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Posts for: January, 2014

TechniqueJustasImportantWithPoweredToothbrushesasWithManual

Electric-powered toothbrushes have been in use for decades, and continue to enjoy wide popularity. But since their inception in the 1950s, there’s been a continuous debate not only about the best choice among powered toothbrushes, but whether powered toothbrushes are as effective in removing plaque as manual toothbrushes.

These debates are fueled by a large body of research over many years on powered toothbrushes. For instance, an independent research firm known as the Cochrane Collaboration has evaluated over 300 hundred studies of powered toothbrushes (over a thirty-year span) using international standards to analyze the data.

Surprisingly, they found only one type of powered toothbrush (using a rotation-oscillation action) that statistically outperformed manual toothbrushes in the reduction of plaque and gingivitis. Although from a statistical point of view the difference was significant, in practical terms it was only a modest increase in efficiency.

In all actuality, the most important aspect about toothbrushes in effective oral hygiene isn’t the brush, but how it’s used — or as we might say, “it’s not the brush so much as the hand that holds it.” The fact remains, after first flossing, a manual toothbrush can be quite effective in removing plaque if you brush once or twice a day with a soft-bristle brush using a gentle brushing motion.

Although a powered toothbrush does much of the work for you, it still requires training to be effective, just as with a manual toothbrush. We would encourage you, then, to bring your toothbrush, powered or manual, on your next cleaning visit: we would be happy to demonstrate proper technique and give you some useful tips on making your brushing experience more effective.

Remember too: brushing your teeth and flossing isn’t the whole of your oral hygiene. Although a critical part, brushing and flossing should also be accompanied with semi-annual professional cleanings to ensure the removal of as much disease-causing plaque as possible.

If you would like more information on types of toothbrushes, 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 “Manual vs. Powered Toothbrushes.”


By Phil Hart, DDS
January 24, 2014
Category: Dental Procedures
HughJackmansShockingTeeth

Australian heartthrob Hugh Jackman has won international recognition for his work on stage, screen and television, including his long-running portrayal of Wolverine in the X-Men film series, and his Academy-Award-nominated starring role in Les Miserables. Oh, and did we mention he was named the “sexiest man alive” by People magazine in 2008? So when Jackman once said “I have shocking teeth”… what did he mean?

“[My dentist] looked at my teeth and went, ‘Oh, my God, you've got gray teeth,’” the actor stated. The proposed cure: tooth whitening. But what if the action hero's teeth were brightened too much — would his look still convey his trademark rugged charm? To see how that issue was resolved, let's look a little closer at various methods of tooth whitening.

All Whitening Isn't the Same
Everyone has seen the kind of over-the-counter tooth whitening strips advertised in magazines and sold in drug stores. Most dentists agree that, given enough time, they can work in many cases. But there may be problems, too.

One is that unless you know what's actually causing the darkening, you can't be sure if there is an underlying issue that needs treatment — a root-canal problem, for example. Bleaching a diseased tooth is like painting over a rusty car: it camouflages the problem, but doesn't fix it. That's one reason why, before any whitening treatment is attempted, it's important to have a complete dental examination, with x-rays.

Another is that without professional supervision, it's more difficult to control the degree of whitening you will end up with. For safety reasons, over-the-counter whitening products have the least concentrated bleaching agent, and will probably require weeks of use to produce noticeable results. The next step up — a custom-designed, at-home bleaching kit from our office — will likely produce results twice as fast.

The Professional Advantage
At-home bleaching done under our supervision uses stronger whitening agents with a flexible plastic tray that's custom-made to fit your teeth. It's a cost-effective way to achieve several shades of whitening in a relatively short time. Plus, with the advantage of our experience and guidance, you can get excellent results safely and efficiently.

If you want the fastest and most controllable whitening, however, in-office whitening treatments are the best way to go. According to one study, using the most concentrated whiteners in a safe clinical setting produced a six-shade improvement in just three office visits! This would have required a week or more of at-home bleaching, or upwards of 16 daily applications of the over-the-counter whitening products!

In-office whitening also offers the greatest degree of control over the outcome. That's why it was the method Hugh Jackman chose for his treatments. By adjusting the concentration of the bleaching solution and the treatment time, Jackman's dentist made sure his teeth were pleasingly light — but still looked completely natural. And in our office, we can do the same for you.

So whether you're looking for a dazzlingly bright smile or a more subtle enhancement, the best way to start is to call our office for a consultation. For more information, see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”


OvercomingDentalCareObstaclesinChildrenWithChronicDiseases

All children encounter sickness as they grow; thankfully most of these conditions are relatively mild and fade away in short order. But some children endure more serious, longer lasting conditions. The health of children with chronic diseases can be impacted in numerous ways, including the health of their teeth and gums.

Unfortunately, dental care is often pushed to the side as caregivers understandably focus on the primary disease. In addition, many chronic conditions involving behavior, such as autism, attention deficit and hyperactivity disorder (ADHD) or intellectual disabilities, may inhibit the child’s ability to cooperate with or even perform daily oral hygiene. Many special needs children have an acute gag reflex that makes toleration of toothpaste, spitting matter from the mouth, or keeping their mouths open more difficult. However difficult it may be, though, it’s still important to establish daily hygiene habits to reduce the risk of tooth decay and gum disease.

There are techniques for building a daily routine for children with physical and behavioral limitations. For example, using “modeling and shaping” behavior, you (or perhaps a sibling) brush your teeth with your child to demonstrate how it should be done. If there’s a problem with cooperation, you can also position the child “knee to knee” with you as you brush their teeth. In this way you’ll be able to meet their eyes at a level position and lessen the chance of a confrontation.

We encourage all children to have their first dental visit before their first birthday. This is especially true for children with chronic conditions. The Age One visit helps establish a benchmark for long-term care; it then becomes more likely with regular visits to discover and promptly treat dental disease. This is especially important for special needs children who may have congenital and developmental dental problems, like enamel hypoplasia, a condition where the teeth have not developed sufficient amounts of enamel.

Teeth are just as much at risk, if not more so, in children with chronic diseases. Establishing daily hygiene and regular checkups can reduce that risk and alleviate concern for their long-term oral health.

If you would like more information on oral healthcare for children with chronic diseases, 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 “Managing Tooth Decay in Children With Chronic Diseases.”


AlthoughChallengingSmileZoneImplantscanAppearBeautifullyLife-Like

Dental implants have quickly become the restoration of choice for two basic reasons: they effectively restore the lost function of missing teeth and simultaneously rejuvenate the smile with their life-like appearance.

Achieving a life-like appearance, however, isn’t always a simple matter. A restoration in what we dentists call the “Smile Zone” (the upper front area that displays both teeth and the gum line when you smile) requires careful planning and technique to ensure they appear as life-like as possible.

Our first concern is whether there’s enough bone to fully anchor an implant. Bone is a living, dynamic tissue that goes through cycles of dissolving (resorption) and growth. The normal forces of biting and chewing transmit through healthy teeth and stimulate growth in the bone. When the teeth are missing and no longer transmit this pressure, the bone will eventually resorb only and not grow.

Adjacent teeth could also be affected with bone loss if the extraction was difficult and a bone graft was not placed into the extraction socket to preserve bone. This not only puts adjacent teeth at risk of gum and bone loss but can also have implications for the final smile appearance. This bone also supports the triangular tissue between teeth known as papillae which give teeth their arched appearance. If the bone isn’t adequate, there’s less hope that the papillae will regenerate.

With these concerns it’s very important to consider how the implant and crown emerges from the gums in the Smile Zone. Recent developments in implant design are helping in this regard. The design change of the top of the implant re-orients the gum tissues in relation to the implant from vertical to horizontal, which dentists call “platform switching.” This provides greater stabilization where bone mass is limited, and helps create a more aesthetically pleasing result. There are also other techniques, such as surgical tissue grafting of the papillae that can further enhance the final appearance.

Although creating a natural, life-like appearance in the Smile Zone is difficult, it’s not impossible. It’s important first to undergo a complete dental examination and profile, where we can advise you on your best options to achieve a beautiful smile.

If you would like more information on the relation of implants to the aesthetics of your smile, 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 “Implant Aesthetics.”