My Blog

Posts for: August, 2014

By Eric G. Piascik, DMD
August 25, 2014
Category: Dental Procedures
Tags: teeth whitening  
HomevsProfessionalTeethWhitening-WeighingYourOptions

If you’re considering tooth whitening, you may be torn between using a home product and undergoing a professional application in our office. Here’s a brief comparison of both approaches to help you in your decision process.

It helps first to know what we’re trying to correct — that dull, discolored tooth stain. Tooth staining comes in two varieties: intrinsic, which occurs deep within the tooth and can be caused by aging, old root canal treatments, tetracycline antibiotic use or excessive fluoride intake during childhood development; or extrinsic, which occurs mainly on the tooth surface and is caused by substances like coffee, tea, wine or tobacco. Intrinsic stains can only be treated through an in-office procedure — the comparison we’re making between home and professional whitening refers only to extrinsic staining.

Whitening, then, is the use of a chemical agent to bleach those stains. The majority of both home and professional products use hydrogen peroxide or carbamide peroxide (which also contains hydrogen peroxide) as its primary bleaching agent. Depending on the application, either of these chemicals can effectively bleach extrinsically stained teeth. The two approaches differ, however, in the strength of the bleaching agent: home products usually contain a 10% or less concentration, while professional solutions usually contain between 15% and 35%. As a result, the home application takes longer than a dentist’s treatment to achieve desired results — two to three weeks as opposed to one or two office visits.

Whichever option you choose, remember teeth whitening isn’t a permanent solution. The brightness will fade over time — six months to a year if you restrict foods and habits that stain teeth. You can also receive a touch-up once or twice a year to help extend brightness.

There’s also a middle of the road option — you can use a home application with guidance from our office. It’s also a good idea to visit us for an examination beforehand — we can then advise you on what options will work for your particular type of staining and teeth condition.

If you would like more information on teeth 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 articles “Teeth Whitening” and “Tooth Staining.”


MarthaStewartShowsOffRenovationWork-InHerMouth

Martha Stewart has built a flourishing career by showcasing the things she’s designed and made — like floral arrangements, crafts, and even home renovations. Just recently, she was showing off her latest restoration project: a new dental bridge. In fact, she live-tweeted the procedure from her dentist’s office… and she even included pictures of the bridgework before it was placed on her teeth!

OK, it’s a departure from paper crafts and home-made pillows… but why not? We can’t help feeling that there’s just as much craftsmanship — even artistry — in dental bridgework as there is in many other custom-made items. If you learn a little more about what goes into making and placing bridgework, perhaps you’ll understand why we feel that way.

Bridgework is one good solution to the problem of missing teeth (another is dental implants). A fixed bridge is anchored to existing teeth on either side of the gap left by missing teeth, and it uses those healthy teeth to support one or more lifelike replacement teeth. How does it work?

Fabricated as a single unit, the bridge consists of one or more crowns (caps) on either end that will be bonded or cemented to the existing teeth, plus a number of prosthetic teeth in the middle. The solid attachment of the crowns to the healthy teeth keeps the bridge in place; they support the artificial teeth in between, and let them function properly in the bite.

Here’s where some of the artistry comes in: Every piece of bridgework is custom-made for each individual patient. It matches not only their dental anatomy, but also the shape and shade of their natural teeth. Most bridges are made in dental laboratories from models of an individual’s teeth — but some dental offices have their own mini-labs, capable of fabricating quality bridgework quickly and accurately. No matter where they are made, lifelike and perfect-fitting bridges reflect the craftsmanship of skilled lab technicians using high-tech equipment.

Once it is made, bridgework must be properly placed on your teeth. That’s another job that requires a combination of art and science — and it’s one we’re experts at. From creating accurate models of your mouth to making sure the new bridge works well with your bite, we take pride in the work we do… and it shows in your smile.

If you would like more information about dental bridges, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Fixed vs. Removable Bridges” and “Dental Implants vs. Bridgework.”


IbuprofenandSimilarPainRelieversEaseDiscomfortFollowingDentalWork

One of our primary goals in dentistry is to deliver effective treatment to patients with the least amount of discomfort. This is especially true after a procedure — controlling pain and inflammation will actually help reduce recovery time.

There are many strong pain relievers available, including prescription opiates like morphine or codeine. It has been shown, however, that healing and comfort are enhanced with non-steroidal anti-inflammatory drugs (NSAID) because they not only minimize pain, but they also reduce inflammation after a procedure. One common NSAID is Ibuprofen, which works by blocking prostaglandins, a substance released by inflamed, damaged tissues. NSAIDs are very popular with dentists and other health professionals because they act primarily on the inflammation site and don’t impair consciousness like opiates. They’re also usually less expensive than pain medication requiring a prescription.

While relatively safe, NSAIDs do have side effects that could cause serious problems for some patients. The most common caution regards NSAID’s tendency to thin blood and reduce the natural clotting mechanism, especially if taken habitually over a period of time. They can damage the kidneys and the stomach lining (causing ulcers or dangerous bleeding), and they’ve also been linked to early miscarriages and heart attacks.

For these reasons, NSAIDs are not recommended for pregnant women, patients with a history of stomach or intestinal bleeding, or patients being treated for heart disease. In the latter case, NSAIDs may interfere with the effectiveness of low-dose aspirin therapy (another type of NSAID) to prevent future heart attacks or strokes.

Health officials recommend all patients limit their dosage of a NSAID to no more than 2400 milligrams a day for short term pain relief, unless otherwise advised by a doctor. For the most part, a single 400 mg dosage is usually sufficient for pain control during a post-procedure recovery.

Your dentist will typically obtain your medical history before you undergo a dental procedure, including the medications you’re taking. Depending on your current health status and the type of procedure you’re undergoing, your dentist will recommend a pain control regimen to follow after the procedure is over.

Following those recommendations, and alerting your healthcare provider if you encounter any side effects from pain medication, will help assure your recovery period after dental work is short, safe and uneventful.

If you would like more information on the use of NSAIDs to control discomfort after a dental procedure, 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 “Treating Pain With Ibuprofen.”




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