If you have discolored teeth, the cause is often staining on the enamel surfaces from foods, beverages, or smoking. But tooth discoloration may also originate deep within the root of a tooth. Sometimes this happens to a tooth that had to have earlier root canal treatment because of injury or decay.
In such cases the living pulp tissue and its blood vessels and nerves had to be removed from the root canals, resulting in the death of the dentin layer, which makes up most of the tooth's body. Over time this caused the dentin to darken. The color may come from remains of blood that was left in the tissue, or from filling materials left in the root canal that are showing through.
Since these stains are caused internally (intrinsic) and not on the outside of the tooth (extrinsic) they must be whitened from the inside. This is usually done by putting a bleaching agent into the empty chamber from which the pulp was removed. Usually the bleaching agent is a substance called sodium perborate.
When it is mixed with a solution of hydrogen peroxide, sodium perborate slowly bleaches the color from the tooth's internal material. It is considered to be safe and reliable for this use.
The work begins by taking x-ray images to make sure that the root canal is correctly sealed and the bone is healthy. After this, we will make a small hole in the back of the tooth through which the root canal space will be cleaned. The root canal space will be sealed and the bleach will be applied in a putty-like form and sealed off from the rest of your mouth. Every few days this procedure will be repeated until the bleaching reaches the desired level.
At this point a tooth-colored composite resin will be used to seal the small hole that was made in the dentin to insert the bleach. After the tooth has reached the level of whiteness that matches it to your other teeth, veneers or crowns must sometimes be used to repair the surface if it is chipped or misshapen, for example.
Contact us today to schedule an appointment to discuss your questions about whitening internally discolored teeth. You can also learn more by reading the Dear Doctor magazine article “Whitening Traumatized Teeth.”
Some patients who wear dentures face a kind of Catch-22: their denture fit may have loosened and become uncomfortable over time due to continued bone loss, yet the same bone loss prevents them from obtaining dental implants, a superior tooth replacement system to dentures.
But there may be a solution to this dilemma that combines the stability of implants with a removable denture. A set of smaller diameter implants — “mini-implants” — can support a removable denture with less bone than required by a conventional implant.
Like all living tissue, bone has a life cycle: after a period of growth, the older bone dissolves and is absorbed by the body, a process known as resorption. The forces generated when we bite or chew are transmitted by the teeth to the jawbones, which stimulates new bone formation to replace the resorbed bone. When the teeth are lost, however, the stimulation is lost too; without it, resorption will eventually outpace bone growth and repair, causing the bone mass to shrink.
Removable dentures also can’t supply the missing stimulation — bone loss continues as if the dentures weren’t there; and due to the compressive forces of a denture, bone loss accelerates. As the jawbone structure used to originally form the denture’s fit eventually shrinks, the denture becomes loose and difficult to wear. It’s possible to adjust to the new jaw contours by relining the dentures with new material or creating a new set of dentures that match the current bone mass. Without adequate bone, fixed crowns or bridges anchored by conventional implants may also be out of the picture.
On the other hand, mini-implants with their smaller diameter need less bone than the traditional implant. A few strategically placed within the jaw are strong and stable enough to support a removable denture. One other advantage: these mini-implants can be installed in one visit with local anesthesia and usually without the need for incisions or stitches.
If you would like more information on dentures supported by mini-implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The ‘Great’ Mini-Implant.”
Bacteria are bad… right? They can cause diseases like pneumonia, strep throat, and tooth decay. They are the reason we wash our hands with soap (or antibacterial gels) and cook (or refrigerate) our food. Yet it turns out that bacteria are also necessary to keep our bodies healthy — and new research is showing just how important these tiny microorganisms are to our well-being. Here are five facts you should know about bacteria.
The bacteria in our bodies outnumber our cells by a factor of 10 to 1. An estimated 100 trillion bacteria live inside the average human — but because they’re so small, they make up only 1-3 percent of our body mass.
The collection of bacteria we harbor is called our “microbiome.” Like the groundbreaking study of human DNA called the Human Genome Project, recent research is leading to a “map” of our bacterial makeup. This revolutionary study is called — you guessed it — the Human Microbiome Project.
No two people have exactly the same microbiome. But in general, the bacteria that live in a particular spot on the body (the mouth, for example) play the same roles in different individuals. Research has also shown that a healthy microbiome looks very different from a diseased microbiome.
In terms of bacteria, the mouth is one of the best-understood areas of the body. It has long been known that tooth decay can result when “bad” oral bacteria begin to outnumber their “good” counterparts. Now we are gaining a better understanding of how certain lifestyle factors — like cigarette smoking — may influence the bacterial balance in the mouth.
Understanding the microbiome may lead to new treatments for disease. Researchers hope that one day, certain serious diseases could be controlled by bacterial “transplants” that re-balance an individual’s microbiome. Maintaining a healthy microbiome could also help prevent many diseases.
So by all means, don’t stop brushing your teeth or washing your hands — this helps control bacteria that could harm you — but do remember that not all bacteria are harmful. One day, an infusion of bacteria might just cure your illness.
Do you still feel tired or unfocused even after a full night’s sleep? Do others complain about your snoring? It’s possible these are signs that you may have sleep apnea.
Sleep apnea is a condition in which you stop breathing while you sleep. Your brain will awaken you to breathe, although you may not consciously realize it since the waking period can be less than a second. But it does disrupt your sleep rhythm, especially during the all-important deep sleep period called Rapid Eye Movement (REM). These disruptions don’t allow your body to receive the full benefit of sleep, hence your lack of energy and focus during the day.
One of the most common causes for sleep apnea is the collapse of soft tissues near the throat as they relax during sleep that restrict the airway. Snoring is an indication this may be occurring: air vibrates rapidly (and loudly) as it passes through this restriction when you breathe in.
As your dentist, we’re well-trained in the anatomy and function of the entire oral structure, and qualified to offer solutions for sleep apnea. If you’ve been diagnosed with sleep apnea (after a complete examination, including an observation session at a sleep laboratory), we can then help you decide on a treatment approach. The following are three such options, depending on the severity of your sleep apnea.
Oral Appliance Therapy. An oral appliance you wear while you sleep is a first line treatment for mild or moderate sleep apnea. The appliance, which we custom design for you, helps hold the lower jaw in a forward position: this moves the tongue and other soft structures away from the back of the throat, thereby opening the airway.
Continuous Positive Airway Pressure (CPAP). Intended for more moderate to severe forms of sleep apnea, a CPAP machine produces continuous air pressure to the throat through a mask you wear during sleep. This forces the tongue forward and the airway open.
Surgical Intervention. These procedures remove excess tissue that may be obstructing the airway. Due to its invasiveness and permanent alteration of the throat area, surgery is reserved for patients who haven’t responded to other therapies in a satisfactory manner.
Whether mild or severe, it’s possible to effectively treat sleep apnea. If successful, not only will you benefit from better sleep and greater alertness, you’ll also improve your long-term health.
If you would like more information on treating sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”
We’re all susceptible to gum disease when we fail to practice effective daily brushing and flossing. But you may have a greater risk of gum disease (and more severe forms of it) if any of the following categories pertain to you:
Aging. Gum disease risk naturally increases with age. We can lower the risk with an effective daily hygiene regimen, along with a minimum of two office cleanings and checkups each year. Brushing and flossing removes bacterial plaque and food particles which accumulate on tooth surfaces. The longer plaque remains in contact with gum tissues, the greater the chances of infection.
Pregnancy. Although women tend to take better care of their teeth than men, they still face unique issues that increase their risk. During pregnancy, for example, certain hormone levels rise, which cause the gums to become more responsive to bacteria. Other hormonal fluctuations throughout a woman’s life, including taking certain drugs for birth control or during menopause, can cause similar situations.
Family History. You could be at higher risk if members of your immediate family have a history of gum disease. Researchers estimate that 30% of the U.S. population has a genetic predisposition to the disease; it’s also possible for family members to transfer bacteria to other family members by way of saliva contact or shared eating utensils.
Smoking. Nicotine, the active ingredient in tobacco smoke, causes changes in the blood vessels of the mouth that could inhibit the flow of antibodies (produced by the body to fight infection) in the bloodstream. As a result, smokers experience more rapid disease development and greater detachment between teeth and gums than non-smokers.
Other Inflammatory Conditions. A number of studies indicate people with other inflammatory conditions like heart disease, arthritis or diabetes have a higher risk for gum disease. Some researchers have even suggested that bacteria associated with gum disease pass into the blood stream and threaten other parts of the body — an added incentive to seek treatment and stop the disease’s advancement.
If you fall into any of these risk categories, it’s even more urgent that you practice effective daily hygiene with regular office checkups. Additionally, if you begin to notice bleeding gums, tenderness and swelling, or loose teeth, contact us as soon as possible for an evaluation.
If you would like more information on the diagnosis and treatment of gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Assessing Risk for Gum Disease.”
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