My Blog

Posts for: July, 2018

By John G. Fisher, DMD
July 26, 2018
Category: Dental Procedures
Tags: teeth whitening  
3ReasonsYouShouldConsiderToothWhitening

White, translucent teeth are the hallmark of a beautiful smile. But with age or the foods we eat our teeth’s natural brightness can dim to a dingy yellow.

If this is your case, you may be able to benefit from teeth whitening techniques that brighten up your less than “pearly whites.” A teeth whitening treatment from time to time could put the dazzle back in both your smile and your self-confidence.

Here, then, are 3 reasons for considering tooth whitening to improve your smile.

You might be able to do it yourself. There are a number of home whitening options (including whitening strips) that are safe and effective to use at home. But there are a couple caveats: because your dentist can use stronger bleaching solutions they may be able to perform the procedure in less time and with longer lasting results than a home kit. Also, some forms of staining originate inside a tooth—a home kit won’t help with that kind of discoloration.

It’s safe and relatively inexpensive. Home bleaching solutions aren’t strong enough to be harmful (unless you disregard the product directions) and are usually not very costly. Your dentist uses stronger solutions but with the training and curing equipment to minimize any risk to your teeth. And compared to other cosmetic treatments, dental office teeth whitening is still a relatively inexpensive option.

Dental office whitening can be more comprehensive and precise. Another reason to opt for your dentist to whiten your teeth is the wide range of discoloration they can alleviate. They have clinical techniques for alleviating internal tooth staining, and could even combine these with treatments for external staining. Your dentist can also help you achieve the exact degree of whiteness you desire—from a more subtle, natural shade to “Hollywood Bright.”

Whitening isn’t permanent—but with a thorough application and avoiding foods and habits that contribute to staining, professional whitening effects can last up to two years. If you’re interested, see your dentist for a full dental examination for any issues that might interfere with the whitening process. From there, you’re not far from a brighter and more attractive smile.

If you would like more information on teeth whitening and other dental cosmetic enhancements, 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 “Teeth Whitening: Brighter, Lighter, Whiter….


By John G. Fisher, DMD
July 21, 2018
Category: Oral Health
Tags: oral hygiene  
YourDentalCareEffortsareJustasImportantasYourDentists

If you’re seeing your dentist regularly, that’s great. But if that’s all you’re doing to stay ahead of dental disease, it’s not enough. In fact, what you do daily to care for your teeth is often the primary factor in whether or not you’ll maintain a healthy mouth.

Top of your oral care to-do list, of course, is removing daily plaque buildup from teeth and gums. This sticky film of bacteria and food particles can cause both tooth decay and periodontal (gum) disease. You do that with effective daily brushing and flossing.

Effective brushing starts with the right toothbrush—for most people a soft-bristled, multi-tufted brush—and fluoride toothpaste. As to technique, you should first avoid brushing too hard or too often (more than twice a day). This can damage your gums and cause them to recede, exposing the tooth roots to disease. Instead, use a gentle, scrubbing motion, being sure to thoroughly brush all tooth surfaces from the gumline to the top of the teeth, which usually takes about two minutes.

The other essential hygiene task, flossing, isn’t high on many people’s “favorite things to do list” due to frequent difficulties manipulating the floss. Your dentist can help you with technique, but if it still proves too difficult try some different tools: a floss threader to make it easier to pull floss through your teeth; or a water flosser, a handheld device that directs a pressurized water stream on tooth and gum surfaces to loosen and flush away plaque.

And don’t forget other tooth-friendly practices like avoiding sugary snacks between meals, drinking plenty of water to avoid dry mouth, and even waiting to brush or floss about an hour after eating. The latter is important because acid levels rise during eating and can temporarily soften enamel. The enzymes in saliva, though, can neutralize the acid and re-mineralize the enamel in about thirty minutes to an hour. Waiting to brush gives saliva a chance to do its job.

Lastly, keep alert for anything out of the ordinary: sores, lumps, spots on the teeth or reddened, swollen, bleeding gums. All these are potential signs of disease. The sooner you have them checked the better your chances of maintaining a healthy mouth.

If you would like more information on caring for your teeth at home, 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 “10 Tips for Daily Oral Care at Home.”


WhatHappensinaRootCanalTreatmentandHowitCanSaveYourTooth

Along with periodontal (gum) disease, tooth decay poses one of the two greatest threats to your teeth. Cavities are just the start: if decay invades the pulp, the tooth’s innermost layer, the infection created can continue to advance through the root canals to the supporting bone. This worst case scenario could cost you your tooth.

But we can stop this advanced decay in its tracks with a procedure called a root canal treatment. A root canal essentially removes all the infected tissue within the tooth and then seals it from further infection. And contrary to its undeserved reputation for being painful, a root canal can actually stop the severe tooth pain that decay can cause.

At the beginning of the procedure, we deaden the affected tooth and surrounding tissues with local anesthesia—you’ll be awake and alert, but without pain. We then isolate the tooth with a dental dam of thin rubber or vinyl to create a sterile environment around it to minimize contamination from bacteria found in saliva and the rest of the mouth.

We then drill a small hole through the enamel and dentin to access the interior of the tooth. With special instruments, we remove and clean out all the diseased or dead tissue in the pulp chamber and root canals. After disinfecting the empty spaces with an antibacterial solution, we’ll shape the root canals to make it easier to perform the next step of placing the filling.

To fill all the root canals and pulp chamber, we typically use a rubber-like material called gutta-percha. Because it’s thermoplastic (“thermo”—heat; “plastic”—to shape), we can compress it into and against the walls of the root canals in a heated state to fully seal them. This is crucial for preventing the empty tooth interior from becoming re-infected. Afterward, we’ll seal the access hole with its own filling; later, we’ll bond a permanent crown to the tooth for additional protection and cosmetic enhancement.

After the procedure you may have some temporary minor discomfort usually manageable with aspirin or ibuprofen, but your nagging toothache will be gone. More importantly, your tooth will have a second chance—and your dental health and smile will be the better for it.

If you would like more information on treating tooth decay, 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 “A Step-By-Step Guide to Root Canal Treatment.”


DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”


NeedanEffectivebutAffordableToothReplacementLookataFlexibleRPD

People with missing teeth have more replacement options than ever before, including the ever popular but often more expensive dental implant. But there has also been an expansion of choice on the more affordable side of dental restorations. The flexible removable partial denture (RPD) is one such choice. 

Though RPDs have been around for some time, the newer flexible RPD offers some advantages over the more rigid traditional RPD. They’re made of a kind of nylon that’s pliable but also strong and durable. This material is thermoplastic, meaning when heated it can be injected into molds based on a patient’s individual mouth to form an accurate denture base. The gum-colored base can also be formed to cover any receded areas of the gums, which can greatly improve smile appearance.

Older versions of RPDs are made of rigid acrylic plastic that stay in place in the mouth with metal clasps that attach to remaining teeth. The flexible RPD, on the other hand, is secured with finger-like nylon extensions that fit and hold in the natural teeth’s concavities near the gum line. This, along with its relatively light weight, offers a more comfortable fit.

But aside from these benefits, flexible RPDs do have a few drawbacks. Although fracture-resistant, they’re not easy to repair or reline to readjust the fit to accommodate mouth changes. They can stain (though not as much as a traditional RPD), so they require diligent cleaning and maintenance.

We consider the whole category of RPDs as “temporary” restorations, meaning they’re intended as a transitional phase between tooth loss and a permanent restoration like a natural tooth-supported fixed bridge or dental implants. For some, however, the flexible RPD might be a more long-term solution. As mentioned before, to extend their life as much as possible they should be removed daily and cleaned thoroughly. And like any form of denture, they should not be worn overnight.

In either case, flexible RPDs offer an effective way to restore not only dental function diminished by missing teeth but an improved appearance as well. With careful maintenance, they could serve you well for some time to come.

If you would like more information on flexible partial dentures, 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 “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”