While wearing braces is the path to a healthier and more attractive smile, it can be a difficult journey. One of your biggest challenges will be keeping your teeth clean to avoid a higher risk of tooth decay.

Tooth decay starts with dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Daily brushing and flossing clear this accumulation. But the hardware of braces makes it difficult to access all tooth surfaces, and can even become a haven for plaque.

One sign in particular of tooth decay while wearing braces is the appearance of chalk-like spots on the teeth known as white spot lesions (WSLs). WSLs occur because the minerals in the enamel beneath them have begun to break down in response to decay. The spots can eventually cause both structural and cosmetic problems for a tooth.

The best approach to WSLs is to prevent them from developing in the first place. You'll need to be extra vigilant with daily oral hygiene while wearing braces to reduce plaque buildup. To help with the increased difficulty you might consider using a special toothbrush designed to maneuver more closely around orthodontic hardware. You may also find using a water flosser to be a lot easier than flossing thread.

Preventing tooth decay and WSLs also includes what you eat or drink to reduce the effects of enamel de-mineralization. The bacteria that cause decay thrive on sugar, so limit your intake of sweetened foods and beverages. And to avoid excessive demineralization cut back on acidic foods as well.

If despite your best preventive efforts WSLs still form, we can take steps to minimize any damage. For one, we can give your enamel a boost with fluoride applications or other remineralization substances. We can also inject a tooth-colored resin beneath the surface of a WSL that will make it less noticeable.

With any of these and other treatments, though, the sooner we can treat the WSL the better the outcome. Practicing good hygiene and dietary habits, as well as keeping an eye out for any WSL formations, will do the most to protect your new and improved smile.

If you would like more information on preventing dental disease while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”

Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”

Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.

Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:

A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.

If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.

Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.

Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.

Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.

If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”

There's no doubt treating dental problems can improve your health. But because the mouth is among the most sensitive areas of the body, many dental procedures can be potentially uncomfortable after treatment.

We rely on pain medication to alleviate any dental work discomfort, especially during recuperation. Our arsenal of pain-relieving drugs includes strong opioid narcotics like morphine or oxycodone which have effectively relieved dental pain for decades. But although they work wonders, they're also highly addictive.

We've all been confronted in the last few years with startling headlines about the opioid addiction epidemic sweeping across the country. Annual deaths resulting from opioid addiction number in the tens of thousands, ahead of motor vehicle accident fatalities. Although illegal drugs like heroin account for some, the source for most addiction cases—an estimated 2 million in 2015 alone—is opioid prescriptions.

Dentists and other healthcare providers are seeking ways to address this problem. One way is to re-examine the use of opioids for pain management and to find alternative means that might reduce the number of narcotic prescriptions.

This has led to new approaches in dentistry regarding pain relief. In a trend that's been underway for several years, we've found managing post-discomfort for many procedures can be done effectively with non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, acetaminophen or ibuprofen. They don't share the addictive quality of narcotics and are regarded as safer when taken as directed.

There's also been a recent modification with using NSAIDs. Dentists have found that alternating the use of ibuprofen and acetaminophen often amplifies the pain relief found using only one at a time. By doing so, we may further reduce the need for narcotics for more procedures.

The trend now in dentistry is to look first to NSAIDs to manage pain and discomfort after dental work. Narcotics may still be used, but only in a secondary role when absolutely needed. With less narcotic prescriptions thanks to these new pain management protocols, we can reduce the risk of a dangerous addiction.

If you would like more information on managing pain during and after dental work, please contact us or schedule an appointment for a consultation.

While dental diseases tend to be a greater concern as we get older, they also pose a potential threat to children. A particular type of tooth decay called early childhood caries (ECC) can severely damage children's unprotected teeth and skew their normal dental development.

Fortunately, you can protect your child's teeth from disease with a few simple practices. First and foremost: start a hygiene habit as soon as possible to remove disease-causing bacterial plaque. You don't have to wait until teeth appear, either: simply wipe the baby's gums with a clean wet cloth after nursing to minimize the growth of oral bacteria.

When their teeth do begin to erupt, you can switch to brushing (you can add flossing as more teeth erupt—but until the child shows appropriate dexterity, you'll need to do it for them). For infants, brush gently but thoroughly with a soft-bristled brush and a smear of fluoride toothpaste. When they grow older you can increase the toothpaste to a pea-sized amount. And as soon as you can, get them involved with learning to perform these vital habits on their own.

You should also limit your child's consumption of sugar. Our favorite carbohydrate is also a favorite of bacteria, who consume any remnants in dental plaque as a primary food source. So, keep sugary snacks and foods to a minimum and limit them mainly to mealtimes. And don't put a baby to sleep with a bottle filled with a liquid containing sugar (including formula and breastmilk).

Finally, begin taking your child to the dentist regularly by their first birthday for routine cleanings and checkups. Besides removing any hard to reach plaque, your dentist may also apply sealants and topical fluoride to help protect and strengthen tooth enamel. Regular visits make it more likely to detect the early signs of decay, before it does extensive damage. And beginning early makes it less likely your child will develop a fear of dental visits that could carry on into adulthood.

These and other steps will go a long way in protecting your child's teeth and gums so they develop normally. A little prevention and protection will help ensure a happy, healthy smile later in life.

If you would like more information on helping your child develop healthy teeth and gums, 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 “Top 10 Oral Health Tips for Children.”

Every May, the National Fibromyalgia & Chronic Pain Association asks people around the world to spread awareness of fibromyalgia and other chronic pain conditions. Anyone with fibromyalgia and its associated joint and muscle pain knows all too well how chronic pain can disrupt everyday life. And as we see frequently in the dental office, people contending with the jaw pain and dysfunction associated with a temporomandibular joint disorder (TMD) can equally relate.

But here’s the kicker—if you’ve been diagnosed with either TMD or fibromyalgia, there’s a good chance you’re also dealing with both conditions. For example, in one recent survey of over a thousand TMD patients, two-thirds reported also having fibromyalgia or similar kinds of health issues. Researchers are looking intently at possible connections between TMD and fibromyalgia since understanding any potential link between the two might open the door to new ways of treatment.

Fibromyalgia patients experience frequent muscle spasms and fatigue throughout their bodies, coupled with other problems like sleeplessness and memory difficulties. Most researchers today believe it’s caused by a malfunction within the central nervous system (CNS) to process pain. Those working with TMD research are also considering whether the same type of malfunction contributes to jaw joint pain and dysfunction.

TMD is an umbrella term for various disorders involving the jaw joints and associated muscles. When you come to the dental office, it is important that we know about any TMD pain you may be experiencing because this can affect your dental visits. For example, people with TMD may have trouble holding their mouth open for an extended period of time, so we can adjust dental exams and treatments accordingly. Also, we will want to look for underlying dental conditions that may have contributed to your TMD.

If you’re experiencing both TMD and fibromyalgia symptoms, be sure you let us as well as your rheumatologist know the various symptoms you’re experiencing with each condition, the treatments you’re undergoing and the medications you’re taking.

For TMD in particular, here are a few things you can do to reduce its impact on your daily life:

• Avoid foods that require heavy chewing or jaw widening;
• Use thermal therapies like warm compresses or ice packs to ease jaw stiffness and pain;
• Practice relaxation techniques to reduce stress in your life;
• Ask about muscle relaxants or other medications that might help.

You may find that some of these practices, particularly stress reduction, are also helpful in managing fibromyalgia. And if there is a deeper connection between TMD and fibromyalgia, unraveling the mystery could hopefully lead to even greater relief for both.

If you would like more information about managing your symptoms, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Chronic Jaw Pain and Associated Conditions” and “Fibromyalgia and Temporomandibular Disorders.”

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”

The longer many health problems go on, the worse they become. Treating them as early as possible could stop or slow their development.

That holds true for poor bites: while we can certainly correct them later in life, it's often better to "intercept" the problem during childhood. Interceptive orthodontics attempts to do this with treatments that influence how the jaws and other mouth structures develop during childhood. Many of these techniques are usually best implemented before puberty.

For example, some very complex problems called cross bites can occur if the upper jaw grows too narrowly. We might be able to stop this from happening by using an orthodontic appliance called a palatal expander during the childhood years. It works because the bone at the center of the palate (roof of the mouth) has a gap running back to front until the early teens when the gap closes.

We fit the palatal expander up under and against the palate, then extend out metal arms from a center mechanism to the back of the upper teeth that exert outward pressure on them. This widens the center gap, which the body continually fills with bone as the device gradually exerts more pressure. Over time this causes the jaw to widen and lessens the cross bite. Timing, though, is everything: it's most effective before the gap closes.

Another way to aid jaw growth is a Herbst appliance, a hinged device that alters the movement of the jaws. As a child wears it, a Herbst appliance draws the lower jaw forward to develop more in that direction. Like the palatal expander, it's best used before significant jaw growth occurs.

These are just two examples of techniques and tools that can guide structural growth and prevent bite problems. Because they're most effective in the early years of oral development, your child should undergo an orthodontic evaluation as early as age 6 to see if they need and can benefit from an interceptive treatment.

Interceptive orthodontics can stop or at least slow a growing bite problem. The effort and expense now could save you much more of both later on.

If you would like more information on interceptive orthodontics, 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 “Interceptive Orthodontics: Timely Intervention can make Treatment Easier.”

Dental veneers are a great way to transform a smile without the expense or effort often required of other restorations. These thin layers of dental material adhere to the front of teeth as a "mask" to cover chips, heavy staining or other blemishes.

Still, veneers require attention to detail for a successful outcome. Here's a step-by-step look at changing your dental appearance with veneers.

Step 1: Considering your options. While most veneers are made of dental porcelain, composite resin materials are increasingly popular. Although more prone to chipping or staining, composite veneers don't require a dental lab for fabrication. Another option, depending on your dental situation, are ultra-thin veneers that require little to no tooth preparation. Your dentist will help you decide which options are best for you.

Step 2: "Test driving" your new smile. We can help you "see" your future smile with special software that creates a computer image of your teeth with the planned veneers. We can also use composite material to fabricate a "trial smile" to temporarily place on your teeth that can give you the feel as well as the look of your future smile.

Step 3: Preparing your teeth. Unless you're getting no-prep veneers, we'll need to modify your teeth before attaching veneers. Although only 0.3 to 0.7 millimeters thick, veneers can still appear bulky on unprepared teeth. They'll look more natural if we first remove a small amount of enamel. A word of caution, though: although slight, this enamel removal permanently alters your teeth that will require them to have some form of restoration from then on.

Step 4: Attaching your new veneers. After the planning phase (which includes color matching to blend the veneers with the rest of your teeth), a dental lab creates your veneers if you've opted for porcelain. After they're delivered, we'll clean and etch the teeth with a mild acidic gel to increase the bonding effect. We'll then permanently attach the veneers to your teeth with a very thin but ultra-strong resin luting cement that creates a unified bond between the veneers and teeth.

Following these steps is the surest way to achieve a successful outcome. With due care you're sure to enjoy the effects for a long time to come.

If you would like more information on changing your smile with veneers, 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 “Porcelain Veneers: Your Smile—Better than Ever.”

Stained teeth can be embarrassing — so much so you may even hesitate to smile. Before you seek out a whitening solution, though, there are a few things you need to know about tooth staining.

Tooth staining is more complex than you might think. There are actually two types: extrinsic, staining from foods and other substances of the outer surface of the enamel; and intrinsic, discoloration deep within a tooth that affects their outward appearance. The latter staining has a number of causes, including the type of dental materials used to fill a tooth, a history of trauma or the use of the antibiotic tetracycline during early tooth development.

There are some noticeable differences between the two types, although an examination is usually necessary to determine which you have. Extrinsic staining tends to be brown, black, or gray, or occasionally green, orange or yellow. Intrinsic staining can be red, pink or, if caused by tetracycline and fluoresced under ultraviolet light, yellow. If only one tooth is discolored it’s most likely intrinsic due to decay in the tooth pulp.

What can be done also depends on which type. Extrinsic staining can be modified through whitening, with either an office application or a home kit (there are differences, so you should consult with us before you decide). It may also be essential to modify your diet by restricting foods and beverages (coffee, wine or tea) known to cause staining and by eliminating tobacco use. You should also practice daily hygiene, including brushing with a toothpaste designed to diminish staining, and regular office cleaning and polishing.

Intrinsic staining can’t be addressed by these methods. Instead, you may need to undergo a procedure where we enter the interior of the tooth and insert a bleaching agent. If this isn’t an option, you can also choose a cosmetic restoration such as a porcelain veneer or crown that will cover the tooth to better match the color of your other teeth.

Dealing with stained teeth begins with a visit to our office to determine what type of discoloration you have and to learn your options. But regardless of what type you have, there is a way to a brighter smile.

If you would like more information on the causes and treatments of tooth staining, 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 “Tooth Staining.”

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

The month of March brings the first day of spring, when nature seems to wake up after a restful winter slumber. It also brings Sleep Awareness Week, which leads us to ask: How's your sleep? For around one of every three people, the answer seems to be: Not so good! In fact, it's estimated that some 50-70 million people in the U.S. alone have sleep problems, including sleep-related breathing disorders like obstructive sleep apnea (OSA).

People who suffer from this condition seem to sleep fitfully and snore loudly—and they may actually wake up dozens of times every night without even knowing it. These "micro-arousals" make it impossible to get restful sleep, which can lead to fatigue, trouble concentrating, and behavioral issues. Children with sleep disorders like OSA are sometimes diagnosed with attention deficit/hyperactivity disorders because the symptoms are very similar.

If you suspect that you (or someone you care about) may have a serious sleep disorder, it's a good idea to get an examination from a medical professional who specializes in this area. If the diagnosis is OSA, there are a number of treatments that can be effective—one of which is an oral appliance that's available from the dental office.

Dentists are quite familiar with the anatomical structure of the mouth, which is sometimes the root cause of OSA. In many individuals, the soft tissue structures in the back of the oral cavity (including the tonsils, tongue and soft palate) can shift position when muscles relax during sleep and block the flow of air through the windpipe. The lack of sufficient air may cause a person to awaken briefly, gasp for breath, and then relax their muscles—over and over again, all night long.

After a complete exam, we can have an appliance custom-made for you that has proven successful in managing mild to moderate cases of OSA. Shaped a little like a retainer, it is worn in your mouth at night and taken out in the daytime. The appliance helps maintain an open airway by re-positioning the jaw and/or keeping the tongue out of the way.

Oral appliance therapy is one of the most conservative options available for treating OSA: It requires no major equipment or irreversible medical procedures. However, there are a number of other options, including machines that supply pressurized air through a face mask and even oral surgery. It's important to consult with a specialist in sleep disorders when you're facing this issue. If the diagnosis is OSA or a similar sleep problem, remember that help may be available here at the dental office.

If you have questions about sleep-related breathing disorders, please contact us or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine articles “Oral Appliances For Sleep Apnea” and “Sleep Disorders & Dentistry.”

Canker sores, known medically as aphthous ulcers, are fairly common among people. Lasting for about a week or so, these mouth sores are usually more irritating than painful. But about a quarter of the population, especially women, frequently suffer from an acute form that doesn't often respond well to over-the-counter remedies.

A typical canker sore is usually round with a yellow-gray center ringed by a reddened "halo." They can be preceded by tingling or painful sensations at the site a few hours or so before breaking out. Recurrent aphthous stomatitis (RAS) is the more severe form of canker sore, often with outbreaks of multiple painful sores. While the more common sore is usually less than a centimeter in diameter, RAS sores are often much larger.

Canker sores often arise during periods of stress or anxiety, and seem to be connected with eating certain acidic foods like tomato sauce, citrus fruits or spicy dishes. RAS also seems to be related to underlying systemic conditions like vitamin deficiencies, anemia or digestive disorders. Besides managing diet and stress, people with regular canker sores and milder cases of RAS can often find relief with non-prescription numbing agents often found in stores and pharmacies.

For more severe RAS, though, you may need the help of your dentist or physician with treatments like prescription steroids or other medications that come in gel or rinse form or through injections. The goal of any treatment approach is to decrease pain severity and shorten healing times after an outbreak.

While most mouth sores, including RAS, aren't dangerous to your health, you should still take any sore seriously. You should especially seek medical evaluation if a sore doesn't heal after a couple of weeks, if they seem to come more frequently and are more severe, or if you don't seem to ever be without a sore in your mouth. These could indicate a serious underlying problem that needs to be addressed.

One thing's for sure: there are ways to ease your suffering if you have frequent bouts with regular canker sores or even RAS. Talk to your dentist about ways to minimize your discomfort from these irritating mouth sores.

If you would like more information on aphthous ulcers or canker sores, 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 “Mouth Sores.”

You have a problem with your teeth. Functionally, there's nothing wrong with them — but it's another story when you look in the mirror: discoloration, wearing or maybe a slight gap between them.

Fortunately, you don't have to settle for a smile you're not happy with. Less costly than crowns or bridgework, porcelain veneers can nonetheless correct many mild to moderate cosmetic problems with teeth and transform them into an attractive smile.

Like the name implies, a veneer is made of thin layers of dental material custom-designed and bonded to the outside of a tooth. Veneers can correct problems with color, tooth shape and size, and mild misalignments or spacing. It's akin to installing new siding on a house.

To begin your journey with veneers, we must first examine your teeth to fully assess your dental needs and ensure you have no issues that could prevent applying them. Then, we prepare your teeth: although not to the extent as for a crown or bridge, we must remove a small amount of tooth material so the veneer will appear natural and not bulky.

We then make an impression mold of your prepared teeth that a dental technician will use to create your veneers. During this process they build up layer after layer of liquid porcelain until they achieve the right thickness, shape and color to match your teeth.

In the meantime, we can fit you with a temporary set of veneers made of acrylic plastic so you can chew, speak and smile normally. These provisional veneers also give you and your friends and family a chance to see what your new smile will look like.

When your veneers are ready, we'll create micro-etches in your teeth that will help keep the veneer secure after we've bonded them. Once bonded, the veneer will feel like an inseparable part of the tooth and look it too. No one except you and us need know you're wearing veneers.

If you take care of them — keeping up daily hygiene habits, not biting into hard surfaces, and visiting us regularly for checkups — your veneers can last for many years. And so will that beautiful, new smile.

If you would like more information on porcelain veneers, 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 “Porcelain Veneers.”

When you’re among the top players in your field, you need every advantage to help you stay competitive: Not just the best equipment, but anything else that relieves pain and stress, and allows you to play better. For top-seeded Canadian tennis player Milos Raonic, that extra help came in a somewhat unexpected form: a custom made mouthguard that he wears on the court and off. “[It helps] to not grind my teeth while I play,” said the 25-year-old up-and-coming ace. “It just causes stress and headaches sometimes.”

Mouthguards are often worn by athletes engaged in sports that carry the risk of dental injury — such as basketball, football, hockey, and some two dozen others; wearing one is a great way to keep your teeth from being seriously injured. But Raonic’s mouthguard isn’t primarily for safety; it’s actually designed to help him solve the problem of teeth grinding, or bruxism. This habitual behavior causes him to unconsciously tense up his jaw, potentially leading to problems with muscles and teeth.

Bruxism is a common issue that’s often caused or aggravated by stress. You don’t have to be a world-class athlete to suffer from this condition: Everyday anxieties can have the same effect. The behavior is often worsened when you consume stimulating substances, such as alcohol, tobacco, caffeine, and other drugs.

While bruxism affects thousands of people, some don’t even suspect they have it. That’s because it may occur at any time — even while you’re asleep! The powerful jaw muscles that clench and grind teeth together can wear down tooth enamel, and damage both natural teeth and dental work. They can even cause loose teeth! What’s more, a clenching and grinding habit can result in pain, headaches and muscle soreness… which can really put you off your game.

There are several ways to relieve the problem of bruxism. Stress reduction is one approach that works in some cases. When it’s not enough, a custom made occlusal guard (also called a night guard or mouthguard) provided by our office can make a big difference. “When I don’t sleep with it for a night,” Raonic said “I can feel my jaw muscles just tense up the next day. I don’t sense myself grinding but I can sort of feel that difference the next day.”

 An occlusal guard is made from an exact model of your own mouth. It helps to keep your teeth in better alignment and prevent them from coming into contact, so they can’t damage each other. It also protects your jaw joints from being stressed by excessive force. Plus, it’s secure and comfortable to wear. “I wear it all the time other than when I’m eating, so I got used to it pretty quickly,” said Raonic.

Teeth grinding can be a big problem — whether you put on your game face on the court… or at home. If you would like more information about bruxism, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”

With the advent of home whitening kits, you no longer have to go to the dentist to have your teeth whitened. DIY kits are relatively safe and effective, if you follow the directions carefully.

So, you might be thinking: why have a dentist whiten my teeth? Actually, there are good reasons why you might. Here are 4 of them.

We'll make sure your teeth are healthy first. Your teeth may need some attention first, such as treatment for dental disease, before we undertake whitening. We'll also determine why your teeth are stained, which could impact how they're whitened (more about that in a moment).

Our application could take less time and last longer. Bleaching agents in home kits make up less than 10% of volume, much weaker than the applications we use. While it often takes several applications at home to achieve the desired brightness, you may only need one or two sessions with us. Our stronger solution may also extend the “fade time” — when the whitening begins to diminish — than what you may encounter with home whitening.

We can be more precise achieving the right shade. There are different shades of teeth whiteness — what looks good for someone else might not look good for you. We have the training and expertise to achieve a color that's right for you. What's more, we also have techniques and equipment like UV lighting that enables us to color match more precisely than you can with a home kit.

Your DIY kit can't alter some forms of staining. Home kits bleach only the outermost layers of tooth enamel. That won't help, though, if your discoloration originates inside the tooth. This intrinsic staining requires procedures only a dentist can perform to bleach the tooth from the inside out.

Even if you'd still like to use a home kit we'll be happy to advise you on purchasing and application. It's also a good idea to have us check the staining first to see if a home kit will work at all. In the end, we share the same desire as you do: that your teeth are as healthy as they can be and bright as you want them to be.

If you would like more information on tooth whitening options, 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 “Tooth Whitening Safety Tips.”

A total tooth replacement option with your Lawrence dentist

Dental implants offer an innovative way to replace your entire tooth, not just the part visible above your gum line. The tiny titanium implant fills the space in your jaw once occupied by your tooth roots. In just six months or less, the dental implant fuses to the bone, offering a permanent replacement for the roots. Adding a crown to the top of the implant fills the gap in your mouth. Implants are often used to replace one missing tooth, but are also an excellent option if you've lost all of your teeth.

Why root replacement is so important

Replacing the roots of a tooth offers two important benefits:

• Increased Comfort: Eating can be agonizing if your dentures slip or your bridge is loose. Every time you eat, your restoration rubs against your gums, creating sore spots. Since dental implants firmly anchor the crowns that sit on top of them, there is no movement when you take a bite and no irritation. In fact, implants feel like any other tooth.
• No Decrease in Jawbone Strength: Your teeth roots constantly press on your jawbone and provide stimulation the jaw needs in order to maintain its strength. Losing a tooth doesn't just affect your smile, but also impacts the health of your jawbone. As the months and years go by, the jawbone can become thinner and weaker. If the problem is severe, some of your teeth may loosen, or you may notice that the lower half of your face begins to sag. Dental implants take over for your natural roots and continue to offer the stimulation needed for a strong jawbone.

Dental implants offer the ultimate tooth replacement option! Call Dr. Herrera, your Lawrence, KS dentist at Rockledge Dentistry, at (785) 331-0027 to find out if dental implants are right for you. Don't let a lost tooth ruin your smile.

Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.

What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!

Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.

If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.

For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.

Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.

Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.

So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.

If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”

Teeth are naturally strong and durable — if we can prevent or control dental disease like tooth decay or gum disease, they can last a lifetime. Still, teeth do wear gradually as we age, a fact we must factor into our dental care as we grow older.

Sometimes, though, the wear rate can accelerate and lead to problems much earlier — even tooth loss. There are generally four ways this abnormal wear can occur.

Tooth to tooth contact. Attrition usually results from habitual teeth grinding or clenching that are well beyond normal tooth contact. Also known as bruxism, these habits may occur unconsciously, often while you sleep. Treatments for bruxism include an occlusal guard worn to prevent tooth to tooth contact, orthodontic treatment, medication, biofeedback or psychological counseling to improve stress coping skills.

Teeth and hard material contact. Bruxism causes abrasion when our teeth regularly bite on hard materials such as pencils, nails, or bobby pins. The constant contact with these and other abrasive surfaces will cause the enamel to erode. Again, learning to cope with stress and breaking the bruxism habit will help preserve the remaining enamel.

Chronic acid. A high level of acid from foods we eat or drink can erode tooth enamel. Saliva naturally neutralizes this acid and restores the mouth to a neutral pH, usually within thirty minutes to an hour after eating. But if you’re constantly snacking on acidic foods and beverages, saliva’s buffering ability can’t keep up. To avoid this situation, refrain from constant snacking and limit acidic beverages like sodas or sports drinks to mealtimes. Extreme cases of gastric reflux disease may also disrupt your mouth’s pH — seek treatment from your medical doctor if you’re having related symptoms.

Enamel loss at the gumline. Also known as abfraction, this enamel loss is often caused by receding gums that expose more of the tooth below the enamel, which can lead to its erosion. Preventing and treating gum disease (the leading cause of receding gums) and proper oral hygiene will lower your risks of receding gums and protect tooth enamel.

If you would like more information on tooth wear, 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 “How and Why Teeth Wear.”

Academy Award-winning actress Kathy Bates knows how important it is to present your best face to the world — and one of the most important features of that face is a beaming smile. But there came a point when she noticed something was a little off. “I've always had good teeth, but it seemed to me as I was getting older that they weren't looking as good,” Kathy explained in a recent interview with Dear Doctor magazine.

That's when she decided it was time to take action. Kathy had orthodontic treatment when she was in her fifties, and she keeps her smile bright with tooth whitening treatments. She uses a kit provided by her dentist with a safe, effective whitening solution.

Of course, a bright, healthy smile looks great anywhere — whether you're on the red carpet or “off the grid.” And you don't have to be a Hollywood star to have professional whitening treatments. In fact, teeth whitening is one of the most popular and affordable cosmetic treatments modern dentistry offers.

The basic options for professional teeth whitening include in-office bleaching or take-home kits. Both types of dentist-supervised treatments offer a safe and effective means of getting a brighter smile; the main difference is how long they take to produce results. A single one-hour treatment in the office can make your teeth up to ten shades lighter — a big difference! To get that same lightening with at-home trays, it would take several days. On the plus side, the take-home kit is less expensive, and can achieve the same results in a bit more time.

It's important to note that not all teeth can be whitened with these treatments. Some teeth have intrinsic (internal) stains that aren't affected by external agents like bleaches. Also, teeth that have been restored (with bonding or veneers, for example) generally won't change color. And you can't necessarily whiten your teeth to any degree: Every tooth has a maximum whiteness, and adding more bleach won't lighten it beyond that level. Most people, however, find that teeth whitening treatments produce noticeable and pleasing results.

What about those off-the-shelf kits or in-the-mall kiosks? They might work… or they might not. But one thing's for sure: Without a dentist's supervision, you're on your own. That's the main reason why you should go with a pro if you're considering teeth whitening. We not only ensure that your treatment is safe — we can also give you a realistic idea of what results to expect, and we will make sure that other dental problems aren't keeping you from having a great-looking smile.

How often does Kathy Bates see her dentist for a checkup and cleaning? “I go about every four months,” she noted. “I'm pretty careful about it.” And if you've seen her smile, you can tell that it pays off. If you would like more information about teeth whitening, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”

Losing a tooth affects not only your smile but your overall dental health too. A dental implant solves both issues: it replaces the whole tooth, including the root, to merge durability with a life-like appearance.

For teenagers with a missing tooth, however, an implant may not be a good idea, at least until they've physically matured. Although their permanent teeth have usually all come in by puberty, the jaws and facial structure continue to develop into early adulthood. An implant placed too early could appear misaligned when the jaw fully matures.

The best approach for teens is a temporary replacement until they're physically ready for an implant. There are two good options: a removable partial denture (RPD) or a fixed bonded bridge.

Common among adults, an RPD is also a viable replacement for a teenager's missing tooth. An RPD consists of a prosthetic (false) tooth set in a nylon or acrylic base that resembles gum tissue. Metal clips formed in the RPD fit over adjacent teeth to hold the appliance in place; this also makes it easy to remove for cleaning or sleep time. We typically recommend an acrylic base for teens because it's easier to adjust if the RPD's fit becomes loose.

To hold it in place, a traditional bridge uses crowns on either side of the replacement tooth to bond over the natural teeth next to the open socket. Because this requires permanently altering the support teeth, we recommend a bonded bridge that doesn't.

This modified bridge uses wing-like strips of dental material on the back of the false tooth that project outward. With the tooth in place, we bond the extending portions of these projections to the back of the adjacent teeth, which secures the false tooth in place.

Of the two options, the bonded bridge is more comfortable, buys the most time and looks the most natural. But it will cost more than an RPD. Bite issues, teeth grinding, overall gum health or your child's level of hygiene conscientiousness could also nix it as a viable option.

Either choice will effectively replace your child's missing tooth until it's time for a permanent restoration. We'll help you weigh all the factors to determine which one is best for your situation.

If you would like more information on restoration options for teens, please contact us or schedule an appointment for a consultation.