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!

Duke's First Birthday: Update

Happy birthday duke!

We thought you would appreciate a quick update from Duke's birthday- a great time was had by all! As you can see, the birthday boy truly enjoyed himself on his special day. Happy birthday Duke- we hope every one is as great as this one!

Office Update: Lindsay

Remember this familiar face? Lindsay was a dental assistant at our office from to the summer of 2006 to the winter of 2009. She and her husband Sam then moved back to his home in the Gold Coast of Australia. This week, Lindsay took some time off from her current assisting job to visit friends and family back in California. She got to spend some time with Dr. Kari and meet Duke for the first time! Safe travels Lindsay!

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!

Greg and Maggie are Engaged!

Congratulations to Greg Hong (Dr. Kari's brother) and Maggie on their recent engagement! Maggie was a dental assistant at our office for many years until she moved with Greg to New York City to launch Reserve, a mobile app for fine dining. They are both doing great and on their way to a wonderful future. Best wishes from California!

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!

Happy Birthday Duke!

Duke will be turning one year old this week and already has 8 of his primary teeth! The American Academy of Pediatric Dentistry recommends that all children have their first dental visit by 12 months to ensure that development is continuing normally. If your youngster needs his first checkup, 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!

Case Presentation: Veneer Transoformation

This case is a great example of the amazing transformations that can be achieved using dental bridges! Today's patient came to us with significant decay on their upper anterior teeth and periodontal disease on their lowers. A thorough examination revealed that the teeth weren't savable and unfortunately needed to be extracted.

While the patient healed, our lab designed upper and lower bridges to replace the missing teeth. In this instance, bridges allowed us to provide permanently fixed and natural appearing restorations. There are no removable parts (as with dentures) and there was no need for surgery (as with implants). Overall, this solution created dramatic and life-changing improvement for this patient's smile!