Dental Questions: What is the difference between a Crown and a Veneer?

Dental crowns and veneers are two of the most commonly used techniques for restoring teeth in the front of the mouth. They are both typically made from thin layers of zirconia or lithium disilicate and are chemically bonded to the teeth. However, the applications in which they are used can be quite different. In general, crowns have certain structural advantages, while veneers allow us to make cosmetic changes while removing a minimal amount of tooth structure. 

Crowns work by encasing all surfaces of a prepared tooth (hence the nickname "cap"). They can be used on any tooth in the mouth for either esthetic or functional purposes. To place a crown, we need to reduce every side of the tooth to make room for the incoming restoration. The complete coverage allows crowns to repair extensive decay, replace fractures and even add some structural integrity to a compromised tooth. Crowns also have incredible retentive properties, as the cement and mechanical design truly lock it to the tooth. 

In contrast, veneers are typically used in cosmetic applications on the anterior teeth. They are bonded to the front surface of the tooth (as opposed to the complete coverage of a crown), and derive their retention entirely from the bonding cement. Veneers are either placed directly over an unaltered tooth or used after reducing the front surface to accommodate the extra width of material. They can repair smaller chips, close gaps between teeth or correct cosmetic concerns. 

Depending on your personal needs, a crown or veneer may be the most appropriate treatment option. If you have any further questions about crowns, veneers or other dental restorations, please give our office a call!

Pediatric and Orthodontic Offices We Work With

Providing care for children is one of the most challenging and sensitive aspect of dentistry. Kids react to the office setting within an entire spectrum of behavior; from eager and inquisitive to scared and frustrated. We have designed our office to be as welcoming as possible for your young ones with toys, cable TV (Nick, Nick Jr., Disney, etc.) and even a dedicated kid's room (seen in the background of the title photo). Still, there are times that we need to rely on our network of specialists to best meet the needs of your individual child. 

We are proud to work with Dr. Ahsan Raza of 1000 Oaks Children's Dental Group. On top of specialized behavioral management techniques, Dr. Raza prides himself in being an extremely communicative and personal pediatric dentist. He uses a number of techniques, ranging from education to sedation to ensure the best possible dental outcomes. Your kids will love his spaceship themed office too!

In terms of orthodontic offices, we are proud to work with Doctors Nagel Sr. and Nagel Jr. of Nagel Orthodontics and Dr. William Hang of Face Focused Orthodontics. Norm and Jeffrey Nagel bring together over 40 years of experience in orthodontics and pride themselves in combining the best parts of digital and hands-on dentistry. Likewise, Dr. Hang has spent his career developing the Face Focused program, an orthodontic system that develops straight teeth while respecting posture and opening airways. 

If you would like to know more about our fantastic network of specialists, please give us a call. We want our patients to know they are in good hands, whether with us or one of our specialists.

Link to Dr. Raza's office

Link to Dr. Nagel and Nagel's office

Link to Dr. Hang's office

Baby Bottle Tooth Decay

Bed time is certainly one of the most difficult daily struggles with infants. Fussy youngsters will pull out all the stops to avoid getting a good night's rest. Many parents resort to a warm bottle of milk to help ease them to sleep. However, we must warn that this seemingly innocent technique has some serious dental consequences. 

Breast milk, formula and cow's milk all contain carbohydrates like lactose and sucrose. While these aren't necessarily "sweet" like orange juice or soda, they contain enough sugars to fuel the decay causing bacteria in your child's mouth. When infants are allowed to fall asleep with a bottle, the teeth are essentially bathed in acid all night. This creates a typical pattern of decay called baby bottle mouth. Here, the cavities develop very quickly and can affect every single tooth. This is a particular problem with teeth such as the incisors, which erupt at 6-12 months and need to last until 6-7 years of age. 

Our recommendation is to avoid the temptation of sleeping with a bottle all together. Even a rare occasion could turn into a difficult habit to break. If you have any more questions about childhood tooth decay and how to keep your children's teeth healthy, please give us a call!

Dental Questions: Why do we put braces on baby teeth?

You may have heard of a relatively new orthodontic technique that involves putting braces on baby teeth. This treatment probably sounds absurd- trying to create a perfect and straight smile only to have the teeth fall out within a few years. On the contrary, this routine (known as interceptive orthodontics) is  a very effective method for developing a life-long beautiful smile. 

Interceptive orthodontics take advantage of the fact that toddlers and young children still have developing bones in their face and jaws. Here, braces and orthodontic appliances tend to have a more drastic effect and can correct defects and malocclusions (conditions where the teeth are misaligned) more robustly. They are almost always used as part of a two stage treatment plan- where earlier braces help create symmetrical and properly sized jaws and later phases create the straight and cosmetically pleasing smile. Overall, this combined approach leads to less time in orthodontics versus single phase treatment. 

Not every child needs interceptive orthodontics or will be a good candidate. If your orthodontist recommends early braces, it is part of a long term plan towards your child's best dental health. If you have any more questions about interceptive orthodontics or how they are used, give our office a call! 

Use this, not that!

In our world of consumer choices, patients are presented with a number of products promising optimal dental health. The options can be overwhelming, with some making lofty promises. In this article, we will take a look at some common dental products and their superior alternatives. Enjoy!

1. Sugared Gum: Any gum containing sucrose, glucose or fructose is bad news for your oral health. Even if they advertise that they clean teeth or stimulate saliva, the fact of the matter is that these products bathe your teeth in sugar. This sends the bacteria in your mouth into a feeding frenzy, which in-turn causes demineralization and decay. Instead, look for gum made with sorbitol (good) or xylitol (best). Oral bacteria can't process these ingredients, and xylitol even inhibits their activity. 

2. Mall Whitening Kiosks: Underneath the advertising and marketing, these whitening booths are essentially selling OTC bleaching products with a significant markup. While they say they use professional grade bleaching material, its the same peroxide gels used in Whitestrips and other products. Instead, try either in-office bleaching procedures (quicker) or OTC products (more cost effective). 

3. Store-Bought Nightguards: Boil-and-bite nightguards will protect your teeth from nighttime grinding damage. However, they can cause headaches and jaw pains in the process. A nightguard made at a dental office is equilibrated so that all your teeth contact it at the same time. This allows jaw pressure to be evenly distributed instead of causing focal pain. Instead, get fitted for a custom nightguard or target the source of your grinding (stress, emotional strain, etc.)

4. Fluoride Free Toothpaste: In today's health-conscious society, many patients seek out fluoride free "all natural" toothpastes. Unfortunately, there is no compound (natural or man made) that can match the remineralizing power of fluoride. It is safe, effective and used universally in toothpastes around the world. Instead, try to find a toothpaste (any toothpaste) that contains some amount of fluoride!

5. "Floss Action" Toothbrushes: Any product that doesn't get physically inserted between the teeth can't match the cleaning power of floss. Some companies suggest or advertise that their toothbrush design can mimic the action of floss. Unfortunately, this is not the case. While these brushes are plenty efficient of cleaning the rest of your teeth, floss is the only way to get those in-between spaces. Instead, try to add flossing to your daily routine!

Dental Questions: What do I do if my implant crown comes loose?

Do you have a dental implant? Have you ever noticed that the crown feels loose or that you can move it with your tongue? This sensation can be quite alarming and seems as though the entire implant is wiggling out. However, looseness is usually the result of the implant crown coming separated from the actual implant. 

Although there are a few different implant designs, they all include two pieces of metal screwed together. Over time, the forces of biting and chewing can cause these screws to work themselves loose. This is typically a issue on older implant designs, but can affect any generation.

Your best bet in solving this problem is returning to the dentist who placed the implant, or obtaining a record of what type of implant they used. This information is crucial in tightening the crown back down. Tools, hardware and design are not the same between companies and using incompatible components could ruin the implant.

After identifying the type of implant used, the treating dentist will evaluate wether or not the crown can be saved. Dental Implants are comprised of three components: the actual implant, an abutment, and an overlying crown. The abutment is essentially a metal post that the crown is screwed or cemented to. Depending on which part of the implant has failed, the entire crown may need to be removed to tighten everything back up. However, most crowns are savable and only need to be repaired or recemented once the procedure is over. If you would like to know more about implants or their maintenance, feel free to give us a call! 

What type of whitening is right for me?

In previous posts, we've discussed the many different tooth whitening products available on the market today. With all the choices, picking one that works for you can be a difficult task. In this article, we will categorize the many methods based on what they do best. Each type has unique advantages and disadvantages, so take a look!

Fastest method: In-office whitening. Products like Phillips Zoom are professionally administered and provide dramatic results in a single visit. A typical appointment is about 80 minutes and matches the results of months of over-the-counter bleaching. 

Cheapest method: Crest Whitestrips and similar products. Over-the-counter bleaching methods will whiten your teeth for the least amount of money. However, they work quite slowly. Expect to use them for weeks/months before you notice a difference. 

Most flexible method: Professional bleach trays. The trays are worn for one hour once a day for two weeks, followed by one day a month for maintenance. You will see fast results and be able to adapt to your own schedule. 

For patients susceptible to "whitening pain:" Professional bleach trays with 10% bleach. Whitening products cause pain because they contain an agent that opens tubules in the tooth to let the bleach in. In some cases the open tubules can cause sensitivity or a sharp "zinging" pain. For these patients, we prescribe a milder bleach along with a fluoride rinse that counteracts sensitivity. This combination seems to be gentle enough for even the most sensitive mouths!

For patients who "just want whiter teeth:" All of the above! Any of these methods will get you to a whiter smile. It's up to you to pick the best product for your specific needs. If you have any further questions, feel free to give us a call!

Types of Dental Whitening

Tooth whitening provides a quick and dramatic improvement to your overall smile. If you've done some research, you have probably found out that there are a number of products and services on the market today. Here is a quick guide to help you pick the best type of whitening for your specific needs!

Home whitening kits- All whitening products that work utilize some form of hydrogen peroxide. The main difference between an over-the-counter solution and something administered by a dental professional is the concentration of peroxide. Products like Crest Whitestrips will give you similar results to in-office whitening, but over a much longer time frame. Given you needs and expectations, this could be the perfect solution!

Whitening trays- These trays are made from a clear material like Invisalign retainers and are custom molded to your teeth. Since they prevent the peroxide from contacting your gums and cheeks, a higher concentration can be used. They are typically used once a day for two weeks, followed by one day a month for maintenance. 

In-office "Zoom" whitening- Here, whitening solutions are directly applied to the teeth under the supervision of a dental professional. The gums are blocked out using a special material and a very high concentration of peroxide is carefully applied to the teeth. The results are instantly noticeable and long lasting. This method achieves the same results as weeks of OTC whitening in about an hour and a half. 

"Mall Whitening" Kiosks- These stands (usually found in shopping malls) offer whitening services for rates somewhere in between home whitening kits and professional in-office whitening. However, the employees operating these stands are not dental professionals and generally cannot offer any products stronger than what you can buy over the counter. Your money is better spent either with a Whitestrip-type product or in an actual dental office. 

Whitening toothpastes, mouthwashes, floss, etc.- Just about every dental product nowadays advertises some sort of whitening ability. However, don't expect to see huge benefits. They are mostly aimed at surface staining, rather than the deep discolorations that cause yellow/ dark teeth. To get vibrant white teeth, you need to seek out a product that contains hydrogen peroxide. 

Natural whitening remedies- In general, whitening products that don't contain hydrogen peroxide (or some form of peroxide) won't really show any benefits. There are a number of instructions online, involving everything from strawberries to oil pulling, but it is unlikely that any of them will actually work. If you're looking to maintain a whiter smile naturally, cut back on pigmented liquids and drink with a straw when possible.

We hope you found our short run down on whitening useful. As always, if you have any questions, please give our office a call!

What About Mouthwash?

Mouthwash can be a great tool in achieving overall oral health. However, it is important to acknowledge why you are using it and pick a product that meets your goals. Many patients gravitate towards alcohol based products like Listerine Ultraclean and Scope. These brands are designed to fight against plaque and gingivitis with their antimicrobial properties. They are excellent choices for individuals with periodontal disease and inflamed gum tissue. However, these mouthwashes tend to be acidic and abrasive to tooth enamel.

We feel that the majority of our patients would be better suited with a fluoride rinse type of mouthwash like Act Rinse. These products are designed to strengthen enamel and interfere with decay-causing bacteria. While they may not have the satisfying "burn" of an alcohol mouthwash, they are definitely doing their job!

Using mouthwash for fresh breath? You might want to try a different tactic. Once the flavoring wears off, mouthwashes aren't particularly protective against bad breath. Your best bet is to target the smells at the source. Flossing and tongue brushing have been shown to be particularly helpful in approving mouth odors. If you have any other mouthwash related questions, be sure to give our office a call!

The Benefits of Xylitol

If you've ever had Ice Breakers gum, Spry mints or a hard candy from our office, you have enjoyed the benefits of Xylitol sweeteners. Xylitol is a natural sugar that is harvested from plants. While it tastes sweet like glucose, a slight difference in chemical structure prevents it from being digested by our oral bacteria. As such, foods with sufficient xylitol content can help prevent tooth decay!

When our mouth bacteria encounter typical sugars (glucose, fructose, cooked starches, etc.), their enzymes process it to make acid that causes tooth decay. However, xylitol interferes with these enzymes and stops the bacteria in their tracks. You will typically find xylitol in products like gum, mints and toothpaste, but it can be used to sweeten anything. Dr. John's candies are a great example of tasty, low calorie xylitol treats (try them at our office!). 

As with anything, enjoy xylitol in moderation! Too much in one setting can cause stomach aches and GI distress. Additionally, xylitol is poisonous to dogs, so make sure you keep it out of Fido's reach. If you have any other questions about xylitol or its benefits, don't hesitate to call our office!