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HOW TO HAVE A HEALTHY, WHITE SMILE
INTRODUCTION
They say that the eyes are the “windows to the soul.” If that is the
case, then the smile must be the doorway. Think about it for a moment.
Have you ever wondered how many times you will smile or laugh in your
lifetime? Does it really matter?
It can matter a great deal if you are one of the millions of Americans
who hide their mouth in shame rather than letting their inner joy reflect
outward.
Nothing lets the world know more about us than the way we project
ourselves on our surroundings and to other people.
Whatever the condition of your smile today, it can be changed. We
are about to show you how.
History
Before you can begin to appreciate what the advances in modern
dentistry mean to us in the modern world, we must take a look at dentistry
throughout the ages.
Sumerian tablets recovered from 5,000 BC tell us that these ancient
people took their dental care very seriously using the first known
toothbrush. It was fashioned from a tree branch and they used it to rid
themselves of "tooth worms."
Jump ahead to just 100 BC and we find a Roman medical writer
named Celsus. Believe it or not, he gave treatment advice for toothaches,
jaw fractures and even oral hygiene.
By the middle ages, medicine began to emerge as a vocation. Monks
were the surgeons and dentists of the day because they were usually the
only "educated" people in their location. They practiced from around 900
AD up until 1163 when "The Church" decided to forbade the practice.
Fortunately, barbers were privy to the knowledge once held by monks
only. During that period in history, barbers visited the monasteries
frequently. Monks required shaved heads then and that was a service
provided by the local barber. Because of their close association, the
barbers frequently assisted the monks in their medical and surgical duties.
It was a natural transition for them to pick up the slack after the monks
forbidden edict.
From around 1200 AD barbers eventually branched off into two
separate entities. One arm continued to do routine services such as
shaving, bloodletting and the extraction of teeth.
The other branch was the basis for more sophisticated medical, dental
and surgical services that eventually comprised the medical community.
By the 18th Century the medical profession had fully evolved. In
1760 the earliest medically-trained dentist arrived in America from England.
His name was John Baker and his was the first American dental practice.
Perhaps you have had an opportunity to view one of the movie “
westerns” where you often see the town barber called upon to extract a
tooth for an ailing cowboy. Even that is a far cry from modern dentistry.
With the advances in science and dental medicine it is now possible for
someone to have a total dental makeover, no matter what condition their
teeth may be in.
In The Beginning
Having a healthy, white smile really isn’t a mystery but in order to
understand how your smile can be improved you need to have a basic
understanding of how your teeth got to where they are today.
The construction and methodology of our teeth has been the same
for thousands of years. Archaeologists recently uncovered a grave that
contained an Eskimo child. Due to the dry cold arctic climate, the mummy
was perfectly preserved.
Using sophisticated imaging the scientists were able to obtain a
perfect image of the skull. There, just below the first set of teeth, lying
dormant inside the jaw lay a full set of adult teeth waiting to erupt. For
our little child, that would never happen but we are able to understand the
progress of dental formation.
Just as our little Eskimo child, we are all born with two complete sets
of teeth. Our first set is called “primary teeth.” You probably recognize
them better when referred to as our “baby teeth.”
They are called baby teeth because the first appear at around 6
months of age. You could almost call these our “practice teeth.” Their role
is to reserve a spot for the permanent tooth which will begin to appear as
the baby teeth are pushed up and out of the way. This onset of permanent
adult teeth begins to occur when we are around 6 years old.
Even though our first set of teeth is temporary, their role in our
dental life is very important. In addition to being placeholders for our
permanent teeth, these baby teeth are what help us to speak and how to
chew.
The first teeth to erupt are usually the four front teeth. You probably
don’t remember what they looked like, but they are the most beautiful
shade of white imaginable! When the permanent teeth push the baby
teeth out of the way and erupt they too will be a beautiful translucent
white. Teeth that dreams are made of!
Even if your child has just one, tiny little pretty white tooth, it is
important that you launch him/her on their road to dental health. So, begin
by brushing that little tiny tooth and all others as they begin to appear. It
isn’t necessary to use toothpaste, just use plain water. It’s never too soon
to begin good dental health practices.
Believe it or not, that first little tooth is just as susceptible to decay
as adult teeth. One common problem connected to tooth decay in infants
is called “baby bottle decay.” It occurs as a result from excessive amounts
of sugar in the formula, juice or milk the child consumes. For this reason it
is a good idea to switch from a bottle to a cup as early as possible for your
child.
You also must not allow a child access to beverages such as this on a
continuous basis. Nor should a child be allowed to roam around with his or
her cup. When a child is thirsty between meal times, offer water. This will
cut down on the possibility of tooth decay and train the child to drink more
water, the healthier choice.
A leading cause of dental problems in children is dry mouth. Mouth
breathing causes the mouth to dry out. A dry mouth provides a perfect
environment for the bacteria that causes tooth decay and to grow.
Children tend to breath through their mouth more often than adults
and appear to have more instances of colds, allergies, sinus infections and
other nose and ear problems.
A child who sucks their thumb or blanket can also dry out the mouth.
Older children who smoke or use alcohol also set themselves up for dry
mouth.
You will set a habitual pattern for your child to follow the rest of his
life and you will be able to remove particles of food that could develop into
plaque which can cause all kinds of problems.
Good Dental Health Care
Do you remember your parents telling you over and over, “brush your
teeth?” There was a reason for it and now that you are an adult you
probably have a much better understanding of how this takes place.
However, there may be some elements you have forgotten so let’s see just
what factors contribute to our dental health.
There are many reasons why teeth become discolored. The majority
of them can be traced back to poor dental hygiene. There is no substitute
for regular personal care. For instance, did you know that you need to
throw away your toothbrush at least every six weeks or so? Don’t wait until
the toothbrush looks like it’s worn out, replace it automatically!
In addition, follow these tips:
Proper way to brush teeth.
You brush should be against the gums at a 45 degree angle. Strokes
should be gentle in tooth wide increments. Brush each side and the top.
Don’t forget to brush your tongue.
Proper toothbrush care.
If this topic appears to be another “no brainer” it really is not. Many
people do not understand proper care of their toothbrush. Remember, it is
an object that enters your mouth daily coming in contact with billions of
bacteria not to mention certain instances of contamination by bleeding of
the gyms or other conditions.
First of all, never share your toothbrush! There is a huge risk of
cross-contamination when this practiced is followed.
Always thoroughly rinse your toothbrush after use and store it brush
side up to dry naturally. If a common storage system is used, do not allow
the brushes to come in contact with one another.
There are mixed thoughts regarding the storage of toothbrushes in a
disinfectant. One school of thought advocates that you can do more harm
by storing the toothbrush in the same disinfection repeatedly, thereby
creating another possibility of cross-contamination.
Never store your toothbrush in a closed container that can set up a
favorable climate for bacteria to form.
Proper way to floss.
Use a length of floss 16 to 18 inches in length. Wrap the floss
around each of your middle fingers. Slip the floss between your teeth.
Form a u shape against the side of one tooth. Beginning at the gum line,
use a gentle rubbing motion to remove the particles of food. Repeat with
each adjacent tooth remembering to take up the slack so that you are using
a clean section of floss for each tooth.
How Teeth Become Discolored
Teeth can become discolored for many reasons. Most apply to poor
hygiene as we stated above. Coffee, tea and tobacco are three culprits
that come to mind. Those are just the tip of the iceberg, however.
The problem is that by the time we realize that our teeth have
seriously deteriorated in color, enough time has gone by that we usually
have some type of dental health problem which must be addressed before
we can even begin to think about “cosmetic” procedures.
Any type of dental disease makes the enamel of the teeth vulnerable
to ugly discoloration.
What are some of the common problems dentists see in their patients
that lead to dental disease, destruction and discoloration? Let’s review
some of what they have to say:
Abscessed tooth.
Infection of the tissue surrounding a tooth that usually fills with pus
which has a very smelly odor.
Alcoholism.
Immoderate use of alcohol causes decreased production of saliva
causing dryness of the mouth. Dry mouth is a leading cause of tooth
decay.
Atrophic rhinitis.
This is an inflammation of the nasal mucous membrane usually a
result of nasal drip due to colds or sinusitis. Bacterial changes in the
mouth can increase risk for dental disease.
Cancers.
Cancers such as esophageal, pharyngeal, oral tumors, leukemia,
pulmonary and stomach cancer all present severe complications due to the
decay that is taking place. Additionally, the medical treatments for these
cancers can exacerbate a problem with bad breath and certain medications
can cause severe discoloration of the teeth.
Oral Candida.
This is a fungal infection of the mouth cavity. Also known as thrush,
it is fairly common among infants, diabetics, chemotherapy patients and
people with HIV or AIDS.
Cavities
Cavities are much less prevalent today than they were in the middle
of the last century. The reason is attributed to the good education with
regard to dental health, but more importantly the introduction of fluoride
into municipal water systems which began in 1945.
Diabetes.
People who have diabetes may also have poor teeth. This occurs
because of poor control of blood sugar, the problem with most diabetics.
The two situations go hand in hand. Gum disease is a problem for
diabetics. And, diabetes is a problem for people with gum disease.
It can be difficult to determine which comes first, the diabetes or the
gum disease, but the underlying problem is clear. High blood sugar
contributes to gum disease. Diabetics have trouble controlling the high
blood sugar. Gum disease is a leading cause of bad breath, hence the
correlation.
The American Dental Association reports that people with type 1
diabetes 5 are at greater risk for gingivitis.
Drugs and drug abuse.
Certain drugs such as antihistamines, antidepressants, blood pressure
meds, steroids, cancer therapy drugs, diuretics and oral contraceptives are
all known to increase the propensity for gum disease.
Drug abuse is a different matter entirely. This is a sad footnote to
our culture today. In years past this subject wouldn’t even be considered in
a guide such as this. A study conducted in 2003 revealed that 12.3 million
Americans 12 years old and over tried methamphetamine at least once.
This number is staggering when you consider that represents 5.2% of our
population.
Not only are the health risks tremendous but the damage to the teeth
is often irreversible. Dentists have reported that the teeth of
methamphetamine users are described as rotting, black, stained and
literally falling apart and crumbling. The drug is highly acidic and reduces
the production of saliva. Users tend to grind their teeth and crave sugar in
any form. The drug also remains in the system for up to 12 hours
prolonging the exposure during a period when the user probably will not
even consider brushing or flossing.
Removal of the teeth is often the only course of action.
Eating disorders.
We have mentioned that vomiting is a known cause of bad breath.
Hand in hand with vomiting are potentially dangerous disorders such as
bulimia and anorexia.
Bulimia involves the practice of repeated binge eating followed up by
self-induced vomiting called “purging” and is normally done secretly.
The reasons for engaging in this practice are different for each
participant. However, it is generally accepted by the medical community
that those who suffer from bulimia eat for “comfort.”
They use food as a therapy and consume large amounts to induce
inner feeling of well being. It appears to temporarily drive away feelings of
anger, loss, sadness and other negative, human conditions.
Each time they binge, they need to purge so they can recapture the
emotional band-aids they get while binging. It is an extremely dangerous
practice.
The purging process is also accomplished by fasting, taking diet pills
or using diuretics. Not only does the practice rapidly deplete the body of
natural resources, it also creates a dry mouth situation which causes decay.
If you know of someone who you suspect may be on a damaging “binge
eating” program watch for the warning signs. If you suspect they may be
engaged in this behavior, intervention may be in order.
Anorexia is also extremely harmful. While it may manifest itself in
some of the same ways as bulimia, it is different in that the victim has a
fear of weight gain and even the slightest ounce of body fat just can’t be
tolerated. Rather than binging and purging, purging is the tool of
preference for people who suffer from anorexia.
Body piercing.
Our purpose of discussion that relates to body piercing is obviously
directed toward oral piercing. It is not our intent to make any judgment of
the practice, merely to point out some of the risks involved for those who
choose to engage in this kind of activity.
The most obvious risk factor is infection which can occur when there is
a lesion on any part of the body. However, as we know that the mouth is
the perfect environment for bacteria to grow, whether it is “good” bacteria
or “bad” bacteria.
You might think that the risk is greater at the time of piercing and
that would be correct. However, continual handling of the jewelry after
placement greatly increases the odds of infection down the road. Oral
piercing may also put you at risk for blood contamination and increase the
possibility of hepatitis B, C, D and G.
Damage to the blood vessels in the tongue or cheek can induce
prolonged bleeding and in some cases nerve damage can occur.
Just having the jewelry in the mouth can damage the soft tissue
around the teeth causing the gums to recede.
Constant clicking of the jewelry against natural and/or restored teeth
can cause the enamel or veneers to crack or chip.
Oral jewelry can also create more saliva than is necessary. Some
people have reported problems with speech and a pronounced reduction in
the ability to pronounce words properly. Others say that their ability to
chew was impaired.
Another worse case scenario is the risk of having the jewelry dislodge
causing a dangerous choking situation or even swallowing the jewelry and
having it end up in the digestive tract which is dangerous itself.
Finally, there is no doubt that having a foreign body in your mouth is
going to create a poor environment for healthy teeth. Keeping the area
around the piercing 100% clean 100% of the time is impossible. It only
takes a few tiny particles lodged in or around the entrance and exit of the
jewelry stud to create tooth decay. And, that’s even before you add in the
factors discussed above.
So, if you do choose to engage in the practice prepare yourself for
some pretty hefty maintenance and the possibility of infection or even
worse circumstances.
These examples are not the norm, of course, but if you do experience
any of them, it would be prudent to contact a physician especially if they
replace previously normal breath odor.
Dry mouth.
Sounds like such an innocuous little phrase, doesn’t it? Thought to
be one of the leading causes of dental disease, dry mouth occurs when
saliva production is reduced and carries its own nasty little package of
problems.
The medical term for dry mouth is “xerostomia” (pronounced
ZEER-oh-STOH-mee-ah). Saliva performs vital work in your body. It aids in
digestion by using the enzymes to help break up different foods and also
makes it easier to talk.
Saliva helps prevent tooth decay by rinsing away food particles from
between the teeth as well as the gums. Saliva also helps you taste the
food you eat and makes it easier for you to swallow that food and is also
known for neutralizing any damaging acids.
It is believed to be caused primarily by certain medications which we
listed in the previously. The symptoms of dry mouth can include:
Dry, rough tongue
Poor sense of taste
Burning sensation in your mouth
Increased plaque
Reduced saliva production
Alzheimer’s disease, AIDS and stroke are also attributed to causing
dry mouth as well as pregnancy and/or hormonal changes due to
menopause.
Increasing fluid intake can help to re-hydrate the mouth. It’s
important to keep it moist so you don’t lose all the benefits provided by
saliva production.
Gum disease/Gingivitus.
This is inflammation of soft tissue surrounding the teeth. This
condition is much more serious than a single abscess. Gingivitis is the
precursor to periodontitis which is the final step of gum disease that can
ultimately lead to tooth loss. This will be discussed in depth a bit further
on.
Impacted tooth.
An impacted tooth is one that rebelliously will not erupt into its
proper position and most often results in infection, which we know is
another cause of bad breath and ultimately can result in loss of the tooth.
Periodontal disease.
It’s hard to believe that in a 2002 poll of 1,000 Americans over the
age of 35, it was determined that 60% of adults polled knew little or
nothing about gum disease! A tragedy when you consider that gum disease
is the leading factor in tooth loss, even healthy teeth.
Your teeth can appear to be healthy and disease free, when under the
surface gum disease can stalwartly march on creating a condition that will
ultimately lead to serious tooth loss. Bad breath is a “red flag” to help
determine if this problem is prevalent in your mouth.
Healthy gum tissue forms a shallow groove at the point where the
tooth meets the gum line. This disease occurs when the anaerobic, sulfur
producing bacteria we discussed earlier, become trapped beneath the gum
line.
This is a perfect breeding ground for the bacteria and they will settle
in and take residence.
Not recognizing and dealing with the problem will result in serious
dental problems up to and including loss of teeth and even underlying bone
disease.
If you are diagnosed with serious periodontal disease, work to save
your teeth needs to begin as soon as possible.
The first step that your dentist will take is probably what is called “
scaling and root planing.” This is a non-surgical procedure to remove the
deposits of plaque on the surface of the tooth including the root. Since
periodontal disease rarely occurs in just one tooth, this will probably need
to be done to all your teeth.
The dentist will scrap the surfaces of the tooth below the gum line to
remove all traces of plaque clear down to the bottom of the pocket. He will
then smooth the surface of the root to encourage healthy gum tissue to
heal. This process also discourages plaque from reforming.
Depending on how involved your case might be, the dentist may
prescribe medication to assist in healing or control pain and potential
infection.
More diagnostics are required before a prognosis of your case of
periodontal disease can be given. Each deposit of plaque creates its own “
pocket” and the dentist needs to measure the depth of the pockets that
were scaled during your first visit.
Often, the scaling procedure works well to eliminate the problem and
you are free from further treatment other than normal examinations. At
this point you would be well served by employing a daily regimen of
preventative maintenance to insure the disease does not return.
However, if the diseased pockets are deep and extending into actual
bone, you may need to have surgery in order to keep the teeth. If this is
the case, your dentist will refer you to a periodontist, a doctor who
specializes in periodontal disease.
The periodontist will use a surgical process to aggressively penetrate
the diseased areas and ferret out the plaque and bacteria. The pockets
where plaque resides must be sealed off so the environment does not
invite a return of the disease.
In some cases bone surgery or bone grafts may be necessary to
rebuild bone that was destroyed by the periodontal disease. If there was
substantial tissue damage grafts may need to be used to replace the soft
tissue. This procedure involves removing gum tissue from your palate to
cover the areas where severe gingivitis has penetrated too far into the gum
line.
Your dentist or oral surgeon may also recommend further treatment
and/or medications. Here is a list of FDA approved products to help combat
periodontal disease:
Name
Colgate Total
What It Is
Over-the-counter
Why It’s Used
The antibacterial
How It’s Used
Used like a regular
triclosan and
fluoride
toothpaste
toothpaste
containing the
antibacterial
triclosan
Peridex or
generic
chlorhexidine
mouth rinse
Prescription
mouth rinse
containing an
anti-microbial
called
chlorhexidine
A tiny piece of
gelatin filled with
chlorhexidine
Periochip
ingredient
reduces plaque
and resulting
gingivitis. The
fluoride protects
against cavities.
To control
bacteria,
resulting in less
plaque and
gingivitis
toothpaste
To control
bacteria and
reduce the size
of periodontal
pockets
Chip is placed in
the pockets after
root planing,
where the
medicine is slowly
released over
time.
Placed in pockets
after scaling and
root planing.
Antibiotic is
released slowly
over a period of
about seven days.
These fibers are
placed in the
pockets. The
medicine is
released slowly
over 10 days. The
fibers are then
removed.
Microspheres
placed into
pockets after
scaling and root
planing. Particles
release
minocycline slowly
over time.
This medication is
in pill form. It is
used in
combination with
scaling and root
planing
Atridox
A gel that
contains the
antibiotic
doxycycline
To control
bacteria and
reduce the size
of periodontal
pockets
Actisite
Thread-like fiber
that contains the
antibiotic
tetracycline
To control
bacteria and
reduce the size
of periodontal
pockets
Arestin
microspheres
Tiny round
particles that
contain the
antibiotic
minocycline
To control
bacteria and
reduce the size
of periodontal
pockets
Periostat
A low dose of the
medication
doxycycline that
keeps destructive
enzymes in
check
To hold back the
body’s enzyme
response—if not
controlled,
certain enzymes
can break down
bone and
connective
tissue.
Used like a regular
mouthwash
Pharyngitis.
This is an inflammation in the area at the back of the mouth known
as the Pharynx as usually occurs because of a virus.
This is the same area where you begin to feel a slight “scratchiness”
at the onset of a cold or flu. The bacteria involved can lead to more
serious streptococcus, commonly known as “strep throat.” If it progresses
it can be highly contagious and because it is bacterial it will produce bad
breath and possible tooth decay.
Poor dental hygiene.
We have discussed some of the leading causes of dental disease, but
nothing matches poor dental hygiene as a leading cause of tooth decay and
discoloration.
Lack of brushing, flossing and regular checkups are the most
important weapon for ridding oneself of bad breath and preventing more
serious conditions from developing.
All of these conditions can leave you with teeth and that need lots of
help!
Fortunately we live in the modern world. Unlike those ancestors of
ours, we have access to dental procedures that were nothing more than “
science fiction” in centuries past.
How To Have A Beautiful Smile
Begin with a healthy diet.
Avoid snacking between meals. Brush and floss your teeth after
every meal. If you must snack, make them healthy snacks Instead of
snacking on junk food, try chewing on fresh fruits and vegetables,
especially the crunchy foods. Apples, pears, celery and carrots are good
suggestions. They will aid in enzyme production and the natural chewing of
the crunchy foods will stimulate the gums.
Drink plenty of water.
Keep your mouth moist and avoid dry mouth. Remember that dry
mouth is a harbinger of dental disease. We also need that water to
stimulate the production of saliva.
Avoid drinking soda pop.
Americans consume gallons of soda pop a day. Most is loaded with
sugar which obviously leads to dental disease and discolored teeth. Don’t
be fooled by a “diet soda” label. Even they have huge amounts of acids
that are deadly to the enamel on your teeth.
And, if you thought that just sodas are the culprit, think again. A
recent study claims that all those popular sports drinks we buy may not be
such a good idea after all. They may re-hydrate the body, but they can
cause irreversible damage to the dental enamel.
The study reports that fitness water, sports drinks, energy drinks and
other non-cola beverages increase the risk of damage by anywhere from 3
to 11 times!
It should be mentioned that the findings are indicative of long term
use. However, it appears that these drinks may not necessarily beneficial
as a substitute for plain old-fashioned fresh water!
Selecting A Dentist
Choosing a family dentist is much the same as choosing your family
doctor. In fact, one tip would be to ask your doctor who he or she chooses
to visit for their dental needs. That’s a pretty good endorsement!
If that is not an option, then common sense should prevail. Do your
due diligence. Try walking through the yellow pages if you’d like, but a bit
more in depth analysis might be prudent.
Check with your state licensing agency to determine if a dentist you
are considering is licensed to practice in your state.
Contact the office of your state attorney general to determine if there
has been any malpractice claims filed against a particular individual.
Check with your Better Business Bureau to determine if there have
been any complaints filed for which the dentist has failed to respond.
Talk to your friends and neighbors to obtain personal referrals or
recommendations.
If you have dental insurance your plan may require you to use their
preferred providers. If that is the case, work from that list following the
recommendations listed above. It’s your family. It’s your money. It’s your
health.
Cosmetic Dentistry
Nothing since that Ancient Sumerian fashioned the first toothbrush
from a simple twig has impacted the dental field more than cosmetic
dentistry. Today it is possible for the average American to sport the same
picture perfect smile as any celebrity.
Cosmetic dentistry encompasses several different procedures which
we will investigate. You may even have some of these procedures in your
mouth right now. . .in fact the odds are that you have had some type of
cosmetic dental procedure in your lifetime.
It’s important to meet with your dentist for an initial examination to
determine if you are a candidate for cosmetic dental work. Your teeth must
be in good condition before any cosmetic work is undertaken. If any type of
dental disease is present, your dentist will explain what needs to be
accomplished before proceeding with cosmetic work.
Once that is determined the dentist will explain the various cosmetic
options available that are suitable for your needs, whether it be braces,
bridges, bonding, veneers, bleaching and so on.
Whitening is one of the primary reasons that people consider
cosmetic procedures. But, it’s important to realize that often whiteners
alone may not help. In fact, studies by the American Dental Association
have shown that teeth with a yellowish tone will whiten well with a
bleaching process whereas teeth that are brownish may not bleach well and
grayish teeth may not bleach well at all.
If you have had other cosmetic processes done and then decide to try
whitening, you could end up with a very undesirable effect of not having all
your teeth uniform in color. It’s important to follow the advice of your
dentist and not be swayed by advertising or how your best friends’ work
turned out!
Let’s explore the cosmetic options:
Braces.
While you may have worn braces as a child, braces are now a
treatment option for adults as well although realignment may take longer
for an adult. In some cases an adult will require more than just an
orthodontic procedure.
Braces are the recommended treatment to correct an orthodontic
problem called malocclusion or “bad bite.” A few of the causes of the bad
bite are extra, missing or crowded teeth. This condition is usually inherited
although some may be caused by accident or other means. Having a tooth
knocked out and chronic thumb or finger sucking may contribute to a bad
bite.
Before treatment can begin, a thorough history is necessary for the
dentist to render a proper prognosis. The dentist may take numerous
xrays, plaster molds and photos of your face and teeth before determining
whether orthodontics is an appropriate method to apply to your individual
situation.
If the dentist determines that your treatment requires mechanical
appliances, the information gathered in his preliminary examination will
help to create your custom appliance(s). There are many different types of
appliances and the best recourse is the one created specifically for you.
Once created and put in place, the appliances will require periodic
adjustments. The dentist needs to monitor the progress frequently in order
to assure that the teeth are shifting in position accurately.
Finally, once the appliances have done their work, they will be
replaced by a “retainer.” The retainer will stay in place so that the newly
aligned teeth will remain in their proper location.
One of the first questions from patients is usually, “how long will I
have to wear this?” This not a “one size fits all” situation as the time
varies from patient to patient. It will take as long as it takes and greatly
depends on patient cooperation. Average time for orthodontic treatment is
around 24 months with adult treatments requiring just a bit longer.
Other factors apply, of course, such as how severe the bad bite,
overall gum and tooth health not to mention how well the patient
cooperates with the procedure. Most people who have worn braces report
years later that it was well worth it!
Bridges.
Sometimes permanent teeth need to be replaced. Teeth can be lost
through dental decay, knocked out in accidents or, in some rare cases,
never grow in the first place.
When this occurs a cosmetic process is used to fill in the blank space
with one or more teeth. The dentist will create what is known as a “bridge.
” Just as the name implies, it entails creating an appliance that will place
a tooth precisely where it needs to be. This is considered a cosmetic
process even though sometimes the bridge is more functional, for instance
in the molar area. The bridge also helps maintain the integrity of the
bones.
There are three types of bridges that your dentist might use
depending on your circumstances. They come in porcelain, alloys or a
combination of both.
Fixed partial bridge. This appliance is used to “fill the gap” created
by a missing tooth or teeth, is considered permanent and bonds directly to
the surrounding teeth for support.
Removable bridge. This bridge is the same as the fixed partial bridge
with the exception that you can remove it.
Implant bridge. Implants are the most recent choice in the family of
bridges. Implant bridges are permanently affixed to the jaw.
Simplistically, a hole is drilled into the jaw below the gum line where a
prosthetic tooth is embedded directly into the bone. The gums will then
grow back around the “root” of the artificial tooth and voila’ out pops a
brand new smile.
Even thought they are expensive, many people have voiced their
approval of the procedure. This is especially true of more mature patients
who may suffer from long term, ill fitting dentures.
The implant bridge is the closest to natural teeth that a patient can
ask for. They are a far cry from the wooden dentures worn by George
Washington in 1776!
Crowns.
Many people who have discolored teeth opt to use a “crown” as a
remedy. Just as the name applies, this is a prosthetic device that covers
the tooth. Sometimes a tooth may have a large filling and there is very
little tooth left to support the filling. This would be an effective treatment
for that situation. They are often used in conjunction with the dental
implants we discussed above. A crown makes your tooth stronger as well
as prettier!
Bonding.
Bonding is a cosmetic treatment for teeth that involves placing tooth
colored bonding material directly to the surface of the tooth using resin.
First the tooth is prepared by slightly etching the enamel. This is done in
order to give the bonding material “mechanical retention” allowing the
bonding material to adhere to the tooth properly. Then the bonding
material is applied, shaped and sculpted. A ultraviolet “laser” light is used
to harden the resin material. When the process is complete the tooth is
polished to a high shine.
Bonding is also used now for “fillings.” In fact, it is favored over the
old silver (amalgam) fillings because the bonding resin can be matched to
the rest of your tooth color. The downside to bonding, is the expense.
Bonding is more expensive to silver. The bonding material is also porous
making it a poor choice for smokers as it will yellow.
This is considered a permanent procedure because of removing small
amounts of the natural tooth enamel.
Enamel shaping.
This process is often done in conjunction with bonding. The enamel
is sometimes removed or reshaped. Shaping allows the dentist to sculpt
chipped, cracked or broken teeth using bonding material as discussed
above. In both procedures the catalyst is usually done with a laser light
which insures that the material is securely merged with the natural tooth
material.
Veneers.
You may have heard the term “veneer” in conjunction with wood
working. The process for cosmetic dental applications is much the same.
Very thin covers are custom created for each individual tooth. They fit the
front side of the tooth and are another option to bonding or shaping. The
same basic process is used to attach the veneers to the teeth. Veneers are
very popular because they are so thin and somewhat resistant to staining.
There are two different options for veneers.
Porcelain, or “indirect” veneers are handcrafted in a laboratory
especially to fit your teeth. They are expensive but are said to last from 10
to 15 years.
Composite, or “direct” veneers are enamel which is bonded directly to
the tooth are significantly less expensive but their “shelf life” is only 5 to 7
years.
If you have Almost translucent they can literally breath new life into
damaged or discolored teeth.
Bleaching.
This process involves the application of a rubber shield or a gel to
your gums before work commences. This is necessary in order to prevent
harm to the soft tissue. Bleaching material is then applied, sometimes
using a laser light to enhance the procedure. The process may require
several visits to the dental office.
Kits for bleaching are available for home use and you might discuss
choose to discuss that possibility with your dentist. The actual bleaching
agent is carbamide peroxide solution. It usually comes as a gel and placed
in a mouthguard. The frequency and length of treatment will vary from
person to person depending on the amount and intensity of whitening you
desire. This should be discussed with your dentist before proceeding.
Occasionally there is some soft tissue irritation. If you experience
any side effects from using the agent, contact the dentist immediately.
Teeth whitening strips.
Teeth whitening strips are simply cool!
These are probably the most convenient advancement in dental care
in decades taking the concept of tooth bleaching to an entire new level of
speed and convenience.
The whitening strips contain hydrogen peroxide which is embedded in
transparent material that fits over the teeth. Almost totally undetectable
when worn, the peroxide goes to work as soon as they are activated by the
moisture in your mouth. (Another good reason to avoid dry mouth!)
There are several brand names on the market and all work pretty
much the same. They are applied over the teeth and worn for 30 minutes
twice a day for 21 days, or you may select the type that can be worn
overnight whitening the teeth while you are sleeping.
How long the effects last will vary depending on diet and lifestyle.
Your teeth will stain again, but you can lengthen the time between
incidences by avoiding tobacco, tea, red wine, colored juices, curry, soy and
soft drinks. If you are on well water, you might want to have the water
tested. High concentrations of minerals in your water will cause staining of
your teeth. Or, you may just opt for bottled water. The results from the
teeth whitening strips are absolutely incredible and you would do well to
give them a try.
Good to Know
Pregnancy and your oral health care.
Having babies does not cause you to lose teeth. If you lose a tooth
during your pregnancy it will be from some other cause. There’s an old
wives tale about losing calcium from your teeth to feed your baby. Plain
and simple, this is a myth.
Calcium for your baby comes from your diet and nutrition, not your
teeth! If your body is lacking calcium then you need to make up for it in
your diet whether it be increasing your intake of foods high in calcium or
taking a supplement. hat does not mean that dental care isn’t important
while pregnant, it just means don’t listen to old wives tales and take your
guidance from your physician.
There is one area of dental health that you should pay attention to at
all times, but especially when you are pregnant.
If you notice that your gums become swollen and you are pregnant,
you should schedule an appointment to see your dentist and rule out
periodontitis, a serious gum disease. Some research has shown that low
birth weight and premature birth are linked to serious gum disease.
Practice good oral hygiene by brushing and flossing properly taking
special care to clean around the gum line. To control gingivitis, you might
want to increase your cleanings to include after all food intake during the
second and third trimester.
Continue regular dental visits and treatments making certain that
your dentist is aware of your pregnancy. One thing to avoid if you are or
suspect that you are pregnant are x-rays.
Grinding your teeth.
Do you grind or clench your teeth? The medical term for this
condition is “bruxism.”
Many people are not even aware they have this condition because it
is done in their sleep. If you find yourself waking up in the morning with a
painful jaw, earache, toothache or headache, this might be the cause.
Bruxism is potentially dangerous for the overall health of your teeth
because the grinding and gnashing can wear away the enamel on the
surface of the tooth. As the grinding continues and more enamel is
removed the layer of actual dentin may be exposed. This can cause your
teeth to become sensitive to hot and cold.
This condition would also remove you as a candidate for any type of
cosmetic dental work until the tooth is repaired.
Causes for bruxism are not well known, although stress, insomnia
and a “bad bite” are some suggestions.
There is treatment available for bruxism and the best detection will
occur at your regular dental checkup.
Sensitive teeth.
Does a shot of hot coffee in your mouth cause you to cringe with
pain? Or does a nice bite of ice cream send you through the ceiling?
This is caused by exposing the layers of dentin below the enamel.
The exposed portion of your tooth (above the gum line) is covered with
enamel and the lower portion (beneath the gum line) is covered with
cementum. This is what protects the softer material beneath it which is
called “dentin.”
When the dentin is exposed the nerve endings are susceptible to
changes in temperature, pressure and so on. This can be caused by
combination of problems. Grinding of the teeth that creates wear on the
enamel, cracking or chipping a tooth and periodontal disease are all
possible culprits.
There are several different treatment options depending on the
severity of the problem. That can only be diagnosed by your dentist so
make certain you schedule your regular checkups.
Antibiotics and dental care.
Certain physical conditions cause interaction with some medications.
The circumstances that determine whether special care needs to be taken
with regard to your dental treatments are heart conditions and joint
replacement.
One situation that should be approached with care is Bacterial
Endocarditis. Your dentist may recommend a regimen of antibiotics prior to
your dental treatment to insure that you are protected should there be any
blood loss during the treatment. This is normally done as a precaution to
combat potential bacterial infection. Some of the heart conditions that
would fall under this category are:
Recent heart surgery
Congenital heart defect
Artificial heart valve
Recent vascular surgery
Heart murmur
Rheumatic fever
Previous bacterial endocarditis
Pacemaker
If any of these apply to your situation or you are seeing a new dentist
for the first time, make certain that the dentist is fully aware of your
medical history.
The same course of action should be taken if you have had joint
replacement for the same reason, a precaution to combat potential
bacterial infection.
Other high risk situations apply as well. If any of the following
conditions apply to you advise your dentist:
Hemophilia
Malnourishment
Type 1 insulin dependent
Cancer
HIV
Rheumatoid arthritis
Immunosuppression
Also make certain that you keep your dentist apprised of any changes
in your health and medications.
Other drug information.
If you take aspirin or any other anticoagulants like heparin or
warfarin, make sure your dentist is aware of it. These are great drugs for
preventing heart disease and stroke, but might cause a problem while
undergoing oral surgery or periodontal treatments.
Pesky cold and canker sores.
These are the two most common mouth sores. They are annoying,
unattractive and painful.
Canker sores are found inside of the mouth and usually begin as a
bump or red spot. No one knows what causes them but genetics does have
some role. It’s believed that white blood cells in the immune system cause
these nasty little things to appear in the mouth lining. Stress, fatigue and
maybe some foods are theorized to be contributors. Since there is no
known cause, there is obviously no cure. Thankfully, they do disappear in 7
to 10 days
Cold sores are a different story. They appear on and around the lips
as small blisters that are filled with fluid. They are sometimes referred to
as fever blisters. There can also be clusters of them on the gums or the
roof of the mouth.
Cold sores are caused by the herpes virus. Highly contagious, the
virus will remain in the body throughout the lifetime. Most of the time it
will remain dormant, but it does periodically activate causing the sores to
appear. The sores will usually heal in about a week or so. An ugly scab
will appear after the blister breaks. About the only thing that can be done
is to apply a topical ointment to treat discomfort.
If you detect any changes in the cold or canker sores, or discover
some other type of unrecognizable lesion, contact your dentist for an
appointment. The dentist is familiar with most conditions having to do
with the mouth and can readily make a diagnosis.
Remember, you are born with two sets of teeth. The first set were
your “training teeth.” The second set are irreplaceable. Treat them with
the care they deserve and they will serve you faithfully throughout your
lifetime.
Resources
Academy of General Dentistry
211 East Chicago Ave., Ste 900
Chicago, IL 60611-1999
Ph: 888.AGD.DENT (888.243.3368)
American Dental Association
211 East Chicago Ave.
Chicago, IL 60611-2678
312-440-2500
National Institute of
Dental and Craniofacial Research
National Institutes of Health
Bethesda, MD 20892-2190
Phone: 301-496-4261
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Oral Health, MS F-10
4770 Buford Highway, NE
Atlanta, GA 30341
1-888-232-2306
American Academy of Periodontology
737 N. Michigan Ave.
Suite 800
Chicago, IL 60611
1-800-356-7736 (to find a periodontist in a particular region)