Brushing and flossing every day are important for preventing dental disease. The object is to remove as much bacterial plaque, the thin biofilm most responsible for disease, from your teeth and gums as possible.
But how do you know your hygiene efforts are that effective? You can of course do the “tongue test” â?? feel your teeth with your tongue after brushing and flossing and see if they feel smooth and “squeaky” clean. We can also give you a “report card” at your regular cleaning appointment. There is, however, a more precise way you can find out at home by using a plaque disclosing agent.
A plaque disclosing agent is a formulation that when applied to the teeth will temporarily dye any bacterial plaque present a distinct color. While dental hygienists occasionally apply them, they’re also available over the counter for use at home. They’re usually found in a solution, tablet or swab form in various flavors.
To use the product you first brush and floss, then swish the disclosing liquid around in your mouth for about 30 seconds before spitting it out (or chew the tablet or apply the swab as directed). The agent will react with any remaining plaque and dye it a bright color. There are even two-tone agents available that can differentiate between old and new plaque and dye them different colors.
Examining your teeth in a mirror will give you a good idea where you need to concentrate your attention when brushing and flossing. If, for example, you see dyed plaque more along the gum line and less in other places, then that’s where you should focus your hygiene efforts.
While the dye will eventually wear off on its own, you should take the opportunity to brush and floss again to remove any remaining dyed plaque. Not only does this provide a more thorough cleaning at that moment, you’ll also get a better sense of how “thoroughness” feels for future brushing and flossing.
It’s always good to know how well you’re doing with your dental hygiene efforts. A plaque disclosing agent can give you just the right feedback to help you improve.
If you would like more information on proper oral hygiene habits, 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 “Plaque Disclosing Agents.”
It takes a lot of skill, experience, talent and artistry to create tooth restorations that look so natural that no one can tell them apart from the originals. To do so requires understanding of the normal anatomy of a tooth as well as of the interactions of light and color.
How the anatomy of a tooth determines color
The color that we perceive when looking at a tooth results from the combined appearance of the tooth’s center core (dentin layer) and its covering enamel. Going from the outside in, the enamel is made of tightly packed crystals of calcium, which cause it to be one of the hardest substances naturally produced by animals. The crystals are also responsible for a tooth’s brilliance and translucence. The dentin is more like bone, a porous living tissue composed of microscopic tubes, interspersed with more calcium crystals. In the very center of the tooth is a central chamber containing the pulp and nerves.
Each of these layers has its own physical and optical properties. Since the enamel is translucent and the dentin is more opaque, most of the tooth’s color comes from the dentin and is transmitted through the enamel layer. Factors that affect this transmission include the thickness and age of the enamel as well as external tooth whitening.
If the enamel is more translucent, more of the color of the dentin shows through. If it is more opaque, the enamel absorbs and reflects light so that less color is visible and the enamel looks brighter.
The language of color composition and reflected light
Color means the whole spectrum in the rainbow. The spectrum is made up of the three primary colors — red, blue, and green. When all are combined, they create white light.
Hue refers to the brightest forms of the colors. The color we perceive depends on the dominant wavelength of light that is reflected by an object.
Value refers to a color’s lightness or darkness. A brighter color has a higher value.
Chroma is the amount of identifiable hue in a color. An achromatic color (without hue) appears gray.
Saturation is a measure of a color’s intensity.
This terminology of color is used not only by dentists and dental technicians, but also by a wide range of artists. It implies expertise and understanding of how colors work, how they vary and change and affect one another.
Contact us today to schedule an appointment or to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor article, “Artistic Repair of Front Teeth with Composite Resin.”
You’ve invested a lot of time and money in orthodontic treatment to improve your smile. If you’re not careful, though, your teeth could actually move back to their old positions. The reason why is related to the same natural tooth-moving mechanism we use to straighten teeth in the first place.
Teeth are held in place by an elastic, fibrous tissue called the periodontal ligament lying between the teeth and the jawbone and attaching to both with tiny collagen fibers. The periodontal ligament allows for incremental tooth movement in response to pressure generated around the teeth, as when we chew (or while wearing braces).
Unfortunately, this process can work in reverse. Out of a kind of “muscle memory,” the teeth can revert to the older positions once there’s no more pressure from the removed braces. You could eventually be right back where you started.
To avoid this, we have to employ measures to hold or “retain” the teeth in their new positions for some time after the braces come off. That’s why we have you wear a dental appliance called a retainer, which maintains tooth position to prevent a relapse. Depending on what’s best for your situation, this could be a removable retainer or one that’s fixed to the teeth.
Patients typically wear a retainer around the clock in the immediate period after braces, and then eventually taper off to just nighttime wear. Younger patients must wear one for several months until the new teeth positions become more secure and the chances of a rebound diminish. For older patients who’ve matured past the jaw development stage, though, wearing a retainer may be a permanent necessity to protect their smile.
Retainer wear can be an annoyance, but it’s an absolute necessity. Think of it as insurance on your investment in a new, more attractive smile.
If you would like more information on improving your smile through orthodontics, 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 “The Importance of Orthodontic Retainers.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
You may not be nervous at all about visiting the dentist. But put yourself in a child’s place — a routine dental visit could be an anxious experience for them, and even more so if it involves dental work.
Dental professionals recognize this and go to great lengths to make children’s visits as pleasant as possible. It’s common among pediatric and family dentists to see child-friendly exam rooms and a well-trained staff experienced with interacting with children.
While this helps, some children still struggle with anxiety. Dentists have one other technique that can ease a child’s nervousness: conscious sedation. This technique involves the use of pills, inhaled gas or intravenous drips to help patients relax.
Sedation is different from general anesthesia, which uses drugs to render a patient unconscious so they won’t experience pain. A sedated patient remains in a conscious but relaxed state: they can still breathe independently and, with the most moderate form of oral sedation, be able to respond to touch or verbal instructions.
Oral sedation may also be accompanied by other methods like nitrous oxide gas that also aid with physical discomfort. Many drugs used often have an amnesiac effect — the patient won’t remember details about the procedure, which could contribute to less anxiety in the future.
Typically, a child receives an oral sedative just before the procedure. Most drugs are fast-acting and leave the child’s system quickly afterward.Â A staff member monitors their vital signs (pulse, respirations, blood pressure, etc.) during the procedure and after in recovery. They’ll remain in recovery until their vital signs return to normal levels and then be able to go home. They should stay home the rest of the day under adult supervision, but should be alert enough the next day to return to their normal activities.
Relieving anxiety is an important tool to ensure your child receives the dental care they need. It also creates a positive experience that could encourage a young patient to continue regular dental care when they reach adulthood.
If you would like more information on conscious sedation for children, 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 “Sedation Dentistry for Kids.”
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