Posts for: February, 2014
Gold is more than a financial commodity or a symbol of wealth — it’s one of the best materials for restoring damaged tooth crowns, the visible portion above the gum line. It’s extremely durable and can last for several decades if properly maintained. It also causes minimal wear to adjacent teeth.
But as new, more life-like materials have come into prominence, gold restorations have diminished in popularity. Dental porcelain in particular, a type of fired ceramic glass that mimics the look and color of teeth, has increased in popularity for use in highly visible areas.
But unlike gold, all porcelain crowns lack strength, tend to be more brittle and can abrade other teeth during biting and chewing. If they break, they can shatter beyond repair. All porcelain crowns are improving dramatically as newer space age materials become available. Historically, though, they are thought of as more unpredictable when used for back teeth; the greater biting forces make them more susceptible to failure than with front teeth.
A Porcelain-Fused-To-Metal (PFM) crown is a hybrid of these two materials that seeks to impart the strengths of both — the aesthetic appeal of porcelain and the durability of gold or platinum. But a PFM crown also has drawbacks: the porcelain surface may still abrade opposing teeth; they can lose their aesthetic appeal if the metal collar becomes visible if gum tissues recede; and they can fail if the porcelain fractures or separates from the metal.
To address some of porcelain’s weaknesses, some PFM variations reduce the amount of porcelain by placing it only on the visible side of a cast gold crown. In addition, other porcelain materials are now coming into use that may be more durable yet just as life-like.
Choosing which material to use for a crown depends on many factors: cost, the location of the crown, and, of course, the patient’s desires for the resulting smile appearance. It all begins with a comprehensive exam: from there, we can advise you on your options and help you make a choice — gold, porcelain or something in between — that’s durable and pleasing to the eye.
If you would like more information on your options regarding dental crowns, 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 “Gold or Porcelain Crowns?”
Tooth whitening procedures and products have become increasingly popular over the last two decades. There are two main sources of application: professional procedures performed in a dentist’s office; and over-the-counter products for performing whitening applications at home. While there are pros and cons to both approaches, neither type poses a significant health risk — that is, if you match the correct product to the type of staining you have, and it’s applied according to the manufacturer’s instructions.
Although whitening treatments may differ in formula and strength, almost all use hydrogen peroxide as the bleaching agent, usually contained in carbamide peroxide which splits into hydrogen peroxide and urea upon activation. After many studies, there’s a strong consensus that hydrogen peroxide used at the levels found in whitening products doesn’t cause any harm to the body, including as a precursor to cancer.
But as the 16th Century Swiss physician Paracelsus once noted, “All substances are poisons… The right dose differentiates a poison from a remedy.” This is true of the chemicals that make up whitening products — they’re safe unless they’re overused. Going beyond their directions for use could lead to tooth enamel damage.
Further caution is also in order for teenagers using whitening products. Although they may have their permanent teeth (although younger teens may still have some primary teeth), the enamel layer is still developing and can be more vulnerable to damage from whitening chemicals than for adults.
The best approach for both a professional or home whitening procedure is to first seek consultation from our office. If nothing else, you should at least undergo a dental examination to identify the true cause of your teeth’s staining or discoloration. If the discoloration originates within the tooth, home applications and many professional treatments will not help if they bleach the outer surface only. We can also advise you on the proper application and dosage for a chosen product.
Using the right whitening product and in an appropriate manner will reduce the risk of injury to your teeth and overall health. And, the end result can be a brighter, more vibrant smile.
If you would like more information on tooth whitening, 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 “Tooth Whitening Safety Tips.”
Teeth are composed of layers of different types of tissue. The main inner layers — the pulp and dentin — help the teeth respond and adapt to external forces. But they’re vulnerable to decay and quite sensitive to environmental extremes. They are protected from all these by a coating of enamel, made of the hardest material found in the human body.
But while enamel is strong, it’s not invincible — it can soften and dissolve (de-mineralize) if the mouth environment becomes too acidic. While de-mineralization occurs normally whenever the mouth becomes too acidic after eating or drinking, saliva helps neutralize the acid (buffering); in fact, saliva can restore to the enamel some of the calcium and other minerals it has lost (a process called re-mineralization).
If the acidic level remains too high for too long it can overwhelm saliva’s buffering ability and cause permanent mineral loss to the enamel. This erosion leaves teeth more susceptible to decay and disease and could lead to tooth loss. With this in mind, here’s some ways you can help preserve your enamel:
- Wait about thirty to sixty minutes after eating or drinking to brush your teeth. Counterintuitive as this may sound, it takes about thirty minutes for saliva to restore a normal pH level and re-mineralize the enamel. If you brush within this window of time, you could brush away some of the softened minerals from the enamel.
- Only brush twice a day. Over-brushing causes undue enamel wear, as well as contributing to receding gums.
- Take advantage of less acidic or mineral-rich beverages. Drink milk or water most of the time, rather than juices, sodas or sports drinks. The calcium in milk or as an additive to acidic beverages aids in buffering and re-mineralization.
- Use a straw for acidic beverages. With a straw your teeth avoid direct contact with most of the beverage’s acid, a key factor in de-mineralization.
- Avoid eating just before bed. Saliva flow decreases significantly when we sleep. If you eat right before bed, there may be less saliva available for buffering and re-mineralization.
Following these tips, along with effective oral hygiene, will go a long way in protecting your teeth’s enamel coating — and preserving your teeth in the long run.
If you would like more information on enamel erosion and how to prevent 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 article “6 Tips to Help Prevent the Erosion of Tooth Enamel.”
Many people suffer from problems with the temporomandibular joint (TMJ); this can result in chronic pain and severely limit the function of the jaw. Yet exactly what causes the problems, how best to treat them… and even the precise number of people affected (estimates range from 10 million to 36 million) are hotly debated topics.
There are, however, a few common threads that have emerged from a recent survey of people who suffer from temporomandibular joint disorders (TMJD). Some of them are surprising: For example, most sufferers are women of childbearing age. And two-thirds of those surveyed say they experienced three or more associated health problems along with TMJD; these include fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, rheumatoid arthritis, chronic headaches, depression, and sleep disturbances. The links between these threads aren’t yet clear.
The survey also revealed some interesting facts about treating TMJD. One of the most conservative treatments — thermal therapy (hot or cold compresses) — was found by 91% to offer the most effective relief of symptoms. By contrast, the most invasive treatmentâ??surgeryâ??was a mixed bag: A slightly higher percentage reported that surgery actually made the condition worse compared to those who said it made them better.
So what should you do if you think you may have TMJD? For starters, it’s certainly a good idea to see a dentist to rule out other conditions with similar symptoms. If you do have TMJD, treatment should always begin with some conservative therapies: moist heat or cold packs, along with over-the-counter anti-inflammatory medications if you can tolerate them. Eating a softer diet, temporarily, may also help. If you’re considering more invasive treatments, however, be sure you understand all the pros and cons — and the alternatives — before you act. And be sure to get a second opinion before surgery.
If you would like more information about temporomandibular joint disorders (TMJD), call our office for a consultation. You can learn more in the Dear Doctor magazine articles “Chronic Jaw Pain And Associated Conditions” and “Seeking Relief from TMD.”