared to chewing gums containing sorbitol/xylitol and sucrose. Xylitol gum also appears to halt the development of tiny cavities when compared to other types of chewing gum.
7. True. Use of these products seems to stop the progression of active decay.
8. True. Xylitol and your saliva combine to re-mineralize (harden) your teeth after an acid attack.
9. True.
10. True. This means two pieces of xylitol gum or two pieces of xylitol candy or mints should be consumed for five minutes four times a day after eating meals or snacks.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”

You didn't have your teeth straightened as a child. Is it too late, or should you have orthodontic treatment now as an adult?

Orthodontics is a sub-specialty of dentistry devoted to the study and treatment of improper bites, or malocclusions. Orthodontic treatment has the goal of slowly applying pressure to teeth in a way that moves them into proper alignment in your mouth.

Recommendations are for children to have their teeth assessed for orthodontic treatment before the age of seven. The whole process can be done more easily while their teeth are coming in and their jaws are still growing.

However, if your teeth are overcrowded, you have an overbite or an underbite, or your teeth are misaligned in other ways, it is never too late. If you “missed the boat” on orthodontic treatment before, here are seven reasons to consider doing it now.

1. Orthodontic treatment brings teeth, lips and face into proportion, resulting in a beautiful smile.
2. An attractive smile contributes to self-esteem, self-confidence and better self-image.
3. Because of improved self-esteem, you may see improved social and career success.
4. Teeth that are in proper alignment will function and wear better over the years as you age.
5. Properly aligned teeth are easier to keep clean, making you less prone to periodontal (gum) disease.
6. If you have any missing teeth that need to be replaced, this can be done more effectively if your remaining teeth are put into their correct spacing and position first.
7. Current options for treatment include fixed appliances (traditional braces) in which bands and brackets are bonded to the teeth and wires are threaded through them — or as an adult you may be able to use removable clear aligners. These consist of a series of nearly invisible computer-generated clear plastic trays that progressively move the teeth into better alignment.

Take the first step: call our office for an orthodontic evaluation. Having orthodontic treatment as an adult may be just the thing to give you an attitude boost as you move forward in your life.

Contact us today to schedule an appointment to discuss your questions about teeth straightening. You can also learn more by reading the Dear Doctor magazine article “Why Straighten Teeth?”

We in dentistry, advise parents to have an orthodontic evaluation some time before your child is 7 years of age. At this time, some of your child's adult teeth have come in and some primary (baby) teeth remain. This is a good time to check for developing problems. Treatment that begins while your child's teeth are coming in is called “interceptive orthodontics.” It provides an opportunity to achieve the best results in orthodontic treatment.

Once this evaluation takes place, it may mean that orthodontic treatment may need to take place in two-stages. A first phase of orthodontic treatment may prevent, intercept or minimize future orthodontic treatment. The first stage may be a process of guiding the growth of the jawbones that support the teeth. This is called “growth modification.” Then when the adult teeth have erupted through the gums, it may be time to do the second and final stage.

If a second phase of treatment is necessary it will probably require braces. These are small metal brackets that are bonded to the teeth. Thin flexible wires are threaded through them, and the wires are designed to push or pull on the teeth to provide a small amount of pressure that makes the teeth slowly reposition themselves within the jawbone. A light and controlled force pulling on a tooth causes new bone and ligament (the fibers that hold teeth in place) to be formed. These are living tissues that are constantly changing and remodeling themselves.

If you wait until your child's permanent (adult) teeth have all come in to start this process, it will be too late to correct some types of orthodontic problems, such as some types of malocclusions (“mal” – bad, “occlusion” – bite). It's better to work together with your child's stages of growth and development in order to have an optimum correction, both in looks and function.

You may be wondering whether a two-stage treatment costs twice as much. In fact, it is likely to be less expensive than a late one-stage treatment would be. Sometimes, the first stage may correct an underlying problem and make further treatment unnecessary. If a second phase is needed, it is likely to be easier and less costly.

Contact us today to schedule an appointment to discuss your questions about orthodontia for your child. You can also learn more by reading the Dear Doctor magazine article “Preventative & Cost Saving Orthodontics.”

You just came in to have your teeth cleaned, but our hygienist is asking you about your general state of health and what medications you are taking. Meanwhile you are wondering why she doesn't just get on with the cleaning.

Dental hygienists are health care professionals who are trained and licensed to preserve your general as well as your oral health. That's why our hygienist begins your visit by asking you about your health history. Some health problems or medications may require special precautions during a dental cleaning. A hygienist also needs to know about your dietary history and other general health questions.

Our hygienist will examine the skin in and around your mouth for sores, lumps, and other areas that could be signs of oral cancer or other problems. She is trained to spot this disease and others.

Dental hygiene is individualized to your own situation. There is not a “one size fits all” solution. During your cleaning, our hygienist will also evaluate the health of your gums and teeth, checking for tooth decay and for inflammation (gingivitis) and bleeding. She will measure the space between your teeth and the surrounding gums, looking for pockets that form when the gums detach from the teeth. Such pockets indicate periodontal disease and can lead to serious problems.

After your health assessment and examination, the actual cleaning will begin. Your dental hygienist will remove deposits of plaque and calculus by using a technique called scaling. Plaque is a biofilm, a film of bacteria that builds up on your teeth. The reason you brush and floss every day is to remove this film from the surfaces of your teeth and gums and from between your teeth. Plaque that is not removed hardens into a mineralized substance called tartar or calculus, and this is what the hygienist removes by scaling.

The next step is a polish to remove surface stains from your teeth and to give your teeth the slick feeling that you identify as clean.

Finally, our hygienist will discuss your state of oral health with you and make suggestions for improvement. Most hygiene appointments take about 45 minutes to an hour. As you can see, during this appointment a lot must be done to preserve your oral health.

If you are in need of a dental cleaning, contact our office today to schedule an appointment. You can learn more about your visit to the hygienist by reading the Dear Doctor magazine article “Dental Hygiene Visit.”

Your smile is one of the first things people notice, but if your pearly whites have lost their luster, chances are you might be hesitant to show them. As we age, our teeth naturally darken, and certain substances can leave teeth stained or discolored, making you appear older. One easy way to turn back the clock is to have your teeth whitened; a safe, painless, and non-invasive way of achieving a young, healthy-looking smile.

Causes of Tooth Discoloration: Exposure to high-levels of fluoride and taking tetracycline antibiotics during childhood can stain the teeth's structure. Smoking cigarettes and using chewing tobacco can also cause tooth discoloration, as well as foods containing tannins such as red wine, coffee and tea. In addition, poor brushing techniques and not flossing regularly cause bacteria to build on teeth resulting in yellow stains.

The Whitening Process: Our office can help you to achieve a brighter smile using either an in-office procedure or an at-home whitening kit. We can help determine the best treatment for your budget, time frame and individual needs. If you choose to have professional whitening done in our office, we will utilize a prescription strength gel sometimes even activated by a concentrated light source. This procedure offers immediate and long-lasting results in less than an hour. After a single treatment, teeth are typically six to ten shades lighter and with proper maintenance, can last five years or longer.

At-Home Results: For those seeking more gradual results, another option is to use custom-fit trays, which our office will make for you to use at home to whiten your teeth. This is generally less expensive, and is very effective at lightening teeth several shades, although it may take a week or longer to see optimal results.

Choosing the Best Procedure: For some people, teeth whitening may not offer adequate results. If you have thin enamel, chipped, uneven or crooked teeth, we may recommend applying porcelain veneers to restore your damaged teeth. Veneers are bonded to the front of teeth to give your smile a straighter, more uniform appearance.

Contact us today to schedule an appointment to discuss any questions you may have regarding teeth whitening. Read more about this topic in the Dear Doctor magazine article “Teeth Whitening: Brighter, Lighter, Whiter.”

Grinding, clenching, and gritting your teeth are common reactions to stress — but their results can be quite complex. Here are some questions and answers that will fill you in on what you may not know about this widespread problem.

My dentist said I was bruxing. What does that mean?
Bruxing means that your teeth are grinding upon each other. Many people carry out this habit subconsciously and are not even aware that they are doing it.

Is bruxing or gritting harmful?
Such habits are called “parafunctional” (from para, meaning outside, and function, meaning purpose). This is because these stress habits exert much larger biting forces — as much as ten times more — than in normal biting and chewing activities. This excess pressure can cause damage to jaw joints and muscles, resulting in muscle spasm and pain; and to the teeth, resulting in wear, fractures or looseness. They can also cause headaches, earaches, and even neck and backaches because of the pressures on various structures in the face and mouth.

What is the usual treatment for problems arising from these stress habits?
The first thing we want to do is relieve your pain and discomfort. Second, we want to stop future damage. Application of heat or cold is helpful, and mild anti-inflammatory and muscle relaxant drugs are prescribed for pain and muscle spasm. To prevent future occurrences, we may treat you with biofeedback or refer you to someone who can offer psychotherapy.

What is a night guard and how can it help?
A night guard is an unobtrusive thin plastic appliance that is made to fit over the biting surfaces of your upper teeth. These guards are so unobtrusive that they can even be worn during the day if your stress level is so high that you grind your teeth during the day. The guard is adjusted to leave the lower teeth free to move against the surface of the guard, but they cannot bite into the upper teeth. This prevents wear on the teeth and lets the jaw muscles relax, preventing the pain of muscle spasm.

Contact us today to schedule an appointment to discuss your questions about stress and tooth grinding. You can also learn more by reading the Dear Doctor magazine article “Stress & Tooth Habits.”

How many of these questions can you answer correctly? The more you know about nutrition and oral health, the healthier you are likely to be.

What are free sugars?
“Free sugars” is a term for sugars including refined cane, beet and corn sugar, which are added to foods or occur naturally in honey, syrups or fruit juices.

You probably know that foods with added sugars are not healthy for your teeth. What is the maximum recommended sugar intake for oral health?
The recommended daily limit for free sugar is 10 teaspoons per day. Note that one can of soda contains over 6 teaspoons.

If a sugary snack is bad for your teeth, what could you substitute that would be better?
Fresh fruits and vegetables would be a better snack. Fresh fruits contain fructose, a sugar that has not been shown to be harmful to teeth if eaten in reasonable amounts.

How can you get enough fluoride to guard your teeth against decay?
If your water supply does not contain fluoride, or if you usually drink bottled water, you may or may not be receiving enough fluoride from your toothpaste. We can assess if you are receiving enough fluoride by examining your teeth, testing your plaque and reviewing your past history of tooth decay. If you are having a problem with tooth decay, we can create fluoride trays for you so you can apply a fluoride solution to your teeth daily.

What is dental erosion and how is it different from tooth decay?
Some acidic foods, particularly drinks such as juices and sodas, wear away your teeth's outer coating (the enamel) when exposed to the teeth's surface. Erosion does not involve bacteria, the cause of dental caries (tooth decay).

Can certain foods stop acidity from attacking your teeth?
Yes, there are foods that reverse the increase in acidity that comes from eating free sugars. One of these is cheese. Cheese stimulates saliva in your mouth, and it contains high levels of calcium, allowing calcium to be added back to your teeth. Many vegetables and starchy whole grain foods require thorough chewing, which also stimulates production of saliva and guards against tooth decay.

We hope you learned some useful facts from this nutrition quiz. If you modify your habits so that you eat less free sugar; drink more water (preferably fluoridated), drink fewer juices and sodas; and snack on fresh fruits, vegetables, and cheese, you can count on having healthy teeth and gums.

Contact us today to schedule an appointment to discuss your questions about diet and oral health. You can also learn more by reading the Dear Doctor magazine article “Nutrition & Oral Health.”

Witnessing or being involved in a sports-related dental injury can be a scary event not only for the player, but also for onlookers even if the injuries turn out to be minor. However, knowing what to do — and more importantly — how quickly to react can make a radical difference to the outcome. This is just one reason why we want to share the following easy-to-remember guidelines for what, how and when you need to respond to various types of dental injuries.

• Immediate — within 5 minutes of the injury: If a permanent tooth is totally knocked out (avulsed), it requires immediate treatment by cleaning and re-implanting the tooth back into its original position to have any hope of saving the tooth long-term. Knocked out baby (primary) teeth are not reimplanted for fear of damage to underlying permanent teeth.
• Urgent — within 6 hours of the injury: If a permanent or primary tooth is still in the mouth but has been moved from its original position, it is considered an acute injury and should be treated within 6 hours.
• Less urgent — within 12 hours of the injury: If a permanent or primary tooth is broken or chipped but has not shifted from its original position, the injury is classified as less urgent. You still need to see a dentist for an exam; however, you generally can wait up to 12 hours before possible irreversible damage occurs.

Want To Learn More?

There are several ways you can learn more about sports-related dental injuries.

• Read the Dear Doctor article, “The Field-Side Guide To Dental Injuries.”
• Download and print the FREE quick reference guide
• Or if you have a traumatized, damaged, chipped or missing tooth from a sports or any other type of injury, contact us to discuss your situation or to schedule an appointment.
]]>Sun, 17 Jul 2011 04:09:10 -0500http://www.smilebrighteners1.com/blog/post/if-you-snore-please-read-more.html

Do you constantly feel like you are running on empty? Do you snore, feel like napping every day, or even drink multiple cups of coffee just for the caffeine boost? You may have a sleep related breathing disorder (SRBD) or Sleep Apnea (“a” – without; “pnea” – breath) in which your airways become obstructed causing chronic loud snoring. The good news is that we can help both diagnose and treat this disorder, which means you will be able to finally get the rest that you (and your sleeping partner) so desperately need.

The reason that sleep apnea is so disruptive to daily living is that it causes awakening for a few seconds up to 50 times per night, significantly decreasing the amount of deep sleep that is necessary for full rejuvenation. Airway blockage during sleep commonly results from obesity, an enlarged tongue or tonsils, and other factors that can cause your airway to close off when you lie down, all increasing the likelihood that you will suffer from sleep apnea. These conditions are dangerous and impair the brain and heart from receiving adequate oxygen, increasing your risk for both stroke and heart attack.

The study of sleep and its disorders is relatively new. One successful way to treat sleep apnea is with a “CPAP” machine which uses a Continuous Positive Airway Pressure mask overnight to keep air passages open while sleeping. Another more comfortable, less noisy, and unobtrusive method is to use Oral Appliance Therapy, which features an appliance like a retainer that can be custom fitted to your mouth made by a dentist trained in sleep medicine.

And yes, dentists are increasingly being recruited to help study and treat sleep disorders. There are actually several ways in which we can help. Because we see our patients on a regular basis, we are uniquely qualified to diagnose early signs of SRBDs. For example, if you start to snore almost immediately after falling asleep in the dental chair, we will be able to discuss this important warning sign with you. We can also examine the back of your mouth to see if you possess any of the traits that point to SRBDs, including large tonsils and/or an elongated uvula — the tissue in the back of your throat that looks like a little punching bag.

So, if you want to stop snoring and start sleeping well or you think you may have a SRBD, call our office to schedule a basic oral exam and consultation. If you would like to learn more about the link between dentistry and the treatment of sleep disorders, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

]]>Sun, 10 Jul 2011 04:07:15 -0500http://www.smilebrighteners1.com/blog/post/understanding-the-4-stages-of-gum-disease.html

Since the dawn of man, periodontal (gum) disease has impacted humans. And while dental health has dramatically improved over the generations, the facts are still clear — millions of Americans are suffering from gum disease and probably do not even know that they have a problem. This is because periodontal disease most often starts without any symptoms or ones that most people tend to discount or ignore.

Stage 1: Gingivitis. The first stage of gum disease is inflammation of the gingiva (gums) without bone loss. While nearly all people will develop gingivitis in the absence of good oral hygiene, only 10 to 15% of them will go on to develop more advanced stages of the disease.

Stage 2: Early periodontitis. With this stage, gingivitis progresses into the deeper periodontal structures — the tissues that attach the teeth to the bone resulting in early or beginning bone loss. About 10% of the population develops full-blown periodontitis with progressive bone loss.

Stage 3: Moderate periodontitis. The third stage of gum disease results in moderate bone loss (20 to 50%) of root surfaces of the teeth due to continued destruction of the surrounding tissues and bone. Periodontal disease is “cyclical” — it goes in cycles with bursts of activity, followed by a period in which the body tries to recover. This is called chronic inflammation, or frustrated healing.

Stage 4: Advanced periodontitis. With the final stage of gum disease, there is severe bone loss (50 to 85%) from the tooth's root. This stage includes looseness of teeth, moving teeth, abscess formation with red, swollen and painful gums. The end results — eating and even smiling is difficult and uncomfortable, and you could lose all your teeth.

You can learn more about gum disease in the Dear Doctor article, “Understanding Gum Disease.”

Have We Described Your Mouth?

If any of the above stages sounds like we are talking about your mouth, contact us today to schedule a consultation, discuss your questions and receive a thorough exam. If addressed promptly and with commitment to following your treatment plan, your mouth can return to good oral health.

]]>Sun, 03 Jul 2011 04:07:53 -0500http://www.smilebrighteners1.com/blog/post/laser-dentistry-faqs.html

For years, lasers have revolutionized the medical industry and now they are beginning to do the same within the field of dentistry. However, anytime new technologies are introduced, people naturally will have questions. Here is a list of frequently asked questions (FAQs).

What is a laser?

Lasers are beams of light that are a single wavelength and color. Laser is an acronym derived from “Light Amplification by Stimulated Emission of Radiation.”

How are they different from regular sunlight?

White light is made up of light with many wavelengths corresponding to the visible spectrum comprising the rainbow (red, orange, yellow, green, blue, indigo, and violet). Laser light consists of beams of a single color and hence a single wavelength of light, concentrated to a high energy level, which can penetrate living tissue.

How are they used in dentistry?

Dental laser usage typically falls into three categories: disease diagnosis; soft tissue procedures of the gums, lips and tongue; and hard tissue procedures of the bone or tooth enamel and dentin. Examples of the most common hard tissue treatments include the diagnosis and removal of tooth decay, while the most common soft tissue treatments include the removal of gum tissue as it relates to cosmetic dentistry and the treatment of gum disease.

Are they safe?

Absolutely! Before blazing a trail in the field of dentistry, lasers have been used for years in the medical field with research evidence and the FDA approving both their safety and efficacy. In fact, they are minimally invasive and can result in less tissue removal, less bleeding and less discomfort for patients after surgery. And what could be better than that?

Want to learn more?

To learn more about lasers and how they are used in dentistry, read the article “Lasers Shine A Light On Dentistry.” And if you want to schedule an appointment, contact us today.

]]>Sun, 26 Jun 2011 04:07:59 -0500http://www.smilebrighteners1.com/blog/post/what-is-a-veneer.html

A veneer is a cosmetic dental procedure that we use in some situations to correct discolored teeth, small spaces or gaps between teeth, small chips or oddly shaped teeth, and teeth that are slightly misaligned by placing a thin shell covering over the teeth. They are artistically hand-crafted by lab technicians out of tooth-colored porcelain using precise molds that we have made in our office. We attach veneers to the tooth's surface using a special adhesive that creates a chemical bond. Veneers are often a key component in a smile makeover.

Traditional veneers will require some tooth preparation, a process where we reduce or file down some of the facial (front, visible) portion of your tooth by 0.3 to 0.7 millimeters. For this reason this cosmetic procedure is not reversible.

How Long Do They Last?

Veneers can last from 7 to 20+ years depending on how you care for them. This may include sleeping in a protective, professionally made mouthguard. And while porcelain is a durable material that can withstand a great deal of pressure, you must remember that they are a type of glass. You could possibly shatter a veneer if you bite into anything that requires a hefty amount of twisting movement and biting pressure.

By using the latest technologies and procedures, we will create the naturally beautiful smile of your dreams and we will restore your mouth to full functionality and optimal health. Contact us today to discuss your questions or to schedule a consultation.

Want To Learn More?

Learn more about veneers when you continue reading the exclusive article from Dear Doctor, “Smile Design Enhanced With Porcelain Veneers.”

]]>Sun, 19 Jun 2011 04:07:46 -0500http://www.smilebrighteners1.com/blog/post/understanding-tooth-sensitivity.html

Tooth sensitivity is an issue that can range from a slight twinge at times to downright excruciating pain. However, before we continue, understanding the cause of tooth sensitivity is helpful to both relieving and treating it.

Tooth enamel is inert in that it has no nerve supply and thus it protects the teeth from temperature and pressure changes — the main cause of sensitivity. Once it is compromised, worn thin, or exposed due to gum recession, it leaves the delicate nerve fibers within the dentin vulnerable to touch, acid, and temperature change. These nerve fibers most often grab your attention when they come in contact with heat, cold, or a “double whammy” combination of both cold and sweet. They also become sensitive to touch — even the bristles of a soft toothbrush can irritate exposed dentin.

As for the causes of tooth sensitivity, one common cause we see is aggressive brushing. Yes, too much brushing can be bad for you! To be more specific, excessive, improper brushing with a sawing back and forth motion can erode the gum tissues, expose, wear, and even groove the dentin. Another cause for sensitivity can be from the destructive process of tooth decay that eats through the enamel and into the dentin.

If you are experiencing tooth sensitivity or have questions about this condition, please contact us to schedule an appointment. Or you can learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”

]]>Sun, 12 Jun 2011 04:07:10 -0500http://www.smilebrighteners1.com/blog/post/sealants-the-protection-your-childrens-teeth-need.html

Protecting your children is one of your most important roles as a parent or caregiver. Dental sealants are one way you can protect your children's teeth from the ravages of tooth decay, drilling and fillings — and they can be applied simply, comfortably and quickly right here in our office.

What is a dental sealant?

A dental sealant is a thin, plastic film that is painted onto the tiny grooves on the chewing surfaces of the back teeth (usually the premolars and molars) to prevent caries (cavities) and tooth decay. And by allowing us to use sealants to seal these little nooks and crannies where your child's toothbrush can't reach, you will dramatically reduce their chances for developing tooth decay. This one, simple and quick office visit could save you both money and time with fewer dental visits and healthier, cavity-free teeth.

So will sealants guarantee no (or no more) cavities?

No, just like life, there are few guarantees. Your child's oral hygiene, regular dental visits, fluoride, sugar consumption and genetics are the other important factors that will determine to what degree your child experiences tooth decay. However, research shows that pit and fissure (chewing surface) decay accounts for approximately 43% of all decayed surfaces in children aged 6 to 7, even though the chewing surfaces (of the back or posterior teeth) constitute only 14% of the tooth surfaces at risk. This demonstrates the vulnerability of the chewing surfaces of the posterior teeth to decay. By placing a protective seal over the areas of teeth at risk, you can effectively and proactively protect your children's teeth.

How long do sealants last?

Research has shown that some sealants can last up to 10 years. However, if you opt for sealants for your children's teeth, we will closely monitor them with each office visit to ensure that they are still doing their job. As needed, we can apply more sealant.

]]>Sun, 05 Jun 2011 04:09:00 -0500http://www.smilebrighteners1.com/blog/post/dental-injuries-the-type-of-sports-you-play-really-matters.html

When it comes to sports, all athletes need to know how to assess their risk for experiencing a sports-related injury as well as how to prevent one. The first step to accomplish this is learning how sports and activities are classified, as they define risks from little-to-no chance of injury to highly susceptible for injuries. These categories include:

• Low velocity, non-contact sports: These sports and activities have the lowest risk, as they typically include sports where the athletes perform individually at reasonable speed without physical contact. Examples include: golf, Nordic skiing, weight lifting, running and swimming.
• High velocity, non-contact sports: These sports and activities are those where athletes move at high rates of speed but with no contact with other participants. While there is no contact, anytime you are moving at high rates of speed, accidents can happen. Examples include: bicycling, motocross, skateboarding, skiing and snowboarding.
• Contact sports: As the title states, these sports and activities include frequent body-to-body contact or body to equipment (e.g., a ball, glove, etc.) contact. Examples include: basketball, soccer, lacrosse, baseball and softball.
• Collision sports: With these sports and activities, strong, forceful, body-to-body or body-to-equipment contact is a primary goal of the sport. Examples include football, ice hockey, rugby, and boxing. Without the proper protective head and mouth gear, participants are highly likely to experience an oral-facial and/or head injury.

The good news is that you can dramatically reduce the odds of serious dental and oral-facial injury by ensuring that you wear a professionally made mouthguard in addition to a helmet, facemask, or other protective gear that is appropriate to the sport. This is especially true if you participate in the high velocity, contact and collision categories. These simple steps can help reduce worries for not only players, but also for parents, caregivers and coaches. For more information, read, “An Introduction To Sports Injuries & Dentistry.” You can also download a FREE, pocket-sized guide for managing dental injuries.

]]>Sun, 29 May 2011 04:07:47 -0500http://www.smilebrighteners1.com/blog/post/your-childs-age-one-dental-visit.html

Parenthood comes with no manual — if it did it would surely include many essential tips to make your job easier while improving your children's lives. One important fact that surprises many people, is the age you should take your children to the dentist for their first dental appointment, age one. The reason that the age one dental visit is so important is that it establishes the foundation of oral healthcare for the rest of their lives. Unfortunately, some parents wrongly assume that because primary teeth “fall out anyway,” they do not need to worry about them. Nothing could be further from the truth!

One problem children may face is Early Childhood Caries (ECC) tooth decay. This is a type of tooth decay that occurs from sucking on a bottle filled with sugary liquids such as formula, juices and fruity drinks for extended periods of time and from a sleep-time bottle. ECC can affect all the primary (baby) teeth in infants soon after they come into the mouth.

Bringing your children into our office for their age one dental visit enables us to establish a friendly, trusting relationship with the whole family while we assess your children's oral health. During this consultation we will identify if the teeth and jaws are developing correctly, whether habits such as sucking on baby bottles are causing tooth decay or if there are other underlying issues that may indicate future problems. And this ounce of prevention often enables us to stop an anticipated problem before it even starts.

]]>Sun, 22 May 2011 04:06:43 -0500http://www.smilebrighteners1.com/blog/post/tooth-sensitivity-faqs.html

It can start with a simple twinge or be as severe as excruciating pain. From time to time, we have patients asking questions about tooth sensitivity — what causes it? What can be done about it? For these reasons, we have put together the following list of frequently asked questions (FAQs) so that you can develop a healthy understanding about this painful and often avoidable condition.

What is tooth sensitivity?

The first layer of protection of the teeth is enamel. Enamel is a dense crystalline structure, the hardest substance produced by animals. It is an inert substance that has no nerve supply and thus it protects the teeth from temperature and pressure changes. When it is compromised, worn thin, or exposed due to gum recession, it leaves the dentin exposed and vulnerable. Unlike enamel, dentin is living and has delicate nerve fibers within it.

What triggers tooth sensitivity?

Once dentin is exposed, it can become sensitive. It typically occurs when the dentin comes in contact with heat, cold, or the “double whammy” combination of both cold and sweets. Even the bristles of a soft toothbrush can irritate exposed dentin causing sensitivity and pain.

What can be done to minimize tooth sensitivity?

One of the simplest ways to minimize or prevent sensitivity is by teaching proper brushing techniques so that teeth are cleaned without causing either sensitivity or damage. Brushing too hard is a frequent culprit. Being overzealous can literally cause gum recession, leave dentin, and wear it away leaving it grooved. Another step to minimize sensitivity is to use a toothpaste containing fluoride. Fluoride increases the strength of tooth surfaces and thus makes teeth more resistant to attack by acids and sweets. If severe, we may need to apply a barrier to cover the sensitive areas. These barriers may range from concentrated fluoride varnishes to replacing lost tooth structure with filling materials.

Want to learn more?

To learn more about this topic, read the article “Sensitive Teeth.” Or if you are suffering from this condition, please contact our office to schedule an appointment. During your appointment, we will conduct a thorough examination to ascertain what is causing your sensitivity as well as what we can do to treat and/or prevent future issues.

]]>Sun, 15 May 2011 04:06:25 -0500http://www.smilebrighteners1.com/blog/post/how-do-clear-orthodontic-aligners-work.html

For adults with a reasonably well fitting bite, but mild to moderate crowding or spaces between your teeth, clear orthodontic aligners can be an ideal solution for straightening your teeth. This is why we offer this treatment option to our patients experiencing these issues. However, for those of you who are unfamiliar with what they are or how they work, this will give you a brief understanding.

Clear orthodontic aligners consist of a series of clear “trays” that fit snuggly over all teeth to slowly shift them into alignment. Patients are typically required to wear them 20 hours per day for about 2 weeks before progressing to the next tray. With each new tray, you are one step closer to achieving your goal of perfectly aligned teeth. The entire process usually lasts 6-18 months depending on how much movement is required to achieve the goals.

Each aligner is individually made from very precise molds of the patient's teeth to ensure proper fit. And we map out the entire alignment process using computer generation from each patient's initial molds so that we can identify the number of trays required. But best of all, clear orthodontic aligners are perfectly smooth with no rough edges like traditional braces, and you can remove them for eating, brushing, and flossing teeth as well as for brief social events.

To learn more about this topic, read the article “Clear Orthodontic Aligners.” Or you can contact us today to discuss your questions or to schedule an appointment.

]]>Sun, 08 May 2011 04:05:17 -0500http://www.smilebrighteners1.com/blog/post/revolutionizing-dentistry-with-lasers.html

We pride ourselves on using the latest, scientifically proven technologies so that we can obtain and maintain optimal oral health for our patients. The word “laser” is an acronym for “Light Amplification by Stimulated Emission of Radiation” and, within the world of dentistry, lasers are used for a variety of procedures and therapies. Simply put, this means that light from a particular crystalline source is stimulated electronically and by the use of mirrors to high energy levels, which can penetrate living tissue. Specific lasers with different light emitting capabilities can be used in dentistry — some on hard tissues and others for soft tissues like gum and oral mucous (skin) membranes within the mouth. Uses include diagnosing cavities, others for removing diseased gum tissues, for example. But best of all, lasers are minimally invasive and can result in less tissue removal, less bleeding, and less discomfort for patients after surgery. For example, using a laser, allows preparation of smaller cavities for fillings by vaporizing away tooth decay often without any anesthesia (numbing of the teeth) or a drill.

If you want to learn more about lasers and how they are used in dentistry, read the article “Lasers Shine A Light On Dentistry.” And if you want to schedule an appointment, contact us today.

]]>Sun, 01 May 2011 04:05:07 -0500http://www.smilebrighteners1.com/blog/post/overcoming-your-fears-of-the-dentist.html

Unfortunately, going to the dentist may still be a fear and anxiety provoking experience for some people even with modern dental techniques — an interesting phenomenon given the fact that no one is born with fear. It is either a learned response based on personal experience or one that is literally imagined based upon hearing of another's treatment. However, regardless of how it develops, a person's perception is their reality. The good news is that we are here to both listen and to offer our patients the benefits of oral sedation (sedation dentistry) that allows relaxation of mind and body. Thus you can focus on feeling peaceful rather than anxious.

While research has shown that 75% of all people surveyed have at least a little fear about going to the dentist, 10-15% have a great deal of fear. In fact, some of these people experience so much fear that they will cancel dental appointments or never schedule in the first place. If the latter describes your feelings, we encourage you to ask us about sedation or comfortable dentistry so that you can receive the oral healthcare you need and deserve to maintain optimal dental health.

And this good news gets even better when you understand that oral sedation does not even involve injections (shots)! We typically administer oral sedation in one of two methods: by giving you a pill to swallow whole or by giving you a tablet to place under your tongue (sub-lingually) where it dissolves. Once the prescription medication takes effect, you will remain awake and aware of your surroundings; however, the medication will help you transition from feeling nervous to a more comfortable state of being. Most of our patients describe their experience as “comfortable” or “relaxation” dentistry due to how they feel during their treatment. Simply put, the anti-anxiety (anxiolytic) medication almost literally dissolves away your fears.

Want to learn more?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more by reading the article “Overcoming Dental Fear & Anxiety.”

]]>Sun, 24 Apr 2011 04:04:24 -0500http://www.smilebrighteners1.com/blog/post/can-a-root-canal-save-my-tooth.html

One of the most common treatments we are asked about is a root canal and the unfortunate bad reputation associated with it. The truth is that the procedure actually relieves the pain associated with the problem and not visa versa. And here's why.

A root canal or endodontic treatment (“endo” – inside; “dont” – tooth) is a necessary procedure in which diseased pulp tissue — and the nerve, which responds by causing the pain — is removed. This is followed by cleaning and sealing the root canals. This usually results from pulp inflammation and infection as a result of a severe decay or in a heavily filled tooth. Root canal treatment is typically performed by general dentists who have taken specialized training or by endodontists, dentists who specialize in the diagnosis and treatment of root canal problems. We perform them here in our practice to save a tooth, literally, from further damage and/or loss.

Here is a quick overview of the procedure. We will begin by making a small opening in the chewing surface of your tooth so that we can access the tooth's root canal. We use small instruments to remove the dead and dying tissues of the pulp. The root canals are cleaned and disinfected. The canals are then sealed with a biocompatible filling material. Lastly, we will seal the access hole with a filling material. You will then need to get a permanent restoration or crown to protect the tooth fully.

If you feel that you have the symptoms of a root canal problem and may need a root canal treatment, contact us to schedule an appointment. And to learn more about the signs, symptoms, and what to expect after root canal treatment, read the article “Common Concerns About Root Canal Treatment.”

]]>Sun, 17 Apr 2011 04:04:07 -0500http://www.smilebrighteners1.com/blog/post/the-truth-about-root-canal-treatment.html

For generations, root canal treatment has received a bad rap. Thought to cause pain, it is actually just the reverse. The truth is that root canal treatment does not cause pain but actually relieves it. Not only does root canal treatment relieve pain, it literally saves the affected tooth or teeth from further damage and/or loss.

To get started, let's define this procedure. A root canal treatment is a procedure in which the diseased pulpal tissue in the root canals are removed, disinfected, cleaned, and sealed. This is usually necessary following inflammation and infection of the pulp — which is the cause of your pain — as a result of severe decay or in a very heavily filled or damaged tooth.

However, if left untreated, an infected tooth can spread into the bone and even cause an abscess — and that can be more painful and impact your overall general health. The good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, it can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our offices as soon as you feel you have a problem with a tooth.

If you are having pain from a tooth or several teeth, you may need a root canal treatment. Please contact us today to schedule an appointment before it gets worse. To learn more about the signs, symptoms, and treatment for a root canal, read the article “Common Concerns About Root Canal Treatment.”

]]>Mon, 11 Apr 2011 10:32:56 -0500http://www.smilebrighteners1.com/blog/post/the-magic-behind-professional-teeth-whitening.html

Whitening your teeth is an easy way for most people to achieve a brighter, more appealing smile. And for older adults, it can also contribute to a more youthful appearance. We are often asked how our tooth whitening products and services stack up when compared to the many over-the-counter (OTC) products available at discount and drug stores. The following are some key facts to understand about teeth whitening so that you can receive the results you want.

What is the real difference between professional products and ones I can buy over-the-counter?

Whether you purchase over-the-counter whitening strips, toothpaste, mouthrinses, or “paint on” tooth whitening products, you are basically receiving the same product, but with a lower concentration of carbamide peroxide, the chemical responsible for teeth whitening. And while some of the products may contain a slightly higher concentration of this solution, they all are under strict governmental guidelines for ensuring you experience little to no side-effects as long as you follow the instructions. However, with our bleaching products and services, you are under the care of a trained professional and thus can receive much higher concentrations without compromising your health or the health of your teeth. This fact means that under our care you can achieve more dramatic results faster.

How long will the results last?

Bleaching is not a permanent solution; thus, your results will diminish over a six-month to one year period of time. However, it doesn't take much to touch up or maintain your white smile in a single visit, or with custom-made whitening trays that we can provide for home use. You can also keep your brighter smile a little longer by avoiding food that stains your teeth. And when drinking coffee, tea, cola, wine and other drinks like these, sip them using a straw so that they are less likely to discolor your teeth.

Is bleaching safe for my teeth?

We pride ourselves on providing and promoting optimal oral healthcare and thus would never offer any products or services that are unsafe. Additionally, there are numerous studies supporting the overall safety of whitening your teeth. We are careful to avoid sensitivity, which is an occasional side effect of intensive bleaching, and we suggest protecting the teeth with fluoride.

Want to learn more?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more by reading the Dear Doctor article, “Teeth Whitening: Brighter, Lighter, Whiter....”

]]>Mon, 04 Apr 2011 11:19:06 -0500http://www.smilebrighteners1.com/blog/post/what-is-a-crown.html

A dental crown is a tooth-shaped “cap” or cover that we place over a tooth that is badly damaged from trauma or decay to restore its shape, strength, size and functionality. We also use them for cosmetic reasons to improve a tooth's appearance with natural, life-like results. Crowns are generally handcrafted by dental laboratory technicians using high-quality dental porcelains (ceramic materials) that are made to fit on precise replicas (molds) of the prepared teeth. In our office, we generally make temporary crowns to protect the teeth to keep them comfortable and functional while the permanent crown(s) is being made. And once a crown is placed (cemented into position), it fully encases the entire visible portion of the tooth that lies at and above the gum line.

When Are They Necessary?

There are many reasons a crown may be needed. Some of these include:

• To repair a tooth that is worn down, broken or badly damaged by decay or injury.
• To restore a tooth so severely damaged by decay that the tooth's structure is no longer intact enough to place a filling or where a filling can't restore the tooth to its former strength.
• To protect a tooth that has minor cracks or fractures from further damage.
• To create a bridge to replace a missing tooth, in which the teeth on either side, known as abutments, must be “crowned” to attach to the “pontic” (from the French word, “pont” that means bridge).
• To create the visible part of the tooth that sits atop a dental implant.
• To improve the appearance of a tooth providing a more appealing shape and color.

To learn more on this topic, read the Dear Doctor article, “Porcelain Crowns & Veneers.” You can also contact us to discuss your questions or to schedule a consultation.

]]>Mon, 28 Mar 2011 08:41:31 -0500http://www.smilebrighteners1.com/blog/post/test-your-dental-injuries-iq.html

Every parent, caregiver, coach, sports fan and especially injured party dreads the moment when an injury to the mouth occurs during a sporting event. The first thought observers have after looking closely to see if it is their child or someone they know is, “I hope someone knows what to do!” Do you know what to do in case of a dental sports emergency? Test your dental injury IQ with this simple, quick quiz. The answers are listed at the bottom of this article.

Dental Injury IQ

1. If a tooth (including its root) is totally knocked out, what can you safely store it in while finding a dentist within 5 minutes of the injury?
1. Water or salt water
2. Milk (preferably cold)
3. Inside the cheek (mouth) of the injured person
4. All of the above
2. True or False: Immediately following the injury, fresh cold tap water or bottled water is the best way to remove debris from where a tooth was knocked out.
3. If a tooth has shifted from its original position following an injury, you should...
1. See a dentist within 5 minutes
2. See a dentist within 6 hours
3. See a dentist within 12 hours
4. Only see a dentist if the tooth is not better in a few days
4. True or False: You treat a knocked out baby tooth in the same manner as you do a permanent tooth.
5. The most important thing to do to save a tooth that has been completely knocked out of the mouth is to…
1. See a dentist as soon as possible
2. Replant the tooth within 5 minutes
3. Stop the bleeding before re-planting the tooth
4. Rinse the tooth with fresh, clean water

The Answers

1) d = all of the above, 2) true, 3) b = see a dentist within 6 hours, 4) false – baby teeth are typically not replanted, 5) b = replant the tooth within 5 minutes

Want To Learn More?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about treating dental injuries when you read the Dear Doctor article, “The Field-Side Guide To Dental Injuries.” Or, you can download a FREE, pocket-sized guide for managing dental injuries.

]]>Mon, 21 Mar 2011 13:49:11 -0500http://www.smilebrighteners1.com/blog/post/do-you-need-a-smile-makeover.html

We are often asked about restorative and cosmetic dentistry procedures and the role they play in a smile makeover. We are also faced with people wondering whether or not they can benefit from treatment. For this reason, we developed the following self-assessment to help you determine whether or not cosmetic dentistry is right for you.

• Do you avoid smiling in public or for photos?
• Are you self-conscious about spaces and gaps between your teeth?
• Do your teeth make you look older than you feel?
• Have you ever held back or restrained a smile?
• Do you feel that your teeth are stained or yellow?
• Do you hold your hand in front of your mouth when talking, laughing or smiling?
• Do your teeth look old and worn down, making you look and feel older?
• Do your teeth appear short because of a “gummy” smile?
• Are your teeth crooked, chipped or crowded?
• Do you wish you had someone else's smile?

If you answered, “yes” to one or more of the above questions, then you could benefit from a smile makeover. However, that is the easiest part of the process. The next step is the one that probably matters the most — scheduling a consultation with us. During this appointment you can discuss the specifics that bother you about your smile using your responses from our self-assessment test. You can also learn about the many treatment options available for providing you with the smile of your dreams.

Ready To Take The Next Step?

Contact us today to discuss your smile makeover questions or to schedule a consultation. Or, learn more now when you continue reading the Dear Doctor article, “The Impact Of A Smile Makeover.”

]]>Mon, 21 Mar 2011 13:25:45 -0500http://www.smilebrighteners1.com/blog/post/what-our-office-can-do-about-your-snoring-or-sleep-apnea.html

Snoring and Obstructive Sleep Apnea (OSA) is a condition that occurs when the upper airway (back of your throat) collapses or is blocked, causing significant airflow disruption. A person with OSA continues snoring at a regular rate but is interrupted by long silent periods during which there is no breathing for atleast 10 seconds or more. Believe it or not, this issue affects millions of people worldwide. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. And if you have OSA that is left undiagnosed and untreated you could fall victim to heart attacks, strokes, irregular heartbeat, high blood pressure, heart disease and even impotence. For these reasons, we feel it is important that you understand the real-world consequences that can occur if you ignore your OSA.

Reality is that most people are unaware that their dentist can be an excellent resource in helping to diagnose and treat OSA. However the first and most important step is to receive a proper, thorough examination and diagnosis with an appropriately trained physician and dentist. If after completing this process you are diagnosed with OSA, we will discuss treatment options. Some of these may include:

• Suggesting that you exercise and lose weight if you are overweight.
• Sleeping with a Continuous Positive Airway Pressure (CPAP) machine that provides pressurized air into your airways through a mask that covers both your nose and mouth while sleeping.
• Sleeping with a professionally made oral appliance or mouthguard that can reposition your lower jaw, tongue, soft palate and uvula (the dangling tissue in the top, back portion of your mouth) into a better position during sleep to relieve blockage.

If you are ready to discuss you questions and concerns about your snoring, or the snoring habits of another family member, contact us today to schedule a consultation. You can also learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.”

]]>Mon, 14 Mar 2011 09:13:27 -0500http://www.smilebrighteners1.com/blog/post/what-scientific-studies-reveal-about-smile-makeovers.html

A generation ago, hearing the term, “smile makeover,” would most likely have resulted in questions and puzzled looks. However, through the power of both the media and celebrities, today it has become a common household term with over 70% of all inquiries coming from people in the 31 to 50 year old age group, according to the American Academy of Cosmetic Dentistry (AACD). While some people seek cosmetic dentistry purely to boost their self-esteem, others pursue it to improve first impressions during business and social interactions, as many studies have revealed that first impressions are the ones that typically last the longest.

The AACD study also revealed other interesting statistics that support why a smile makeover is a wise choice that can yield a life-changing return on your investment — you!

• 99.7% of Americans believe a smile is an important social asset.
• 74% feel an unattractive smile can hurt chances for career success.
• 50% of all people polled were unsatisfied with their smile.

Another important study recently conducted by Beall Research & Training, Inc., an independent marketing research firm, used before and after photos of smile makeovers for polling purposes. The research found that people who have had a smile makeover are viewed by others as more attractive, intelligent, happy, successful in their career, friendly, interesting, kind, wealthy, and appealing to the opposite sex. This evidence clearly proves just how important a first impression can be as well as what it can silently communicate about you.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule a consultation. We look forward to meeting with you to learn about your specific concerns and to show you what we can do for you. You can also learn more by reading the Dear Doctor article, “The Impact Of A Smile Makeover.”

]]>Mon, 07 Mar 2011 09:45:27 -0600http://www.smilebrighteners1.com/blog/post/does-mouthwash-cure-bad-breath.html

In our office, many of our patients are always asking us if over-the-counter (OTC) mouthwashes or mouthrinses are truly effective tools for curing bad breath. Unfortunately, nearly all of them merely mask any odorous smells temporarily — regardless of how refreshing they taste. There are mouthrinses available that are effective for treating gingivitis and tooth decay, but you must visit our office to obtain a proper diagnosis and a prescription for them. Reality is that a mouthrinse alone can't cure bad breath; however, there are products available that can make a positive impact on your dental health. The key is to match the right mouthrinse to your specific dental need.

• OTC mouthrinses that contain about 0.05% sodium fluoride are an effective tool that when combined with good oral hygiene can significantly reduce the development of tooth decay.
• OTC mouthrinses that contain alcohol, triclosan, sanguinaria extract, zinc and/or essential oils such as menthol can somewhat help reduce the bacteria in plaque, which in turn can reduce gum inflammation (gingivitis) and bad breath when used in combination with proper brushing and daily flossing.
• Prescription mouthrinses containing chlorhexidine may be more effective in helping to control both gingivitis and tooth decay in certain circumstances. This is because chlorhexidine inhibits the formation of dental plaque by preventing bacteria from sticking to your teeth.

While bad breath may seem unbearable, it is often treatable. The key is to determine and then address what is causing your bad breath. A simple trip to our office for a proper exam, assessment and thorough cleaning along with improved oral hygiene may just do the trick. Contact us today to schedule a consultation for an examination and treatment plan.

Learn More

To learn more about mouthrinses, read the Dear Doctor article, “Mouthrinses.”

]]>Sun, 27 Feb 2011 04:02:16 -0600http://www.smilebrighteners1.com/blog/post/smile-makeovers-mdash-planning-for-your-wedding.html

Of major importance in all wedding day plans is to ensure that you have your special day captured on film. And it is that fact that influences most brides and grooms to take a long and hard look in the mirror to observe their smiles. Not only do wedding dates motivate many brides and grooms to address concerns regarding their smile, it also serves as the perfect time for their parents to pursue their smile makeover dreams so that they too feel good about themselves in your wedding photos.

A proper smile makeover should have a two-fold design plan that ensures you obtain optimal functionality and oral health while creating the cosmetic look you want. Starting with the basics, a thorough dental cleaning is the least expensive way to remove stains and freshen both your smile and breath. We will also use this consultation to learn about your concerns, goals, expectations, and wedding day timeline to create the action plan for future treatments in reaching your smile makeover goals. You may also want to discuss whitening your teeth during your appointment, as whitening teeth is an effective way to brighten your smile a few shades in as few as 1 to 2 appointments plus whitening while at home.

If your smile makeover is a bit more challenging, relax. There are a wide variety of tools and techniques available that include bonding, veneers, crowns, bridges, and dental implants for restoring your smile. Or we may work closely with a specialist such as an orthodontist to straighten your teeth or a periodontist for periodontal plastic surgery that can alter your gum tissues and their relationship with your teeth. The most important tip to remember is to schedule your first dental appointment soon after you become engaged so that you have plenty of time prior to the big day to attain your picture perfect wedding day smile.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule an appointment. You can also learn more by reading the Dear Doctor article, “Planning Your Wedding Day Smile.”

]]>Sun, 20 Feb 2011 04:02:25 -0600http://www.smilebrighteners1.com/blog/post/sports-related-dental-injuries-mdash-determining-your-risks.html

A recent study revealed that on average there are 22,000 dental injuries in children under the age of 18. This alarming reality makes it clear that parents, caregivers, and coaches need to understand the risks for dental injuries so that they are best equipped to prevent them...or at least be prepared to manage one should it occur. The four most common categories for measuring risks associated with sports injuries are:

• Age: Age is an important factor when accessing risk. Sports-related dental injuries tend to spike during the teenage years. Recent research shows that children under the age of 13 tend to not be injured as often.
• Gender: Gender is probably the second most influential factor. The facts are that males top the list for experiencing dental injuries during sports or vigorous activities. However, more and more females are playing highly competitive and contact sports or activities; thus, their risk of injury is increasing.
• Shape and position of your teeth: Both the condition and positions of the teeth affect their risk of injury. More prominent or “buck” teeth are considered a higher risk for injury than teeth in a more normal position. Furthermore, 80% of all dental injuries involve the upper front teeth.
• Sports type: This last category is the one most often asked about, as parents, caregivers and athletes want to know which sports or activities have the highest risks for dental injuries. And while baseball and basketball top the list, the American Dental Association (ADA) has put together a comprehensive list of sports and activities. To review this list, read the Dear Doctor article, “Athletic Mouthguards.” The ADA also urges athletes to wear professionally-fitted mouthguards to protect against dental and facial injuries.

Knowing the above categories can help you assess your risk for a dental injury while playing in a sport or recreational activity. To learn more about sports-related dental injuries, read, “An Introduction To Sports Injuries & Dentistry.” Or if you have a traumatized, damaged, chipped or missing tooth from a sports or any other type of injury, contact us to discuss your situation or to schedule an appointment.

]]>Sun, 13 Feb 2011 04:01:44 -0600http://www.smilebrighteners1.com/blog/post/dental-crown-faqs.html

Dental crowns are excellent tools that we use to restore functionality, color and/or beauty to teeth and your smile. And while many people may have heard of them, often times there are many questions surrounding the process, costs and their maintenance. This is why we have put together this list of some of the questions we are commonly asked on this subject. Our goal is to provide you with straightforward answers so that you have a clearer understanding of the treatment and are comfortable making the decision to go forward with these excellent tooth restorations should they ever be required.

What Is A Crown?

A dental crown is a tooth-shaped “cap” or cover that a dentist places over a tooth that is badly damaged from trauma or decay in order to restore its color, strength, size and functionality. They are also used for cosmetic reasons to improve discolored or misshapen teeth.

Why Can The Cost Of Crowns Vary?

The reason the cost of a crown can vary greatly, even from dentist to dentist is quite simple. The most beautiful crowns require the artistry and years of experience of a team of dental professionals; your dentist and the laboratory technicians that handcraft crowns. To meet higher expectations of some individuals requires more experience, artistry and skill. And great art just tends to cost more. A customized temporary crown may even be used as a preview to see what a final crown will look like. Another critical factor is the choice of materials used. For example, while all porcelain crowns are made from high-quality ceramic (glass) material, they are not equal. It is therefore more expensive in terms of time, skill and expertise to produce the most natural looking results.

How Long Will A Crown Last?

Most dentists expect a crown to last at least 7-10 years with normal wear and proper maintenance. However, depending on the materials used and location of the tooth, they can last upwards of 50 years or more. For example, a gold crown has the longest lifespan because gold is such a durable material that has little to no negative impact on surrounding teeth. On the other hand, porcelain produces a completely natural look but can cause wear to adjacent teeth.

What Materials Are Most Often Used For Crowns?

The three most common materials used to make crowns are as follows:

• Gold
• Porcelain-Fused-to Metal (PFM)
• All porcelain

To learn more on this topic, read the Dear Doctor article, “Porcelain Crowns & Veneers.” You can also contact us to discuss your questions or to schedule a consultation.

]]>Sun, 06 Feb 2011 04:00:46 -0600http://www.smilebrighteners1.com/blog/post/are-porcelain-veneers-right-for-you.html

If you are unhappy with your smile or the way some of your teeth appear, porcelain veneers may be the solution to your concerns. They are a fast, effective, and well-proven method for cosmetically enhancing your smile — and a secret that Hollywood and other celebrities have been taking advantage of for years. To help you determine if they are right for you, here are some questions we typically receive.

What is a veneer?

A veneer is a custom made thin “shell” or thin layer of a dental ceramic material (usually porcelain) used to replace the front, visible surface of the tooth. They are artistically and hand-crafted using a precise model of your mouth and teeth to achieve a natural look.

What can they do for me?

Veneers are the optimal choice for correcting small to medium gaps between teeth; slight rotations of teeth causing them to be misaligned; oddly shaped, chipped, or “short” teeth; as well as teeth that are discolored or unevenly colored. However, veneers have their limitations, too. They cannot correct bite issues, poor tooth position, or profile issues. It is also important to note that if you have this procedure, we will typically need to remove a small amount of enamel from your teeth to accommodate the veneer and produce dramatic improvements to your smile.

How long will they last?

While they can vary widely from person to person, porcelain veneers usually last from 7 to 20 years. Factors that impact this timeline include your oral hygiene habits, diet, lifestyle, as well as how well you protect your veneers during sleep and while playing sports.

Have more questions?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about veneers by reading the Dear Doctor article, “Smile Design Enhanced With Porcelain Veneers.”

]]>Sun, 30 Jan 2011 04:00:27 -0600http://www.smilebrighteners1.com/blog/post/some-facts-about-thumb-sucking.html

It may alarm some people, but finger or thumb sucking is a completely normal activity for babies and young children. In fact, sonograms often reveal babies sucking a finger or thumb while still in the womb! However, if children are allowed to suck fingers, thumbs or pacifiers indefinitely, it can become problematic, with serious consequences particularly as they get older.

The list below contains important facts about thumb sucking and pacifiers that all parents of young infants should know.

• The American Academy of Pediatric Dentistry recommends that parents and caregivers encourage children to stop thumb sucking by age 3.
• Recent studies have shown that pacifier use after the age of two may cause long-term changes in the mouth; thus these researchers recommend stopping pacifier use by 18 months.
• If thumb and finger sucking habits do not stop soon enough, the upper front teeth may tip toward the lip or not come into the correct position in the mouth.
• Most children who suck their thumbs or fingers tend to stop between the ages of 2 and 4.
• For obvious reasons, a pacifier habit is often easier to break than a finger or thumb-sucking habit.
• One tip for encouraging older children to stop this habit gradually is to use behavior modification with appropriate rewards given at pre-determined intervals to refrain from using a pacifier, or sucking fingers or a thumb.

Be sure to inform us if any of your children suck their fingers, thumb or a pacifier so that we can begin monitoring their development. Our general recommendation is that you schedule an appointment around your child's first birthday.

]]>Sun, 23 Jan 2011 04:00:27 -0600http://www.smilebrighteners1.com/blog/post/caring-for-your-pets-oral-health.html

While pets are loving members of many families, they are often overlooked when it comes to their oral health. In fact, by age 3, 80% of dogs and 70% of cats show some signs of oral disease, according to the American Veterinarian Dental Society. This is because bacteria and tartar impact your pet's mouth causing periodontal (gum) disease just as it does in humans. You can tell if your pet has this problem if you see signs of red, swollen and bleeding gums and persistent bad breath. Other signs of trouble include changes in eating habits, irritability, excessive drooling or your pet pawing at its face. And this can be serious. It can also contribute to life-threatening conditions that could all be avoided with proper oral healthcare.

Another problem that primarily impacts dogs is broken teeth. Injury can expose pulp and nerve endings, which can become extremely painful. This situation gets worse when food and debris become impacted in or between teeth attracting bacteria that can lead to infection. While broken teeth are not a big issue with cats, studies have revealed that at least 28% will develop painful lesions in the mouth.

The good news is that you can prevent most of your pet's oral health problems by routinely brushing your pet's teeth with a soft bristled toothbrush. It is critical that you use toothpaste made specifically for pets and never use your own “human” toothpaste. Your toothpaste can give your pet an upset stomach if swallowed. This is the same effect it can have on humans if swallowed and the reason you must closely monitor young children when they brush their teeth.

It is also important that you take your pet in for routine dental care checkups from your veterinarian. During these visits, your veterinarian can assess your pet's oral and dental health, help prevent disease and promote good general health. Following these simple tips will help ensure you keep you pet happy and healthy.

]]>Tue, 18 Jan 2011 16:58:38 -0600http://www.smilebrighteners1.com/blog/post/mouthguards-is-your-child-or-athlete-protected.html

Nearly everyone who has ever played a sport, or had a child participate in one, has had that panic-filled moment when they witness an injury. And when you consider that there are more than 22,000 dental injuries each year in children younger than 18 years of age, you see there is fact to backup this concern. This is just one reason why we strongly encourage all of our patients who are involved in activities such as football, soccer, hockey, wrestling, lacrosse, skateboarding, field hockey and more to wear one of our custom-fitted professional mouthguards. It is especially true for basketball and baseball, which are responsible for the largest number of dental injuries.

The following are some key issues to help you understand the importance and advantages mouthguards offer.

Is there a way to determine who is at the highest risk for sports injuries?

Yes there are several. Age, gender, dental anatomy, and the type of sports being played are the four categories used to measure the risks for dental injuries. Young male teens still top the list of most likely to be injured; however, the gap is closing with more females getting involved in sports. Learn which sports or exercise activities made the American Dental Association’s list of recommendations for using a custom mouthguard, when you continue reading “Athletic Mouthguards.”

What's the difference between a “boil and bite” mouthguard and a professionally made mouthguard?

We are often asked this very important question. While some over-the-counter (OTC) mouthguards provide what is advertised as a “custom-fit” to your teeth, it is nowhere near the fit — and thus protection — you receive from our mouthguards that are crafted from precise molds of your teeth. Additionally, because all aspects of our mouthguards are tailored to each specific mouth, they provide much more protection and comfort. This important fact can enhance performance as the athlete can literally breathe easier while wearing one of our mouthguards.

What can I do if I witness a dental injury?

The first important fact to know is that you do not have to be a dental or healthcare professional to assist. However, before jumping in to help out, consult Dear Doctor's Field-Side Guide to Dental Injuries. This pocket-sized, quick-reference guide details what you should do at the scene of a dental injury based on the type of injury. But best of all, it is available to you free of charge from Dear Doctor.

Want to know more?

Contact us today to discuss your questions or to schedule an appointment.

]]>Mon, 10 Jan 2011 10:21:18 -0600http://www.smilebrighteners1.com/blog/post/preventing-childrens-tooth-decay.htmlHow can I help my child prevent tooth decay? Brushing teeth after meals, regular flossing and fluoride treatments are the best ways to prevent tooth decay. Children should also be supervised as they brush. A good rule of thumb is when children can dress themselves and tie their own shoes, then they are ready to brush unsupervised. Children should be supervised in proper flossing techniques until age of 10. If you have any concerns about your child's dental health or want some tips on preventing tooth decay,call our office today.

 

]]>Tue, 04 May 2010 10:41:41 -0500http://www.smilebrighteners1.com/blog/post/bacteria-in-and-around-the-gumline.htmlSome people don't accumulate dental plaque and calculus.Most of us need to visit hygienists to get our teeth cleaned periodically. As dental hygienists can tell you, the smell of what comes out between our teeth and our gums can be AWFUL. These areas are perfect hiding places for bacteria. The bacteria that grow beneath the gum lines are a combination of those that use oxygen and those that can grow only when there is no oxygen (anaerobes). These 2 kinds of bacteria live in harmony, the first type using the available oxygen, and the second kind taking advantage of the oxygen-free environment. The aerobic bacteria may also play a role in clipping the sugar residues off the glycoproteins found in the mouth. This makes the resultant proteins more conducive to breakdown by the anaerobes. The anaerobes are responsible for the SMELL---a fierce combination of volatile sulphur compounds combined witha variety of others, possible including nitrogen-containing gases such as cadaverine (smell of dead animals), putrescine (smell of decaying meat), and other odors.
]]>Tue, 27 Apr 2010 14:54:28 -0500http://www.smilebrighteners1.com/blog/post/dental-emergencies.htmlGetting to a dentist within 30 minutes can make the difference between saving and losing a tooth. Dental emergencies can be avoided by taking some simple precautions, such as wearing a mouth guard during sports and recreation and staying away from hard food such as candy that may crack a tooth. Accidents do happen however, and it is important to know what actions to take immediately. Injuries to the mouth may include teeth that are knocked out, forced out of positon and loosened or fractured. In addition, lips, gums, or cheeks can be cut. Oral injuries are often painful and should be treated by a dentist as soon as possible. Call our office for any quesstions you may have.
]]>Tue, 27 Apr 2010 13:43:04 -0500http://www.smilebrighteners1.com/blog/post/teens-oral-health.html Why should i make time for healthy habits? Quick meals in the form of "nutrition" bars and fast food help keep you alert and on schedule between school, extracurricular activities, and part-time jobs. However, today's fast-paced lifestyles threatens to leave the teen generation with permanent damage to oral and over-all health. You can keep travel-size brushes in lockers or back packs. Chewing sugarless gum with xylitol after meals or snacks can also help cleanse your mouth. Drinking water throughout the day can help clean your teeth of excess bacteria and food debris.
• Drs. Dolgow and Fiacos encourage all teens to see their dentist twice a year. Regular dental visits can help catch minor problems before they become major ones!
]]>Thu, 01 Apr 2010 12:18:42 -0500http://www.smilebrighteners1.com/blog/post/www.html
• Healthy Gums Keep Joints Moving...Maintaining a healthy mouth has many health benefits, and researchers from the Case Western Reserve University School of Dental of Medicine and the University of Cleveland have found one more-improved joint health. In a may 2009 study, the researchers found that individuals who suffer from periodontal disease, as well as a severe form of rheumatoid arthritis, experienced reduced arthritic pain, a decreased number of swollen joints, and a lessened degree of morning stiffness after they received treatment for, and were subsequently cured of, their gum disease. These findings strengthen the link between oral health and overall health.

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.