Dental Tips

Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth has become popular in today's society and tooth bleaching can be the answer.

Tooth bleaching safely lightens the color of the teeth and can last for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.

Generally, bleaching is successful in at least 90 percent of patients, although it may not be an option for everyone.

Tooth bleaching is effective for teeth darkened from extrinsic stains such as aging, coffee, tea or smoking. Teeth darkened by intrinsic stains caused by fluorosis, tetracycline, or other medications and by congenital abnormalities won't respond well to bleaching.

Teeth darkened with the color of yellow, brown or orange respond better to lightening than gray staining. If you have very sensitive teeth, periodontal disease or teeth with worn enamel, your dentist may discourage bleaching.

First, the dentist must determine whether you are a candidate for tooth bleaching and what type of bleaching system would give you the best results.

If you're in a hurry for whiter teeth, you may decide to have your teeth whitened immediately. Your dentist will use either an in-office bleaching system or laser bleaching while you sit in the dental chair.

However, most patients choose dentist-supervised, at-home bleaching, which is more economical and provides the same results.

At the next appointment, if you don't choose laser bleaching, the dentist or hygienist will make impressions of your teeth to fabricate a mouthguard appliance for you. (The mouthguard is used to hold the bleaching solution against your teeth.)

The mouthguard is custom-made for your mouth. It can be worn comfortably while you are awake or sleeping.

The mouthguard is so thin that you should even be able to talk and work while wearing it. Along with the mouthguard, you'll receive the bleaching solution and instructions on how to wear the mouthguard.

Some bleaching systems recommend bleaching your teeth from two to four hours a day. Generally this type of system requires three to six weeks to complete, and works best on patients with sensitive teeth. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10 to 14 days to complete.

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee or tea. At this point you may choose to get a touch-up. This procedure may not be as costly because you can probably still use the same mouthguard. The treatment time also is much shorter than the original treatment time.

The active ingredient in most of the whitening agents is 10 percent carbamide peroxide, also known as urea peroxide. When water contacts this white crystal, the release of hydrogen peroxide lightens the teeth, bleaching out the porous surface of the enamel.

The higher the strength of carbamide peroxide and the quicker the bleaching process is carried out, the greater the chances for sensitivity.

Several studies during the past five years have proven bleaching to be safe and effective. The American Dental Association has granted its seal of approval to some tooth-bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

No one can really predict how much lighter your teeth will become, but the key is to have a realistic expectation before starting the process. Every case is different.

Typically, there is a two-shade improvement as seen on a dentist shade guide. The success rate depends on the type of stain involved and your compliance. Bleaching can only provide a shift in color, from gray to a lighter shade of gray, for example.

Bleaching does not lighten artificial materials, such as white fillings (resins) or porcelains. So if you are considering bleaching, it would be best to bleach before resin fillings or porcelain crowns, onlays or inlays are placed, to allow for the shade to be matched.

Hey, show off that smile :-).

Plaque is a sticky layer of material containing germs that accumulates on teeth, including places where toothbrushes can't reach. This can lead to gum disease. The best way to get rid of plaque is to brush and floss your teeth carefully every day.

The toothbrush cleans the tops and sides of your teeth. Dental floss cleans in between them.

Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces, and controls bad breath. Floss is the single most important weapon against plaque, perhaps more important than the toothbrush. Many people just don't spend enough time flossing or brushing and many have never been taught to floss or brush properly. When you visit your dentist or hygienist, ask to be shown.

Flossing is the one most important step in oral care that people forget to do or claim they don't have time for. By flossing your teeth daily, you increase the chances of keeping your teeth a lifetime and decrease your chance of having periodontal or gum disease. Flossing cleans away the plaque from between your teeth, decreases the chance of interproximal decay and increases blood circulation in the gums.

Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridgework. Tapes are usually recommended when the spaces between teeth are wide. They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss, but does tear more than waxed floss.

There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don't cut off your finger's circulation!) Wind the rest of the floss similarly around the same finger of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don't pull it down hard against your gums or you will hurt them. Don't rub it side-to-side as if you're shining shoes. Bring the floss up and down several times forming a "C" shape around the tooth, being sure to go below the gum line. The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gum line forming a "C" on the side of the tooth.

Floss and keep you teeth for a lifetime :-).

As a child I used to get terrible headaches. It took years, and many test until it was finally diagnosed as migraine headaches.

I recently learned that your mouth can play a role in headaches.

An average person swallows 2,000 times per day, causing the upper and lower teeth to come together and push against the skull.

People who have poorly aligned bites or missing teeth can have related health problems, such as frequent headaches or sleep disorders, because their jaw muscles are strained, according to a recent article in AGD Impact, the news magazine of the Academy of General Dentistry.

This strain, known as orofacial pain, is defined as any pain in and around the face. Some people may experience pain in the ears, eyes, sinuses, cheeks or side of the head, while others experience clicking when moving the jaw.

Orofacial pain can also be caused by nerve disorders, temperomandibular disorder, stress or muscle spasms. Serious causes of orofacial pain are tumors in the jawbone area, oral cancer or referred pain from cardiac disease.

At the first sign of discomfort or noted abnormality when closing your mouth, see your general dentist to have a preliminary evaluation to disclose any potential problems early. He or she knows your mouth best and how you handle daily stress.

Sometimes the pain may be difficult to diagnose if its origin is not localized in one area. The dentist will try to diagnose the pain source by conducting tests to rule out a cracked tooth, the need for a root canal, gum disease, clenching or grinding. These factors can cause pain in the facial area, but can be easily treated.

Orofacial pain that lasts longer than 10 days to two weeks, or is not related to a specific stressful event such as a car accident, may signal a more serious problem requiring additional tests.

One in eight Americans suffers from headaches. Does you mouth cause yours?

Radiographic or X-ray examinations provide your dentist with an important tool that shows the condition of your teeth, its roots, jaw placement and the overall composition of your facial bones. X-rays can help your dentist determine the presence or degree of periodontal disease, abscesses and many abnormal growths, such as cysts and tumors. X-rays also can show the exact location of impacted and unerupted teeth. They can pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination.

Your radiographic schedule is based on the dentist's assessment of your individual needs, including whether you're a new patient or a follow-up patient, adult or child. In most cases, new patients require a full set of mouth X-rays to evaluate oral health status, including any underlying signs of gum disease and for future comparison. Follow-up patients may require X-rays to monitor their gum condition or their chance of tooth decay.

Typically, most dental patients have "periapical" or "bitewing" radiographs taken. These require patients to hold or bite down on a piece of plastic with X-ray film in the center. Bitewing X-rays typically determine the presence of decay in between teeth, while periapical X-rays show root structure, bone levels, cysts and abscesses.

Just as a panoramic photograph allows you to see a broad view such as the Grand Canyon, a panoramic radiograph allows your dentist to see the entire structure of your mouth in a single image. Within one large film, panoramic X-rays reveal all of your upper and lower teeth and parts of your jaw.

What is apparent through one type of X-ray often is not visible on another. The panoramic X-ray will give your dentist a general and comprehensive view of your entire mouth on a single film, which a periapical or bitewing X-ray can not show. On the other hand, periapical or bitewing X- rays show a highly-detailed image of a smaller area, making it easier for your dentist to see decay or cavities between your teeth. X-rays are not prescribed indiscriminately. Your dentist has a need for the different information that each radiograph can provide to formulate a diagnosis.

All health care providers are sensitive to patients' concerns about exposure to radiation. Your dentist has been trained to prescribe radiographs when they are appropriate and to tailor radiographic schedules to each patient's individual needs. By using state-of-the-art technology and by staying knowledgeable about recent advances, your dentist knows which techniques, procedures and X-ray films can minimize your exposure to radiation.

Using the best tools available to provide the best care...

...or better yet don't ever start.

Most people know that smoking can cause heart disease, stroke, lung cancer or other respiratory diseases. However, they don't consider what smoking does at the site where they actually place the end of the cigarette—their mouths.

Stained teeth, brown hairy tongue and bad breath are the least of their problems, but few people ever think about what else smoking might be doing to their mouths. Many studies show that smokers tend to have more tooth decay than non-smokers.

Smoking compromises your saliva flow and function. Saliva is important for cleaning the lining of the mouth and teeth and protecting teeth from decay.

More disturbing, however, are recent studies that show that children who are raised in households where one or both adults smoke are more likely to develop tooth decay.

Long-term studies have shown that smoking can cause gum disease and bone loss and eventually tooth loss. Smoking reduces blood flow to the gums and cuts the supply of vital nutrients. It can also reduce vitamin C levels by half! Vitamin C helps gums to stay healthy.

These two factors, reduced blood flow and vitamin C levels, make attempts to treat gum disease in smokers less likely to succeed.

Smoking also raises the mouth's temperature, damaging and killing important oral tissue cells. When you combine this with the cancer-causing compounds found in tobacco, you have a recipe for disaster: oral cancer (cancer of the mouth).

Smokers are two to 18 times more likely to develop oral cancer than non-smokers. It depends on how heavily they smoke. Oral cancer strikes more Americans annually than some better-known cancers such as brain, thyroid, stomach, cervical and ovarian. The numbers of young people experiencing oral cancer have risen over the past decade.

Worse yet, the overall survival rate for oral cancer is low: nearly half of all oral cancer patients die within five years. The survival rate is probably low because more than half of all oral cancers are not detected until they reach an advanced stage.

Early warning signs of oral cancer include:

• A swelling, lump, or growth in the mouth that does not heal.
  
• White or red patches inside the mouth that don't go away.
  
• Loose teeth for no apparent reason.
  
• Pain when swallowing.
  
• Persistent sore throat.
  
• Difficulty swallowing or opening your mouth.
  
• A nagging cough or persistent hoarseness.
  
• Unusual bleeding in your nose or mouth.
  
• Numbness or tingling in your lips or tongue.
  

The most treatable form of oral cancer is a small, early lesion, which may only be detectable by a health professional. As highly trained specialists in oral diseases, dentists are the healthcare providers of choice for detecting oral cancers. Your best defense against oral cancer is to stop smoking, and make sure you receive an oral cancer examination at your annual dental visit.

No jokes here, wishing you the best.

Every year thousands of infants and young children suffer from extensive tooth decay. Surprisingly, the major culprits are milk and other liquids from the baby's bottle.

Just like an adult's mouth, a baby's mouth is full of bacteria. These bacteria feed on sugars found in the liquids we drink and in the foods we eat. Ungrateful hosts, these bacteria produce acid as a by-product of their feasting. It is this acid which attacks the tooth enamel and causes cavities.

Many parents put their children to sleep with a bottle. They often find that this helps the baby settle down. Unfortunately, studies show that babies fall asleep with the baby bottle nipples in their mouths, allowing fluid from the bottle to pool around teeth.

Sugar present in the fluid continually nourishes the bacteria that are in the baby's mouth. Using this constant source of sugar, bacteria multiply and create a steady stream of tooth damaging acid. Night after night of acid attack results in cavity formation and extensive tooth decay. In some cases, the entire tooth can be eaten away by bacterially produced acid.

It is especially important to be vigilant against baby bottle tooth decay because baby teeth are more susceptible to tooth decay than adult teeth.

Additionally, constant sugar in the mouth can lead to a build-up of bacteria to a point where more harmful types of bacteria start becoming predominant. These bacteria cause gingivitis by invading gum tissue and releasing toxins. In severe cases, the bacteria and their toxins can attack bone structures supporting the teeth (periodontal disease) resulting in permanent damage.

What can parents do to protect their children's teeth? I suggest that after every bottle feeding you take a wet cloth or gauze pad and gently wipe your child's gums and teeth. This will remove any bacteria containing plaque and excess sugar that may have built up.

What liquid should you put in your baby's bedtime bottle? Natural juices such as grape juice or apple juice contain natural sugars which bacteria can use to create acids. Milk contains a sugar called lactose which bacteria can also use to create acid.

If you give you child a bedtime bottle, the liquid of choice inside of the baby's bottle is water. Water contains no sugar and can not be used by bacteria to produce acid.

Finally, never give your baby a pacifier dipped in any type of substance containing large amounts of sugar. Many parents, for example, give their children pacifiers dipped in honey. This can be very bad for the baby's teeth.

When you protect your child from baby bottle tooth decay you ensure that their smile will last a lifetime.

There is a story running in the UK about an unlicensed practice. The dentist hid his lack of qualifications and medical insurance by hijacking the identity of a dead dentist.

Here is what you should know about the qualification to be a dentist in the US:

All 50 States and the District of Columbia require dentists to be licensed. To qualify for a license in most States, a candidate must graduate from one of the 55 dental schools accredited by the ADA’s Commission on Dental Accreditation in 2002 and also must pass written and practical examinations. Candidates may fulfill the written part of the State licensing requirements by passing the National Board Dental Examinations. Individual States or regional testing agencies administer the written or practical examinations.

Dental schools require a minimum of 2 years of college-level predental education, regardless of the major chosen. However, most dental students have at least a bachelor’s degree. Predental education emphasizes course work in science, and many applicants to dental school major in a science such as biology or chemistry, while other applicants major in another subject and take many science courses as well. A small number of applicants are accepted to dental school after 2 or 3 years of college and complete their bachelor’s degree while attending dental school.

All dental schools require applicants to take the Dental Admissions Test (DAT). When selecting students, schools consider scores earned on the DAT, applicants’ grade point averages, and information gathered through recommendations and interviews. Competition for admission to dental school is keen.

Dental school usually lasts 4 academic years. Studies begin with classroom instruction and laboratory work in basic sciences, including anatomy, microbiology, biochemistry, and physiology. Beginning courses in clinical sciences, including laboratory techniques, also are provided at this time. During the last 2 years, students treat patients, usually in dental clinics, under the supervision of licensed dentists.

Most dental schools award the degree of Doctor of Dental Surgery (DDS). The rest award an equivalent degree, Doctor of Dental Medicine (DMD).

Currently, about 17 States license or certify dentists who intend to practice in a specialty area. Requirements include 2 to 4 years of postgraduate education and, in some cases, the completion of a special State examination. Most State licenses permit dentists to engage in both general and specialized practice. Dentists who want to teach or conduct research usually spend an additional 2 to 5 years in advanced dental training, in programs operated by dental schools or hospitals.

Dentistry requires diagnostic ability and manual skills. Dentists should have good visual memory, excellent judgment regarding space and shape, a high degree of manual dexterity, and scientific ability. Good business sense, self-discipline, and good communication skills are helpful for success in private practice. High school and college students who want to become dentists should take courses in biology, chemistry, physics, health, and mathematics.

Some dental school graduates work for established dentists as associates for a year or two in order to gain experience and save money to equip an office of their own. Most dental school graduates, however, purchase an established practice or open a new one immediately after graduation. According to the ADA, each year about 12 percent of new graduates enroll in postgraduate training programs to prepare for a dental specialty.

I'm working on some tips on how to find a specialist that is right for you. Stay tuned...

This is a question I get quite often.

Once upon a time, if you had a tooth with a diseased nerve, you'd probably lose that tooth. Today, with a special dental procedure called a root canal, you may save that tooth. Inside each tooth is the pulp which provides nutrients and nerves to the tooth, it runs like a thread down through the root. When the pulp is diseased or injured, the pulp tissue dies. If you don't remove it, your tooth gets infected and you could lose it. After the dentist removes the pulp, the root canal is cleaned and sealed off to protect it. Then your dentist places a crown over the tooth to help make it stronger.

Treatment usually involves one to three appointments.

First, you will probably be given a local anesthetic to numb the area. A rubber sheet is then placed around the tooth to isolate it. Next, a gap is drilled from the crown into the pulp chamber, which, along with any infected root canal, is cleaned of all diseased pulp and reshaped. Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, or the tooth may be left open to drain, or the dentist may go right ahead and fill the canals.

If you're given a temporary filling, usually on the next visit it's removed and the pulp chamber and canal(s) are filled with rubberlike gutta percha or another material to prevent recontamination. If the tooth is still weak, a metal post may be inserted above the canal filling to reinforce the tooth. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve appearance.

You can find a nice graphical overview here.

I believe diabetes is a leading cause of death in the United States and is especially prevalent among African Americans. I see many people in clinic with diabetes and oral care should be an important part of their health regiment.

First you should be able to recognize the symptoms of diabetes; elevated sugar levels in the urine and blood, increased urination, thirst, hunger, weakness, weight loss, and itching. Prolonged hyperglycemia (excess blood glucose) leads to increased protein and fat catabolism, a condition that can cause premature vascular degeneration and atherosclerosis. Uncontrolled diabetes leads to diabetic acidosis, in which ketones build up in the blood. Patients have sweet-smelling breath, and may suffer confusion, unconsciousness, and death. There are two distinct types of diabetes mellitus: insulin-dependent and noninsulin-dependent.

Insulin-dependent diabetes (Type I), also called juvenile-onset diabetes, is the more serious form of the disease; about 10% of diabetics have this form. It is caused by destruction of pancreatic cells that make insulin and usually develops before age 30. Type I diabetics have a genetic predisposition to the disease. There is some evidence that it is triggered by a virus that changes the pancreatic cells in a way that prompts the immune system to attack them. The symptoms are the same as in the non-insulin-dependent variant, but they develop more rapidly and with more severity. Treatment includes a diet limited in carbohydrates and saturated fat, exercise to burn glucose, and regular insulin injections, sometimes administered via a portable insulin pump. Transplantation of islet cells has also proved successful since 1999, after new transplant procedures were developed, but the number of pancreases available for extraction of the islet cells is far smaller than the number of Type I diabetics. Patients receiving a transplant must take immunosuppressive drugs to prevent rejection of the cells.

Noninsulin-dependent diabetes (Type 2), also called adult-onset diabetes, results from the inability of the cells in the body to respond to insulin. About 90% of diabetics have this form, which is more prevalent in minorities and usually occurs after age 40. Although the cause is not completely understood, there is a genetic factor and 90% of those affected are obese. As in Type I diabetes, treatment includes exercise and weight loss and a diet low in total carbohydrates and saturated fat. Some individuals require insulin injections; many rely on oral drugs, such as sulphonylureas metformin, or acarbose.

If you have either form of diabetes, make sure you take care of your mouth. People with diabetes are at risk for mouth infections, especially periodontal (gum) disease. Periodontal disease can damage the gum and bone that hold your teeth in place and may lead to painful chewing problems. Some people with serious gum disease lose their teeth. Periodontal disease may also make it hard to control your blood glucose (blood sugar).

Other problems diabetes can cause are dry mouth and a fungal infection called thrush. Dry mouth happens when you do not have enough saliva—the fluid that keeps your mouth wet. Diabetes may also cause the glucose level in your saliva to increase. Together, these problems may lead to thrush, which causes painful white patches in your mouth.

You can keep your teeth and gums healthy. By controlling your blood glucose, brushing and flossing everyday, and visiting a dentist regularly, you can help prevent periodontal disease. If your diabetes is not under control, you are more likely to develop problems in your mouth.

Take steps to keep your mouth healthy. Call your dentist when you notice a problem.

If you have diabetes, follow these steps:
1) Control your blood glucose.
2) Brush and floss every day.
3) Visit your dentist regularly. Be sure to tell your dentist that you have diabetes.
4) Tell your dentist if your dentures (false teeth) do not fit right, or if your gums are sore.
5) Quit smoking. Smoking makes gum disease worse. Your physician or dentist can help you quit.

Take time to check your mouth regularly for any problems. Sometimes people notice that their gums bleed when they brush and floss. Others notice dryness, soreness, white patches, or a bad taste in the mouth. All of these are reasons to visit your dentist.

Remember, good blood glucose control can help prevent mouth problems.

Hi and welcome to my blog. I am currently a dental student practicing in clinic. Ever since I enrolled in dental school people think I have at the answers. I really don't but I can usually find the answers for people. I've decided to use this blog as a place to disseminate the little knowledge that I have.