Time to tune up the brightness on your teeth? Here are six modern methods of whitening and brightening your smile.

• In-office “power” bleaching under the supervision of my staff and me is recommended if your teeth are badly stained, or if you are about to have veneers or crowns made. It's quick, safe, and effective. Gels containing high concentrations of bleach are applied to your teeth in our office, often with the enhancement by heat and light to make them act faster. Results show teeth becoming up to ten shades lighter in about an hour.
• “Take home” whitening solutions and trays are designed to fit your mouth and can also be provided by my office. The technique is easy to perform and is less expensive than in-office power whitening system, although it takes longer to see the same results. General recommendations are for 30 minute applications twice a day. You can usually see a change after two to four sessions. This requires patience, because it is important not to exceed recommended exposure in order to avoid damage to your teeth, gums, and the inside skin of your mouth. After two weeks of use, teeth can be expected to be about eight shades lighter.
• Whitening strips look like clear Band-Aids that are applied to the tooth surfaces. They should be worn twice a day for 30 minutes each time, for seven days. On average, they claim to lighten teeth more than three shades. They take about two weeks to work at 30 minutes per day.
• “Paint on” or “Brush on” whitening formulas are also available. These are gels that are painted onto the teeth every night at bedtime, for two weeks. Some claim that this line of home whitening can whiten teeth two to five shades. These gels may make your mouth feel goopy, but they are relatively inexpensive. Some gels come with a small brush to scrub them onto the teeth.
• Over-the-counter “mouth-tray” whiteners use mouth trays that are not designed for your particular mouth, so they may not fit well and may be messy or uncomfortable. They are filled with gel and worn 45 minutes a day for one week. On average, teeth become two shades whiter.
• Whitening gum is a relatively new product. It requires chewing two pieces for at least 20 minutes, four times a day, to see an effect.

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.”

The CDC (Centers for Disease Control and Prevention) calls fluoridation of drinking water one of the ten most important public health measures of the 20th century, along with such measures as vaccination and motor-vehicle safety.

A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The connection between fluoride and oral health was confirmed in the first half of the 20th century, and by 1955 the first clinically proven fluoride toothpaste was launched. Fluoride-containing toothpastes are common today, along with other fluoride-containing products.

Protective Effects of Fluoride
Ongoing studies have shown that fluoride has both a systemic (through the body) effect and a local effect at the tooth surfaces. Tooth decay takes place as part of a kind of active war between de-mineralization and re-mineralization, in which acids produced by bacteria in plaque (a biofilm in your mouth) soften and dissolve the minerals (de-mineralization) in the tooth's surface. At the same time, the saliva bathing the tooth acts to re-harden the tooth's surface by adding minerals back (re-mineralization). If fluoride is present in the biofilm and in the saliva, it protects against de-mineralization.

The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface. The fluoride in toothpastes and products like rinses is delivered directly to the tooth surface. Fluorides can also be eaten in foods with high fluoride content such as teas, dry infant cereals and processed chicken, fish and seafood products.

Problems with Over-use
Eating or swallowing too much fluoride can contribute to a discoloration of teeth called dental fluorosis, which varies in appearance from small white striations to stained pitting and severe brown mottling of the enamel. To avoid this effect, monitor children's tooth brushing to make sure they use only a small amount of fluoride toothpaste and do not swallow it.

Adding fluoride to water has been controversial because some people believe that it may cause other harmful effects. However, most health experts believe that fluoridated water carries no significant health risks and significantly contributes to public health by preventing tooth decay.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can also learn more by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”

If you've lost one or more of your teeth due to tooth decay, trauma, gum disease or a failed root canal, there are a variety of ways that our office can help you to restore your smile and increase your confidence. Crowns, conventional bridges and dentures aren't your only options for replacing missing teeth. Dental implants, surgically placed below the gums, are another alternative for replacing missing teeth.

Getting Started: If you would like to explore the option of having dental implants to replace one or more teeth, you will first need a comprehensive exam. The ideal candidate for implants is in good general and oral health. Adequate bone in your jaw is needed to support an implant. Smokers and those with uncontrolled chronic diseases like diabetes may not be good candidates for dental implants because healing may be impaired or slow. In addition, dental implants aren't appropriate for children or teens until their jaw growth is complete.

The Process: Dental implant surgery can be performed in our office using either a local or general anesthetic. The implants actually replace tooth roots; they are placed into the bone surgically. Generally made of commercially pure titanium, this metal has the remarkable ability to fuse with the bone as it heals forming a union known as osseointegration (“osseo” – bone; “integration” – to fuse with). This process takes two to six months depending upon many factors of which bone quality is the most important.

The next step is to place an abutment (a small connector) which attaches the implant to the crown. The crown is the part of the tooth that is normally seen in the mouth above the gums.

Assessment of your individual situation and deciding if dental implants are right for you takes knowledge and experience. Contact us today to schedule an appointment to discuss any questions you may have regarding dental implants. Read more about this topic in the Dear Doctor magazine article “Dental Implants: Options for Replacing Missing Teeth.”

Thinking or knowing you have an impacted wisdom tooth can be alarming news for some people. Unfortunately, one of the main reasons for this feeling is due to the mythology surrounding wisdom teeth...and especially impacted wisdom teeth. While an impacted wisdom tooth can cause intense pain, some people are quite shocked to learn that they even have impacted wisdom teeth, as it is causing no pain at all.

By definition, an impacted wisdom tooth is a third (and last) molar that gets jammed against an adjacent tooth or other important structures such as gum, bone nerves, blood vessels. And having an impacted wisdom tooth does have its consequences — even if you are unaware you have one. The most common issue is gum (periodontal) disease. This is the main reason why it is so important to have a problematic wisdom tooth removed early when you are young and before periodontal disease has started. If left untreated, you risk damaging and/or losing the impacted tooth and adjacent teeth.

The key to managing wisdom teeth is to monitor them closely through thorough routine examinations and x-rays between the ages of 17 and 25, the time when wisdom teeth typically appear. This is so vital because it allows us to predict the way your wisdom teeth will erupt (become visible) or come into proper position with useful biting function. We can use these visits and x-rays to monitor development so that we are best equipped to determine if or when wisdom teeth need to be treated or removed.

It is also important to contact us as soon as you think you may have an impacted wisdom tooth that is causing pain, swelling or even infection. We can put your mind at rest with the facts of what needs to be done after we've completed our exam.

If you feel that you or a family member has an impacted wisdom tooth, contact us today to schedule an appointment to discuss your questions. Or you can learn more now about the symptoms and treatment options of impacted wisdom teeth by continuing to read the Dear Doctor magazine article “Wisdom Teeth.”

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?”