Transforming your smile doesn’t necessarily require complex treatments like orthodontics, dental implants or porcelain veneers. Sometimes a little brightness can mean all the difference in the world.
Bleaching (or teeth whitening) is a proven method for dealing with tooth discoloration and staining. Nearly all whitening products, whether home or professional, contain the bleaching agent carbamide peroxide or its breakdown product hydrogen peroxide. These agents effectively diminish staining deep within a tooth (intrinsic) or on the enamel surface (extrinsic), although intrinsic staining will require a more invasive office procedure.
If you have extrinsic staining you have three basic options: dental office bleaching, a retail home kit or a kit purchased from a dentist. Again, you’ll find the same basic bleaching agents in each of these versions. The difference will be the concentration: home kits contain about 10% agent by volume, while the office application will be a much higher range of 15% to 35% (which may also employ specialized lights or lasers to increase the bleaching effect). As a result, an office bleaching may take only a visit or two to achieve the desired brightness while a home kit about two or three weeks.
Whitening is a more economical route for smile enhancement of otherwise sound teeth than other measures. But there are other considerations you should weigh before undergoing a procedure. Whitening isn’t a permanent fix — the brightness will diminish over time, optimally six months to a year in what dentists call the “fade rate.” You can slow this process by avoiding or limiting foods and habits that cause staining.
If you have other dental work — crowns, bridgework or fillings — it may be difficult to achieve a tint level that matches these restorations, especially at home. And while whitening is relatively safe (as long as you’re using your kit as directed), you may experience tooth sensitivity, gum irritation or other minor oral side effects.
Before you decide on whitening, visit us first for a complete dental examination. From there we can advise you on whether whitening is a good smile enhancement choice for you.
If you would like more information on teeth whitening, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Whitening.”
As dentists, we often see other mouth problems besides those with teeth and gums. One of the most common is cracking around the corners of the mouth. Although usually not serious, it can be irritating and uncomfortable.
Medically known as angular cheilitis (literally “an inflammation of the angles of the lip”), it’s also called perleche, derived from the French lecher, “to lick.” The latter moniker aptly describes the tendency of sufferers to compulsively lick the sores to relieve irritation, which actually can make things worse.
Perleche has a number of possible causes, mostly from in or around the mouth (although systemic diseases or medications can cause it on rare occasions). It’s often found among younger people who drool during sleep or older people with deep wrinkles along the sides of the mouth that increase the chances of dryness and cracking. Long-term wind or cold exposure, ill-fitting dentures or a lack of back teeth (which help support facial structure) may also contribute to the condition.
Patients with perleche can also develop yeast infections from a strain called candida albicans. The infection can spread through the whole mouth, significantly increasing the chances of physical discomfort.
Treating perleche often involves topical ointments with inflammation-reducing steroids and zinc oxide, which has antifungal properties, to provide an environmental barrier during the healing process. If a yeast infection occurs, we may treat it with oral or topical antifungal medication like Nystatin for the whole mouth and chlorhexidine rinses, which has antibacterial properties.
It also helps to adopt a few preventive measures that can minimize the occurrence of perleche. If you wear dentures, for example, cleaning them often (including, if necessary, with chlorhexidine) and leaving them out at night reduces bacterial and fungal growth. We can also see if your dentures are fitting properly. Replacing missing teeth provides better facial support and could minimize wrinkling around the mouth. And, of course, keeping up daily brushing and flossing helps ensure a healthy and disease-free mouth.
If you’re experiencing cracked mouth corners, let us know at your next appointment. With our help and of other medical professionals we may be able to give you relief from this irritating condition.
If you would like more information on gaining relief from angular cheilitis, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Cracked Corners of the Mouth.”
It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.
“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”
While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)
When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.
Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.
But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.
Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
There are a lot of things we do without much conscious thought — habits we've developed over time. Some habits help streamline our lives for the good; others, though, hold us back or even harm us. A lot of these habits, both good and bad, form during our childhood years.
That's why it's important for you to guide your children into forming good habits. The goal is that when they're adults they'll “own” these habits, and their life will be healthier and happier because of them.
One particular area of habit-forming focus is dental care. It's essential your children develop good habits caring for their teeth and gums. The most important is a daily routine of brushing and flossing.
Brushing and flossing has one primary aim: to remove bacterial plaque, a thin film of food particles that builds up on tooth surfaces. Bacteria in plaque are the main cause for two potentially devastating diseases, tooth decay and periodontal (gum) disease. Allowing plaque to build up over just a few days can trigger an infection that inflames the gums or softens enamel leading to tooth decay. Left untreated these diseases can ultimately cause tooth and bone loss.
A daily habit of brushing and flossing, along with semi-annual professional cleanings, can drastically reduce a person's risk for these diseases. It's best to instill these habits and their importance as soon as your child's teeth begin to erupt in the mouth.
In the beginning, you'll be performing the habit for them: for children two and younger use a slight smear of toothpaste on the brush. As they get older, you can increase it to pea size. Eventually you'll want to help them learn to brush on their own. In this case, modeling the behavior — both of you brushing your teeth together — will have the biggest impact and help them see how important the habit really is.
Before you know it, brushing and flossing will become second nature, a habit they'll begin doing on their own without being told. Once instilled, it'll be a habit they'll practice long after they leave your care — and one they'll hopefully pass on to their own children.
If you would like more information on proper dental care for your child, 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 “How to Help Your Child Develop the Best Habits for Oral Health.”
Dental work isn’t performed in a vacuum — the state of your general health can have an impact on procedures and vice-versa. This is especially true if you’re taking certain medications like blood thinners.
Blood thinners such as Warfarin or Clopidogrel are used for a number of medical conditions as an anti-coagulant (inhibiting blood from clotting). They’re commonly part of a stroke or heart attack prevention strategy in patients with cardiovascular disease, or those with tendencies for thrombosis (blood clot formation within blood vessels) or pulmonary embolisms (blood clots within the lungs). They’re also used with patients with artificial heart valves or on a temporary basis with patients who’ve recently undergone knee replacement or similar surgical procedures.
In most cases, dental work won’t be affected by your use of a blood thinner. An issue might arise, however, if an invasive procedure has the potential to cause bleeding, like a tooth extraction or gum surgery. Because the blood doesn’t clot normally it may be difficult to stop the bleeding during such procedures.
To avoid undue complications, it’s always best to let your dentist or oral surgeon know what medications you’re taking, especially blood thinners (this includes low-dose aspirin, a common over-the-counter drug that’s often prescribed as a mild blood thinner). Depending on the procedure and your dosage, they may consult with your prescribing doctor to see if temporarily stopping the medication or reducing the dosage is an acceptable precautionary measure for your dental treatment. Your dentist may also take precautions during the procedure to help reduce bleeding such as using haemostatic agents around the wound site to help stabilize blood clotting, while carefully suturing the wound to avoid disrupting smaller blood vessels (capillaries) that easily bleed.
If your dosage has been temporarily stopped or reduced, you’ll usually be able to resume blood thinners immediately after the dental procedure. Working together, your dentist and doctor will help ensure that your health won’t be at risk and your dental procedure will occur without undue complications.
If you would like more information on dental work precautions with medications, 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 “Oral Surgery & Blood Thinners.”
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