Teeth Whitening

The popularity of teeth whitening has increased to the point where it appears that everyone is doing it. If you desire a radiant, white smile, bleaching your teeth may be a wonderful consideration. Not only is it effective, but it may also significantly alter your smile and boost your self-esteem. Only your dentist can determine whether or not your teeth and gums are healthy enough to undergo whitening dental services. Though teeth whitening is safe, it is safest when supervised. If you’re thinking of getting your teeth whitened, speak with your dentist to see which options are best for you, especially if you have sensitive teeth, dental restorations, dark stains, or lots of fillings and/or crowns.

Popular Methods for Teeth Whitening

• Whitening Toothpaste – To eliminate surface stains, teeth whitening toothpaste contain moderate abrasives. Although some whitening toothpaste contains extra polishing agents and specific chemicals that are more successful at removing stains than regular toothpaste, they are not designed to “bleach” your teeth. Whitening toothpaste can lighten your teeth’ color by a shade or two. On the other hand, prescription whitening at your dentist’s office can brighten your teeth by three to eight shades.

• Over-the-Counter Whitening Strips and Gels– Whitening gels are translucent, peroxide-based gels that are applied to the surface of your teeth with a tiny brush. Depending on the strength of the peroxide, different instructions are required and must be carefully followed. The duration of a full course is between 10 and 14 days. It’s possible that you’ll need to use them twice a day.
  
  Whitening strips are very thin, almost undetectable, and have a peroxide-based whitening cream on them. These over-the-counter whitening strips are relatively inexpensive, and simple to use, and most of them actually work. Depending on the concentration of peroxide in the strips, it may take longer to achieve the desired results than in-house whitening. For both gels and strips, the first results appear after a few days, and the final results last for roughly four months.

• Tray-Based Teeth Whiteners – Tray-based tooth whitening systems involve filling a mouth guard-like tray with a gel whitening solution that contains a peroxide-bleaching agent – this can be acquired over-the-counter or via a dentist. While both will whiten your teeth, there are some differences between them.
  
  Teeth whitening kits from the dentist provide faster and more effective results than over-the-counter whitening kits because they contain a stronger peroxide bleaching ingredient. Another advantage of dentist-provided trays and gels is that they are custom-made to suit your teeth perfectly. The tray is worn for a period of time, ranging from a few hours each day to every night depending on the degree of discoloration. The results of this method are usually very pleasing, and patients save the trays for future “touch-ups.”

• In-Office Whitening – Teeth whitening at the dentist is significantly faster than at-home whitening. Heat, light, or both can be utilized to speed up and improve the whitening results of professional therapy, in addition to the stronger peroxide solution used in dental clinics. The major advantage of in-office teeth whitening is the dentist’s care throughout your procedure. They will monitor to ensure nothing goes wrong or doesn’t work. Professional teeth whitening is more expensive, but the results show that you get what you pay for.

It’s Worth Getting Your Teeth Whitened at the Dentist

Because there is such easy access to teeth-bleaching products, long-term overuse has become an issue. Excessive bleaching has a variety of effects on your teeth, ranging from mild discomfort to outright pain. Hypersensitivity, gum inflammation, darker teeth, and erosion are all risks for patients who use at-home therapies. The intensity of over-whitening discomfort depends on the substance you’re using, how often you’re using it, and the state of your teeth before you start.

For your best results, schedule an appointment with My First Dental for a “whitening evaluation” to find out what system is best for you. If cost is the issue, our Dentists in Somerville and Medford can recommend the best low-cost or over-the-counter whitening system based on your circumstances.

Dentists Come in Many Forms

Different dentists treat specific challenges, much as doctors do. While any dentist can practice general dentistry, some choose to specialize in certain procedures. Braces and tooth alignment, pediatric dentistry, replacement dentistry, major dental surgery, and specialist gum care are examples of these procedures.

When it comes to dentists, there are seven different things to choose from. Let’s look at each of these types and how they give specialized types of dental treatments.

Dental Specialists and Associated Treatments

Regular visits to a general dentist are the best way to determine which expert will do the dental work you require. Routine oral exams help your general dentist detect potential concerns and, if necessary, refer you to a specialist. 

• General Dentists – They provide general dental care, such as dental cleanings and exams. They also offer emergency dental services, fillings, tooth restoration, crowns, bridges, and veneers. Oral cancer screenings and gum disease treatments are also conducted by general dentists.
• Orthodontists – Malocclusion is a disorder in which the teeth in the upper and lower jaws are not aligned properly, resulting in an under or overbite. Orthodontists specialize in treating malocclusion. Orthodontists use both fixed and removable appliances to realign teeth and adjust a person’s bite over time.
• Pediatric Dentist – Pediatric dentists are extensively trained to work with a kid’s growing teeth and jaw, as well as child behavior, physical growth and development, and special needs children. Tooth decay, tooth placement, crowding, crooked teeth, and missing teeth are all common problems they treat. Pediatric dentists assist in the prevention and treatment of tooth decay in children because they are more prone to it.
• Endodontists – Endodontists are experts in the dental pulp, blood vessels, tissues, and nerves that surround the root of a tooth. They’ve had extensive training in root canal therapy and dental pulp disease treatments. General dentists conduct two root canals every week on average, while endodontists perform over twenty.
• Oral Surgeons – Wisdom tooth extractions are the most common procedure performed by oral surgeons, especially when the wisdom teeth are impacted. They also do more difficult oral procedures, such as correcting misaligned jaws, face injuries from an accident, dental implants, TMD surgeries, bone transplants, and oral biopsies to check for oral cancer, in addition to these extractions.
• Periodontists – A periodontist specializes in problems with the gums, bones, and tissues that sustain the teeth. They concentrate on gum disease prevention as well as the treatment of gum disease and periodontal disease. These dentists collaborate closely with general dentists to help prevent gum disease and provide treatment strategies for those who already have it.
• Prosthodontists – Prosthodontists create oral prostheses to replace missing or damaged teeth, enhancing both appearance and function. Crowns, bridges, veneers, dentures, and implants are examples of oral prostheses. When treatment permits, prosthodontists collaborate with general dentists and endodontists to supply these dental appliances.
• Cosmetic Dentistry – Cosmetic dentistry treatments enhance a patient’s self-esteem by improving their smile. Cosmetic dentistry is practiced by many general dentists. To get qualified, they must complete further training after dental school.

Visit One of the Finest Dentists in Massachusetts

Somerville and Medford’s dentists treat unique dental issues, while general dentists may handle the most common dental issues. Knowing the various sorts of dentists might assist you in determining which one you require for the greatest dental care.

Our Somerville and Medford dental staff can help you meet with a general dentist, cosmetic dentist, periodontist, endodontist, orthodontist, oral surgeon, prosthodontist, or pedodontist. Please contact us to make an appointment for all of your dental needs.

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.”

Children’s permanent teeth normally erupt over several years after first forming below the gum line. All their permanent teeth should come in by the time they reach early adolescence.

Unfortunately, this process doesn’t always happen as it should. If the erupting teeth become crowded due to a poor bite (malocclusion), teeth still to come in may not have enough room to fully erupt. They become impacted, a condition in which the visible crown remains partially or completely submerged below the gum line.

Impacted teeth create consequences for other teeth and dental health overall. They more readily cause abscesses (a localized infection within the gum tissue) and can damage the roots of nearby teeth. Impacted front canine (eye) teeth can interfere with bite function and their visual absence mars an otherwise attractive smile.

If your child’s canine teeth have failed to erupt properly, there is a way to help them fully come in if you act before their mouth structure fully matures. The first step is an orthodontic evaluation of the entire bite. This will determine if there’s enough space to move other teeth to make room for the impacted canines.

If so, we would then find the exact position of the impacted teeth using x-rays and possibly cone beam CT scanning for a detailed three-dimensional image. The teeth could be in a variety of positions, such as angled toward the roof of the mouth or cheek or buried high in the jawbone. If the teeth are too far out of position the best course of action may be to remove them and replace them later with a dental implant.

If the impacted teeth, though, are in a feasible position for retrieval, we first expose each tooth through the gums with a minor surgical procedure and bond a small bracket to it. We then attach a small gold chain to the bracket that loops over an orthodontic appliance attached to other teeth. The appliance will exert pressure over several months to pull the tooth into the proper position.

If successful, your child will gain the use of these important teeth and a more attractive appearance. But don’t delay — this desired outcome will become much harder if not impossible to attain as their teeth and jaws continue to develop.

If you would like more information on treating impacted teeth, please contact us or schedule an appointment by calling us at (617) 623-8489 for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Exposing Impacted Canines.”

Have damaged teeth? Inlays and Onlays can help to protect your damaged teeth by restoring their functionality and strength. Dr. Farshad Ghobbeh at First Dental, which has offices in Somerville and Medford, MA, offers a full range of dental services. Read on to find out how inlays and Onlays work.

Dental Inlays Overview

An inlay is an indirect dental restoration consisting of a solid substance (such as composite resin, gold, or porcelain) fitted to a cavity in a tooth and bonded into place. An inlay fills the space in between the rounded edges (cusps), at the center of the tooth’s surface. Most inlays are more durable than dental fillings. They are also less expensive than dental crowns.

Dental Onlays Overview

Dental Onlays can be made from porcelain, composite resin, or gold. Dental Onlays are the same as dental inlays, except that they cover one or more cusps or the entire chewing surfaces of the damaged teeth. Because of this extensive coverage, onlays are referred to as “partial crowns.” Since the materials and the process of bonding are the same as you find with dental inlays, the longevity of a dental onlay is equally as impressive.

The Use of Inlays and Onlays

When your dentist suggests you need an inlay or onlay, it is likely due to a damaged tooth. If the tooth damage is not severe enough for a dental crown, your dentist can treat it with an inlay or onlay. Some dentists choose to replace old fillings with inlays or onlays to save the teeth from further damage.

The Inlay and Onlay Procedure

During your first visit, your Somerville and Medford dentist will prepare your damaged tooth. An impression of the tooth will be taken and sent to a laboratory, where the restoration will be fabricated. Your dentist will place a temporary filling to preserve the tooth while the final restoration is being fabricated. During your second visit, the temporary filling is removed and your onlay or inlay is placed. Once fitted, the restoration is bonded onto the tooth and the margins are polished.

If you need an inlay or onlay, why wait? We can help you today. Call First Dental today to schedule a dental appointment in Somerville, MA, (617-623-8489), or Medford, MA, (781-395-0300). We believe that everyone deserves a healthy, beautiful smile!

There are a variety of methods for treating periodontal (gum) disease depending on its severity — from routine office cleanings to periodontal surgery. But the goal behind all of them remains the same: remove bacterial plaque and calculus (tartar), the root cause of gum disease, from all tooth and gum surfaces.

The traditional method for doing this is called scaling in which we use special hand instruments (scalers) to mechanically remove plaque and calculus. Scaling and a similar procedure called root planing (the root surfaces are “planed” smooth of plaque to aid tissue reattachment) require quite a bit of skill and experience. They’re also time-consuming: full treatment can take several sessions, depending on how extensively the infection has spread.

In recent years, we’ve also seen a new method emerge for removing plaque: lasers. Commonly used in other aspects of healthcare, lasers utilize a focused beam of light to destroy and remove diseased or unhealthy tissue while, according to studies and firsthand accounts, minimizing healthy tissue destruction to a better degree than traditional techniques. Procedure and healing times are likewise reduced.

Because of these beneficial characteristics, we are seeing their use in gum disease treatment, especially for removing diseased and inflamed tissues below the gum line and decreasing sub-gingival (“below the gums”) bacteria.

Dentists who have used lasers in this way do report less tissue damage, bleeding, and post-treatment discomfort than traditional treatments. But because research is just beginning, there’s not enough evidence to say laser treatment is preferably better than conventional treatment for gum disease.

At this point, lasers can be an effective addition to conventional gum disease treatment for certain people, especially those in the early stages of the disease. As we continue to study this technology, though, the day may come when lasers are the preferred way to stop gum disease from ruining your dental health.

If you would like more information on treating gum disease, please contact us and schedule a consultation by calling (617) 623-8489 . You can also learn more about this topic by reading the Dear Doctor magazine article “Lasers Versus Traditional Cleanings for Treating Gum Disease.”

In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?

“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.

How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.

With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.

In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.

While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.

Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”

Dental implants can do more than replace individual teeth — a few well-placed implants can support other restorations like a fixed bridge. The natural integration that occurs between the bone and the implant’s titanium post creates a strong, durable hold for both implant and the supported restoration.

But if a bone-implant connection weakens, the implant could be in danger of failing. This can occur because of periodontal (gum) disease caused by dental plaque, a thin film of built-up food particles and bacteria on the teeth. Untreated, the infection can ultimately spread from the gums to the bone and cause it to diminish in volume. If bone loss occurs around an implant the threaded surface of the post may be exposed, inviting more plaque buildup. This can trigger more bone loss and eventually implant failure.

That’s why you must brush and floss daily to remove plaque on and around your fixed bridge just as you do your natural teeth. Brushing around a bridge could be difficult with a traditional brush, so you may want to use an interproximal brush designed for just such situations. Be sure any utensil you use contains only plastic parts — metal creates microscopic scratches in the restoration materials that could harbor plaque.

You should also floss between the bridge and gums and between any natural teeth. While this can be difficult with traditional flossing methods, there are some tools to make it easier.

One is a floss threader, a small tool with a loop on one end and a stiff plastic edge on the other. With floss threaded through the loop, you gently guide the edged end between the bridge and gums. Once it passes through, you wrap the two ends of the floss with your fingers as you would normally and work it along each side of the nearest implants.

You can also use pre-cut floss sections with stiffened ends to pass through the gap or an oral irrigator that loosens and flushes away plaque with a pressurized water stream. Just be sure you wash debris away from the gum and not toward it.

Keeping all surfaces of your implant-supported bridgework clean of plaque is necessary for longevity. Be sure you also visit your dentist regularly for more thorough cleanings.

If you would like more information on oral hygiene with dental implants, please contact us by calling (617) 623-8489 or (781) 395-0300 to schedule an appointment for a consultation.