Nothing conveys confidence quite like a bright, white smile. Unfortunately, not all smiles are created equal. And, some smiles are much whiter than others. Whether your teeth have become discolored from food and drink or general wear and tear from aging, you may find yourself looking in the mirror one day wishing that there was a simple way to enhance your smile.

You've probably seen many over-the-counter products that claim to whiten your teeth. However, the strongest and fastest whitening solutions are those that are available in our office. There are many reasons why a professional whitening treatment might be the right solution for you. Here are a few:

1. Economical. Whitening is one of the least expensive cosmetic remedies available to improve a faded smile.
2. Convenient. Depending upon your time frame, you will be able to choose from whitening at home or in our office. With in-office whitening, we will apply a gel to your teeth and leave it on for about an hour. With take-home whitening, you'll receive custom-made trays that we will ask you to fill with the whitening gel and leave on your teeth 30 minutes a day, twice a week for about six weeks.
3. Effective. With professional whitening, your teeth will get anywhere from three to eight shades lighter. It's a noticeable difference that will surely help you regain confidence in your smile.
4. Low-Risk. Since whitening is a non-invasive procedure, the side effects are minimal. You may feel a bit of tooth sensitivity or gum irritation following treatment, but if such effects do occur, they will last no more than one to four days.
5. Easy to Maintain. Whether you choose in-office or take-home, your whitening treatment will likely last from six months to two years. The good news is that your new white smile will be easy to maintain. By avoiding tobacco and foods containing tannins such as red wine, coffee and tea, you will be able to preserve the brightness of your smile. You should also continue your regular oral care routine of brushing twice a day and flossing daily.

If you would like more information about teeth whitening, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Important Teeth Whitening Questions Answered.”

Halitosis (bad breath) is a major personal and social concern — so much so that Americans spend nearly $3 billion annually on rinses, mints and gum to freshen breath. While helpful in alleviating occasional bad breath caused by oral dryness (brought on by stress, eating certain foods, prescription medications, smoking or consuming alcohol), those with chronic halitosis require a much different treatment approach.

That's because there are a number of possible causes for chronic halitosis, among them: xerostomia (chronic dry mouth), caused by mouth breathing; periodontal (gum) disease; or candidiasis, a yeast infection caused by some antibiotics. It may also arise as a secondary symptom of systemic diseases like liver disease, diabetes or cancer.

The most common cause, though, is bacteria. Many types of oral bacteria can produce terrible odors, most notably volatile sulphur compounds (VSCs) with their “rotten egg” smell. Because of its relative dryness and difficulty in cleaning, the back of the tongue is a wonderful environment for bacteria to multiply and thrive.

If you suffer from chronic halitosis, our primary objective then is to try to uncover its specific cause, which will determine what course of treatment we would recommend. First, what is your experience with halitosis — have others noticed it or just you? Next, we would consider your medical history — have you had any health issues with your ears, nose or throat, or experienced any gastrointestinal disorders or lung problems? What kind of medications do you take, and are your kidneys and liver functioning properly? We would also perform a thorough dental exam for any signs of tooth decay, gum disease or a dry, coated tongue as well as look at your diet and lifestyle choices, like smoking or alcohol use.

Having a better idea of what may be causing your bad breath, we can then tailor a treatment plan that might involve, among other things, treatment for tooth decay, a periodontal cleaning (scaling), instruction on better oral hygiene and tongue cleaning with a scraper or brush, or the removal of third molars where debris may be accumulating in the gum flaps.

Finding the cause of bad breath can take time, but is well worth the effort. The end result is a treatment plan that works.

If you would like more information on understanding and treating chronic halitosis, 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 “Bad Breath: More than just embarrassing.”

Whether you think they're the height of fashion or the depth of “ice,” oral piercings like tongue bolts are a sign of our times. But along with these bodily adornments come a host of questions about risks to the wearer's health, both immediate and long-term. To help sort out these concerns, here are five facts everyone ought to know about oral piercings.

Oral piercings can cause acute health problems.

Rarely, nerve problems may result from an oral piercing. In at least one case, a teenager who had just gotten a tongue bolt developed severe facial pain and the feeling of electrical shocks. A neurologist traced these symptoms to an irritated nerve in the tongue, and the bolt's removal made the pain go away. More commonly, however, the immediate problems are soreness in the area of the piercing, bleeding in the mouth, and the risk of infection.

Oral piercings can lead to gum disease.

Periodontal problems associated with oral piercings include gum recession, inflammation, and even infection. Long-term bone loss may also be an issue. Over time, all of these conditions may affect a person's general health.

Oral piercings can lead to tooth problems.

Tooth pain and sensitivity are sometimes reported after the installation of an oral piercing. Chipping of the teeth is also a possibility, due to repeated contact with the metal of the ornament. People who decide to wear oral piercings should consult with us about increasing the frequency of their dental checkups.

Closing the hole left by a tongue piercing may require minor surgery.

As is the case with an ear piercing, the hole made for a tongue bolt often closes on its own. If it doesn't, a little surgery may be required to help it. In some cases, the tissue around the piercing may need to be removed before the hole itself can be sewn closed. Carried out under local anesthesia (a numbing shot), however, the procedure is usually simple and quick to heal.

Removing an oral piercing improves your oral health.

Losing the piercing reduces your risk factors, and thus improves your oral health. It's as simple as that. But any decision about oral piercings is ultimately yours to make. You should have a frank conversation about its risks and benefits with a knowledgeable health professional.

If you would like more information about oral piercings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “How Oral Piercings Affect Your Oral Health,” and “Body Piercings and Teeth.”

If a glance in the mirror reveals stained or discolored teeth that are detracting from your self-confidence, it's time to do something about it. The first step is to make an appointment for an office visit to find out how we can help you.

External (extrinsic) stains that form on the surfaces of teeth are usually caused by beverages such as red wine, tea, coffee as well as unhealthy habits like tobacco use. Extrinsic stains generally come in shades of browns, black or grays, but may even be orange or green from color producing bacteria.

Internal (intrinsic) stains are part of the structure of the tooth and cannot be removed by polishing. Among their causes are excessive fluoride levels or tetracycline antibiotics given in childhood and during tooth formation. Teeth do become more yellow and discolored as we age. Discoloration of individual teeth may be indicative of tooth decay, or teeth that have had root canal treatment and have literally lost their vitality tend to darken over time. Internal discoloration comes in a variety of shades and hues from yellows, grays, browns, and even some reds or pink.

Five Ways to lighten, whiten and brighten stained or discolored teeth

1. Change your habits. Reduce or stop consuming or using foods, drinks or tobacco if they are staining your teeth.
2. Improve your daily oral hygiene. Make sure to brush your teeth well, twice a day. Change to a toothpaste that contains a mild abrasive. Some toothpastes also contain tooth whiteners.
3. Visit our office for a professional cleaning and polish. Routine scaling and polishing will remove most superficial external stain and discoloration. Sometimes ultrasonic cleaning (by high frequency vibration) and polishing with slightly abrasive pastes may just do the trick.
4. Treatment for internal stain and discoloration. Brown colored decaying teeth need to have the decay removed and the teeth restored. Stained old and leaking fillings may also need to be replaced.
5. Tooth whitening by bleaching. Bleaching or tooth whitening is a safe and effective way to brighten stained teeth. Internal tooth bleaching can whiten even discolored root canal treated teeth. Ask us for more information about this technique.

If your mirror tells you that your smile needs attention, there's no time like the present to get started. Get back your bright, white smile and your self-confidence as well.

Contact us today to schedule an appointment to discuss your questions about tooth staining and its treatments. You can also learn more by reading the Dear Doctor magazine article “Tooth Staining.”

If you have ever had tooth decay, you should know:

1. Tooth decay is one of the most common of all diseases, second only to the common cold.
2. Tooth decay affects more than one-fourth of U.S. children ages 2 to 5, half of those ages 12 to 15, and more than 90 percent of U.S. adults over age 40.
3. Tooth decay causes pain, suffering and disability for millions of Americans each year — even more disturbing, tooth decay is preventable.
4. If it is not treated, in extreme and rare cases tooth decay can be deadly. Infection in an upper back tooth can spread to the sinus behind the eye, from which it can enter the brain and cause death.
5. Tooth decay is an infectious process caused by acid-producing bacteria. Your risk for decay can be assessed in our office with a simple test for specific bacterial activity.
6. Three factors are necessary for tooth decay to occur: susceptible teeth, acid-producing bacteria and a diet rich in sugars and refined carbohydrates.
7. Babies are not born with decay-causing bacteria in their mouths; the bacteria are transmitted through saliva from mothers, caregivers, or family members.
8. Fluoride incorporated into the tooth structure protects teeth against decay by making the enamel more resistant to acid attack.
9. Sealants, which close up the nooks and crannies in newly erupted teeth, stop bacterial collection where a toothbrush can't reach. Teeth with sealants have been shown to remain 99 percent cavity-free over six years.
10. Restricting sugar intake is important in preventing tooth decay. Your total sugar intake should be less than 50 grams a day (about ten teaspoons) including sugars in other foods. A can of soda may have six teaspoons of sugar — or more!

Contact us today to schedule an appointment to discuss your questions about tooth decay. You can learn more by reading the Dear Doctor magazine article “Tooth Decay – The World's Oldest & Most Widespread Disease.”

Some people are planners, and others just go with the flow. Some spend all winter in the gym, and others try and lose ten pounds right before beach season. Some have every detail of their wedding day planned out months in advance, and others... don't.

No matter which kind of person you are, you'll want to look your best for your wedding day. And that includes sporting a bright, healthy-looking smile. Depending how much time you have beforehand, there's a range of dental treatments that can help you look and feel great — not just that day, but every day. Here's a rundown of what you can do in the time remaining before your big day.

Time Left: Up to two years. If you've planned this far in advance, congratulations! You probably have time for almost any needed dental treatment — including orthodontics, which can straighten misaligned teeth and correct a bad bite. But even if you don't have quite so much time, don't despair: Clear aligners and tooth-colored or tongue-side braces, if recommended, can make orthodontic appliances nearly invisible.

Time Left: Six months to one year. Many dental treatments, like periodontal plastic surgery or tooth implants, can achieve remarkable results in this time. Periodontal surgery can give you a less “gummy” smile and greatly improve the aesthetics of your teeth. Tooth implants are modern dentistry's best option for replacing missing teeth. Natural-looking implants have a success rate of 95%, and can last a lifetime.

Time left: Three or four months. There's plenty you can do! If the roots are intact, a crown can be placed on a damaged tooth to restore its appearance and function. Or, missing teeth can be replaced via bridgework, which supports a false tooth from abutments on either side. Stained or discolored teeth can also be dramatically lightened with veneers, where a porcelain shell replaces the tooth's outermost layer of enamel. Tooth implants are still a possibility, under the right circumstances. We can evaluate your individual situation and come up with the best option to replace missing teeth.

Time left: Six weeks or so. You still have time for some basic, yet effective, treatments. Small chips or discolored fillings can be restored with tooth-colored materials that securely bond to the teeth themselves. You can also brighten your teeth by several shades using the techniques of bleaching. In-office whitening treatments are the fastest, but take-home kits, used under our supervision, offer similar results in a longer time.

Have even less time? At the very least, come in for a thorough cleaning right before the date! This will help remove many surface stains and freshen up your smile. Be sure to call in advance so that you're able to get an appointment. Then, smile for the camera!

If you would like more information about a wedding-day smile makeover, please contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Wedding Day Smiles.”

Oral cancer accounts for approximately 3% of cancers in men and 2% in women. That may not sound like a lot, but the disease often isn't detected until it has progressed to its later stages when it's harder to treat and the outlook for survival is significantly diminished.

The main areas where oral carcinomas (cancers) occur are:

• the tongue (most common location, particularly the sides and underneath)
• the lip (especially the lower one),
• the oral cavity (the mouth), and
• the pharynx (back of mouth and throat).

Risk Factors You Can't Control

Even if you can't change these risks, awareness helps raise your vigilance in order to catch potential problems early when treatment options and positive outcomes are greatest.

• Heredity
• Aging — More than 90% of all oral cancers occur in individuals over 40. However, the incidence among younger people has been on the uptick recently, perhaps related to lifestyle behaviors.
• Race — African Americans have a higher incidence of oral cancer than Caucasians.

Risk Factors You Can Address

• Smoking and chewing tobacco — Smokers are at five to nine times greater risk and snuff and tobacco chewers at about four times greater risk
• Alcohol — Moderate to heavy drinkers are at three to nine times greater risk; the higher the alcohol content, the greater the risk
• Chronic sun exposure — Often connected with lip cancers.
• Viral infections — Namely the human papilloma virus “HPV 16,” which has been linked to sexual transmission (oral sex) and cervical cancer in women.

One way you can address these risk factors is to have a diet rich in fruits/vegetables, which are high in antioxidants because they been found to have a protective effect against a variety of cancers, including oral.

As part of your routine oral hygiene, you should be closely monitoring any non-healing changes in your mouth (e.g., ulcers or sores, white or red patches on the tongue). And rest assured that as part of your regular check-ups, our office performs a comprehensive visual screening for signs of oral cancer.

If you would like more information about oral cancer prevention and detection, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”

If your teeth are not as bright as they used to be, or as white as you'd like them to be, then whitening or bleaching them may be the solution. Surface stains from coffee, tea, red wine or tobacco may be the most likely culprits. Internal staining can also be the result of root canal treatments, large fillings, too much of a good thing, like fluoride — or just plain aging. In some cases taking an antibiotic (tetracycline) during tooth development can cause permanent staining. In most cases bleaching stained or yellow teeth can really make a difference, helping to make them brighter and whiter.

The active ingredient in whitening products is hydrogen peroxide, which is also the breakdown product in carbamide peroxide. If a good regular dental cleaning doesn't remove your stains, then these products can bleach stains that are either superficial (on the surface) or deeper within the tooth structure. “In office” professional tooth whitening speeds the process along with the use of specialized lights or lasers, so that your teeth will whiten after only one or two office visits. Professional whitening or bleaching, which uses up to 35% peroxide solutions, may cause transient tooth sensitivity, but this will fade away quickly within a few days. Gum protection is also necessary to prevent irritation.

The effects of bleaching usually last six months to a year, at which time all that may be necessary is a minor touch up or refresher. And your whiter, brighter teeth will last longer if you avoid the habits that caused them — like avoiding smoking and foods that cause staining.

Whitening products for home use are an alternative to professional whitening systems that we apply in the office. Products for home use have a lower concentration of the active bleaching ingredients. We can make you custom fitted “trays” that exactly fit your teeth, and provide you with home strength whiteners, so that you can whiten at your own pace and stop at the brightening level of your choice.

And finally there are over-the-counter (OTC), whitening products, at even lower strengths for safety, but they are slower to work.

If whitening doesn't give you the smile you want, and deserve, then you may need to consider veneers or crowns to improve your smile.

Make an appointment to have a consultation with us about your personal cosmetic needs. We will review all the risks, benefits and alternatives to bleaching. You can learn more about teeth whitening by reading the Dear Doctor magazine article “Teeth Whitening: Bleaching is an effective method with minimal side effects.”

The old saying, “If it ain't broke, don't fix it,” doesn't really apply when discussing your wisdom teeth. It's great if they are not bothering you, but don't wait for problems to develop before you take action. This may seem counter-intuitive, but you should know that the best time to have your wisdom teeth removed is when they are not causing problems.

Why do wisdom teeth cause problems?

Wisdom teeth are so-called because they appear at ages 17 to 25, the age of supposedly attaining wisdom. They are also known as third molars and are farthest back in your jaws. For some people they come through the gum-line only partially, or they may not erupt into the mouth at all. Unerupted they have the potential to cause problems associated with the neighboring teeth and surrounding gums.

You may have heard of “impacted” wisdom teeth. This means that they are impacted or forced against neighboring structures, teeth or bone that prevent them from coming into the mouth in correct biting position. Since they are your last teeth to come in, space for them may be severely limited. They may push into the teeth that are already in place, becoming stuck as they try to erupt. When wisdom teeth are trapped like this below the gum line and are pushing against neighboring teeth, these molars can cause problems such as infections, cysts, or gum disease.

My wisdom teeth seem OK, so why remove them?

The dilemma is that if you wait until you feel pain connected with your wisdom teeth, their neighboring teeth may already be in trouble.

Another reason to remove these back teeth before they cause problems is that it's a good idea to have your surgery while you are young. Younger, healthy patients with no infections at the site have the best chance of having their wisdom teeth extracted without complications, with an easier recovery and uneventful healing.

Of course, each situation is different. Make an appointment with us for an examination and a consultation to discuss the risks and benefits of removing your wisdom teeth. For more information read the article “Removing Wisdom Teeth” in Dear Doctor magazine.

Nearly everyone has snored at some point in life. However, if your sleeping partner routinely tells you that you suffer from this problem, you really should take action to confirm or deny your suspicions. You may be like one of the 50 to 70 million people in the US alone that suffer from Obstructive Sleep Apnea (OSA), a medical condition in which the upper airway (the back of your throat) collapses during sleep thus limiting your intake of oxygen. And this condition is serious. If left untreated, OSA can lead to a stroke, impotence, an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease.

The first and most important step you should take if you snore is to obtain a thorough examination by both your primary-care physician and our office. We have completed specialized training in sleep medicine so that we can not only diagnose but also thoroughly treat your sleep disorders.

If you are diagnosed with this problem, relax. We have many ways we can treat your condition. One of the most common methods is to provide you with oral appliance therapy. This first line of treatment involves our making a customized oral appliance (mouthpiece) that will hold your lower jaw forward. By doing this, we can move your tongue away from the back of your throat so that your airway is less likely to get blocked while you sleep. (It is this blockage that causes the infamous snoring sound.)

Another option we may consider using to treat your sleep apnea if it is moderate to advanced is a Continuous Positive Airway Pressure (CPAP) machine. These machines require you to sleep with a mask over your nose and/or mouth and produce continuous pressure in your windpipe so that your tongue is forced forward away from your airway. Not only can these machines potentially eliminate your snoring, but they can also give you the restful night's sleep that you have been missing.

The last and most permanent solution for treating certain non-responsive cases of sleep apnea is surgery. This option is typically reserved for the most advanced cases to eliminate or reduce an obstruction to the airway.

Contact us today to discuss your questions about sleep apnea or to schedule an appointment. You can also learn more about sleep apnea when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Twenty-first Century techniques can create a replacement for a missing or damaged tooth that looks exactly like a natural tooth and actually fuses with the bone of your jaw. How does this amazing technology work? Test your knowledge on these questions.

What is a dental implant?
A dental implant is actually a replacement for the root of a tooth. In the natural tooth, the root is the part of the tooth below the gum line that is suspended in the bone by ligaments that attach the root to the bone. An implant is a root like substitute that is directly attached to the bone by a process referred to as osteointegration. An implant crown is then attached to the implant and is the visible part that we see above the gum tissues.

What is a modern dental implant made of?
Most are made of titanium. This metal is not rejected by the body and in fact fuses with the bone in which the implant is anchored, making it extremely stable.

How long do implants last?
A successful implant can last a lifetime. Factors that can affect an implant's success are smoking, certain drugs, osteoporosis, a history of radiation treatment, or a compromised immune system. We will evaluate all your conditions of dental and general health before deciding on an implant for you.

What makes the crown look like a real tooth?
The new crown looks real if it matches the shape and color of adjacent natural teeth. Its appearance also depends on what we as dentists refer to as the emergence profile (the way the crown seems to emerge from the gum tissue).

What is the function of a temporary crown?
A customized temporary crown can allow details of color, shape, and emergence profile to be worked out during this “temporary” phase of treatment. It can also test whether the tooth will function correctly for speech, biting and chewing. After these details are worked out, the temporary crown can be used as a blueprint for the permanent one.

What is the first step to getting a dental implant?
Make an appointment with us for a full assessment, diagnosis, and plan for placing the implant and crown.

Contact us today to schedule an appointment to discuss any additional questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Dental Implants, Your Third Set of Teeth.”

If you like soft drinks and carbonated colas, beware. Acids in these drinks may be dissolving the minerals in your teeth — a process called chemical erosion. And don't think that natural fruit juices or sports and high energy drinks are any better than sodas. They also contain acids that dissolve the surface enamel of your teeth. Once your enamel is lost, it is gone forever. It cannot naturally recover.

Sadly, teeth in children and teenagers — an age group most likely to drink large quantities of soda and juices — may be more easily eroded by acids. These youngsters have not had long-term exposure to fluorides which harden tooth enamel and protects them from acid erosion.

The Difference between Erosion and Decay
Chemical erosion is not the same as tooth decay (cavities). In chemical erosion, acids in your mouth react directly with minerals in the outer enamel of your teeth. In the case of tooth decay, bacteria in dental plaque (a bacterial film that forms on your teeth) utilize the sugars in the drinks and produce acids that attack your teeth.

After Acidic Exposure, Wait 30 Minutes to an Hour before Brushing
You may think that the solution to chemical erosion is to brush the acidic solution from your teeth as soon after drinking them as possible. But tooth brushing immediately after can actually accelerate chemical erosion and make it worse. After they are bathed in an acidic solution, minerals in the tooth surface become partially dissolved. Brushing at this time may brush away the affected layer. If you wait a half hour to an hour, your saliva will have time to neutralize the acids and harden the tooth surface by adding minerals back into it.

Drinks Less Likely to Cause Dental Erosion
Instead of drinking colas and sports drinks, stick to water and/or milk, which have the added benefit of supplying calcium to help add minerals back to the tooth surface.

If you must sip on juices or soft drinks, try to do so only at mealtimes. This is preferable to drinking them all day long, which leaves your teeth constantly bathed in an acid solution. Avoid swishing the drinks in your mouth, and sip them with a straw to reduce contact between acidic drinks and your teeth.

Contact us today to schedule an appointment to discuss your questions about acid erosion of teeth. You can also learn more by reading the Dear Doctor magazine article “Dental Erosion.”

Dental implants are replacements for missing teeth. They are very stable and can be made to look as good as or better than the teeth they replace. How do we do it? Here are seven frequently asked questions.

What are the parts of a dental implant?
The implant consists of a root, usually made of a titanium alloy, which extends below the gum tissue into the bone; and a crown, which emerges from the gum and resembles the crown of the original tooth.

Why is a dental implant so stable?
Titanium has a property of fusing with the bone of the jaw, so that it actually becomes part of the bony structure. The new implant's stability depends on having the needed volume of bone and gum tissue in the right position to anchor the implant.

How can you make sure I have enough bone?
When a tooth is lost, the bone in which it was anchored will resorb or melt away if care is not taken. It is important to minimize trauma during tooth removal to preserve bone tissue. If tissue has been lost it can be built up by bone grafting techniques.

What factors make a crown on an implant look real?
How real the crown looks depends on its shape, particularly as it emerges through the gum tissues, its color and its position relative to the teeth around it.

What is the emergence profile?
This term refers to the way the crown emerges through the gum tissue. It involves both the shape of the implant and how far it is placed into the gum and bone tissues.

How do you match the color of the crown?
We analyze your tooth color using shade guides and/or photography to provide the dental lab with as much information as possible to create the best color match. This is part of the artistry of reconstructive dentistry.

How will my gums look with my dental implant in place?
When people use the word “gums” they are often referring to the small pink triangles of tissue that fill in the spaces between teeth, called “papillae.” An implant must be placed at the correct distance from adjacent teeth and at the correct depth below the gum tissue for natural looking papillae to form.

You can see that success in matching of color, shape, and location of an implant is not simple and depends on the skill, artistry, and experience of your dental team.

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 & Dental Implants.”

What causes stains on teeth?

Staining can occur on the outside surfaces of teeth and is caused by foods such as red wine, coffee, and tea, as well as by tobacco use. They can also be developmental, affecting the structure of the teeth due to excessive fluoride levels or from tetracycline antibiotics given during childhood to name a few. Changes in a tooth's enamel or dentin during tooth formation, or as teeth age, can also cause discoloration.

What is going on inside a tooth's structure that makes it look stained?

Most of a tooth's covering (95 percent) is composed of highly mineralized enamel. The crystals of enamel are contained in a framework, or matrix, of organic matter. Dentists believe that various organic compounds that get into this matrix can cause staining.

How do whiteners work?

Tooth whiteners or bleaches expose the teeth to a peroxide compound. This creates reactive oxygen that breaks down highly colored organic compounds within the tooth's sub-surface matrix, making the tooth look whiter, but without changing its internal structure.

What professional in-office whitening techniques are available?

During treatment, a high concentration of peroxide solution in the form of a gel is applied directly on the teeth, often with activation by a heat or light source. These systems use custom tailored trays fitted to an individual's mouth. Silicone barriers or protective gels are used to keep the peroxide gel away from the gums or sensitive membranes in the mouth.

How are professional home whiteners different?

Home whiteners involve a less concentrated solution of peroxide in a gel form. It is delivered to the tooth surface by a bleaching tray that is custom-made in your dentist's office. Over-the-counter whiteners such as whitening strips or paint-on formulas can also be used, but they take longer and they're not as effective — the more diluted solutions are used for safety.

Can toothpastes really whiten teeth?

Mild abrasives in toothpastes clean surface stains but cannot change the underlying tooth color or remove significant staining.

How long do the results last?

Usually, the results last from six months to two years, but effects will diminish over time. You can make them last longer by avoiding the foods and habits that cause staining.

Are teeth whiteners safe to use?

Teeth whitening products are safe if used according to our recommendations or the product manufacturer's directions. Peroxide products may be toxic if used in excess of recommended intervals and amounts.

Read more about teeth whitening in the article “Teeth Whitening, Brighter, Lighter, Whiter...” Contact us today to schedule an appointment or to discuss whether tooth whitening is right for you.

A number of factors can lead to dental caries (tooth decay). To find out if you are at high risk, ask yourself these questions.

Is plaque visible in my mouth?
Dental plaque is a whitish film of bacteria that collects on your teeth. If it is clearly visible, it means that there is a lot of it. Among the bacteria in the plaque are those that produce tooth decay, particularly in an acidic environment. (A normal mouth is neutral, measured on the pH scale, midway between the extreme acidic and basic ends of the scale.)

Do I have a dry mouth?
Saliva protects your teeth against decay by neutralizing an acidic environment and adding minerals back to the outer surface of enamel of your teeth, so reduced saliva is a high risk for caries. Many medications can cause dry mouth as a side effect.

Do I eat a lot of snacks, particularly unhealthy ones?
Frequently eating sugars, refined carbohydrates, and acidic foods promotes the growth of decay-producing bacteria. The more frequently you eat, the longer your teeth are bathed in sugars and acids. Acidic foods not only promote bacterial growth, they also directly cause erosion of the tooth's hard surface by softening and dissolving the minerals in the enamel.

Do I wear retainers, orthodontic appliances, bite guards or night guards?
These appliances are recommended for various conditions, but they tend to restrict the flow of saliva over your teeth, cutting down on the benefits of saliva mentioned above.

Do my teeth have deep pits and fissures?
The shape of your teeth is determined by your heredity. If your teeth grew in with deep grooves (fissures) and pits in them, you are at higher risk for bacterial growth and resulting decay.

Do I have conditions that expose my teeth to acids?
If you have bulimia (a psychological condition in which individuals induce vomiting), or GERD (Gastro-Esophageal Reflux Disease), your teeth may be frequently exposed to stomach acids that can cause severe erosion to your teeth.

Do I already have cavities?
Visible cavities can range from those only visible with laser technology or x-ray examination to those a dentist can see with a naked eye. If you already have small cavities, you are at high risk for developing more.

Do I have white spots on my teeth?
White spots are often the first sign of decay in a tooth's enamel. At this point, the condition is often reversible with fluorides.

Have I had a cavity within the last three years?
Recent cavities point to a high risk of more cavities in the future, unless conditions in your mouth have significantly changed.

If you have any of these indications of high risk, contact us today and ask us for suggestions for changing the conditions in your mouth. You can also learn more by reading the Dear Doctor magazine article “Tooth Decay.”

Whether you have worn dentures for years or they are new to you, knowing the proper way to care for them is critical. This is why we have put together this fun and insightful test so that you can see just how much you know.

After reading each of the following statements below, determine whether you think the statement is true or false. See below for the answers.

1. Boiling your dentures at least once a week is an excellent way to sterilize them.
2. With a proper fit, it is perfectly acceptable to wear your dentures continuously (24 hours per day).
3. The bacterial biofilm that accumulates under a denture causes inflammation referred to as denture stomatitis.
4. You should store your dentures immersed in water after cleaning or when not in your mouth.
5. Once you have dentures (and no longer have any teeth), you really only need to schedule a dental appointment if you have a problem with your dentures or damage them.
6. To best clean a denture, you should use a slightly abrasive cleanser and a firm toothbrush.
7. The pressure from wearing dentures causes jawbone loss over time.
8. The optimal method for cleansing your gums is to take a moistened washcloth and gently massage your gums two times each day.
9. If you are careful, you can use denture cleaners while your false teeth are in your mouth.
10. You should never use sodium hypochlorite bleach to clean your dentures.

Answers

1. False. You should never boil dentures. 2. False. You should not wear your dentures 24/7. 3. True. 4. True, as this prevents your dentures from warping. 5. False. Even though you may not have teeth, you need to visit our office at least once a year for a thorough examination and to ensure your dentures are fitting and functioning properly. 6. False. You should never use a firm toothbrush OR any type of abrasive cleanser to clean your dentures. 7. True. This is unfortunate, but a fact nonetheless. 8. True. 9. False, you should only use a denture cleanser outside of the mouth. 10. False. Sodium hypochlorite bleach is an excellent cleanser; however, you should never soak your dentures in this solution for periods that exceed 10 minutes.

To learn more tips, continue reading the Dear Doctor magazine article “Top Ten Tips For Denture Care & Maintenance.” Or you can contact us today to schedule an appointment to discuss your questions.

If you believe you need a crown or if we have already confirmed this fact, you need to understand that there are several options. The most common are gold crowns, porcelain-fused-to-metal crowns and all porcelain crowns. Each has both pros and cons; thus we will work with you to determine which will work best for your specific needs. However, to help you learn more now, here are some facts.

Gold Crowns

Made from cast gold, this type of crown has been around for over 100 years and is the most successful type of crown. It can last more than 50 years and thus many dentists prefer gold restorations for their own teeth, where cosmetics is not a concern.

All Porcelain Crowns

All porcelain crowns can produce an incredible, life-like appearance. However, because they are made purely from dental porcelain (a type of glass), they tend to be more fragile than gold crowns and may be more at risk with certain high biting forces. Thus they may not be as durable. Porcelain can also cause wear to the natural teeth they bite against. Therefore they are typically preferred for front teeth, rather than back teeth. They have an aesthetic longevity of about 10 years and a functional longevity of about 20 years.

Porcelain-Fused-To-Metal Crowns

As the name states, porcelain-fused-to-metal (PFM) crowns provide the best of both worlds. They are made of natural tooth-colored dental porcelain that is fused on top of a precious or noble metal (usually gold or platinum). They are stronger than porcelain alone and are a good option for back teeth because they offer a better cosmetic result than gold crowns. This is also true for front teeth, however the gold support beneath the porcelain can compromise its life-like qualities. These crowns also have a proven track record and have been used with excellent results for over 40 years.

Learn more about crowns when you read, “Gold or Porcelain Crowns.” Or you can contact us today to discuss your questions or to schedule a consultation.

While we have gained recognition for our role in creating gorgeous smiles with porcelain veneers, the often overlooked or unknown key contributors in this process are the dental laboratory technicians. These behind-the-scenes artists are the trained professionals in the art of using dental porcelain to hand-craft veneers and crowns into near exact replicas of natural teeth in shine, opacity, translucence and shape.

Through the use of precise molds and excellent communication skills, we share detailed information with the laboratory technician to create veneers or crowns specifically for enhancing and improving your smile. In fact, communication must be so exact that it often demands correct lighting, cameras and computers to produce optimal results. This process also requires a variety of colors, shapes and translucency, created so that once we cement them into place, they appear as beautiful natural teeth. If your veneers are part of a smile restoration or makeover and you are getting them for several front teeth, the end results are typically brighter and whiter than your natural teeth. However, they must blend with surrounding teeth if those teeth are not also receiving veneers. So it is often recommended to have your natural teeth whitened before the veneers are replaced.

Good dental porcelains in the right hands can make for spectacular tooth imitations by mimicking tooth enamel perfectly. And now that you have these facts, you begin to understand all of the expertise, artistry, and the technology required by laboratory technicians to produce the most dazzling porcelain veneers.

To learn more about porcelain veneers, continue reading the Dear Doctor article, “Smile Design Enhanced With Porcelain Veneers.” Or if you are ready to see what cosmetic dentistry can do for you, contact us to schedule a consultation.

Dental professionals agree that effective removal of plaque, the film of bacteria (also called a biofilm) that gathers on everyone's teeth, is the key to good dental health. Daily brushing and flossing are the usual recommendation for plaque removal. It is important to ask us about effective brushing and flossing. At your next appointment, ask us for a demonstration.

Effective brushing removes plaque from the easily accessed surfaces of the teeth. To remove plaque from between the teeth, you must floss.

Some people find it awkward to hold the floss with their fingers as they move it around their teeth. One technique for flossing, suggested by a dentist in Dear Doctor magazine, may make it easier than more traditional methods, although it does take a little practice.

Preparation
This method requires tearing off a 10 to 12 inch length of floss and tying it to form a circle big enough for your fingers, but not your thumbs, to fit within it. The circle should be knotted with a double knot.

To Clean Teeth and Gums
Keep the floss taut at all times, with about and inch or less between your thumb and index fingers for your upper teeth, or index fingers only for your lower teeth. Curve the floss around each tooth and gently move it up and down until you hear a squeaky clean sound. Extend the downward movement of the floss to just below the surface of the gum, without being too harsh and causing injury. As you move from tooth to tooth, move around the floss circle so that each tooth gets a clean section of floss.

Upper Teeth
Place all your fingers in the ring, with the floss over your left thumb and right index finger to floss your upper left teeth, and over your right thumb and left index finger to do the other side.

Lower Teeth
Use both index fingers to floss all your lower teeth.

You may only need to floss once a day before or after brushing to keep your gums health and ward off periodontal (gum) disease. Your dentist will guide you as to how often you may need to floss your teeth. Try this technique and see how it works for you.

Contact us today to schedule an appointment to discuss your questions about flossing techniques. You can also learn more by reading the Dear Doctor magazine article “Flossing — A Different Approach.”

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.