• Cosmetics
• Whitening
• Orthodontics
• Gum Disease
• Air Abrasion
• Root Canal
  

Whitening

What is tooth whitening?
Tooth whitening is a process where a mild bleaching solution is applied to the tooth to whiten discolorations of the enamel and dentin.

What causes tooth discoloration?
Commonly, discoloration can be caused by aging or by consumption of coffee, tea, caffeine soft drinks, red wine, etc. Tooth discoloration can also occur during tooth formation due to trauma or medications taken during that time.

How long does it take to get results?
If you follow your dentist's recommendations, you will see results in 10-14 days. The type of whitening selected for you will determine how often you will apply the solution. Nite White is worn once per day for two hours. Day White is worn one to three times per day for 30 minutes. Zoom Whitening is worn four to eight hours while sleeping, for only three days.

Will my fillings change color?
No. If you have some original tooth-colored fillings that are noticeable when you smile, they will not change color with the whitening solution.

How long will it last?
Your teeth will always be lighter than they were initially. Your teeth may need to be "touched up" with one or two applications, once or twice a year. In order to maintain the whitest tooth shade possible, it is best to avoid substances like coffee, tea or tobacco. To keep your teeth looking their best we recommend flossing, as well as brushing twice daily with professional whitening toothpaste, specifically designed to keep your teeth looking their brightest.

How does it work?
As the carbamide peroxide (active ingredient) is broken down, oxygen enters the enamel and dentin and dissolves the stains. The tooth structure does not change but the tooth is made lighter.

Is tooth whitening safe?
Studies indicate that tooth whitening under the supervision of a dentist is safe for the teeth and the gums. However, it is not recommended for anyone under the age of thirteen or for pregnant or lactating women.

What about sensitivity?
The majority of patients do not experience sensitivity. If you do experience mild, temporary sensitivity, it should subside within a few hours after treatment. If sensitivity persists, wearing times can be varied or teeth can be treated with desensitizing toothpaste. Lingering sensitivity will subside one to three days after completion of the treatment.

Orthodontics

What is Orthodontics?
The area of dentistry called orthodontics involves straightening of teeth with the use of braces. Orthodontics is also indicated when the patient has a bad bite, which can cause digestive or other health problems and make the patient feel self-conscious. Braces are less conspicuous and more comfortable than ever before, due to the use of new high performance arch wires, which exert continuous, light force on the teeth. Children should have an orthodontic assessment before the age of five so that early treatment with functional appliances can reduce the time spent wearing braces. 

How long does orthodontic treatment last? 
The average length of time for orthodontic fixed braces would be 1.5 to two years when all the permanent teeth have erupted. The treatment time obviously depends on the seriousness of the problem and when treatment is started. Our office recommends that children be evaluated before age five to see if the problem is a bone problem or a tooth problem. If the problem involves the bone, such as the upper or the lower jaw being too narrow or the lower jaw being underdeveloped, then we recommend this problem be treated immediately with functional appliances. The use of functional appliances can reduce the time the child must wear fixed braces and reduce the need for the extraction of permanent teeth. If the problem is merely crooked teeth, many times treatment will be delayed until all the permanent teeth erupt.

Are there different kinds of braces? 
Most patients today think braces are 'cool' because of all the different colours. In fact, there are more that 40 different combinations of coloured elastics, which fit over the braces to keep the wires in place. Every month the patient has their choice of coloured elastics. Most children pick the metal braces, which are much smaller today. Adults and teenagers prefer the clear braces because they blend in with the colour of the teeth and are harder to see. We have some females who prefer gold braces since they look like jewelry. The newest and latest trend is toward invisible braces, which use trays that are changed periodically and move the teeth into a better position.

Will teeth move when the braces come off? 
You will be provided with a clear retainer to wear when your braces are removed. The roots of the teeth need enough time to settle in the bone, so it is absolutely imperative that you follow the instructions on wearing the retainer to maintain your beautiful smile at the end of treatment.

How long do I have to wear my retainers? 
The length of time for retainers varies depending on the amount of tooth movement that was necessary. However, as a general rule of thumb, we recommend full-time wear of the upper clear retainer for one full year followed by one year of night-only wear. We generally like to make the lower retainer fixed, behind the lower front teeth, and to leave it in place for three to five years.

Gum Disease

What is gum disease?
Gum disease or periodontal disease, is a chronic inflammation and infection of the gums and surrounding tissue. Gum disease is the major cause of about 70 percent of adult tooth loss, affecting three out of four persons at some point in their life.

What causes gum disease? 
Bacterial plaque, a sticky, colorless film that constantly forms on the teeth, is recognized as the primary cause of gum disease. Specific periodontal diseases may be associated with specific bacterial types. If plaque isn't removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar). Toxins (poisons) produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets which fill with even more toxins and bacteria. As the disease progresses, pockets extend deeper and the bacteria moves down until the bone that holds the tooth in place is destroyed. The tooth will eventually fall out or require extraction. 

Are there other factors? 
Yes. Genetics is a factor, as are lifestyle choices. A diet low in nutrients can diminish the body's ability to fight infection. Smokers and spit tobacco users have more irritation to gum tissues. Stress can also affect the ability to ward off disease. Diseases that interfere with the body's immune system, such as leukemia and AIDS, may worsen the condition of the gums. In patients with uncontrolled diabetes, where the body is prone to infection, gum disease is more severe or harder to control.

What are the warning signs of gum disease? 
Signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, loose or separating teeth, pus between the gum and tooth, persistent bad breath, change in the way teeth fit together when the patient bites, and a change in the fit of partial dentures. While patients are advised to check for the warning signs, there might not be any discomfort until the disease has spread to a point where the tooth is unsalvageable. That's why patients are advised to get frequent dental exams. 

What does periodontal treatment involve? 
In the early stages, most treatment involves scaling and root planing, removing plaque and calculus around the tooth and smoothing the root surfaces. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, called gingivitis, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums, removing the hardened plaque build-up and recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean.
 
How do you prevent gum disease? 
Removing plaque through daily brushing, flossing and professional cleaning is the best way to minimize your risk. Your dentist can design a personalized program of home oral care to meet your needs. If a dentist doesn't do a periodontal exam during a regular visit, the patient should request it. Children should also be examined. 

Is maintenance important? 
Sticking to a regular oral hygiene regimen is crucial for patients who want to sustain the results of therapy. Patients should visit the dentist every three to four months (or more, depending on the patient) for spot scaling and root planing and an overall exam. In between visits, they should brush at least twice a day, floss daily, and brush their tongue. Manual soft nylon bristle brushes are the most dependable and least expensive. Electric brushes are also a good option, but don't reach any further into the pocket than manual brushes. Proxy brushes (small, narrow brushes) are the best way to clean in between the recesses in the teeth, and should be used once a day. Wooden tooth picks and rubber tips should only be used if recommended by your dentist.

Air Abrasion

How does air abrasion work?
An instrument that works like a mini sandblaster is used to spray away decay. During air abrasion, a fine stream of particles is aimed at the decayed portion of the tooth. These particles are made of silica, aluminum oxide, or a baking soda mixture and are propelled toward the tooth surface by compressed air or a gas that runs through the dental hand piece. Small particles of decay on the tooth surface are removed as the stream of particles strikes them. The particles of decay are then "suctioned" away.

Is air abrasion safe?
Yes. The only precautions needed before air abrasion is undertaken are protective eye wear (to prevent eye irritation from the spray) and the use of a rubber dam (a rubber sheet that fits around teeth) or protective resin applied to nearby teeth and gums to protect areas of the mouth that aren't being treated.

What are the advantages of air abrasion?
Compared with the traditional drilling method, the advantages of air abrasion are many and include the following:

• Air abrasion generates no heat, sound, pressure or vibration. 
• Air abrasion reduces the need for anesthesia, particularly if the cavity is shallow. 
• Air abrasion leaves much more of the healthy tooth tissue behind. 
• Air abrasion leaves the working area relatively dry, which is an advantage during the placement of composite fillings. 
• Air abrasion reduces the risk of microfracturing and chipping of the tooth, which some experts believe can lead to premature restorative failures. 
• Air abrasion allows the dentist to treat multiple sites in the mouth during a single visit. 
• The procedure is relatively simple and quick. 

What are the disadvantages?

• Air abrasion is not necessarily totally painless. The air can cause sensitivity and so can the abrasives used. 
• Air abrasion is not recommended for deep cavities (those close to the tooth's pulp). It is best suited for removing small cavities that form early on the surface of teeth. 
• Only composite filling material can be used following air abrasion because it adheres well to the smooth surface created by the air abrasion (amalgam or silver fillings require drill-based cuts to prevent the filling from falling out). 

Who are the best candidates for air abrasion procedures?
Air abrasion is ideal for use in children and others who are fearful and have minimal decay.

What other procedures can be performed with air abrasion?
Air abrasion can also be used to:

• Remove some old composite restorations, but not metallic restorations such as silver amalgam fillings.
• Prepare a tooth surface for bonding or sealants.
• Remove superficial stains and tooth discolorations.
  

Root Canal

What is a root canal?
Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the pulp, which carries the tooth's nerves, veins, arteries and lymph vessels. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but no more than four root canals.

Why do I feel pain?
When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow and cellular activity, and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks.

Why do I need root canal therapy?
Because the tooth will not heal by itself. Without treatment, the infection will spread, bone around the tooth will begin to degenerate, and the tooth may fall out. Pain usually worsens until one is forced to seek emergency dental attention. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift crookedly, resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal therapy. If you have the choice, it's always best to keep your original teeth. 

What is involved in root canal therapy? 
Once your general dentist performs tests on the tooth and recommends therapy, he or she can perform the treatment or refer you to an endodontist (a pulp specialist). Treatment usually involves one to three appointments. First, you will probably be given a local anesthetic to numb the area. Next, a gap is drilled from the crown into the pulp chamber, which, along with any infected root canal, is cleaned of all diseased pulp and reshaped. Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, or the tooth may be left open to drain, or the dentist may go right ahead and fill the canals. If you're given a temporary filling, usually on the next visit it is removed and the pulp chamber and canal(s) are filled with rubberlike gutta percha or another material to prevent recontamination. If the tooth is still weak, a metal post may be inserted above the canal filling to reinforce the tooth. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve appearance. 

What are the risks and complications?
More than 95 percent of root canal treatments are successful. However, sometimes a case needs to be redone due to diseased canal offshoots that went unnoticed or the fracturing of a canal filing, both of which rarely occur. Occasionally, a root canal therapy will fail altogether, marked by a return of pain.

What happens after treatment?
Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic. A follow-up exam can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods on the treated tooth, and see your dentist regularly.