Wednesday, February 27, 2013

Choose the Best Teeth Whitener


There's a saying: "A smile can brighten the darkest day." Maybe that's why so many of us look for ways to change our teeth from dull and yellow to bright and shiny.
Yellow, stained teeth tend to come with the territory for coffee, tea, and red wine drinkers. Smokers, of course, put their teeth at greatest risk for unsightly stains. But everyone's teeth suffer after years of wear and tear --etchings or grooves begin to develop on the teeth's surface, making them more susceptible to stains over time. That's why the same glass of red wine you drink today may do more to discolor your teeth than it did 10 years ago, says Mark Wolff, DDS, PhD, professor and chair of the Department of Cariology and Comprehensive Care at New York University College of Dentistry
If you're in the market for a teeth-whitening solution, you have plenty of options. Today's professional and do-it-yourself bleaching methods are effective and have proven to be extremely safe, says Denise J. Estafan, DDS, MS, director of esthetic dentistry at New York University College of Dentistry.


Store-bought vs. dentist whiteners
Peroxide -- either carbamide or hydrogen -- is the active agent in teeth whiteners sold by dentists and drugstores alike, and the strength of the peroxide is what mostly sets them apart: Store-bought kits, such as whitening strips and trays, contain as much as 7% peroxide, Estafan says, while whiteners used in your dentist's office can have 35% or, less commonly, 45% peroxide.
The way the whiteners are delivered differs, too. Just one hour in the dentist's chair can turn your smile from dull to dazzling. After applying a high-concentration tooth-whitening gel, your dentist will aim a special heating lamp directly at your teeth for three 20-minute intervals, taking five-minute breaks in between to reapply the gel. "When it's warm, the carbamide peroxide works better," Estafan explains.
During the procedure, a rubber dam or other protective barrier is placed in the mouth to isolate the lips, gums, and tongue so the whitening gel stays concentrated where it's needed: on your teeth. Estafan says the in-office treatment works best when you follow up at home by using whitening trays that are custom-made for your teeth by your dentist. The tight fit keeps bleaching solutions in close contact with the tooth's surface and minimizes the amount of peroxide that is swallowed or contacts the gums.
Professional whitening at your dentist's office works well, but you'll pay for the privilege. Expect to shell out about $500 for the in-office light treatment (which Estafan says also includes at-home trays and solution) and from $300 to $400 for the personalized trays if used alone.
Whitening kits sold in drugstores contain lower levels of peroxide than those sold by your dentist but may work just as well, if more slowly. And they are considerably less expensive than professional options: Kits range from $25 to $100.
Can You Whiten Sensitive Teeth?
Tooth and gum sensitivity is a common side effect of teeth whiteners, though it's not clear why some people are affected and others are not, explains Denise J. Estafan, DDS, MS. Here are a few expert tips for whitening your teeth in comfort.
Don't worry.
Touchy teeth and gums are no cause for concern when using whiteners. "Healthy individuals with perfectly healthy gums can have a high level of sensitivity," Estafan says. The pain usually subsides within a few days.
Take it slow.
"You don't want to use the strongest and fastest [solution] because it comes with the most side effects," says Mark Wolff, DDS, PhD. Slow and consistent wins the race.
Kill the pain.
Discomfort can be tempered by brushing with toothpaste made for sensitive teeth. Also, if you're using whitening trays, ask your dentist for fluoride or potassium nitrate solutions, which can be applied to teeth in the same tray used for whitening gel and can help decrease tooth sensitivity.
Expert Tip
"If you're going with a drugstore option, you should choose whitening strips. They work better than store-bought trays because they adhere much more closely to the tooth surface." -- Mark Wolff, DDS, PhD

Country Club Dentistry
72775 Frank Sinatra Drive
Suite B
Rancho Mirage, CA 92770
Tel: 760-341-2599


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Tuesday, February 19, 2013

10 Toothbrushing Mistakes



Toothbrushing is such an ingrained habit, few people think twice about it. But as with any habit, you can get sloppy, and that can lead to cavities and gum disease.

Toothbrushing Mistake No. 1: Not Using the Right Toothbrush

Consider the size of your mouth when picking a toothbrush, says Richard H. Price, DMD, the consumer advisor for the American Dental Association. "If you are straining to open wide enough to let the brush in, the brush is probably too big," he says.
''The handle has to be comfortable," he says. It should feel as comfortable as holding a fork when you eat.
"The more comfortable it is in your mouth and your hand, then the more likely you will use it and use it properly," he says.
Which is the better toothbrush: Electric or manual?
"It's an individual preference," says Michael Sesemann, DDS, president of the American Academy of Cosmetic Dentistry and an Omaha dentist.  "A person who brushes well with a manual will do as well as a person who brushes well with an electric."
Price agrees. "It's not the toothbrush, it's the brusher."

Toothbrushing Mistake No. 2: Not Picking the Right Bristles

Some toothbrushes have angled bristles, others straight. So is one type better? Dentists say no.
''It's more related to technique than the way the bristles come out," says Sesemann.
What is important when buying a toothbrush? Bristles that are too stiff can aggravate the gums. The ADA recommends a soft-bristled brush.
''Bristles should be sturdy enough to remove plaque but not hard enough to damage [the teeth] when used properly," says Price. He doesn't recommend "natural" bristles such as those made from animal hair or boar bristle.

Toothbrushing Mistake No. 3: Not Brushing Often Enough or Long Enough

Softly brushing your teeth at least twice a day is recommended. ''Three times a day is best," says Sesemann.
With too much time between brushings, he says, bacterial plaque will build up, boosting the risk of gum inflammation and other problems.
Brushing should last at least two minutes, says Sesemann. Three minutes is even better, says Price.
Most people fall short of both time lines, says Sesemann. "It's an arbitrary number, but it's just so people take the time to clean all the surfaces." He often recommends people divide the mouth into quadrants and spend 30 seconds a quadrant. Some electric toothbrushes include built-in timers.  
To make the two minutes go faster, Sesemann says he ''multitasks,'' fitting in a little TV viewing as he brushes.

Toothbrushing Mistake No. 4: Brushing Too Often or Too Hard

While brushing your teeth three times a day is ideal, more may not be, says Sesemann. "More than four toothbrushings a day would begin to seem compulsive."
Excessive brushing could expose the root of the tooth to irritation, and that could in turn irritate the gums. Brushing vigorously can also erode tooth enamel. The trick is to brush very gently for two to three minutes.

Toothbrushing Mistake No. 5: Not Brushing Correctly

''Long horizontal strokes along the gumline can lead to abrasions," says Sesemann. "Aim your bristles at the gum line at a 45-degree angle and do short strokes or vibrations." Softly brush up and down your teeth, not across your teeth. The strokes should be vertical or circular, not horizontal.
Be sure to brush outer and inner tooth surfaces, the chewing surfaces, and your tongue.

Toothbrushing Mistake No. 6: Starting in the Same Place Each Time

Many people start brushing the same part of their mouth over and over, dentists find.
"Start in a different place so that you don't get lazy in the same area of your mouth," says Price. He reasons that by the time you get to the last quadrant of your mouth, you're bored with brushing.

Toothbrushing Mistake No. 7: Skipping Inner Tooth Surfaces

Most people forget to brush the inner surfaces of teeth -- the surface that your tongue presses against.
"The plaque you can't see is just as important to remove as the plaque you can see," says Price.  
The most commonly skipped area, dentists say, is the inner surface of the lower front teeth.

Toothbrushing Mistake No. 8: Not Following Up With a Rinse

Bacteria can grow on an un-rinsed toothbrush. Then, the next time you brush your teeth, you may actually put old bacteria back in your mouth, says Laurence Rifkin, DDS, a dentist in Beverly Hills, Calif.
Rinsing the toothbrush after you brush will help remove any leftover toothpaste, too.

Toothbrushing Mistake No. 9: Not Letting the Toothbrush Dry

"If you have a toothbrush that's perpetually moist, it will cultivate more bacteria," says Sesemann.
"If the bristles stay soggy, you can misshape them as you use the brush," Price says. "Or it might be a breeding ground for bacteria."
It's a good idea to shake out the moisture, then recap it with a cap that allows air in, he says.

Toothbrushing Mistake No. 10: Not Changing the Toothbrush Often Enough

The American Dental Association recommends getting a new brush every three or four months, or even sooner if the bristles look frayed.
But rather than go by a strict timeline, Price says a visual inspection of the bristles is better. "Once the bristles lose their normal flexibility and start to break apart, change your toothbrush," he says.
"Look more at the state of the bristles than the time period," he says.
Some brushes have colored indicators that alert you when they need replacing, says Price.

Country Club Dentistry
72775 Frank Sinatra Drive
Suite B
Rancho Mirage, CA 92770
Tel: 760-341-2599

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Tuesday, February 12, 2013

Preventing and Treating Gum Problems


Healthy teeth depend on healthy gums. Gums protect the base of the teeth, where connective tissue anchors them to bone. Left untreated, gum problems can lead to tooth loss. Fortunately, there’s plenty you can do to keep gums healthy.

2 Types of Gum Disease

Gum disease takes two forms: gingivitis and periodontitis.
Gingivitis occurs when bacteria collect in tiny pockets at the gum line, causing inflammation. The most common symptoms are bleeding when teeth are brushed and persistent bad breath. Gingivitis accounts for about 70% of gum disease. Periodontitis makes up the other 30%.
If gingivitis goes untreated, the inflammation can invade connective tissue and even bone. This causes periodontitis.
Symptoms of periodontitis include:
  • Receding gums
  • Visible pockets of inflammation along the gum line
  • Gum pain
  • Unusual sensitivity to temperature changes
Eventually, even the healthiest teeth can become loose and even fall out.

The Role of Dental Exams in Preventing Gum Disease

“Unfortunately, by the time most people notice any of the warning signs of periodontitis, it’s too late to reverse the damage,” says Sam Low, DDS, professor of periodontology at the University of Florida and president of the American Academy of Periodontology.
That’s why regular dental checkups are so important, according to Low. Dentists spot trouble in the form of pockets of inflammation or places where gum tissue has eroded slightly, exposing the root of the tooth.
  • With regular checkups, the condition of your gum tissue can be compared over time.  Any erosion that has taken place is noted. Dental X-rays can reveal early signs of gum disease.
  • During the exam, the dentist carefully measures the depth of gum pockets around a selected number of teeth. You should have this exam every 18 to 36 months, according to Low.
Unfortunately, not all dentists check carefully enough for gum disease.
“We estimate that only about one-third of general dentists really take the time to really look for gum disease,” says Low.
The American Academy of Periodontology works closely with professional dental groups to encourage better detection of gum problems during dental checkups.
Catching signs of gum disease early may be far more important than previously thought, experts say. Advanced periodontal disease can cause tooth loss. But it may also cause other health problems.

Prevention and Treatment of Gum Disease

Proper dental hygiene can go a long way toward preventing gum disease. Most of us know the basics:
  • Brush your teeth at least twice a day, for two minutes.
  • Floss every day.
  • Use an antibacterial mouth rinse for more protection from plaque and to improve gingivitis.
  • Smoking increases the danger of gum disease by damaging gum tissue and increasing inflammation. If you smoke, preventing gum disease is one more very good reason to try to quit.
  • If gingivitis occurs, your dentist can scrape away plaque buildup at the gum line.
  • Brushing, flossing, and using an antibacterial rinse can usually prevent gingivitis from recurring.

Managing Periodontitis

Managing periodontitis is more complex, because the inflammation has already invaded below the gum line. You’ll need care from a dentist and home care as well.
  • The first step is for a dentist to remove plaque and tartar from below the gum line. You may need a local anesthetic so you don’t feel pain.
  • Next, your dentist may prescribe an antibiotic to prevent infection. Some people, may need periodontal surgery to fold back gum tissue. Periodontal surgery can also treat deeper pockets of infection.
  • Your dentist or periodontist may need to do a procedure called grafting. For that, he takes tissue from one part of your mouth (such as the roof) to replace gum tissue that has eroded, exposing the roots of your teeth.
After treatment, commit to practicing good dental care to reduce your risk of further inflammation and damage. Your dentist or periodontist may recommend more frequent checkups to monitor gum health. Between those visits, brush, floss, and rinse at home to prevent tartar from returning.
Following a healthy diet can help you maintain healthy gums. New research suggests that a diet rich in omega-3 fatty acids, the kinds found in fatty fish (herring, salmon, sardines, trout, tuna,) fish oil, and flaxseed, reduces inflammation.
“Periodontitis is a condition that needs to be managed carefully,” Low says. “But with regular periodontal care, [you and your dental team] can keep gums healthy and prevent tooth loss.”

Country Club Dentistry
72775 Frank Sinatra Drive
Suite B
Rancho Mirage, CA 92770
Tel: 760-341-2599

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Friday, February 1, 2013

The Daily Grind: What Wears Down Your Teeth


Teeth are built tough. With regular care they can last a lifetime. Still, the daily grind of chewing, brushing, and grinding, along with accidental injuries, can take a toll. Here are three of the biggest threats, and what you can do to avoid them.

Chipped, Fractured, or Broken Teeth

Teeth can sometimes chip or fracture when you bite down on something hard, such as a popcorn kernel or stale bread. “But that kind of injury is actually quite uncommon,” says Steven E. Schonfeld, DDS, PhD, a dentist in private practice and spokesman for the American Dental Association.  
Teeth that have fillings or root canals are at highest risk, because they aren't as strong as intact teeth. “But even intact teeth can chip or fracture if you happen to bite down in just the wrong way on something hard,” Schonfeld says.
More often, teeth are damaged as a result of accidents or sports injuries. When researchers surveyed athletes competing in the Pan American World Games recently, they found that almost half showed signs of tooth fractures believed to have occurred over time during training or competing. In that study, sports most commonly associated with tooth injuries included wrestling, boxing, basketball, and karate. But even non-contact sports such as in-line skating or skiing can result in damage to teeth.
What you can do: If you have fillings in your back molars, it's wise to avoid biting down on hard foods such as bones, hard candies, and ice. Wear a mouth guard if you play sports that pose a risk of injury, and get them for your kids that play sports, too. A 2002 survey of college basketball players found that mouth guard wearers significantly reduced their risk of dental injuries. Simple mouth guards are available at most sporting goods stores. Your dentist can also make a custom-fitted mouth guard.
A dentist can repair chipped teeth. Fractures are harder to fix, especially if the crack extends below your gum line. If you have a badly fractured tooth, your dentist may remove it.

Bruxism: Grinding Your Teeth

Teeth are built to chew and grind food. But unconscious grinding or clenching of teeth, over time, can damage the chewing surfaces. “Chronic tooth grinding, called bruxism, can cause micro-cracks in the enamel, making teeth more susceptible to decay, and even wear down the pointed surfaces of molars,” says Anthony M. Iacopino, DMD, PhD, dean of the University of Manitoba Faculty of Dentistry.
Tooth grinding can also cause headaches, muscle pain, and jaw injury. In many cases, people with bruxism don't realize they have a problem until a dentist notices tell-tale signs on their tooth surfaces. That's one more good reason to get checkup every six months, Iacopino says.
Researchers suspect that stress or anger may lead to tooth grinding. A 2010 study found that people with sleep bruxism were more likely than people who don't grind their teeth to report trouble at work, daily problems, and physical problems.
What you can do:  Stress management techniques may help. “I tell my patients who have signs of tooth grinding to find ways to relax,” Declan Devereux, DDS, says. “Take a walk. Learn to meditate. Avoid stressful or frustrating situations if possible.” For some patients, that may be enough to ease tooth grinding. If not, dentists may prescribe a mouth guard or splint, which fits over the upper or lower teeth, protecting them from becoming damaged.

Acid and Tooth Enamel Erosion

As tough as teeth are, they become vulnerable when acid levels in the mouth are too high. Acid erodes enamel, making teeth more susceptible to decay. Acidic foods and drinks, and acid-producing bacteria in the mouth are prime culprits. Enamel erosion may also be due to other conditions such as bulimia, chronic gastritis related to alcoholism, or frequent vomiting related to pregnancy. Researchers have recently recognized another threat: gastroesophageal reflux disease (GERD).
GERD causes the highly acidic contents of the stomach to back up into the esophagus, sometimes even into the mouth, where it can erode teeth. Anyone who suffers GERD is at risk. In a study of 117 patients with GERD, 28 had dental erosion. Another study of 20 patients found evidence in about half of the patients.
What you can do:  Ask your doctor for support and referrals to treat bulimia or alcoholism. If you’re pregnant and vomiting a lot, it might be a good time for you to get a dental checkup (one is recommended during pregnancy).
If your dentist notices signs of enamel erosion and suspects that the problem may be GERD, she is likely to recommend you see your doctor. The only way to prevent further damage is to control your GERD. In addition to taking a prescription acid-blocker medicine, make some changes to what and when you eat to reduce the frequency of reflux. Start by avoiding foods that make GERD worse: chocolate, peppermint, fatty foods, coffee, and alcoholic beverages. Eating smaller meals helps prevent GERD. Also, don’t eat for at least two hours before bed so your stomach has time to partially empty before you lie down.


72775 Frank Sinatra Drive
Suite B
Rancho Mirage, CA 92770
Tel: 760-341-2599

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