If you're ready to put the "pizzazz" back into your smile, your dentist may be able to help. It's possible your dull, dingy smile could be transformed with teeth whitening.

Teeth whitening or bleaching is a technique that applies a solution with a bleaching agent (usually up to 35% hydrogen peroxide in an office setting) to the teeth to whiten them. Although there are Do-It-Yourself home whitening kits you can use, there are a few good reasons why you should first consider a whitening procedure in a dental office setting.

To begin with, you should first have your teeth examined by a dentist to determine why they're discolored. Certain foods and beverages we consume or tobacco habits are the usual culprits causing stains on the enamel, the outermost tooth layer. These are the kinds of stains targeted by most whitening solutions.

But the interior of a tooth can also become discolored for reasons like trauma, past dental work or tetracycline use at an early age. If your staining is internal (intrinsic) rather than external (extrinsic) reducing that discoloration will require an invasive procedure only a dentist can perform—a home kit won't be able to do the job.

Another reason for having your teeth whitened by your dentist (even extrinsic staining) involves your time and the degree of brightness you'd like. Because dentists use stronger bleaching solutions (home kits usually use a weaker solution of 10% carbamide peroxide) it takes fewer sessions than home kits to achieve results—and they may last longer. In addition, dentists have more control over the level of brightness to match your expectations of a more subdued, natural look or a dazzling "Hollywood" smile.

A dentist can also help you navigate special circumstances like matching and managing natural teeth whiteness with dental restorations (which don't bleach) or special whitening situations like a single discolored tooth.

Even if you eventually decide to go the home kit route, consulting with a dentist first can still prove helpful. You'll get expert advice on products, tips on how to apply them and how to prolong the whitening effect. Whichever way you go, home kit or dentist, you can gain a brighter, more confident smile with teeth whitening.

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 “Important Teeth Whitening Questions…Answered!”

Malocclusions (bad bites) may cause more than an appearance problem — with teeth and jaws not working together properly, you’re at higher risk for dental disease or accelerated tooth wear. Fortunately, most malocclusions can be corrected through orthodontics, a specialty for moving teeth to better functioning and more attractive positions.

If you’re considering orthodontic treatment for a malocclusion, here are the basics on 3 of the most common orthodontic appliances used for straightening misaligned teeth.

Metal Braces. These appliances have a proven track record for correcting most forms of malocclusion. Braces consist of metal brackets bonded to the front teeth and an anchor band to the back teeth. A thin metal wire passes through the brackets to attach to the bands in the back. Gradually increased tension in the wire incrementally moves the teeth to the desired position.

Clear Bracket Braces. While metal braces do an effective job of tooth movement, they leave less to be desired in appearance. Made of polymer material rather than metal, clear bracket braces offer a more appealing look. But while they’re similar in construction to the metal version, they’re more susceptible to breakage. Wearers must be extra cautious and avoid hard foods or extreme physical sports contact.

Clear Aligners. The previous appliances are fixed and can’t be removed by the wearer. Clear aligners take a different approach with removable plastic trays that fit snugly over the dental arch. A series of trays are computer generated to carefully match the patient’s mouth structure, each incrementally smaller than the previous one in the series. After wearing the first tray for two or three weeks, the wearer changes to the next (and slightly smaller) tray in the series, repeating the process until all the trays have been worn. Of the three options, the clear aligners offer the best appearance; however, they’re best suited for cases that don’t require complex movements.

We can advise you which option is best for you after a complete evaluation, factoring in age, lifestyle and the complexity of your malocclusion. Regardless of the choice, the aim is the same — achieving a healthier mouth, better function and a more attractive smile.

If you would like more information on orthodontic 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 “The Magic of Orthodontics.”

When planning for your new smile, we look at more than the condition of individual teeth. We also step back for the bigger “bite” picture: how do the teeth look and interact with each other?

If we have a normal bite, our teeth are aligned symmetrically with each other. This not only looks aesthetically pleasing with the rest of the face, it also contributes to good function when we chew food. A bad bite (malocclusion) disrupts this mouth-to-face symmetry, impairs chewing and makes hygiene and disease prevention much more difficult.

That's where orthodontics, the dental specialty for moving teeth, can work wonders. With today's advanced techniques, we can correct even the most complex malocclusions — and at any age. Even if your teen years are well behind you, repairing a bad bite can improve both your smile and your dental health.

The most common approach, of course, is braces. They consist of metal or plastic brackets bonded to the outside face of the teeth with a thin metal wire laced through them. The wire attaches to an anchorage point, the back teeth or one created with other appliances, and placed under tension or pressure. The gradual increasing of tension or pressure on the teeth will move them over time.

 Braces are versatile and quite effective, but they can be restrictive and highly noticeable. Many people, especially older adults, feel embarrassed to wear them. There is an alternative: clear aligners. These are a series of clear, plastic trays that you wear in sequence, a couple of weeks for each tray. When you change to the next tray in the series, it will be slightly different than its predecessor. As the trays change shape guided by computer-enhanced modeling, the teeth gradually move.

If you're interested in having a poor bite corrected, the first step is a comprehensive orthodontic examination. This looks closely at not only teeth position, but also jaw function and overall oral and general health.

With that we can help you decide if orthodontics is right for you. If so, we'll formulate a treatment plan that can transform your smile and boost your dental health.

If you would like more information on the cosmetic and health benefits of orthodontics, 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 “The Magic of Orthodontics.”

Families of children with chronic conditions face many challenges. One that often takes a back seat to other pressing needs is the prevention of tooth decay. But although difficult, it still deserves caregivers’ attention because of the dental disease’s potential long-term impact on oral health.

Chronically ill children are often at higher risk for tooth decay, most commonly due to challenges in practicing effective oral hygiene. Some conditions create severe physical, mental or behavioral impairments in children’s ability to brush and floss: for example, they may have a heightened gag reflex to toothpaste in their mouth or they may not be able to physically perform these tasks on their own.

Some children may be taking medications that inhibit salivary flow as a side effect. Saliva is critical for disease prevention because it both neutralizes mouth acid (which can erode tooth enamel) and is a first line of defense against disease-causing bacteria. And a child’s diet, while designed to support treatment of their chronic condition, may conversely not be the best for supporting their dental health.

It’s best if caregivers and their dentists develop a strategy for decay prevention, which should include the following:

• Regular dental visits beginning at Age One. Besides monitoring dental health, dental visits also provide cleanings and other preventive measures like topical fluoride or sealants;
• Brushing and flossing support. Depending on a child’s physical and mental capacities, caregivers (or an older sibling) may need to model brushing and flossing, or perform the tasks for the child;
• Medication and diet changes. If medications are causing dry mouth, caregivers can speak to their physicians about possible alternatives; likewise, they should see if modifications can be made to their diet to better support dental health.
• Boosting salivary flow. It’s especially important with children who have dry mouth to drink more water or use aids (like xylitol gum or candies) to boost salivary flow.

Although it requires extra effort and time to give attention to a chronically ill child’s dental health, it’s well worth it. By working to prevent tooth decay early in life, these children will be more likely to enjoy good dental health in the future.

If you would like more information on dental care for children with special needs, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Managing Tooth Decay in Children with Chronic Diseases.”

Due to financial circumstances, people often have a lost tooth restored with a removable partial denture, an effective appliance that restores function and a degree of aesthetic appearance. Later, though, they may want to improve both function and appearance with a dental implant.

If this describes you, you’re making a great choice. Dental implants are the closest technology we have to a natural tooth. But there may be a roadblock to your implant, especially if a long time has passed since your tooth loss—there may not be enough bone at the site to place an implant.

The heart of an implant is a titanium metal post surgically imbedded in the jawbone. The titanium naturally attracts bone cells, which grow and adhere to it to form a solid hold that can support a porcelain crown or other restorations like bridges or dentures. But to achieve a natural appearance it’s important that the implant is placed in the right location. To achieve that requires adequate bone.

But there may not be adequate bone if the tooth has been missing for a while. The forces generated when we chew travel through the teeth to the jawbone, which stimulates bone growth. If that stimulus is absent because of a missing tooth, new bone cells may not replace older ones at a healthy rate and the total bone volume begins to diminish. A denture can’t compensate and, in fact, accelerates bone loss.

But there may be a solution: bone grafting. With this procedure we place a donor bone graft into the area of bone deficiency some time before implant surgery. The graft serves as a scaffold for new bone cells to grow upon. Hopefully, this will produce enough healthy bone to support an implant. If the bone deficiency is minor, we may place the implant and the bone graft at the same time.

If you have experienced bone loss, we must first determine the amount of bone at the missing tooth site and whether grafting is a viable option. Bone grafting postpones your implant, but the delay will be worth the wait if we’re successful. With increased bone volume you’ll be able to obtain a new tooth that’s superior to your current restoration.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.