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Posts for: October, 2013

EndtheEmbarrassmentofStainedTeethwithWhitening

You have a beautiful smile, but you hesitate to show it because of your stained teeth. Fortunately, whitening techniques could take away that embarrassment.

There are two basic types of tooth staining or discoloration: extrinsic, in which the stain is on the surface of the teeth and mostly caused by substances like coffee, wine or tobacco; and intrinsic, which occurs deep within the tooth, caused by such factors as aging, previous dental treatments and fillings, the use of antibiotics (tetracycline, predominantly), or over-exposure to fluoride.

Whitening or bleaching is an effective and relatively affordable solution for many instances of both intrinsic and extrinsic staining. Bleaching solutions are available in over-the-counter (OTC) home kits or as a professional application in the dental office.

Most bleaching solutions use carbamide peroxide, a chemical compound that is effective in removing most stains. OTC home applications contain carbamide peroxide (or an equivalent) in concentrations of about 10% as opposed to 15-35% found in professional solutions. Though less costly than a professional application, OTC products take longer (usually up to three weeks) to achieve desired results. With its stronger solution, a professional application in our office can achieve the same level of brightness in only one or two visits. We may also use special lighting to accelerate the chemical process, as well as rubber dams or gels to protect gums and soft tissues from solution irritation during the procedure.

Although effective, whitening isn't a permanent solution — over time the effect will fade, usually six months to a year depending on how you care for your teeth. Matching tooth color can also be difficult in some cases, especially if you have a mix of natural teeth and artificial crowns or bridges. And, whitening may not be adequate for some types of staining.

Regardless of which application you wish to use — OTC or professional — it's a good idea to visit us first for a professional consultation. We can recommend whether whitening is a good choice for your particular type and level of staining, or if some other option like porcelain veneers might be the better choice. Regardless, there are solutions to the problem of staining, and a way to gain a brighter smile.

If you would like more information on bleaching, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Whitening.”


TestingYourKnowledgeWhatDoYouKnowAboutBadBreath

Bad breath, medically known as halitosis (“halitus” – breath; “osis” – disorder) is an unpleasant condition that can negatively impact your personal and business relationships. It's more than just embarrassing! In fact, one recent survey found that three out of five people would rather work with someone who talks too loudly than with someone who has bad breath! Gum, mints and mouth rinses can temporarily remedy the situation, but not cure it permanently. So how much do you know about the underlying causes of bad breath?

The following true/false quiz will help you discover, while learning more about bad breath.

Questions

  1. The most common orally related sites associated with bad breath are the tongue and gums.
  2. Systemic (general body) medical conditions can't cause bad breath.
  3. Bad breath is always worse in the morning.
  4. Effective treatment depends on the underlying cause of the disease.
  5. Dentists can do very little to diagnose the cause of bad breath.

Answers

  1. True. The back of the tongue and diseased gums can become repositories for bacteria. In the case of the tongue they are from left over food deposits and even post-nasal drip. Bad breath that emanates from the tongue has a “rotten egg” odor caused by volatile sulfur compounds (VSCs).
  2. False. Medical conditions can cause bad breath including lung infections, liver disease, diabetes, kidney infections and cancer.
  3. True. Saliva flow decreases during the night making the mouth feel dry, and giving you that typical “morning breath” taste and odor upon wakening.
  4. True. As with any medical condition, uncovering the origin will dictate appropriate treatment. For example, tongue scraping or brushing can help eliminate odor that originate from the tongue. If the cause is disease related, the disease will need to be treated to control associated bad breath.
  5. False. There are several things dentists can do starting with a thorough medical history and oral examination. For example, decayed or abscessed teeth, diseased gums, coated tongue or infected tonsils are all common oral causes. We can also conduct breath tests to determine if the odor is emanating from the mouth or lungs, and test to determine the level of VSCs in the mouth.

Learn More

Worried about bad breath? Are you ready to trade your breath mints for a more permanent solution? Call our office today to schedule an oral examination. For more information about the causes of bad breath, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”


TreatingtheImmediateandLong-TermEffectsofaGumAbscess

If you have recently noticed swelling, bleeding or pain in your gums, you may have developed a gum abscess. It's the result of periodontal disease, an infection in the gum tissue caused by bacterial plaque that has adhered to the teeth. It's important in the short term to treat the abscess, and in the long-term the underlying gum disease for the survival of the affected tooth and your overall health.

A gum abscess is a sac filled with infection that has developed between the tooth and gum. Besides swelling, you may also notice tenderness when you bite down on a tooth or feel that the tooth is loose. If the abscess originates from a root canal infection it tends to be much more painful, and the pain will seem generalized rather than from a specific tooth.

The first step in treatment is to drain the abscess. We would numb the area with a local anesthetic and then allow the infection to drain. After drainage we would clean and irrigate the infected root surfaces to remove any noticeable bacterial plaque, and possibly prescribe antibiotics and anti-inflammatory medication to reduce swelling and pain. The drained abscess should heal in a few days to a week.

The next step is to treat the underlying cause of the abscess. Depending on what we find in our examination, this can include root planing and scaling (deep plaque and tartar removal), or a root canal treatment where the infected pulp within the root canal is removed, and the canal is then cleaned, filled and sealed.

It's also a good idea for patients with gum disease to have a thorough health checkup. It's possible that other general health conditions such as diabetes or heart disease may be contributing to the gum disease, and vice-versa.

Treating a gum abscess and the underlying cause is about more than relieving pain or discomfort — you're also protecting your dental and general health.

If you would like more information on the treatment of abscesses or gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal (Gum) Abscesses.”


By Mark Lukin
October 11, 2013
Category: Oral Health
Tags: dental injuries  
GivingaKnockedOutToothaSecondChance

It can happen in an instant — your child takes a hard hit to the mouth while playing football, basketball or some other contact sport. Suddenly, he or she faces the severest of dental injuries: a knocked out tooth.

There's both good and bad news about this situation. First, the good news: the knocked out tooth can be reinserted into its socket and take root again. The bad news, though, is that the tooth has only the slimmest of chances for long-term survival — and those chances diminish drastically if the reinsertion doesn't take place within the first five minutes of the injury.

Outside of the five-minute window, it's almost inevitable that the tooth root won't reattach properly with the tiny fibers of the periodontal ligament, the sling-like tissue that normally holds the tooth in place to the jawbone. Instead, the root may fuse directly with the bone rather than via the ligament, forming what is called ankylosis. This will ultimately cause the root to melt away, a process known as resorption, and result in loss of the tooth.

Of course, the resorption process will vary with each individual — for some, tooth loss may occur in just a few years, while for others the process could linger for decades. The best estimate would be four to seven years, but only if the tooth receives a root canal treatment to remove any dead tissue from the tooth pulp and seal it from possible infection. Over time the tooth may darken significantly and require whitening treatment. Because the tooth may be fused directly to the jawbone it can't grow normally as its neighbor teeth will and thus may appear uneven in the smile line. From a cosmetic point of view, it may be best at that time to remove the tooth and replace it with an implant or other cosmetic solution.

In many ways the longevity of the tooth post-injury really depends on time — the time it takes to reinsert the knocked out tooth into its socket. The quicker you take action, the better the chances the tooth will survive.

If you would like more information on treating a knocked out tooth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Knocked Out Tooth: How Long Will a Tooth Last After Replantation?


By Mark Lukin
October 03, 2013
Category: Oral Health
Tags: sleep apnea   snoring  
FiveThingsYouShouldKnowAboutSleepApnea

Sleep apnea, a form of sleep-related breathing disorders that is estimated to affect some 22 million Americans, is sometimes thought of as the “quiet culprit” lurking behind many other maladies. But ask anyone who sleeps alongside a sufferer, and you'll get a different response: It isn't quiet at all! Instead, it's often marked by loud snoring and scary episodes where breathing seems to stop. If you've ever worried that you or someone you care about may have this condition, here are five facts you should know.

1) Sleep apnea is a potentially deadly disease

For one thing, it leads to chronic fatigue that can make accidents far more likely — a special concern in potentially dangerous situations, like operating machinery or driving a vehicle. It also appears to be related to heart conditions such as high blood pressure, irregular heartbeat, coronary artery disease, and even stroke. Plus, it can lead to weight gain, depression and mood disorders.

2) People with sleep apnea may wake hundreds of times every night

These “micro-arousals” may occur 50 or more times per hour, and may keep a person from getting any relaxing sleep — even though they retain no memory of the episodes. That's why people who suffer from sleep apnea often go through their days on the verge of exhaustion. And they aren't the only ones who suffer: Their bed partners may also be kept up throughout the night, becoming anxious and irritable.

3) Persistent snoring can be a symptom of sleep apnea

Snoring is caused when breath being drawn into the lungs is obstructed by soft tissue structures in the upper airway. Most everyone snores sometimes… but chronic loud snoring is a common symptom of obstructive sleep apnea (OSA) — and the louder and more frequent the snoring, the greater the likelihood of OSA. To confirm a diagnosis of sleep apnea, a sleep study using special monitors may be conducted in a clinical setting, or an at-home test may be used.

4) Your dentist may be able to help diagnose and treat sleep apnea

What does dentistry have to do with sleep apnea? For one thing, sleep apnea is a disease that involves structures in the oral cavity — an area dentists are quite familiar with. Sometimes, fatigued folks who suffer from OSA begin snoring when they recline in the dental chair, showing their symptoms firsthand. But even if their patients don't fall asleep, dentists with proper training are recognized by the American Academy of Sleep Medicine (AASM) as being able to provide first line therapy for mild to moderate sleep disorders.

5) An oral appliance is a good step to try before more invasive treatments

If it's appropriate in your situation, your dentist can custom-fabricate an oral appliance that may alleviate sleep-related breathing disorders. This device, worn while you're sleeping, helps to maintain an open airway in the throat and to reduce breathing problems. With a success rate of around 80%, in many cases it's comparable to the more complex CPAP (continuous positive air pressure) machines, but people often find it easier to wear. Plus, it's a non-invasive treatment that can be explored before deciding on a more involved treatment, such as surgery.

If you would like more information about dentistry and sleep problems, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea FAQs.”