MOUTH GUARDS

It seems that removing wisdom teeth has become a rite of passage into adulthood, but is it always necessary to remove them? The answer varies because each case is different. While it is true that extracting wisdom teeth can prevent dental problems, both now and later, only after assessing the growth, position and impact on surrounding teeth can we decide whether it’s best to remove them.

They cause gum problems. Impacted wisdom teeth crowd other teeth and cause pain and swelling, especially when only they only partially erupt (push themselves up through jawbone and gum tissue into the mouth). Partially erupted (impacted) teeth may lead to infections, cysts or tumors in the gum tissue or jawbone. These are serious problems that negatively affect your overall health. Incompletely erupted teeth can create deep pockets around themselves where bacteria and food can collect and infection can develop. Their growth can cause damage to neighboring teeth. Deep pockets around incompletely erupted teeth create areas where bacterial plaque, calculus and food collect. Cavities on tooth roots may develop in these areas. If cavities do develop on the roots of the neighboring teeth, extraction of the wisdom teeth and the neighboring teeth will likely be required. The position of the tooth hinders jaw movement or affects chewing function in any way. Does the wisdom tooth scrape the soft tissues in your mouth? Does it cause you to bite your cheek? Does food get caught under the gum tissue around the wisdom tooth and cause swollen and/or painful gums that you bite while chewing? These are concerns that need to be addressed to keep you chewing your food well and facilitating digestion. It’s clear they won’t fully erupt and they are either: moving in the direction of neighboring tooth roots or will never come into contact with an opposing tooth. Wisdom teeth do move within the jawbone as they attempt to erupt. If they move in the direction of adjacent tooth roots and put pressure on them, the roots will resorb. This will permanently damage the adjacent tooth and will require either surgery on the affected roots or tooth extraction. Alternatively, if it’s clear that the wisdom tooth will not come into contact with its opposing tooth, it is functionally useless and the risks of keeping it can often outweigh the benefits of keeping it. Conversely, if your wisdom tooth is impacted and not causing harm in any way, it’s best to leave it in place.

Healthy Fully erupted Positioned correctly and not overly crowding adjacent teeth Functioning properly

X-rays and an exam to confirm the need for extraction and plan the procedure. A consultation to discuss your options for anesthesia, sedation and to review the overall extraction process before the day of the procedure Administering anesthetic and possibly sedation on the day of the procedure in the comfort of the dental office Opening the gum tissue and removing the wisdom tooth or teeth Closing the gum tissue with sutures, which will be removed during a follow-up appointment (In some cases, the gum tissue is left open to heal) The procedure may take 1 hour or more. The doctor can give you an estimate of the time required during your consultation appointment.

Post-operative instructions will be reviewed with you in the dental office. Keep gauze pads in the area to help stop any bleeding. Ice packs may be used on your cheek(s) to help avoid or reduce swelling. Rest and refrain from any sports or strenuous activities for a few days. Avoid smoking, carbonated beverages, drinking from straws, touching the extraction site, chips and nuts and eat soft foods for 2 to 3 days. Take any medications prescribed as directed.

Over the years there has been some concern as to the safety of amalgam (silver) fillings. An amalgam is a blend of copper, silver, tin and zinc, bound by elemental mercury. Dentists have used this blended metal to fill teeth for more than 100 years. The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems. According to the American Dental Association (ADA), up to 76% of dentists use silver containing mercury to fill teeth. The ADA also states that silver fillings are safe and that studies have failed to find any link between silver containing mercury and any medical disorder. The general consensus is that amalgam (silver) fillings are safe. Along with the ADA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost effective. The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling. The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, and this is out of countless millions of silver fillings over the decades. Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material when we are exposed at high, unsafe levels. For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them. However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe. There are numerous options to silver fillings, including composite (tooth-colored), porcelain, and gold fillings. We encourage you to discuss these options with your dentist so you can determine which is the best option for you. Canadian Dental Association AMALGAM FAQ Listed below are commonly asked questions and Canadian Dental Association's (CDA) response. 1. Who is responsible for judging the safety of medical devices and materials? In Canada, medical devices and materials are under the regulatory authority of the Health Protection Branch (HPB) of Health Canada. 2. Is dental amalgam approved for use in Canada and is it judged to be safe? Restorative materials do not fall into a classification for which Health Canada requires pre-market approval. However, HPB can take regulatory action on any medical device or material at any time, and HPB currently does not restrict dental amalgam in Canada. 3. Have recent studies proven that dental amalgam releases mercury vapour and that it should not be used? Scientific studies have not verified that dental amalgam is causing illness in the general population. It has been known for some time that amalgam fillings release minute amounts of mercury vapour, especially with chewing, and that this mercury can be absorbed, reach body organs, and cross the placenta. This is also true of mercury absorbed from natural sources, such as food. 4. Isn't mercury known to be a poisonous substance? As a single element, mercury is a poisonous metal to which we are all exposed through air, water, soil and food. In dental amalgam, it is bound in an alloy, which also includes silver, copper and tin. Very small amounts of mercury vapour are released from amalgam with chewing. Mercury's toxicity is related to the amount absorbed. The mercury absorbed from all sources accumulates in body organs and tissues, mostly in the kidneys, but also in the brain, lungs, liver and gastrointestinal tract. 5. What amount of mercury does a person take into the body from natural sources and how much comes from amalgam fillings? The amount depends on a number of factors, such as the type of food you eat, your occupational exposure, environmental levels and the number of amalgam fillings you have. Health Canada estimates that for the average Canadian adult 20 to 59 years old the amount of mercury absorbed by the body from all sources is about nine millionths of a gram per day. Of this total dental amalgam is estimated to contribute about three millionths of a gram per day. 6. Is the mercury, which is absorbed into the body harmful? For the overwhelming majority of people no harmful effects are known to be caused by the average levels of mercury exposure from amalgam fillings. For those subject to high exposures, for example, in industrial settings, the severity of any scientifically validated harmful effects depends upon the duration and amount of exposure. Subclinical effects (effects which are observable but are below the threshold of disease or illness) have been observed in groups of people with tissue mercury levels ten times higher than those in the general population. However, at the low levels of exposure associated with amalgam fillings, the relationship between levels and duration of exposure and any possible effects is not known. Scientific observation of patients over the course of 150 years of using ever-improving formulations of dental amalgam is the foundation of CDA's confidence in this material for general use. It is the most durable and most affordable of all restorative material options. The Canadian Dental Association has been urging the government of Canada to support further research to achieve definitive scientific answers, which can better assure Canadians of the safety of amalgam as well as all other alternative restorative materials. 7. Why does the dental profession continue to use amalgam when questions are being raised about its safety, even if there are no proven dangers? Every time a foreign substance is used in the human body for therapeutic purposes, there is an element of risk. Health professionals must constantly weigh the known risks of a particular intervention against known benefits. In the case of dental amalgam, the scientific evidence indicates that no significant risks are involved. If there were risks, they would have been clearly observed during the 150 years that this material has been in use. Dental team members, in particular, would have shown clinically demonstrable effects due to their considerable exposure to the substance. The risks associated with the use of dental amalgam appear to be limited, and the benefits to patients are known to be large. Dental amalgam is much stronger and more durable than alternative restorative materials, and amalgam restorations can be completed at a more reasonable cost. Recent advances, such as the development of amalgam bonding techniques, have made amalgam even more advantageous as a restorative material. Gold alloy inlay castings would be a reasonable substitute if the material and required procedures were not so costly. It is also possible that alternative materials, subjected to the same level of scrutiny as dental amalgam, will prove to have other advantages and disadvantages. The dental profession is aware of research to find more durable alternatives to amalgam, and these materials may be available within the next decade. 8. Can dental amalgam be safely used with every patient? No. There are patients who are sensitive to the components of amalgam, just as there are individuals who are sensitive or allergic to other chemical substances or even foods such as milk or bread. It has been estimated that the prevalence of mercury sensitivity in the general population is approximately three per cent (JADA, Vol. 122, Aug. 1991, p. 54). Dentists may consider the use of composite fillings or other restorative materials in individual cases. Dentists routinely take a number of considerations into account in selecting a restorative material, including tooth size, location and the individual's condition and medical and dental history. For example, alternatives may be considered for individuals who are immunologically compromised, or who suffer from a neurological condition. Health Canada suggests that alternatives should be considered for patients with impaired kidney function. Although dental amalgam itself is not linked to such conditions, there is evidence that total body burden of mercury is of particular concern with these patients. Amalgam may similarly be contraindicated for workers with known occupational exposure to heavy metals or for individuals with greater than average exposure to mercury because of a diet, which is primarily seafood. 9. Should special precautions be taken with pregnant women or with children? Dentists consider a number of factors in determining treatment for children and for pregnant patients. Assuming that they are aware of the pregnancy, and in consultation with the patient, dentists may recommend alternative restorative materials, other forms of treatment, or delay of treatment. In many instances amalgam presents the best possible option for restorative treatment. There is no scientific evidence of ill effects, although mercury is known to cross the placenta. A stakeholder committee convened by Health Canada concluded that while "the research evidence did not support excluding children, pregnant or lactating women...from receiving amalgam fillings...common sense dictated that pregnant women should avoid any elective medical or dental intervention until after delivery." Most children today have far fewer cavities than in the past, and, consequently, less exposure to mercury. Dentists give special consideration to restorative treatment for children and any concerns expressed by parents. Dental amalgam offers distinct advantages in many cases. Alternative materials are considered when suitable and recommended as indicated. 10. Is dental amalgam safe when it rests against another metal (e.g. braces) in the mouth? It should be noted that Health Canada has taken the position that "new amalgam fillings should not be placed in contact with existing metal devices in the mouth, such as braces." Health Canada's concern is related to galvanic effect, which occurs when two different metals are in close proximity and create the potential for electric current to be generated. Dentists are aware of the possibility of abutting metals creating a galvanic effect. It is also recognized that galvanic effect, through corrosion of metallic dental materials, may increase the release of mercury and other elements or compounds. Some recent evidence suggests that galvanic effect may also slightly increase the release of mercury vapour from amalgam. For all these reasons, it is prudent for dentists, in suggesting a restorative material, to avoid creating a galvanic effect whenever patient care will not be compromised. It is also inadvisable to remove existing fillings unless the patient complains of symptoms which may be attributed to galvanic effect. At the same time, the placement of orthodontic braces on patients with amalgam is often necessary and desirable, and has not been shown to be associated with ill effects. It may also be necessary, for the purpose of adequate restorative treatment, to place restorations in close proximity and to create the potential for galvanic effect. CDA's Committee on Clinical and Scientific Affairs notes, however, that when amalgam has been in the mouth for a small period of time, oxidation (corrosion), through a complex process, contributes to the reduction of electrical flow. Galvanic effect, apart from its potential to contribute to heavy metal body burden, has not been demonstrated to be harmful, and concerns about galvanic effect must be considered in the context of the patient's overall oral health care needs. CDA has asked Health Canada for an annotated scientific bibliography supporting its unconditional recommendation on galvanic effect. If this information is received, it will be reviewed immediately and, if necessary, further advisories will be sent out to the profession and made available to patients. 11. There is a report on mercury exposure and risks from dental amalgam which was released by Health Canada on November 27, 1995. It suggests that the number of amalgam restorations should be limited to reduce the total daily average exposure of an individual to mercury from all sources (including food, water, air and dental amalgam). What does this report mean to me as a dental patient? The assessment of mercury exposure and risks from dental amalgam conducted by G. Mark Richardson, PhD, is a review and analysis of the scientific literature by a scientist commissioned by Health Canada. The study involved no new research of the kind that CDA has been urging. It was a form of risk assessment using sophisticated mathematical techniques and computer modelling. CDA arranged to have the study reviewed and assessed by an international panel of scientists, which concluded that the available mercury exposure data are not reliable enough to permit confident determination of a tolerable daily intake (TDI) for mercury. Both the CDA panel and the stakeholder group convened by Health Canada came to this same conclusion and both advocated further definitive research. 12. What does the Richardson study say about the contribution of dental amalgam to the human body burden of mercury? The study is consistent with a number of other studies in suggesting that the contribution of dental amalgam to the human body burden is in the neighbourhood of three millionths of a gram per day. The Richardson analysis and review of scientific literature has gone a step further in attempting to estimate a total daily intake from all sources and to calculate a tolerable daily intake (TDI). 13. When will research provide more information about dental amalgam? CDA continues to encourage the federal government to support further research specifically related to dental amalgam. Further risk assessment of total body burden of mercury from all sources should be undertaken, by means of an expert panel of scientists working openly and cooperatively with the scientific and professional communities. CDA has offered to cooperate on such research and to contribute to funding. 14. Should I have my amalgam fillings replaced? It does not make sense from either a general health point of view or a cost point of view to replace amalgam fillings simply on the basis of the current questions being asked about possible amalgam toxicity. Replacement may be considered for individuals sensitive to dental amalgam. 15. Do I have the option of asking for alternative restorative materials rather than dental amalgam when I need a dental restoration? Yes. Dentists recognize patient concerns with respect to choice of restorative materials and the patient's right to choose a dental material or to refuse treatment with any material. You should note, however, that the dentist may be concerned about the retention, durability or strength of alternative restorations in particular applications, and advise you to choose amalgam. The final choice, however, is yours. 16. Is the dental profession suppressing information on the dangers of amalgam? No. The dental profession believes in informed patient consent and recognizes patient interest above any other considerations. Dental amalgam is still the restorative material of choice in most instances, and because of its excellent durability and low cost as a restorative material, the risk/benefit ratio is in the patient's interest. 17. Where does all this leave me as a dental patient? What sort of attitude should I take to dental amalgam? Take a common sense approach to your decisions about dental amalgam. Discuss your situation with your dentist and determine if there are special reasons to be cautious about amalgam use in your case. Your dentist wants you to be aware of the conclusions reached in the range of scientific studies on dental amalgam. And don't just decide to have your amalgam fillings removed in response to media reports focussing on selected scientific studies. If you have strong personal concerns, ask about alternative restorative materials (such as composite fillings, ceramic inlays or onlays, or gold castings) as your fillings need to be replaced. 18. My dentist is recommending an amalgam filling but I want a white filling (or vice versa). Where does this leave me? You and your dentist should decide together which filling material will work best for you. If you want one kind of material or wish to avoid a certain type, tell your dentist. He or she will advise you if the material that you want will work. The most common materials for restoring (or filling) teeth are amalgam (sometimes called silver), composite resin (sometimes called plastic or white), gold, ceramic and glass ionomer. Each material has pros and cons. Some materials may better meet your needs than others. It depends on the size of your cavity and its location. If your cavity is in a molar, for example, the filling will receive a lot of biting force or stress, so a strong material is needed. If it is in the front of your mouth where there is less biting force and people will see it, a different material may be better. 19. I would also like my dentist to use a laser instead of a drill to do my filling. Is this possible? There are also new and different ways to prepare a cavity for a filling. Lasers are a fairly new tool in dentistry. They have been used for several years on soft tissues, like the gums. Some dentists are starting to use lasers in place of drills to remove tooth decay. Lasers work best on decay close to the tooth's surface. Over the next few years, lasers will likely be refined and more dentists may be using them instead of drills. Air abrasion is another new way to remove tooth decay. It uses a fine, sand-blasting spray and works best on surface decay. If you are interested in having air abrasion, call your local dental society or a few dentists in your area to find out which dentists are using it.

Bad breath (halitosis) can be an unpleasant and embarrassing condition. Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning. There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue. Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent. What may cause bad breath? Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath. Certain foods – Garlic, onions, etc. Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled. Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth. Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums. Dental cavities and improperly fitted dental appliances – May also contribute to bad breath. Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing. Tobacco products – Dry the mouth, causing bad breath. Dieting – Certain chemicals called ketones are released in the breath as the body burns fat. Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away. Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath. Keeping a record of what you eat may help identify the cause of bad breath. Also, review your current medications, recent surgeries, or illnesses with you dentist. What can I do to prevent bad breath? Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque from in between the teeth and under the gumline. Brush or use a tongue scraper to clean the tongue and reach the back areas. Replace your toothbrush every 2 to 3 months. If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning. See your dentist regularly – Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, your dentist will recommend more frequent visits. Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit. Drink water frequently – Water will help keep your mouth moist and wash away bacteria. Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor. Ask your dentist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem. In most cases, your dentist can treat the cause of bad breath. If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

Brushing and flossing help control the plaque and bacteria that cause dental disease. Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay. Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease. Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids. Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with a soft bristle brush and toothpaste. Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums. Brush the outer, inner, and biting surfaces of each tooth. Use the tip of the brush head to clean the inside front teeth. Brush your tongue to remove bacteria and freshen your breath. Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time. Flossing – Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone. Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands. Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion. Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth. Floss holders are recommended if you have difficulty using conventional floss. Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist. Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage. Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease: Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth. Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria. Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums. Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins. Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc. Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums. Signs and Symptoms of Periodontal Disease Red and puffy gums – Gums should never be red or swollen. Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss. Persistent bad breath – Caused by bacteria in the mouth. New spacing between teeth – Caused by bone loss. Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone). Pus around the teeth and gums – Sign that there is an infection present. Receding gums – Loss of gum around a tooth. Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth. Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth. Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease. Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone. Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums. Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar). This will further irritate and inflame the gums and also slowly destroy the bone. This is the beginning of periodontal disease. How to floss properly: Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands. Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion. Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth. Floss holders are recommended if you have difficulty using conventional floss. Daily flossing will help you keep a beautiful smile for life!

If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile. Cosmetic dentistry has become very popular in the last several years, not only due the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health. This includes dental prevention and having a healthier, whiter, more radiant smile. There are many cosmetic dental procedures available to improve your teeth and enhance your smile. Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over. Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry. Cosmetic Procedures: Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking. Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present. Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings. Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth. This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession. Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile. They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth. Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth. Porcelain Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size. Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations. They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed. Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth. Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, and durable solution to removable dental appliances. Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients. Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces. Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth. They are very durable and will not stain, making them a very popular solution for those seeking to restore or enhance the beauty of their smile. Veneers may be used to restore or correct the following dental conditions: Severely discolored or stained teeth Unwanted or uneven spaces Worn or chipped teeth Slight tooth crowding Misshapen teeth Teeth that are too small or large Getting veneers usually requires two visits. Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile. With little or no anesthesia, teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers. The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and occasionally a specialized light may be used to harden and set the bond. Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile.

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile. Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and is an ideal way to enhance the beauty of your smile. Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the American Dental Association (ADA). As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade. The color of our teeth also comes from the inside of the tooth, which may become darker over time. Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull. Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline. Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored. It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching. Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains. Since teeth whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins. Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth. Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright. The most widely used professional teeth whitening systems: Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth. The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep. It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening. In office teeth whitening: This treatment is done in the dental office and you will see results immediately. It may require more than one visit, with each visit lasting 30 to 60 minutes. While your gums are protected, a bleaching solution is applied to the teeth. A special light may be used to enhance the action of the agent while the teeth are whitened. Some patients may experience tooth sensitivity after having their teeth whitened. This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one weak. Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!