Posts for: November, 2016
Stained teeth can be embarrassing — so much so you may even hesitate to smile. Before you seek out a whitening solution, though, there are a few things you need to know about tooth staining.
Tooth staining is more complex than you might think. There are actually two types: extrinsic, staining from foods and other substances of the outer surface of the enamel; and intrinsic, discoloration deep within a tooth that affects their outward appearance. The latter staining has a number of causes, including the type of dental materials used to fill a tooth, a history of trauma or the use of the antibiotic tetracycline during early tooth development.
There are some noticeable differences between the two types, although an examination is usually necessary to determine which you have. Extrinsic staining tends to be brown, black, or gray, or occasionally green, orange or yellow. Intrinsic staining can be red, pink or, if caused by tetracycline and fluoresced under ultraviolet light, yellow. If only one tooth is discolored it’s most likely intrinsic due to decay in the tooth pulp.
What can be done also depends on which type. Extrinsic staining can be modified through whitening, with either an office application or a home kit (there are differences, so you should consult with us before you decide). It may also be essential to modify your diet by restricting foods and beverages (coffee, wine or tea) known to cause staining and by eliminating tobacco use. You should also practice daily hygiene, including brushing with a toothpaste designed to diminish staining, and regular office cleaning and polishing.
Intrinsic staining can’t be addressed by these methods. Instead, you may need to undergo a procedure where we enter the interior of the tooth and insert a bleaching agent. If this isn’t an option, you can also choose a cosmetic restoration such as a porcelain veneer or crown that will cover the tooth to better match the color of your other teeth.
Dealing with stained teeth begins with a visit to our office to determine what type of discoloration you have and to learn your options. But regardless of what type you have, there is a way to a brighter smile.
If you would like more information on the causes and treatments of tooth staining, 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 “Tooth Staining.”
There are many reasons why teeth may need a whitening treatment to achieve an appealing brightness: what we eat and drink, natural aging, genetics, and the lack of dedication to oral hygiene can all play a role in how we look.
For vital (living) teeth, there are basically three different options for teeth whitening, and we’d be happy to help you decide which is right for you:
- In-office tooth whitening: The fastest way to get your smile radiant. A high concentration of a peroxide gel solution is applied directly to the tooth surface. Gums and other soft tissues are completely protected for your safety. This technique is excellent for whitening deep surface stains as well as general tooth whitening. This professional treatment requires the least amount of time to achieve the desired whiteness.
- The professional take-home option: Custom-made bleaching trays are prepared by our office. This technique is convenient and less expensive, but the desired whiteness will take longer to achieve than the in-office option.
- Over-the-counter products: These offer the least expensive option but use weaker whitening agents. For example, whitening strips, like the ones advertised on television, are popular and easy to use but will generally take the most time to achieve the desired success. Also, even agents that are not the strongest available may cause damage to teeth if used inappropriately and without professional supervision.
While there are normally no serious side effects after professional whitening treatments, there is a potential risk of tooth sensitivity and gum irritation. If either one or both of these occur, it should disappear within a few days.
It should come as no surprise that bleaching is not permanent. The whiteness will fade eventually depending on your diet, habits, hygiene, etc., but it usually will last at least six months — more often up to two years. Obviously, if you avoid drinking coffee, tea, or red wine, don’t smoke, and have a diligent oral hygiene routine your results may last longer.
Advertisements for teeth-whitening products are everywhere. If you have any questions about what you see, or simply want to do a reality check on their claims, please contact us or schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine articles “Teeth Whitening: Brighter, Lighter, Whiter...,” and “Important Teeth Whitening Questions Answered.”
A child's toothache is no fun for either the child or the parent. But if you're faced with this situation, don't panic — unless they have a fever or you notice facial swelling, it's unlikely an emergency.
Â Instead, take the following steps:
Find out where it hurts and for how long. Tooth pain can stem from a lot of causes, including decay or a localized area of infection called an abscess. See if your child can tell you if it's coming from one particular tooth or from a general area. Although children can't always judge how long they've hurt, try to get a general idea so you'll know if you need to call us sooner rather than later.
Look for problem signs in the mouth. As you look where they say it hurts, see if you can see brown spots or cavities on any teeth — this would indicate tooth decay. Look also at the gums or inner areas of the mouth for sores or swelling. Unless they've had an injury, this could indicate an abscess.
Try to dislodge any food shards between teeth. It's also possible the pain is coming from a piece of hard food like a popcorn kernel wedged between their teeth. Help them gently floss between the teeth to see if you can dislodge any.
Try to ease the pain. Although you may not need to see us immediately, your child's mouth still aches. You can help relieve it temporarily with a child's dose of ibuprofen or acetaminophen. You can also apply an ice pack to the outside cheek for swelling, but don't apply the ice directly to the skin, which can burn it. And don't rub aspirin or other pain relievers on the gums — they're acidic and can irritate soft tissue.
See us for a full examination. It's wise to have any tooth pain checked — the question is often how soon. You should see us the same day or first thing in the morning if the pain has persisted for more than a day or night, pain relievers haven't eased the pain or they have fever or facial swelling. If the pain is short-lived you can usually wait until the next day — but do get it checked out.
If you would like more information on treating your child's toothache, 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 “A Child's Toothache.”
A third of people treated for cancer develop adverse side effects within their mouth. But while these effects can be devastating to teeth and gums, there are ways to minimize the damage.
Treatments like chemotherapy and radiation work by destroying cancer cells. Unfortunately, they may also destroy normal cells. The accumulation of this “collateral damage” ultimately affects uninvolved areas and organ systems of the body. Chemotherapy, for example, can interrupt bone marrow blood cell formation and decrease the body's ability to fight infection.
These ripple effects can eventually reach the mouth. It's not uncommon for cancer patients to develop mouth sores or see an increase in tooth decay or periodontal (gum) disease. The treatments may also inhibit saliva flow: because saliva neutralizes acid and provides other benefits that lower disease risk, dental disease is more likely to develop when the salivary flow is reduced.
The first step to minimizing these effects is to improve oral health before cancer treatment begins. An unhealthy mouth vastly increases the chances for problems during treatment. Cooperating with your cancer physicians, we should attempt to treat any diseases present as soon as possible.
During cancer treatment we should also monitor your oral health and intervene when appropriate. If at all possible, you should continue regular dental visits for cleaning and checkups, and more so if conditions warrant. We can also protect your teeth and gums with protective measures like antibacterial mouth rinses, saliva stimulation or high-potency fluoride applications for your enamel.
What's most important, though, is what you can do for yourself to care for your mouth during the treatment period. Be sure to brush daily with a soft-bristle brush and fluoride toothpaste. You can use a weak solution of one-quarter teaspoon each of salt and baking soda to a quart of warm water to rinse your mouth and soothe any sores. And be sure to drink plenty of water to reduce dry mouth.
While you're waging your battle against cancer, stay vigilant about your teeth and gums. Taking care of them will ensure that after you've won your war against this malignant foe your mouth will be healthy too.
If you would like more information on taking care of your teeth and gums during cancer treatment, 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 Health During Cancer Treatment.”