Teeth Whitening

Do you want your teeth to be whiter? Whitening of teeth is universally desirable and accepted well around the world. It is the most conservative and economical option of improving your smile and self esteem.

There are almost no side effects to this process if the whitening is carried out properly. There can however be too much whitening. A good rule to gauge an adequate white is to match to the shade of white in the eyes.

Some patients also experience sensitivity following whitening but this usually goes away within a few days.

Some tooth shades respond better to whitening than others do.

Discoloration due to a pulp breakdown does respond initially to whitening but the discoloration tends to return over time.

Internal tooth discolorations during tooth development in childhood can often be lightened with some degree of success.

Florosis (excessive floride) can be resistant to significant shade changes but can be aided by whitening

Staining of teeth from a diet comprised of dark color foods such as coffee, tea or chocolate is very easily removed.

Discolorations as a result of aging also noticeably respond to whitening.

Options for teeth whitening:

Veneers and Crowns are a great alternative when the internal discoloration in teeth is significant and whitening is unlikely to significantly lighten the shade. The restorative alternatives are more expensive and extensive but can also correct decay, misshapen and mal positioned teeth.

Bonding is the process of adding a thin layer of resin material over the surface of the tooth to improve shade and minor defects on the surface of the tooth. Although less expensive than a veneer or a crown, bonded restorations can significantly improve esthetics but may discolor over time needing replacement.

At Home Whitening This widely used and hugely successful whitening technique is the most popular one in dentistry. A flexible tray is custom made for your mouth. After adequate instructions are given by the dental staff, you are given hydrogen peroxide to take home with you. Each day you will place a small amount of material into the tray and seat in the mouth for various lengths of time as instructed. The progress is monitored by the dental staff to avoid unwanted effects. Several days later, a significant whitening of teeth is observed. There may be slight sensitivity with the procedure, which goes away in a couple of days.

In Office Whitening is a supervised whitening which takes place within the office. In office whitening uses higher concentrations of hydrogen peroxide compared to at home whitening. The major advantage to doing in office whitening is the result is accomplished much faster but the disadvantage is that there could be more tooth sensitivity because of the rapid pace of whitening. De sensitizers can be applied to the sensitive areas to reduce post -whitening sensitivity.

Cost is moderate for both the options.

A wide range of whitening products are available over the counter (OTC) that produce varying degrees of results. Some work better than others and depend on the degree and the nature of discoloration. In general, OTC products are less effective than the dentist supervised products. Do seek dental professional guidance in selecting the best OTC whitening products to help maintain a shade that blends with your natural teeth and dental restorations. OTC products however, do not have the predictability of professional whitening.

Some degree of whitening is reversed within days of the whitening procedure and stabilizes within a couple of weeks and only slowly progresses towards a darker color overtime. The whitening process may need to be repeated within a year and sometimes months.

Visit www.smileartistrychino.com for details or call 9-09 627 6699 for an appointment.

MINI IMPLANTS or Small Diameter Implants

Dental Implants are small metal screws that are surgically placed in the bone and are considered the most important innovations in the history of dentistry. 

Many denture patients have difficulty holding their dentures securely in the mouth because of reduced bone quantity. Dental implants have allowed these patients to restore a good fit and function of the dentures.

Types of dental implants:

There are many types of implants and the ones most currently used are the ones in the shape of a root of tooth. Dental implants vary in length and diameter. Small diameter implants are only 2mm in diameter.

Small implants are needed in mouths with significant bone loss where very little jaw bone is remaining to place standard implants Alternatively, patient can undergo bone- grafting to surgically enhance bone formation but many patients prefer non traumatic procedures or overall health may limit surgical intervention.

Uses of small diameter implants:

Retention of Lower complete denture

Retention of Upper complete denture

Retention of Removable Partial dentures

Anchoring Fixed Bridges

Single tooth replacement

The number of small diameter implants necessary to facilitate the above functions depends on the quality and quantity of remaining bone and needs to be addressed on an individual basis.

Advantages of Mini Implant:

Surgery is minor and usually with no complications

Simple placement

Retention of dentures is immediate

Lower cost compared to standard implant options

Almost anyone with an ill-fitting denture is a candidate for mini implants. The difference in the fit and function is immediate and is a source of instant gratification for the patient and the dentist.

Call our office at 909 627 6699  if you would like to schedule a consultation.  Visit www.smileartistrychino.com for our practice information.

Antibiotics and Dental Procedures

The mouth is packed with various strains of bacteria, which in a healthy individual maintain optimal oral health. During daily routines like chewing, brushing or flossing, the bacteria can enter the blood stream but don’t present a problem for most of us  when the immune system is healthy. In compromised health, bacteremia (bacteria entering blood stream) can cause infections elsewhere in the body.

Specific heart conditions and orthopedic implants such as artificial joints have known to be the more vulnerable sites for potential infections. 

Antibiotic prophylaxis, or preventative use of antibiotics prior to a dental visit is recommended in conditions like-

-Artificial heart valves

-History of infection of the lining of the heart or heart valves known as Infective Endocarditis

-A heart transplant

-Congenital heart conditions like Cyanotic congenital heart disease

-Defects repaired with a prosthetic device

The criteria for antibiotic prophylaxis is periodically updated by the American Heart Association and the American Dental Association depending on current research and development. Currently, the AHA recommends prophylactic antibiotics only on patients with a history of endocardial bacterial endocarditis.

American Associations of Orthopedic Surgeons in their revised guidelines no longer recommend antibiotics for patients with artificial joints.

In an abundance of caution, our office coordinates with the patient’s physician to determine the appropriate antibiotic protocol. 

Visit www.smileartistrychino.com to E mail us at lovemydentist@gmail.com

Why does my filling need to be replaced?

A tooth that has decay or fractures will need either a filling or other restoration depending on the extent of decay.  Poor oral hygiene, a poor diet, gum recession or a lack of saliva can contribute to tooth decay. Para functional habits like clenching and grinding and traumatic occlusion are usually the cause of teeth fractures.

Choices of restorations

Composite filling: Is a tooth colored plasticed material that is bonded to the tooth when a small area of tooth that is decayed needs to be restored.  This is a popular option considering the capability of matching shades to the tooth, conservative prep design preserving natural tooth and affordability.

Amalgam filling: This option has fallen out of vogue because of potential mercury toxicity, silver color compromising aesthetics and the technique requiring removal of a lot of tooth structure to achieve mechanical retention. Many dental offices no longer offer this procedure.

Onlay/Inlay: Is a lab processed restoration usually chosen when a small area of the tooth needs to be restored with better seal and marginal integrity for long term success. It is a two visit procedure that entails a higher cost for lab fabrication. These can be processed in tooth colored porcelain or gold based on patient preference.

Full coverage crown: restores the entire coronal portion of the tooth and is usually indicated on endodontically treated teeth (root canal), extensive breakdown of tooth from fractures and/or decay. They are lab fabricated and also entail two visits.  Crowns can be fabricated in gold, non precious metal or various porcelains depending on patient preference, cost considerations and aesthetic demands.

 A dental filling usually lasts many years before it needs replacing. However, teeth are subject to constant stress from chewing, clenching and grinding. All of these can cause a filling to gradually wear away, chip, crack or fall out.

Reasons for replacement

Recurrent decay
Fracture of filling
Fracture of tooth
Material upgrade

Regular dental examinations are important to maintain soft tissue health, assess existing restorations and maintain bite and functionality of the mouth.  Detecting a failing filling early can reduce damage to tooth and eliminate the need for more invasive and complicated procedures.

Visit www.smileartistrychino.com or call 909 627 6699  for more information. Feel free to stop by our office on 10th street in Chino, California.

Dental Veneers- Ceramic or Composite- What are the Considerations?

For a discolored tooth, chipped tooth, misshaped tooth or a tooth slightly out of alignment, a dental veneer may be an option.

 An explosion of dental materials and techniques have provided ample solutions to correct the condition and there are several considerations to assess to arrive at the best choice for you..

Age, cost and  durability are usually at the top of the consideration list. Location of the defect, is defect natural or acquired, oral habits, smile line, personality, occupation are other important considerations.

Veneer is a thin covering that is placed over the front of the tooth. Any stain or decay present on any additional surfaces will more likely be better served with a crown or other full coverage restorations making a veneer an inadequate choice.

The age of the patient is another important consideration. A conservative composite veneer is an excellent choice for a tooth is the developing stage. A developing smile which is constantly evolving is best fitted with a composite veneer that is economical and  can be easily modified with changes in shape, shade and configuration, unlike a lab fabricated ceramic veneer.

Ceramic veneers are thin shells made of a strong, stain resistant and durable dental ceramic. A very small amount of tooth structure is removed  to make room for a natural and ideal looking tooth form.This restoration involves more than one visit and is fabricated in the dental lab. Ceramic veneers are the most natural looking with customizable,  polychromatic shades to exactly match and compliment the adjacent teeth- an ideal option for highly visible smiles requiring a confidence boost. These are  the veneers that are highlighted in the much publicized smile make overs. A thorough understanding of the underlying design principles and identifying dental labs and technicians that are detail oriented and take pride in their creations is the key to achieving these results.

Teeth must be healthy and free of decay and active periodontal disease prior to veneer preparation. The process is irreversible once the enamel is removed.

Patients who clench and grind their teeth are not good candidates for veneers, because the thin veneers may chip or break. A plastic dental nightguard is usually recommended to help minimize the stress on the teeth.

No special maintenance is needed other than good oral hygiene each day. Avoid biting fingernails and chewing on hard objects such as pencils or ice to keep veneers well maintained.

Visit www.smileartistrychino.com or call our office at 909 627 6699 to schedule a cosmetic consultation. 

Smile, You're on Intraoral Camera

A tiny new camera allows patients to see the insides of their mouth by projecting the image on a TV monitor.  For many patients, this is the first time they have had a clear view of  the inside of their mouth. And what they are seeing is not always a pretty picture.  Many patients are surprised if not shocked by their oral condition.

An image can be worth a thousand words when motivating patients to improve their oral health.  Once an image is projected on the monitor, the dentist can easily discuss any problems and explain the treatment. 

Because oral conditions can be magnified, this method provides better visibility than direct vision.  Once on the screen, the image can be rotated, saved, printed and sent electronically to family, a specialist or submitted as supporting documentation.

Another valuable and common use of camera is helping patients make cosmetic decisions about their teeth.  The image of a patient's teeth can be projected onto the screen and manipulated to show how the person's smile might look after treatment. Patient's can get a good idea of what the recommended procedure will look like before it is even done.  

Call our office 909 627- 6699  or visit our website www.mydentistchino.com for more information.

Dentistry for the Elderly (1st of the series)

The aging population is the most important demographic trend.  Nearly 20% of the U S population will be older than sixty five by the year 2030.  As the age of the older adult is upon us, the services rendered should be age appropriate and have lasting value. 

Older adults have the most diverse clinical and physical presentation than any other age group. We could see fully functioning independent adults, frail older adults characterized by numerous medical conditions that impair mobility and dexterity and those who are dependent on help to carry out the normal daily activities.

.  Age is often a primary consideration when developing a treatment plan but it is important to assess each patient’s individual needs and capacities instead of relying on stereotypes of aging. 

The rapid growth of the elderly population affects dentistry in a number of ways. 

1/ the elderly are retaining teeth longer than the previous generation

        Approximately 90% of the seniors who have their natural teeth have    experienced decay with 64 % suffering from periodontal or gum disease.

2/ the body changes that occur with aging often make treatment planning more complex.

3/ medical problems and medications complicate and in some cases exacerbate dental disease.

Limitations in frail older adults create barriers to achieving and maintaining optimum oral health. 

 Visit our website www.mydentistchino.com or Call 909 627 -6699 for more information.

Revisit this site next week for more on prevention and disease management of this vulnerable group.

Dry Mouth or Xerostomia

Dry Mouth is a symptom rather than a specific disorder. Saliva cleanses the mouth and begins the digestive process as foods are chewed. Adequate saliva flow coats and lubricates the mouth. When dry mouth or xerostomia occurs, soft tissues get irritated and inflamed and are more susceptible to oral infections. Without the cleansing and shielding effects of adequate salivary flow, tooth decay and periodontal disease become more prevalent.   Constant dryness and lack of protection provided by saliva contribute to bad breath.  In denture wearers, dentures feel less comfortable without the thin film of saliva to help them adhere properly to the mouth.

Causes of Dry Mouth

Prescribed and over the counter medications have emerged as the most common cause of dry mouth.

Medications including  antihistamines, decongestants, pain killers, diuretics, anti hypertensives and anti depressants are among 400 other medications that have side effects of dry mouth.

Aging does minimally reduce the salivary flow.

Radiation of head and neck

Emotional stress 

Autoimmune disease like Sjogren’s  syndrome and diabetes

.

Hormonal alterations associated with  pregnancy and menopause have been associated with dry mouth.

Symptom Relief

Chewing sugar free gum or candy to stimulate salivation

 Drinking frequent sips of water

Use of alcohol free oral rinses

Restricted use of caffeine, alcohol and carbonated beverages

Regular check- ups and teeth cleaning are more important in mouths experiencing  xerostomia  to minimize decay and periodontal disease.  Additional fluoride products may be recommended to safeguard your dental health.

Visit www.mydentistchino.com for additional information.