Dental professionals sometimes use specialized words, and you may not be clear about exactly what we mean. Test yourself on some of the specialized vocabulary concerning tooth whitening. How many of the following can you define correctly?

1. Bleaching?
A method of making yellow, discolored teeth whiter. It is relatively inexpensive and safe, with few side effects.

2. External or extrinsic staining and whitening?
Extrinsic staining mainly results from diet and smoking. For example, foods such as red wine, coffee and tea can produce extrinsic stain. Teeth with these stains are bleached by placing whitening substance in direct contact with the living tooth surface.

3. Internal or intrinsic staining and whitening?
Intrinsic tooth discoloration is caused by changes in the structure of enamel, dentin, or pulp tissue deep within the root of the tooth. When the discoloration originates with the pulp tissue, root canal treatment may be needed to whiten the tooth from the inside.

4. Chromogenic material?
Color generating material that may get incorporated into the tooth's substance. It can be a result of wear and aging, or can be caused by inflammation within the tooth's pulp.

5. Carbamide Peroxide?
A bleaching agent discovered in the 1960s and frequently used for tooth whitening. When used, carbamide peroxide breaks into its component parts, hydrogen peroxide and urea, which bleach the colored organic molecules that have been incorporated between the crystals of the tooth's enamel.

6. Power Bleaching?
This technique is used for severely stained tooth. It uses a highly concentrated peroxide (35 to 45 percent) solution placed directly on the teeth, often activated by a heat or light source. This must be done in our office.

7. Tetracycline?
An antibiotic used to fight bacterial infections. It can result in tooth staining when taken by children whose teeth are still developing.

8. Rubber Dam?
Use of strong bleaching solutions requires protection for the gums and other sensitive tissues in your mouth. This is done using a rubber dam, a barrier to prevent the material from reaching your gums and the skin inside your mouth. Silicone and protective gels may also be used.

9. Whitening Strips?
Strips resembling band-aids that you can use in your home to whiten your teeth. They generally contain a solution of 10 percent or less carbamide peroxide gel. When using them, be sure to read the directions and follow them strictly to avoid injury or irritation.

10. Fade Rate?
The effects of bleaching may fade over time, from six months to two years. This is called the fade rate. It can be slowed down by avoiding habits such as smoking, along with food or drink that causes tooth staining.

Contact us today to schedule an appointment to discuss your questions about tooth whitening. You can also learn more by reading the Dear Doctor magazine article, “Teeth Whitening.”

If you have noticed that one or more of your teeth have lost some of the surrounding pink gum tissue so that part of the root surface is now uncovered, you are experiencing gum recession. It's a very common problem — in fact millions of Americans have some degree of gum recession. Fortunately, there are very effective methods of treating it.

Gum recession can be unsightly, but there are more serious concerns. Tooth root surfaces exposed by gum recession can become sensitive to temperature and pressure changes and can decay or wear away. In very severe cases, teeth can actually be lost. That's because gum or “gingival” tissue as it is medically known is supposed to encircle and firmly attach to the necks of the teeth and the underlying bone. This forms a protective barrier that is resistant to the abrasive action of foods during eating, biting and chewing.

Gum tissue is largely made of a fibrous protein called collagen, covered by a layer of another very resilient protein called keratin (nails and hair are also made of it). Yet it is still possible for this tough tissue to lose its grip on the teeth it protects. Here are some of the ways this can happen:

• Ineffective oral hygiene — inadequate removal of dental bacterial plaque (biofilm) with daily brushing and flossing.
• Excessive brushing (and flossing) — too hard, or for too long.
• Habits — holding foreign objects between the teeth, such as bobby-pins, nails etc that press on the gum tissues.
• Oral appliances and ornaments — badly fitting removable partial dentures and orthodontic appliances (braces), or tongue bolts and oral piercings can apply pressure to the gums.

Treatment will depend in part on whether the recession is stable or progressive. For example, an older person might have a few areas of gum recession but there are still adequate zones of attached protective gum tissue and the exposed tooth root surfaces are healthy. In this case, there may not be reason to do anything but monitor the situation. On the other hand, a teenager with a history of fairly rapid gum recession (over a period of months) usually requires immediate treatment. The dental specialty of periodontics (“peri” – around; “odont” – tooth) has developed predictable surgical techniques to deal with recession.

Free Gingival Grafting, for example, involves taking a very thin layer of skin from the palate, where the tissue is identical to gum tissue, and transplanting it to the area where gum has been lost. Both sites will heal in a very predictable and uneventful manner. The free gingival graft is so-called because it is “freed” from the donor (original) site completely. It is crucial to make sure individuals with gum recession correct faulty hygiene habits prior to this (or any) treatment so that they will not jeopardize their future results.

If you are concerned about gum recession, please contact us or schedule an appointment for a consultation. You can also learn more about gum recession and gingival grafting by reading the Dear Doctor magazine article “Periodontal Plastic Surgery.”

An icy cold beverage on a hot day or a steaming cup of cocoa on a frigid day are some of the simple pleasures in life. So why do they sometimes seem to turn against you and send sharp, sudden pain shooting through your teeth?

When pain affects your teeth, it's because the nerves within the very center portion, the “pulp,” are reacting to a stimulus such as temperature, pressure changes, or acidic or sugary substances. In healthy teeth, the pulp is protected from stimuli. Above the gum line, a layer of enamel encases and protects the visible portion of tooth (crown). Below, the gums (gingiva) and a thin layer of “cementum” protect the root portion. Neither of these contains nerves. However, directly under the enamel and cementum, surrounding the interior pulp, is the “dentin.” This layer contains nerve fibers that can relay sensations to the nerves in the pulp, which respond as they are designed to — with an unpleasant feeling that tells you somethingâ??s wrong.

That feeling can range from a momentary pang, to prolonged dull throbbing, to downright excruciating distress. The nature of the pain depends on the type and degree of stimulus. The only way to be certain of what's causing the pain is with a professional dental examination. However, your symptoms can hint at some possible sources.

Fleeting sensitivity triggered by hot and cold foods generally does not indicate a serious problem. It may be due to any of the following:

1. a small area of decay in a tooth,
2. a loose filling,
3. an exposed root surface resulting from gum recession (often due to improper or excessive brushing), or
4. temporary pulp tissue irritation from recent dental work.

To help alleviate root sensitivity, make sure the tooth is free of dental bacterial plaque by brushing gently no more than twice a day. Fluoride-containing toothpaste made for sensitive teeth might help. Fluoride and additives such as potassium nitrate or strontium chloride help relieve sensitivity. Try using the toothpaste like a balm, gently rubbing it into the tooth surface for about 10 minutes. If the sensitivity is related to recent dental work, it should resolve within a few days to a week or two, depending on the extent of the work you had done. A mild over-the-counter pain reliever may help in the meantime.

No matter what the reason, if the sensitivity persists or worsens, please come see us. Together we'll get to the root of the underlying problem and resolve it so you can get back to enjoying the foods and beverages you love, no matter what the temperature!

If you would like more information about tooth sensitivity and ways to prevent or treat it, 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 “Sensitive Teeth” and “Tooth Pain? Don't Wait!”

Oral cancer is a serious health problem, responsible for the death of about one person every hour, every day in the United States. It was once thought that folks over 40 were chiefly at risk for the disease. If present trends continue, however, younger people may soon form the majority of oral cancer patients. So, no matter who you are, it makes sense to recognize the risk factors, and find out what you can do to reduce your chances of getting the disease.

As in many other diseases, genetic factors play a role in determining whether an individual will develop oral cancer. At present, there's nothing we can do about these inborn traits. But there are several choices we can make that will lessen our risk of oral cancer. Most of these risky behaviors are associated with other types of cancer as well.

Moderate to heavy drinkers, and users of tobacco products of all types, are as much as 9 times more likely to develop the disease than non-users. Chronic exposure to the sun has long been associated with the development of cancers of the lip. And, because the sexually-transmitted Human Papilloma Virus (HPV) can lead to oral cancer, unsafe sexual behavior is a factor that's fast becoming a primary cause of the disease.

So if you need another reason to quit smoking, stop drinking excessively, wear sunscreen and practice safe sex — consider this your warning. But there's still more you can do to reduce your risk for oral cancer, and improve your general health as well.

Eating a plant-based, whole food diet doesn't just reduce your risk of getting oral cancer — it also makes you less likely to develop many other cancers, and various chronic conditions like heart disease. The exact mechanisms by which this happens aren't completely understood, but its effects have been documented in numerous studies.

Avoiding certain chemicals, like the nitrites often found in preserved foods, can reduce cancer risk. And the antioxidants you get by eating a balanced diet rich in fruits and vegetables can help protect your body from cancer-causing substances.

Finally, don't ignore regular cancer screenings. The early signs of oral cancer are difficult for many people to distinguish from common mouth sores — but we are trained to identify possible problem areas, and can schedule further tests if needed. You can get an oral cancer screening (a fast and painless procedure) at your regular dental checkup. And you always get your checkups on time — don't you?

If you have concerns about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”

1. What is a mouthguard? A mouthguard or mouth protector is a protective appliance that covers the teeth and gums to prevent or reduce injury to the teeth, gums, jaws, and lips during sports or other activities prone to injuries.
2. Who should use a mouthguard? Children, adolescents or even adults who participate in contact or injury prone sports should use a mouthguard.
3. What do you mean by contact sports? Mouthguards are used most commonly in sports such as boxing, football, hockey and lacrosse. The American Dental Association recommends protection for 27 different sports, including basketball, soccer, water polo, rugby and more. The governing bodies of football, boxing, ice hockey, men's lacrosse and women's field hockey require mouth protection. It's a good idea to use a mouthguard during any activity that could result in a blow to the face or mouth.
4. What does the mouthguard protect against? A mouthguard protects against breaking or dislodging teeth or injuring jaws, gums, lips, or tongue, all injuries that can happen when you engage in contact or injury prone sports.
5. What are my choices for mouthguards? The best choice is a custom-made mouthguard fitted and made by a dentist. Stock mouthguards that are one size fits all can be bought off-the-shelf in stores, but there is no guarantee of fit or protection. A third type is a “boil and bite” guard, in which the guard material is heated and then shaped by biting down on the softened material. This offers some attempt at fitting that is better than off-the-shelf, but not as good as a mouthguard that is designed specifically for you.
6. Why is it better to get a mouthguard from our office than to buy one at a store? Studies have shown that store-bought stock or boil-and-bite mouthguards do not offer the same protection as a custom-made mouthguard. In our office we will make a mold of your mouth and design your mouthguard to fit your individual characteristics. It will be comfortable and easy to clean and will not restrict your speech or breathing. It will be made of resilient and tear-resistant materials, properly adapted for maximum protection, comfort and injury protection.

Wearing a properly fitted and properly used mouthguard prevents injuries to teeth, jaws, gums, lips, or tongue when you or your child participates in contact sports. Make an appointment with us to discuss your custom fitted mouthguard. To learn more read the Dear Doctor magazine article “Mouthguards.”