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.”

Teeth whitening is an extremely popular remedy for a lackluster smile, and with good reason: It works! So what's the best way to whiten teeth? We recommend in-office whitening treatments or at-home bleaching with custom-made flexible plastic trays. Either of these techniques will give you faster results than over-the-counter products while giving us the opportunity to monitor your individual response to the whitening process.

In-office whitening can produce dramatic results in just one visit. The bleaching solutions used in this process are the strongest available, so we will take precautions to protect your gums before we start. We will then brush the bleach onto your teeth and leave it there for about an hour. Once the session is finished and the bleach is rinsed from your teeth, you will be delighted by the results! If you want your teeth to reach their maximum brightness, a second treatment can be scheduled.

At-home bleaching with custom-made flexible plastic trays is also very effective, though you will bear a greater responsibility for sticking to the treatment regimen. We will first make a mold of your teeth that will be used to fabricate the bleaching trays. When the trays are ready, we will provide a prescription-strength bleaching solution in gel form. We will show you how to line the trays with the gel and then fit them over your teeth. You will generally need to repeat the bleaching process daily for about an hour until your desired results are achieved — usually about two weeks.

Both methods above have advantages over OTC (over-the-counter) whitening products. The most important is that we can verify that your tooth discoloration is purely a cosmetic problem and not the result of an infection or other dental problem requiring treatment. Also, we can monitor your reaction to the whitening process and make adjustments as needed. Finally, we are always available for any questions that come up before, during or after bleaching.

If you are interested in learning more about teeth whitening, please contact us today to schedule an appointment for a consultation. For more information on teeth whitening, please see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Tooth Whitening Safety Tips.”

Worldwide it is generally accepted that the best method for permanently replacing a missing tooth is with a dental implant. However, one fact that can affect the timing of placement of dental implants is that the person should be fully mature. In this case, it means that growth is complete, in particular the jawbones have completed growing. And while we are sensitive to teens who may beg for a dental implant to replace a missing, damaged or traumatized tooth, parents or caregivers should know that research and experience have shown that it is better to wait.

The main reason it is best to wait is because natural teeth grow and move with the jaws as they mature whereas implants don't. Natural teeth change positions and move with the jaws as the jaws grow, implants don't. They are fused to the bone in one position and as the jawbone grows, they get left behind and appear to sink as the adjacent teeth and jawbone grow in harmony.

Although it is not really possible to determine exactly when a person has finished growing, it is generally best to wait until the jaw is fully matured and developed. However, we are the most qualified, along with our orthodontic colleagues to “guesstimate” based on family history, age and genetics. Specialized radiographs (x-rays) of the skull and jaws may also be helpful in determining the timing of jaw growth completion and when implants can be placed.

Dental implants are a permanent solution to a dental problem and thus should not be used until all growth is complete. Think about it. Your young child gets a beautifully restored smile through a dental implant...and for a year or two it looks fantastic. However, as your child's jaws continue to grow, everyone begins to notice gaps between the implant and adjacent teeth. So it makes sense to avoid this eventuality; by just waiting until late teens when beautifully restored crowns on properly positioned dental implants should last for many many years.

To learn more on this subject, read the Dear Doctor article, “Teenagers & Dental Implants.” You are also welcome to contact us to discuss your questions or to schedule an appointment.

Dental crowns are excellent tools that we use to restore functionality, color and/or beauty to teeth and your smile. And while many people may have heard of them, often times there are many questions surrounding the process, costs and their maintenance. This is why we have put together this list of some of the questions we are commonly asked on this subject. Our goal is to provide you with straightforward answers so that you have a clearer understanding of the treatment and are comfortable making the decision to go forward with these excellent tooth restorations should they ever be required.

What Is A Crown?

A dental crown is a tooth-shaped “cap” or cover that a dentist places over a tooth that is badly damaged from trauma or decay in order to restore its color, strength, size and functionality. They are also used for cosmetic reasons to improve discolored or misshapen teeth.

Why Can The Cost Of Crowns Vary?

The reason the cost of a crown can vary greatly, even from dentist to dentist is quite simple. The most beautiful crowns require the artistry and years of experience of a team of dental professionals; your dentist and the laboratory technicians that handcraft crowns. To meet higher expectations of some individuals requires more experience, artistry and skill. And great art just tends to cost more. A customized temporary crown may even be used as a preview to see what a final crown will look like. Another critical factor is the choice of materials used. For example, while all porcelain crowns are made from high-quality ceramic (glass) material, they are not equal. It is therefore more expensive in terms of time, skill and expertise to produce the most natural looking results.

How Long Will A Crown Last?

Most dentists expect a crown to last at least 7-10 years with normal wear and proper maintenance. However, depending on the materials used and location of the tooth, they can last upwards of 50 years or more. For example, a gold crown has the longest lifespan because gold is such a durable material that has little to no negative impact on surrounding teeth. On the other hand, porcelain produces a completely natural look but can cause wear to adjacent teeth.

What Materials Are Most Often Used For Crowns?

The three most common materials used to make crowns are as follows:

• Gold
• Porcelain-Fused-to Metal (PFM)
• All porcelain

To learn more on this topic, read the Dear Doctor article, “Porcelain Crowns & Veneers.” You can also contact us to discuss your questions or to schedule a consultation.

If you believe you need a crown or if we have already confirmed this fact, you need to understand that there are several options. The most common are gold crowns, porcelain-fused-to-metal crowns and all porcelain crowns. Each has both pros and cons; thus we will work with you to determine which will work best for your specific needs. However, to help you learn more now, here are some facts.

Gold Crowns

Made from cast gold, this type of crown has been around for over 100 years and is the most successful type of crown. It can last more than 50 years and thus many dentists prefer gold restorations for their own teeth, where cosmetics is not a concern.

All Porcelain Crowns

All porcelain crowns can produce an incredible, life-like appearance. However, because they are made purely from dental porcelain (a type of glass), they tend to be more fragile than gold crowns and may be more at risk with certain high biting forces. Thus they may not be as durable. Porcelain can also cause wear to the natural teeth they bite against. Therefore they are typically preferred for front teeth, rather than back teeth. They have an aesthetic longevity of about 10 years and a functional longevity of about 20 years.

Porcelain-Fused-To-Metal Crowns

As the name states, porcelain-fused-to-metal (PFM) crowns provide the best of both worlds. They are made of natural tooth-colored dental porcelain that is fused on top of a precious or noble metal (usually gold or platinum). They are stronger than porcelain alone and are a good option for back teeth because they offer a better cosmetic result than gold crowns. This is also true for front teeth, however the gold support beneath the porcelain can compromise its life-like qualities. These crowns also have a proven track record and have been used with excellent results for over 40 years.

Learn more about crowns when you read, “Gold or Porcelain Crowns.” Or you can contact us today to discuss your questions or to schedule a consultation.