Do your teeth stain easily? Are you worried that your new white fillings won't remain white for very long? Staining generally falls into one of two categories — extrinsic (external) staining, which affects the outside of the teeth, and intrinsic (internal) staining, which is discoloration of the tooth structure itself. The good news is that both can be treated and, once we determine the exact cause, there are a number of options to remedy it. You can have whiter teeth in almost no time!

External staining is generally caused by beverages or foods like red wine, tea, coffee and some spices, or even substances like tobacco. Stain that is brown, black or gray can become even worse in the presence of dental bacterial plaque and when the mouth is dry. On the other hand, internal tooth staining can make the teeth appear more yellow as a natural result of aging, or after root canal treatment when tooth structure can become more brittle and dry.

Treatment for external (extrinsic) staining includes:

• Lifestyle modification: You can help put a stop to your staining problem by reducing or eliminating the habits that cause it, such as smoking and drinking red wine.
• Practicing efficient oral hygiene: Preventing extrinsic staining can be as simple as brushing twice a day with toothpaste that contains tooth-whitening agents or other solutions to reduce the appearance of stains. Don't be embarrassed to ask our office about brushing and flossing because most people do it wrong until they're properly instructed.
• Professional Cleaning: We can remove some extrinsic staining with ultrasonic cleaning followed by polishing with an abrasive prophylactic paste.

Other treatment options to reverse either intrinsic or extrinsic staining include:

• Whitening by bleaching: Bleaching for extrinsic stains can be performed either in our office or at your home using a whitening kit. Bleaching for internal (intrinsic) stains can only be conducted in our dental office because it typically involves bleaching the tooth or teeth from the inside.
• Fillings and restorations: For teeth that have been stained due to decay, or for fillings that are old and discolored we can remove the decay and restore the teeth, which will restore them to their natural brighter color.

If you are ready to say goodbye to your stained teeth, call our office today to make an appointment. For more information about treating stained teeth, read the Dear Doctor magazine article “Tooth Staining: Getting To The Cause Of Tooth Discoloration Is The First Step Toward Successful Treatment.”

Some people are planners, and others just go with the flow. Some spend all winter in the gym, and others try and lose ten pounds right before beach season. Some have every detail of their wedding day planned out months in advance, and others... don't.

No matter which kind of person you are, you'll want to look your best for your wedding day. And that includes sporting a bright, healthy-looking smile. Depending how much time you have beforehand, there's a range of dental treatments that can help you look and feel great — not just that day, but every day. Here's a rundown of what you can do in the time remaining before your big day.

Time Left: Up to two years. If you've planned this far in advance, congratulations! You probably have time for almost any needed dental treatment — including orthodontics, which can straighten misaligned teeth and correct a bad bite. But even if you don't have quite so much time, don't despair: Clear aligners and tooth-colored or tongue-side braces, if recommended, can make orthodontic appliances nearly invisible.

Time Left: Six months to one year. Many dental treatments, like periodontal plastic surgery or tooth implants, can achieve remarkable results in this time. Periodontal surgery can give you a less “gummy” smile and greatly improve the aesthetics of your teeth. Tooth implants are modern dentistry's best option for replacing missing teeth. Natural-looking implants have a success rate of 95%, and can last a lifetime.

Time left: Three or four months. There's plenty you can do! If the roots are intact, a crown can be placed on a damaged tooth to restore its appearance and function. Or, missing teeth can be replaced via bridgework, which supports a false tooth from abutments on either side. Stained or discolored teeth can also be dramatically lightened with veneers, where a porcelain shell replaces the tooth's outermost layer of enamel. Tooth implants are still a possibility, under the right circumstances. We can evaluate your individual situation and come up with the best option to replace missing teeth.

Time left: Six weeks or so. You still have time for some basic, yet effective, treatments. Small chips or discolored fillings can be restored with tooth-colored materials that securely bond to the teeth themselves. You can also brighten your teeth by several shades using the techniques of bleaching. In-office whitening treatments are the fastest, but take-home kits, used under our supervision, offer similar results in a longer time.

Have even less time? At the very least, come in for a thorough cleaning right before the date! This will help remove many surface stains and freshen up your smile. Be sure to call in advance so that you're able to get an appointment. Then, smile for the camera!

If you would like more information about a wedding-day smile makeover, please contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Wedding Day Smiles.”

Because its symptoms can be easy to overlook, gum disease is sometimes called a “silent” malady. But don't underestimate this problem! Untreated periodontal disease can progress into a serious condition, possibly leading to tooth loss and even systemic (whole-body) health issues. With proper preventive measures and appropriate treatment, however, the disease can be controlled.

The root cause of periodontal disease — actually, a group of related diseases, all of which affect the tissues surrounding the teeth — is the buildup of bacterial plaque (also referred to as biofilm) around the gums. While hundreds of types of bacteria live in the mouth, only a comparatively few are thought to be harmful. But when oral hygiene (namely, brushing and flossing) is inadequate, the environment in the mouth becomes favorable to those harmful types.

The disease often begins with inflammation of the gums called gingivitis. It symptoms include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. However, in some people these early warning signs are ignored, or masked by the effects of harmful habits like smoking.

Gum disease is chronic; that means, if left alone, it will worsen over time. Periodontitis, as it progresses, causes damage to the ligament that helps hold the tooth in place, as well as bone loss. This may become increasingly severe, and ultimately result in the loss of the tooth. Severe periodontitis is also associated with whole-body (systemic) inflammation, which has been linked to an increased incidence of cardiovascular diseases, like stroke and heart attack.

But there's no reason to allow gum disease to progress to this stage! Prevention — that is, regular daily brushing and flossing as well as regular dental cleanings — is a primary means of keeping this problem at bay. Plus, every time you have a regular dental checkup, your gums are examined for early signs of trouble. Of course, if you notice the symptoms of gum disease, you should come in for a check-up as soon as you can.

There are a number of effective treatments for gum disease. One of the most conservative, routine ways are those regular dental cleanings we referred to earlier, usually called scaling and root planning. Using hand-held and ultrasonic instruments, the buildup of plaque (tartar) is carefully removed, sometimes under local anesthesia. A follow-up evaluation may show that this treatment, carried out on a regular schedule, is all that's needed. Or, it may be time for a more comprehensive therapy.

If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”

Like the ones worn by kings and queens of old, dental crowns were traditionally made of that most “royal” of metals: solid gold. This style of crown is still going strong after over a hundred years, but recent advances may have stolen some of its luster. Want to learn more about the different materials from which crowns can be made? Read on!

Gold crowns have stood the test of time, and many still consider them the best. Gold is one of the earliest materials to be successfully used for making crowns, and when properly done, it also lasts the longest: over 50 years in some cases. For these and other reasons, many dentists prefer to get gold restorations for their own teeth.

But in recent years, the use of gold crowns has been in decline — especially when the crown is for one of the front teeth. Why? In one word: aesthetics! With the advent of porcelain and porcelain-fused-to-metal (PFM) crowns, many people have opted to go with these more natural-colored tooth restorations.

PFM restorations have been in use for some four decades. They combine the strength of precious metals (gold or platinum) with the appeal of a finish that appears more like a natural tooth. With proper care, a PFM restoration may have a functional life of around 20 years.

With their pearly luster and semi-translucent sheen, all-porcelain crowns have an incredibly lifelike appearance. Porcelain itself is a glass-like material, which is specially modified to add strength when it's used in dentistry. In the past, there were some problems with brittleness in all-porcelain restorations. Today, newer formulations have been designed to avoid these issues.

High-tech materials that have recently become available to dentistry include a polycrystalline ceramic substance called zirconium dioxide or “Zirconia.” It shows great promise in terms of aesthetics and strength, and is the subject of much ongoing research. One day, it may replace other materials and become the new “gold standard” of crowns.

Depending on the particular situation, one or more of these materials may be considered for your crown.

If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Gold or Porcelain Crowns?”

There's nothing quite like watching your son or daughter compete on the athletic field. It's a mixture of anticipation, pride — and occasionally, anxiety. Despite all the protective gear and training, kids are sometimes injured playing the sports they love. In fact, when it comes to dental injuries, teens are the most susceptible of any age group. Here's what you should know about preventing sports-related dental injuries in kids.

Of course you know that football and hockey players should always wear mouthguards, both at games and during practice. But don't forget about kids who play soccer, do gymnastics, wrestle or play basketball. According to the American Dental Association (ADA) these athletes — along with participants in about 20 other sports — also need to wear this important piece of protective gear. In fact, the ADA states that not wearing a mouthguard makes an athlete 60 times more likely to sustain dental injury!

In selecting a mouthguard, there are three basic options to choose from: the “off-the-shelf” type, the so-called “boil and bite” protector, and the custom-fitted mouthguard that we can fabricate. Let's look briefly at all three.

The first type, available at many sporting goods stores, comes in a limited range of sizes, and an unknown range of quality. It's the least expensive option, offering a minimal level of protection that's probably better than nothing.

The second type, although popular, is also limited in its protection. This one is designed to be immersed in hot water, and then formed in the mouth using finger, tongue and bite pressure. If it can be made to fit adequately, it's probably better than the first type — though it often lacks proper extensions, and fails to cover the back teeth. Also, upon impact, the rubber-like material will distort and not offer as much protection as you would like to have.

The third is a piece of quality sports equipment that's custom-made for your child's mouth (or your own). To fabricate this mouthguard, we first make a model of the individual's teeth, and then mold the protector to fit just right. Made from tough, high-quality material, it's designed to cover all teeth, back and front, without being excessively bulky. It can even be made to accommodate growing teeth and jaws. And, it's reasonable in cost.

To paraphrase the ADA's recommendation, the best mouthguard is the one you wear. A comfortable, correctly-fitted mouthguard is easy to wear — and it can help prevent dental injury, giving you one less thing to worry about. Now, if you could just get you child to keep her eye on the ballâ?¦

If you have questions about mouthguards or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”