How much do you know about dental implants? Test yourself with this quiz.

1. Earliest recorded attempts at using dental implants were from
1. Medieval England
2. The ancient Mayans
3. U.S.A. in the 1950s
2. Dental implants are called endosseous. What does this mean?
1. They fuse with the bone
2. They are inside the mouth
3. They are not real teeth
3. What are most dental implants made of?
1. Aluminum
2. Titanium
3. Steel
4. What part of the tooth does an implant replace?
1. The implant is the root replacement
2. The implant is the root plus the crown
3. The implant is the crown
5. What is the success rate of dental implants?
1. 50 percent or less
2. 75 percent
3. 95 percent or more
6. What could cause an implant to fail?
1. Smoking or drug use
2. Poor bone quality and quantity at the implant site
3. Both of the above
7. What is a tooth's emergence profile?
1. The implant and crown's shape as it emerges from beneath the gum line
2. A measure of the urgency of the tooth replacement
3. A measure of the time it takes for you to be able to chew on the new implant
8. What are some of the factors that go into the aesthetics of designing the crown?
1. Choice of materials
2. Color matching
3. Both of the above

1. b. The concept of dental implants goes back to the Mayan civilization in 600 AD.
2. a. The word endosseous (from endo meaning within and osseo meaning bone) refers to the implant's ability to fuse with or integrate with the bone in which it is placed.
3. b. Most implants are made of a titanium alloy, a metallic substance that is not rejected by the body and is able to fuse with the bone.
4. a. The term “implant” refers to the root replacement, which is anchored in the gum and bone. A crown is put around the implant where it emerges from the gumline.
5. c. The majority of studies have shown long term success rates of over 95 percent.
6. c. Factors that could cause an implant to fail include general health concerns such as smoking and drug use, osteoporosis, or a compromised immune system; poor bone quality or quantity; and poor maintenance such as lack of proper brushing and flossing.
7. a. The emergence profile has a lot to do with the implant's natural appearance. It involves the way the crown, which attaches to the implant, seemingly emerges through the gum tissue like a natural tooth.
8. c. Choices such as materials, color, and position can be worked out in the design of a customized temporary crown, which acts as a template or blueprint for a final crown.

Contact us today to schedule an appointment to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Implants.”

It is not uncommon to have one or more teeth that are particularly sensitive to heat, cold, or pressure. If you have such a tooth, you probably want to know what caused it and what you can do about it. Here are some frequently asked questions, and their answers.

What causes teeth to become sensitive?
The most common cause of sensitivity is exposure of the tooth's dentin, a layer of the tooth's structure that is just below the outer protective layer (the enamel).

The dentin is sensitive but the enamel layer is not. Why?
The enamel is composed of minerals that are hard and protective. It is not living tissue and has no nerve supply. The dentin layer underneath is bone-like living tissue that does contain nerve fibers. It is protected by enamel above the gum line and by gum tissue in the area of the tooth's root, below the gum line. If the tooth's protective covering is reduced, the nerve fibers in that section of the dentin are exposed to changes in temperature and pressure, which they conduct to the inner pulp layer (nerve) of the tooth. The sensations that reach the tooth's interior pulp layer cause pain.

What causes exposure of the dentin layer in teeth?
Often the dentin is exposed by receding gums, causing areas of the tooth that are normally below the gum surface to be uncovered.

What makes gums recede?
One cause of receding gums is excessive, rough brushing techniques. This is particularly common in individuals who have a family history of thin gum tissues. Removing the film of bacteria called plaque requires only gentle action with a soft brush. This is one reason that we stress the value of learning proper and effective brushing techniques. Gum recession becomes worse after the uncovered dentin of the tooth's root is exposed to erosion from sweet and acidic foods and beverages, such as fruit juices.

Doesn't tooth sensitivity indicate decay?
Decay can also cause tooth sensitivity. As decay destroys a tooth's structure, it eventually invades the inner pulp of the tooth, causing greater and greater pain.

How can you prevent or reduce tooth sensitivity?
As we mentioned above, learn proper brushing techniques; we would be happy to demonstrate them. Use a toothpaste that contains fluoride, which increases the strength of the tooth's protective coating. In more serious cases, we can apply a fluoride varnish or a filling material as a barrier to cover sensitive areas. If you experience long-term tooth sensitivity, make an appointment for an assessment and diagnosis so that we can determine the cause and proper treatment.

Contact us today to schedule an appointment to discuss your questions about sensitive teeth. You can also read the Dear Doctor magazine article “Sensitive Teeth.”

Teeth whitening is a great way to improve your smile. For best results and to ensure your safety, teeth should be bleached under professional supervision. We can help you choose the whitening method that's right for you, and monitor the effects of your treatment. Here are some answers to frequently asked questions about this relatively inexpensive cosmetic procedure:

Is teeth whitening safe?
A lot of research has been done on teeth whitening, so we know that specific bleaching formulas, from a reputable source, are safe if used as directed and after a proper dental examination. You should be aware that tooth sensitivity is a common side effect of bleaching, but brushing with a desensitizing toothpaste containing potassium nitrate for two weeks prior to bleaching can reduce sensitivity. Using potassium nitrate during the bleaching process can also help.

Is it effective?
Professional bleaching is very effective. Peroxide goes through tooth enamel (the outermost layer) and the dentin (middle layer) to the pulp (the innermost layer) in 5 to 15 minutes. The bleach actually changes the color of the enamel and dentin, and removes stains.

How is teeth whitening done?
Basically there are three options: in-office whitening (done by a dentist), at-home bleaching with custom-made flexible plastic trays (with prescription bleach), and over-the-counter (OTC) products. Not all OTC products are equal, and the results will take longer to achieve than with professionally supervised procedures.

How long does it take?
That depends on what method you choose and, in the case of at-home whitening, how conscientious you are about following through with your course of treatment. One study found that a six-shade change required either: three in-office applications of 38% hydrogen peroxide; one week of 10% carbamide peroxide used at home nightly in a custom-made tray; or 16 daily application of 5.3% hydrogen peroxide on a whitening strip.

Will it last?
It really depends on the individual. No bleaching method can whiten teeth permanently, though some people's teeth remain white for over 10 years with no touch-up treatment. More typical results vary from six months to two years. Keeping up with your regular oral hygiene routine at home and your professional cleanings at the dentist's office will help maintain the results; so will avoiding tobacco and beverages that stain, such as red wine, tea and coffee. You can also consider a bleaching touch-up once or twice a year at home or here at the dental office.

I want to go for it! What's the first step?
Step one is a pre-bleaching dental examination to determine the cause of your tooth discoloration. We want to make sure that your discoloration is not the result of an oral health-related problem. For example bleaching will mask but not resolve issues such as abscessed teeth, decay, and root canal problems. We want your teeth not only to be beautiful, but healthy, too!

If you are interested in learning more about teeth whitening, please contact us today to schedule an appointment for a consultation. For more information on teeth whitening, please see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Tooth Whitening Safety Tips.”