Posts for: June, 2015
Whether performed in a dental office or using a home kit, teeth whitening applications are quite effective for bleaching exterior (extrinsic) stains on enamel surfaces. But what if your discoloration comes from inside the tooth? In this case, extrinsic teeth whitening won’t work — you’ll need to undergo an “internal bleaching” method, which can only be performed in a dentist's office.
There are a number of causes for “intrinsic” staining, including too much fluoride exposure or tetracycline use during childhood. One of the more common causes, though, occurs from root canal treatments used to remove the remnants of the pulp tissue inside a tooth’s pulp chamber and root canals. Certain cements used during the procedure to help seal in the filling material and leftover blood pigments can cause the tooth to darken over time.
To alleviate this discoloration, we use a bleaching agent, usually sodium perborate mixed with a diluted solution of hydrogen peroxide to achieve a safe, accelerated color change. After determining that the root canal filling is still intact and the bone is healthy, we create a small cavity in the back of the tooth to access the pulp chamber. The chamber is cleaned of any debris or stained material and then thoroughly irrigated. The original root canal filling is then sealed off to prevent leakage from the bleaching agent.
We then place the bleaching agent in the cleaned-out space with a cotton pellet and seal it in with a temporary adhesive. This step is repeated for several days until we achieve the desired shade of white. Once that occurs we then seal the dentin with a more permanent filling and then restore the cavity we created with a composite resin bonded to the enamel and dentin.
If we’re successful in achieving the desired color, intrinsic whitening could help you avoid more costly options like veneers or crowns for an otherwise healthy and attractive tooth. The end result would be the same — a beautiful smile without those unsightly stains.
If you would like more information on treating internal tooth stains, 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 “Whitening Traumatized Teeth.”
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”