Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Teeth Whitening - Brighter, whiter...
The subconscious impact of a white smile is radiant health, happiness, warmth and invitation. This phenomenon has been reinforced with the spread of American culture worldwide, where an especially white smile has even been coined a "Hollywood smile". Today brighter, lighter, whiter teeth have become a norm. Tooth whitening by bleaching is a successful, conservative, relatively inexpensive and safe alternative... Read Article
Smile Design with Porcelain Veneers
In part two of the series on Smile Design, Dear Doctor takes an in-depth look at Porcelain Veneers, a superior yet minimally invasive technique for smile enhancement. We'll explain not only when they're appropriate, but also when they're not... Read Article
Porcelain Veneers – Without A Drill
No drilling — reality or ridiculous? A no-drill technique requires a second look, as new materials and concepts have created new esthetic possibilities. Reactions and opinions among dentists have ranged from absolute disbelief to moderate acceptance. This article gives hope and reasons for patients to get excited about this conservative drill-free cosmetic technique... Read Article
Cosmetic Dentistry - A Time For Change
Join us as we review the myriad of possibilities available to you for cosmetic dental change. But the biggest part is not just how your smile looks, it's how you feel when you show it... Read Article
Dental Implants - Your Third Set of Teeth
A discovery fifty years ago paved the way for one of dentistry's most exciting, natural looking and successful tooth replacement systems. Learn how dental implants might just possibly change your life... Read Article
What is Tooth Decay?
Tooth Decay is an infection, and many people don't realize that it is preventable. This article is the first in a series about tooth decay, perhaps the number one reason children and adults lose teeth during their lifetime. Explore the causes of tooth decay, its prevention and the relationship to bacteria, sugars and acids... Read Article
Don't wait for cavities to occur and then have them fixed — stop them before they start. Modern dentistry is moving towards an approach to managing tooth decay that is evidence-based — on years of accumulated, systematic, and valid scientific research. This article discusses what you need to know to assess your risk and change the conditions that lead to decay... Read Article
The Beauty of Tooth Colored Fillings
The public's demand for aesthetic tooth colored (metal free) restorations (fillings) together with the dental profession's desire to preserve as much natural tooth structure as possible, has led to the development of special "adhesive" tooth colored restorations... Read Article
Wisdom Teeth – To Be Or Not To Be
Facts you need to know about these curiously named teeth. They are so-called because a moderate amount of wisdom is supposedly achieved at about the same time these teeth typically make their appearance. This article will review the problems associated with wisdom teeth and whether or not they should be removed... Read Article
Oral Hygiene - Dental Health for Life
The best tools for maintaining your oral health and minimizing dental problems are a quality toothbrush, toothpaste, a roll of dental floss, approved mouthwash and good diet. This article cuts through the confusion with a winning game plan for oral health... Read Article
Understanding Gum Disease
Have your gums ever bled when you brushed or flossed? This most commonly overlooked simple sign may be the start of silent (periodontal) disease leading to tooth loss. Learn what you can do to prevent this problem and keep your teeth for life... Read Article
The Impact of a Smile Makeover
Americans are catching on to the emotional and social importance of a healthy, beautiful smile, and they're seeking out ways to improve their smiles. Learn why and what a change could mean for you...Read Article
The orthodontic treatment using clear aligners consists of a series of aligners that you change about every two weeks over a course of treatment lasting six to eighteen months depending on how much movement is needed... Read Article
This article may just save your life. Learn how to notice any unusual lesions (sores or ulcers) anywhere in your mouth that do not heal within two-three weeks. Early detection is key... Read Article
Implant overdentures represent a major change for the dental profession and the public. The lower jaw two-implant overdenture may be considered a more appropriate starting point over regular dentures... Read Article
TMD – The Great Impostor
This “chameleon” of dental disorders manifests in a variety of ways, including joint pain, sinusitus, ear pain, tooth and headaches. The causes of TMD, its signs and symptoms and what can be done to treat this common disorder... Read Article
Lasers Shine a Light on Dentistry
Lasers have revolutionized medicine and now they're beginning to blaze a new trail in dentistry. Today, at the dawn of the 21st century there are a variety of dental uses for lasers, from diagnosing cavities and the removal of gum and tooth structure to the treatment of disease... Read Article
Oral Sedation Dentistry
Step out from under the shadow of fear and into the calm of sedation dentistry. There are safe and time-tested options available to ensure that you have a positive and painless dental experience. Your apprehension and hypersensitivity to pain melt away, yet you remain awake and in control... Read Article
Sleep Disorders and Dentistry
If my partner snores loudly, should I be concerned and what can be done to alleviate the problem? Why does my sleeping partner have lapses in breathing while sleeping and is it dangerous? Why do I wake up exhausted even though I get up to 10 hours sleep at night? The answers to these and more questions and how dentistry can help all revealed within... Read Article
About Dear Doctor Dentistry Magazine
Dear Doctor - Dentistry & Oral Health is a dental magazine written for the education of the general public. Dear Doctor provides information that is accurate, authoritative, and trustworthy on all aspects of dentistry and oral health including teeth whitening, porcelain veneers, dental implants, cosmetic dentistry, smile makeovers and more.
Copyright © 2012 Dear Doctor, Inc. All rights reserved. Copying or reproducing any text or graphics is strictly prohibited.
Teeth whitening is one of the most popular cosmetic dental treatments — and it's easy to see why. Having whiter teeth can make you look years younger, and the procedure itself is among the most conservative (and cost-effective) cosmetic treatments dentistry offers. Sometimes, however, achieving a pleasing, even shade of lightness can be challenging; this is particularly true when a tooth that needs to be lightened has been subjected to an injury (dental trauma) in the past.
Dental trauma encompasses any damage to the tooth that's caused by an external agent, whether accidental or intended. It may be due to a fall, a sports injury — or even a past orthodontic procedure. According to some studies, around a quarter of Americans aged 6 to 50 years old have experienced some traumatic dental injury, with most occurring before age 19. Traumatized teeth may react to whitening procedures differently from undamaged teeth, which can make them difficult to treat. However, several effective treatments are available.
Diagnosing a Discolored Tooth
The first step in the process of lightening a traumatized tooth is a thorough exam to find out what's causing the dark staining — and one of the first things we will determine is whether or not the tooth's pulp is “vital,” or alive. This is readily revealed by radiographs (x-rays) or other tests. If the tooth is still vital, external bleaching can often yield satisfactory results — even if it's just one tooth that needs to be whitened. In-office treatments or take-home trays are effective, but office procedures generally take much less time to produce good results.
In many cases, however, discoloration of a traumatized tooth is itself an indication that the nerves in the tooth's pulp have died. In this case, before whitening treatment can start, a root canal procedure will be necessary to remove the dead or dying tissue and prevent infection. It can also happen that a tooth that appeared normal will begin to discolor many months (or years) after a root canal has been performed. In either situation, it may be possible to whiten a non-vital tooth with a procedure called internal bleaching.
Whitening From the Inside Out
Because a non-vital tooth's stains are intrinsic (inside, rather than outside, the tooth), we need to put the bleaching agent itself inside the tooth. Internal bleaching is a routine procedure, here's how it works:
Access to the pulp chamber (the small passageway in the tooth's center) will be gained by making a small hole in the back of the tooth. Then, any debris from the chamber will be removed and rinsed away, and a special cement will be added to prevent the bleaching agent from leaking into the tooth's roots.
Next, some bleaching agent (commonly sodium perborate) will be placed in the empty pulp chamber, and temporarily seal it in. At this point, you can get up and leave the office… which is why this procedure is sometimes called the “walking bleach” technique. However, you'll return in a few days for another round of bleaching; it may take up to four visits to get the degree of lightening you want.
When the tooth reaches the desired color change, a more permanent restoration will be placed on the tooth to seal that little hole — usually a tooth-colored filling material of composite resin. Many times, this relatively conservative procedure will give your tooth all the lightening it needs. If it's not enough, the tooth can be bleached externally as well, or you can even consider a veneer or crown. The goal is to recommend the most appropriate cosmetic dental procedure, and get you the best possible results.
Whitening Traumatized Teeth Sometimes teeth that have had root canal treatment darken over time. These teeth may not respond to the usual methods of whitening, but they can often be successfully bleached from the inside. This offers a more conservative option than using a veneer or crown to cover the discoloration... Read Article