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Posts for category: Dental Procedures

By George Mui, DDS, Ltd. Gentle Dental Care
May 17, 2019
Category: Dental Procedures
Tags: teeth whitening  
WhatYouShouldKnowAboutaHomeTeethWhiteningKit

A relatively easy and inexpensive way to improve your smile is to whiten your teeth. In fact, you may even be able to do it yourself at home. Although there are differences between at-home and professional whitening, the former can still be effective.

That effectiveness, though, might be dependent on how well you understand what home whitening can do and what it can’t. So before you purchase your kit, here are a few things to know about DIY teeth whitening.

Home kits are safe—when used as directed. Although nothing in life is completely risk-free, home whitening kits are relatively safe. But only if you follow the directions: If you overuse the bleaching solution beyond its intended use, you could wind up with permanent damage to your tooth enamel that can be costly to treat.

Bleaching solutions are relatively mild. Nearly all home kits use carbamide peroxide, a form of hydrogen peroxide, as their bleaching agent. Home kits usually contain no more than 10% of this agent, much lower than professional solutions. Used as directed, this amount of bleaching agent poses little to no risk to dental or general health. On the other hand, the weaker home kit solution does limit the extent of brightness you can achieve compared to stronger professional treatments.

For top results (or certain conditions), consider professional whitening. While you can obtain good results with a home whitening kit, professional whitening provides more precise brightness control and range, and may possibly last longer. That’s because your dentist has more advanced techniques and equipment, as well as stronger bleaching solutions. And, if your discoloration originates inside your teeth, a home kit won’t help—only a dentist can address that kind of discoloration.

Even if you decide to “go solo,” your dentist can still give you advice on what to look for in a home kit, as well as tips for the actual procedure. But whether you whiten at home or let your dentist do it, teeth whitening can take years off your smile and give you a more attractive look.

If you would like more information on teeth 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: Are Bleaching Products Safe?

By George Mui, DDS, Ltd. Gentle Dental Care
May 12, 2019
Category: Dental Procedures
AdvancesinPorcelainVeneersImproveBothStrengthandAppearance

One of the best restorative options for slightly deformed, misaligned or stained teeth is a porcelain veneer. Composed of thin, laminated layers of dental material, the veneer is bonded to the outside of the tooth to transform both its shape and color to blend with other natural teeth.

Veneers are more than a technical process — they’re works of art produced by skilled artisans known as dental lab technicians. They use their skills to shape veneers into forms so life-like they can’t be distinguished from other teeth.

How technicians produce veneers depends on the material used. The mainstay for many years was feldspathic porcelain, a powdered material mixed with water to form a paste, which technicians use to build up layers on top of each other. After curing or “firing” in an oven, the finished veneer can mimic both the color variations and translucency of natural teeth.

Although still in use today, feldspathic porcelain does have limitations. It has a tendency to shrink during firing, and because it’s built up in layers it’s not as strong and shatter-resistant as a single composed piece. To address these weaknesses, a different type of veneer material reinforced with leucite came into use in the 1990s. Adding this mineral to the ceramic base, the core of the veneer could be formed into one piece by pressing the heated material into a mold. But while increasing its strength, early leucite veneers were thicker than traditional porcelain and only worked where extra space allowed for them.

This has led to the newest and most advanced form that uses a stronger type of glass ceramic called lithium disilicate. These easily fabricated veneers can be pressed down to a thickness of three tenths of a millimeter, much thinner than leucite veneers with twice the strength.  And like leucite, lithium disilicate can be milled to increase the accuracy of the fit. It’s also possible to add a layer of feldspathic porcelain to enhance their appearance.

The science — and artistry — of porcelain veneers has come a long way over the last three decades. With more durable, pliable materials, you can have veneers that with proper care could continue to provide you an attractive smile for decades to come.

If you would like more information on dental veneers, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers.”

By George Mui, DDS, Ltd. Gentle Dental Care
April 27, 2019
Category: Dental Procedures
Tags: teeth grinding  
StressandNighttimeTeethGrinding

April is National Stress Awareness Month. But what does stress have to do with dentistry? According to the American Academy of Sleep Medicine, if you have a Type A personality or are under a lot of stress, you are more likely to suffer from a condition called bruxism, which means you habitually grind or gnash your teeth. One in ten adults grind their teeth, and the rate is much higher in stressful professions. In fact, the bruxism rate is seven times higher among police officers!

Many people grind their teeth in their sleep without realizing it, so how would you know if you are a "sleep bruxer"? If your spouse frequently elbows you in the ribs because of the grinding sounds you make, that could be your first clue. Unfortunately, dental damage is another common sign. Some people find out they are nighttime teeth grinders only when they are examined by a dentist since bruxing often leads to wear patterns on the teeth that only happen because of this behavior. Other complications can also develop: The condition can interfere with sleep, result in headaches and cause soreness in the face, neck or jaw. Chronic or severe nighttime teeth grinding can damage dental work, such as veneers, bridgework, crowns and fillings, and can result in teeth that are worn down, chipped, fractured or loose.

The most common treatment is a custom-made night guard made of high-impact plastic that allows you to sleep while preventing your upper and lower teeth from coming into contact. Although a night guard will protect your teeth and dental work, it won't stop the grinding behavior. Therefore, finding and treating the cause should be a priority.

The Bruxism Association estimates that 70 percent of teeth grinding behavior is related to stress. If you are a bruxer, you can try muscle relaxation exercises, stretching and breathing exercises, stress reduction techniques and, where feasible, any lifestyle changes that can allow you to reduce the number of stressors in your life. Prescription muscle relaxants may also help. In addition, teeth grinding may be related to sleep apnea. This possibility should be investigated since sleep apnea can have some serious health consequences—we offer effective treatments for this condition as well.

We can spot signs of bruxism, so it's important to come in for regular dental checkups. We look for early indications of dental damage and can help you protect your smile. If you have questions about teeth grinding or would like to discuss possible symptoms, please contact our office or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “Stress & Tooth Habits.”

By George Mui, DDS, Ltd. Gentle Dental Care
April 22, 2019
Category: Dental Procedures
WemayNeedtoRemoveoneorMoreTeethBeforeApplyingBraces

“To gain something, sometimes you have to give up something else.”

No, that isn't the latest viral meme on the Internet. It's actually a practical consideration that could arise in orthodontics.

In this case, the “something” to gain is a straighter, more attractive smile; the “something” you may have to part with is a few teeth. This may be necessary if there are too many teeth on a dental arch for its capacity, a situation called crowding. A lack of space is the main reason teeth come in misaligned.

Before we can correct this, we'll need to free up space to allow for tooth movement by removing one or more of the existing teeth. The ideal candidates are those that are near to the teeth we wish to move but not highly visible. The first bicuspids are the most frequent choices for removal: they're located behind the cuspids or eyeteeth (the pointed teeth right under the eyes).

Ideally, we'll remove the target teeth some time before we apply braces to give the gums a chance to heal. At the same time we want to preserve the bone that once supported the teeth we've extracted. This is because when we chew the forces generated by the teeth stimulates bone replacement growth. When a tooth is no longer there the supporting bone doesn't receive this stimulation and may ultimately reduce in volume.

We may try to prevent this by placing a bone graft in the empty socket immediately after removing the tooth. The graft serves as a scaffold to encourage new bone to grow. Hopefully when we're ready to apply braces, the bone will be strong and healthy to handle the movement of the teeth.

As the teeth move under the influence of braces, they'll begin to fill up the space created by tooth removal. Once it's completed, the extracted teeth won't be missed — the other teeth now straightened will completely fill out the smile.

The different steps in this process must be carefully planned and executed precisely, and it will take months or even years to complete. In the end, though, this complicated bite problem can be corrected and replaced with an attractive, straight smile.

If you would like more information on correcting a poor bite, 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 Removal for Orthodontic Reasons.”

By George Mui, DDS, Ltd. Gentle Dental Care
April 12, 2019
Category: Dental Procedures
Tags: dental implants  
ReplacingaMissingToothisntJustAboutImprovingYourSmile

Seven out of ten Americans are missing at least one tooth due to decay, periodontal (gum) disease or injury. Unfortunately, the consequences go far beyond a missing tooth — the loss of even one could set in motion a cascade of problems.

Perhaps the most damaging of these problems is bone loss. Like other living tissue, bone has a life cycle — older cells dissolve (resorb) into the body and are replaced by fresher cells. This growth cycle in the jawbone receives stimulation from forces generated by teeth when we chew or bite. If a tooth is no longer present to provide this stimulation, the affected bone cells won’t regenerate at a healthy rate. Over time this causes the volume of bone to diminish, as much as 25% the first year after tooth loss.

The void left by a missing tooth can also adversely affect remaining teeth. Teeth are held in place by a tough but elastic tissue known as the periodontal ligament that lies between the tooth and the bone. The ligament enables teeth to move gradually in response to mouth changes so that the teeth remain tightly aligned with each other. When there’s a gap from a missing tooth, this tendency will cause the teeth on either side to move (or “drift”) toward the open space. Although a natural phenomena, it can result in a malocclusion (poor bite).

That’s why it’s important to replace a missing tooth with a life-like replica — not just for appearance’s sake, but also to improve function and prevent the rise of these other problems. While many options exist (from removable dentures to fixed bridges) the choice most preferred by dentists and patients is the dental implant.

An implant replaces the tooth root as well as the crown, because it’s imbedded securely into the jawbone. Because of a natural affinity with titanium, the principal metal used in implants, bone cells will grow to its surface. Not only will this anchor the implant more securely, it will slow or even stop bone loss.

If you have a missing tooth, you should visit us as soon as possible to consider your options for a replacement. A new tooth will help stop even greater problems from occurring.

If you would like more information on effects and treatment of tooth loss, 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 Hidden Consequences of Losing Teeth.”