Whitening Traumatized Teeth

Do you have a front tooth that has turned dark over the years? As we age, our teeth naturally become more yellow, and in some instances more grayish due to the natural wearing of enamel. There are certain situations where a tooth can become dark very quickly, its cause being trauma or a root canal.

In a healthy tooth with a healthy pulp (the nerve), blood is cycled in and out. In a tooth that has lost the vitality of the nerve, blood is no longer able to be cycled in and out and so the expired cells become to accumulate leading to the dark color.

In the past, many would immediately restore these rather unaesthetic presentations with a conservative veneer or a crown. In many situations, dependent on the amount of healthy tooth structure available, these are still the preferred methods of treatment for root canaled or traumatized teeth. In situations where the teeth are preserved, the root canal treatment is done conservatively, then the treatment options to address color issues can be even more conservative.

In this situation, we have elected to whiten the tooth from within. The process is as easy as two or three visits. The first visit is an evaluation after the tooth has been seen by an endodontist (a root canal specialist). Once the tooth is determined healthy enough to proceed to bleaching or "restoring", can we begin the process. For internal bleaching, we will make a small access hole without the need for anesthetic so we can place a special type of bleaching material. Depending on how dark the tooth is, there may be a need to have multiple follow-up appointments to reapply the bleaching material inside the tooth.

Once the tooth color has become stable, we flush all of the bleaching material out, place a temporary and wait for 10 days before placing a final filling. The reason we need to wait between flushing out the bleaching material and placing a filling is to allow for all of the bleaching material to stop oxidizing, as this can interfere with the adhesion of the bonding system. If the bonding is unable to be at its maximum strength, we run the risk of decreasing the life of the restoration. The following is a video of our latest case that outlines the steps involved. Enjoy!

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Minimally Invasive Cosmetic Options

No longer is it necessary to remove more tooth structure than necessary to get an aesthetic result. In the earlier days of dentistry, due to limitations of materials and techniques, it was common for dentists to recommend multiple porcelain veneers or crowns in the front to fix simple shade and shape issues.  With better materials and a clearer understanding of how to use these new materials, no longer are such invasive solutions necessary.  While porcelain is a great material for crowns and veneers, teeth whitening and direct composite bonding can be a very aesthetic yet cost effective way to address your various cosmetic needs.  In this video, the steps to do a direct composite veneer are demonstrated.   Contact our office to make an appointment for a consultation to see if you are an ideal candidate for this minimally invasive procedure!  #smilesbd #hellobetter

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Eat, Drink and Be Merry!

Does drinking wine through a straw really help prevent wine staining? Do those at-home whitening strips work? 

Before we dive into some stain treatment tips, lets go into what it is, how does it occur? After I go into the various types of stains can we then find out what are some options for treatment, when do we know we need to bring a professional in? And most important of all, how do we prevent it?  

What is it? 
There are three ways teeth can get staining- either internally or on the outer surface, or by natural aging.  For internal staining, that can be developmental (born with it) in origin, or in some cases where a young infant ingests too much fluoridated water (which is rare but happens more often in parts of the country where there is a higher unregulated natural occurring concentration of fluoride in the water), too high of fluoride intake during development can lead to staining of the permanent teeth even if the baby teeth were unaffected. For external stains, those are usually caused by our office favorites; wine and coffee. The last kind, which is less talked about, is how the dentin (the inner portion of the tooth) is naturally yellow and our teeth naturally appear more yellow as we age since the enamel that covers the teeth get thinner.  

How to treat? 
So what can we do about these stains?  Depending the cause of the staining treatment options vary.  The easiest stains to deal with are the surface stains.  Most common, especially on social media is teeth bleaching.  For teeth whitening bleaching, they can be purchased from the store or from your dentist.  Whitening toothpaste is a great option, however they aren’t very effective in many cases. Whitening toothpaste also has a higher abrasive content and so if you have gum recession, it may not be the best choice.  In a future post, we’ll go over whitening; at-home versus in-office, to the stuff you see all over on social media.  

When should I call my dentist? 
It is highly recommended that you consult with your dentist before attempting to address any staining concerns. In our practice, our job is to help our patients find out the root cause of the staining problem and present the most conservative treatment option to address that. Like most things in life, there isn’t a one-size solution that fits all.  You dentist should be able to recommend the appropriate treatment options- whether an at-home remedy or in-office option.   

Most importantly
Ok, now to the most important part of this post.  As always, we like to save the best for last.  Prevention, prevention, prevention.  No matter what type of procedure you decide to go with to whiten teeth, there are relapses that occur.  So unless you want to keep purchasing whitening in perpetuity, here are a few tips that I recommend.  

Keep up with your brushing!  Brush at least twice a day.  Rinse with water after having wine, coffee, or other drinks and foods that can stain your teeth.  Also, keep up with your regular cleanings.  The cleanings will help reduce the amount of plaque and calculus (tartar) buildup, which will allow your teeth to stay stain free as well.  And yes, drinking things through a straw can help but not as much as you would think.  The fluid will still make contact with your teeth.   Glass Dharma makes a great reusable glass straw so you can keep enjoying you glass of yummy merlot from Malibu Wines or that cup of joe from Blue Bottle!  

For more tips, follow us on our instagram which can be found on our office website-- http://siliconbeach.dental 

We're Changing Names!!

HI Playa Vista.Dental fans, we have decided to change our names to SiliconBeach.Dental for a variety of reasons that are simply out of our control. 

The most important reasons, we felt that the name is more true to our core.  That we are a Silicon Beach inspired dental practice, where we take all the rules out and start fresh.  

As John Maynard Keynes states, "The difficulty lies not so much in developing new ideas as in escaping from old ones."  

So here's to a new beginning!!

Less Is More

“Wearing a veneer of perfection never did me any good.” -Liz Phair

I frequently get asked by friends and patients what I think about veneers. Before I go into my answer, let me define what a veneer is. A veneer is a thin shell of medical-grade ceramic (or resin) that is traditionally attached to the front surface of a tooth. Veneers are individually crafted by a skilled lab technician who uses man-made materials to mimic a natural tooth. Dentists use veneers for a variety of dental issues including  color correction and orthodontic adjustments.

Due to Hollywood, veneers are synonymous with cosmetic dentistry. (Literally, in the 1920’s, Hollywood actors and actresses were known to get false front teeth.) Generally, when a patient comes to my office inquiring on how to improve their smile, they always ask about veneers. But are veneers really the best choice for everyone in every situation?

Honestly, it depends on the situation. If it's a color modification you seek, a simple course of teeth whitening may be all that is needed. If the goal is to correct the alignment of your teeth, a visit to your orthodontist is a much more conservative option. Although veneers are a conservative alternative compared to crowns, in most cases you still need to give up some tooth structure for the veneer to properly bond.

In summary, more is not always better. Ask your dentist to explore less invasive options before you begin an irreversible procedure. Keep in mind that in some cases, ultimate results can be achieved with a blend of the veneer alternative treatments discussed above. There are instances where good intra-professional collaboration of teeth whitening, orthodontics, and good planning can yield optimal cosmetic results as conservatively as possible.

So Many Choices

I am frequently asked "What toothpaste do you recommend?"  To be honest, there is no single toothpaste that serves everyone's needs. When deciding, there are a few things to keep in mind.

Cavity Protection
Does the product contain fluoride?  Fluoride is a mineral that occurs naturally in water sources, it’s really unavoidable unless you want to consume only deionized water for life. Fluoride has garnered a bad rep lately, kind of unfair if you ask me. Fluoride is actually pretty cool; if Fluoride were a person, we’d definitely hang out. Research has shown that fluoride not only reduces cavities, but it also helps repair and potentially reverse the early stages of tooth decay. Pretty cool, right? 

Whitening
Whitening toothpastes are formulated with a higher abrasive content, sometimes in conjunction with hydrogen peroxide. If you have sensitive teeth or have been told by your dentist that you have gum recession, you may want to use these with caution.

Desensitizing
For sensitive teeth, these operate on the opposite mechanism as your whitening toothpaste. They contain less abrasives and use ingredients which help locally sedate the tooth surface. An ingredient to look for would be potassium nitrate. Little known fact: sodium fluoride also has desensitizing properties.

Antibacterial
For those who are trying to keep the bugs that cause gingivitis and periodontitis at bay, some brands are incorporating antibacterial ingredients into their toothpastes. Triclosan and stannous fluoride (told you fluoride was amazing) are two ingredients with antibacterial properties.

At the end of the day, when in doubt, consult with your general dentist for any professional recommendations. You can clearly tell from my casual writing style that these are my own off-the-cuff opinions.

For more of my opinions, check us out on http://siliconbeach.dental or shoot me an email at hello@siliconbeach.dental.

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