Wow – 2009 really flew by! As this year draws to a close and another prepares to bloom, take time to reflect on your life and plan for a better future. Did you do well taking care of yourself this year? Could you do better? What is your new year’s resolution? Being happy with our dental health should be one of our top priorities for 2010. It’s up to us to control our future! Have fun and be safe this new year!
Holidays are a joyful time for friends and family, filled with good food and great memories. During this happy time you must remember to take care of your oral health, not only during the feast but beforehand as well! Since most dental offices close for the winter holidays (some for up to two weeks!), it is a good idea to get a checkup before the holiday – especially if you have any pain or sensitivity.
With regards to holiday staining of your teeth, as I have previously mentioned in a wine blog, white wine has an acid content that tends to increase the risk of stain or darkening of your teeth, if combined with other habits of drinking tea, or similar dark beverages. Do not be fooled by the crystal clear appearance of a white wine – they are certainly capable of dulling your teeth. Both whites and reds are equally capable of staining teeth. Certain acidic properties present in wine (white, red or rose) create micro-porosity etching which rough the surface of your teeth, making your teeth much more susceptible to stains from other foods.
If you were to drink a glass of white wine with a red meat sauce, the acidic properties in the white wine could make your teeth more prone to staining from the red sauce in your meal, or the cup of tea after the dinner! Red wine is still more “dangerous” to the pearly opalescence of your teeth than white, however, as it contains pigment molecules known as chromagen, which will stain your teeth. All wines contain tannins, which act as a binding protein, aiding chromogen to saturate upon the surface of the tooth. Just remember to brush and floss after every meal, especially during the holidays!
When you do drink acidic liquids or eat sugary foods, be sure to rinse your mouth with water. Brush and floss twice daily, and after meals – oral hygiene should be routine to avoid problems. Prevention is the most powerful form of self defense from oral health problems!
Apart from keeping your teeth beautiful and pearly-white, remember not to over-do the quantity of the foods you eat during over the holidays. Lean proteins (like turkey and chicken), veggies (like green beans and yams), fruits (like pumpkin and cranberries) are all delicious in moderation – the Christmas ham could be a bit much (taste everything)! Don’t forget the pumpkin or pecan pie for desert! Holiday meals don’t have to be boring and bland to be healthy; sample everything in moderation. Have a happy and safe new year!
People ask me all the time whether they should have laser bleaching to whiten their smile. “It all depends on whether you are in a hurry to get your teeth whitened, and whether or not you are a candidate for tooth whitening in the first place” – my typical response! The benefits of laser bleaching over an over-the-counter home solution include instant results, a painless experience and a completely guided procedure. If your teeth can benefit from teeth whitening, at-home tray bleaching techniques will work for most people unless their teeth are sensitive, eroding, severely worn or if they have gum recession. If you do have severely discolored teeth, a combination of laser bleaching and home bleaching would be the best approach to obtaining and maintaining a bright and dazzling smile.
Laser bleaching utilizes laser light energy to accelerate the chemical reaction of a bleaching agent, typically a hydrogen peroxide base product. Hydrogen peroxide is very unstable in response to light and heat (which is why over-the-counter 3% hydrogen peroxide solution is stored in opaque dark brown bottles). Because of this, light energy can excite peroxide molecules, breaking the covalent bonds of the bleaching agent. The agent then reacts to and breaks the long, discolored molecule chains into shorter-chained molecules, lightening the tooth color. The bleaching agent used with laser bleaching is a high-strength solution when compared to home bleaching agents or over-the-counter kits. Your mouth will be protected with an isolator to protect the oral tissues , and placement of the bleaching agent is done in a very controlled manner by a highly trained dental professional. Once a 10-to-15 minute bleaching cycle is complete, the teeth will be cleaned and evaluated to discern whether additional applications of bleaching agent will follow. Normal bleaching procedures involve three applications of the bleaching gel, with an “instant average” of six shades of whiteness typically resulting. Laser bleaching is instantly gratifying. In my office, you can watch a movie through virtual i-glasses while the procedure takes place, and before your movie is finished your teeth will have been transformed into a younger, prettier and whiter smile!
Many different types of lasers (or light) are used for eliciting fast chemical reactions in teeth whitening. Some people will experience more sensitivity when infrared energy (heat) is utilized, which appears in most dental offices, but a few alternatives like Argon or KTP lasers (which emit blue and green light) exist. These lasers have the correct level of energy required to excite the bleaching gel, but they leave the teeth cool and comfortable. Most sensitivity is transient, and should subside within a day (Ibuprofen will be helpful if there is any available). After a smile has been bleached with a laser, one must be very careful to maintain his or her newly brightened smile lest the brilliant white color fade and dull over time. Alcohol, soft drinks and smoking are all bad habits which can stain teeth and regress any laser bleaching process. A healthy diet will also be beneficial for your physical and oral health. If you take care of your mouth, your reward will be apparent with a happy and healthy smile.
Antibiotics help us fight infections, however certain antibiotic medication could dim your smile! When taking antibiotic medications, it is important to realize that these types of medications not only eliminate harmful bacteria, but also affect the body by disturbing the balance of our gastrointestinal system. Sometimes the chemical components of antibiotic meds can leave deposits in the hard tissues of the oral cavity, like in the tooth and bone, affecting the color of the teeth.
Staining from the antibiotic tetracycline.
It has been well established that commonly prescribed antibiotics like tetracyline, if taken during the second half of the pregnancy can affect the future teeth of the fetus. Children younger than eight years old with prescription tetracycline (for treating ear infections) can have seriously discolored teeth as well from chemical deposits on the inner layer of the tooth structure (dentin), causing grayish brown bands that are not so easy to correct. Discoloration is usually a consequence of the chemicals affecting the developing stage of the teeth. If any discoloration is noticed in a child with primary teeth, promptly speak with your doctor or dental professional! Review the child’s history to determine whether the discoloration could possibly be associated with any medications, diet or even drinking water. Discoloration of erupted permanent teeth has also been proven to result from antibiotic use, as discussed in an earlier edition of the Journal of the American Dental Association. Although this is fairly rare, discoloration can happen to nearly anyone taking tetracycline, erythromycin, minocycline, or rinses containing chlorhexidineantiseptic solution. Keep your dental professional informed as to your antibiotic regiment.
In Kentucky, a 25-year-old woman whose teeth were gray-streaked from use of antibiotics was highlighted in a study completed by Frederick M. Parkins, D.D.S., of the University of Louisville School of Dentistry. The patient took two years of tetracycline therapy for teenage acne. She had been taking minocycline (brand name Minocin), a synthetic form of tetracycline and now has very discolored teeth (see above picture). Thankfully, only about 3-6% of adult antibiotic users will experience tooth-staining. Discoloration can develop as early as one month after the antibiotic regiment begins, but the staining could take years to appear!
Prevention is always the best solution – avoid teeth staining medications. If staining does occur, speak with your dental professional about options to whiten affected teeth. Procedures such as in-office or take-home whitening and bleaching will be the first conservative treatment option available to you before porcelain veneers or bonding procedures, which work well at masking over discolored areas of teeth.
The American Dental Association (ADA) has given its golden seal to brand name fluoridated toothpastes for their cavity fighting features. It’s no surprise really – topical use of fluoride has been proven to be effective at inhibiting tooth demineralization, promoting remineralization and inhibiting the growth of bacteria associated with tooth decay. Fluoride is marketed in the US as a bone fortifier and is administered at the dentist’s office for nearly all pre-adolescent teeth cleanings. Finally, the idea of fluoridated water may seem like a great thing to add to your new child’s water, because it fortifies teeth – but beware! What isn’t so well known is that the potential toxicity of fluoride is dangerous, and if swallowed in concentrated form or ingested over a longer period of time, it may have potentially damaging side effects.
In 1977, The Institute of Medicine (IOM) specified adequate intakes of fluoride of 0.01 mg/day for infants through 6 months, 0.05 mg/kg/day for children beyond 6 months of age, and 3 – 4 mg/day for adults, to prevent dental caries. Upper limits (UL) of 0.10 mg/kg/day in children less than 8 years old and 10 mg/day for those older than 8 are recommended for prevention of dental fluorosis. Similar levels have been endorsed by the American Dental Association (ADA, 1994) and the American Dietetic Association (ADA, 2000). What does this all mean? Fluoride has an affinity for calcified tissues. The trace amount of daily intake of fluoride is beneficial, but too much of it can result in patchy or mottled looking teeth, known as dental fluorosis (or brittle bones, known as skeletal fluorosis). Studies are needed for health researchers to investigate the relationship between intake levels and human health. 75% of our daily fluoride intake is from water or beverages, like tea and juices.
The fluoride content of a water supply is often described by the term ‘parts per million’ (ppm). 1 ppm = 0.1 milligrams of fluoride per 100 milliliters of water. About 1 ppm seems to be the optimal level of fluoride for a drinkable water supply; a litre of such water would provide 1 milligrams of fluoride. At 2 ppm, mottling of tooth enamel may occur. The actual condition of ‘fluorosis’ or excessive deposition of fluoride in bones is only present after prolonged consumption of 20 to 80 milligrams of fluoride per day.
Repeated exposure to fluorine in naturally-occurring forms (such as in fruits and other produce) is one thing, but overexposing your child to fluoridated baby formula (identifiable by needing to add water to the formula) could put your child’s appearance – and bodily health – at risk. The key take-home message for parents is to avoid added fluoridated liquids or even foods of any kind. No level of fluoride is perfectly safe, and ideally, we wouldn’t need to use it at all – however, fluoride’s teeth strengthening properties, when used in proper doses, can be a beneficial additive.
If your child does develop dark-spotted or mottled teeth after getting his or her primary teeth, pay close attention to their diet! Nutrition should be strictly monitored for fluoride ingestion (including toothpaste!) – if so, he or she should have perfectly clear, spotless permanent teeth erupting around age 5. Experts also agree that it is a good idea to test the water from your home water lines, to see if it is overly fluoridated. Simple take-home tests are available from your local water or health bureau, or can often give past and current fluoride level readings. Do your research to protect your child’s and your health.
Have you ever felt sick, taken some Pepto Bismol and then a while later, had a black tongue? You may be thinking you’ve eaten something strange, or that you are having an allergic reaction! This is actually not a rare side effect of Pepto Bismol however – read on to find out why your tongue is black!
Black Tongue is harmless.
Numerous brands of nausea medication, including Pepto Bismol, have an active ingredient called Bismuth subsalicylate, a multi compound drug useful in treating nausea, heartburn, indigestion, diarrhea, and other temporary discomforts of the stomach and gastrointestinal tract. In a tablet form, Bismuth subsalicylate is meant to be swallowed with water – however, when exposed to the surface of your tongue (from chewing), the drug will often turn the tongue black after several hours, and can last several days. A black tongue and black stools in some users of the drug is not harmful, but the color is produced as a side effect of the drug interacting with saliva and the gastrointestinal tract.
The good news is this discoloration has no adverse affect on your health; there is nothing to worry about if your tongue has gone black or if it is staining your teeth with black strips after taking Pepto Bismol. The stain can be removed easily by thorough brushing or seek help from your dental professional. If a thorough brushing was followed after taking the Pepto Bismo, the staining issue would be eliminated. You must be aware of your body if you have a upset stomach in the first place; getting a good assessment and managing the root of the problem rather than just masking the symptoms should be the overall, long-term goal. Maintain a healthy diet, full of fruit, vegetables and lean proteins to control the PH of your body (which should be neutral or mild alkaline). Getting 7-8 hours of sleep every night will ease and equip your body to deal with the stress. If you do have an upset stomach, have a cup of peppermint or chamomile tea with honey on me, which will help with your upset stomach. We can all work on respecting our body and mind to take better care of ourselves.
Respite with Chardonnay, sip the stress away! It’s carefree time. On the other side of the coin, white wine can also make your cosmetic dentist frown for your dulling smile. We are talking about the tooth stain effect from white wine – what’s that, you ask? White wine stains your teeth? You probably are already aware that certain foods can cause staining and discoloration to your teeth – but many foods or beverages without a strong or dark color (which look innocent) can still cause stains on your teeth.
White wine can stain your teeth - just like red wine!
A new NYU study shows white wine has an acid content that tends to increase the risk of stain or darkening of your teeth, if combined with other habits of drinking tea, or similar dark beverages. Do not be fooled by the crystal clear appearance of a white wine – it certainly is capable of dulling your teeth. Certain acidic properties present in wine (white, red or rose) create micro-porosity etching rough the surface of your teeth, which make your teeth much more susceptible to stains from other foods. For example, if you were to drink a glass of white wine with your spaghetti dinner, the acidic properties in the white wine could make your teeth more prone to staining from the red spaghetti sauce in your meal, or the cup of tea after the dinner beside your wine! Red wine is still more “dangerous” to the pearly opalescence of your teeth than white, however, as it contains pigment molecules known as chromagen, which will stain your teeth., but all wines contain tannins act as a binding protein, which will aid chromogen to saturate themselves upon the surface of the tooth.
Sodas and other beverages like ice tea and cocktails can wreak havoc upon your teeth as well, and not just the color! Stringent acids or sugars (turned into acids) present in most sodas (and acidic fruit juice, like lemonade) are the worst type of liquid to expose your teeth to, and can cause tooth erosion and tooth decay. A bleaching effect of phosphoric acid in the soda can also weaken your bone in addition to their staining properties. If you must drink any of these liquids, be sure to brush and floss after every meal – or at the very least, rinse your mouth or have a glass of water. Do not allow your oral environment stay in an acid bath! If you can feel astringency or drying of the mouth, drink some water and rinse your mouth before brushing to prevent rubbing the acid into your teeth.
Please enjoy your glass of wine, just be wise about the consequences! Yes, we can still keep your healthy and clean looking smile if we keep up the good oral hygiene habits. You can always consult with your dental professional for tips.
If your eyes are the gateway to your soul, your smile is the gateway to your heart. There are many factors that contribute to a beautiful smile in my line of work, but teeth whitening is one of the simplest ways to give your smile a brighter, whiter lease on life.
When we are children, our deciduous teeth (baby teeth) are bright, white and full of life – that is, until they fall out and are replaced by permanent teeth. From this point onward, our teeth are exposed to a multitude of conditions which endanger the white enamel surface of the tooth. Foods, dark liquids such as tea, coffee, red wine and caffeinated beverages, smoke and even some prescribed medication can all cause your teeth to loose their whiteness. A history of dental trauma can also cause tooth discoloration, which would require a different approach to reach the desired whiteness. Generally speaking, the teeth bleaching only applies to oxidizing normal tooth enamel. Whitening will not change the color of any dental restorations, and should not be used on darker root structures of the tooth or with tetracycline staining. Sometimes, cosmetic procedures such as porcelain veneers or bonding would be a better solution, in which case a consultation with your dentist would be necessary.
There are two ways to whiten your teeth: with whitening kits, and laser whitening (power bleaching). Over-the-counter kits to whiten teeth are sold both at your local pharmacy and from your dentist’s office. Custom fitted kits sold from your dentist’s office include retainer-like trays which are made from custom impressions of your teeth, whereas over-the-counter varieties are not as effective. The active ingredient breaks down into hydrogen peroxide, which oxidizes the stain deposits in the enamel of your teeth. Application is done for a few hours per day, for one to two weeks. The advantage to whitening kits is that you can keep your impression trays for future use, and only have to buy the whitening gel again. Regular dental check ups are necessary to make sure your teeth are healthily receiving the bleaching process.
Laser whitening is the method to whiten teeth I use in my office. Employing the use of an argon laser enables fast, painless and safe whitening of the teeth without potentially harmful UV damage, or heat which can irritate the pulpal tissues of the teeth. Arc lamps, a more common light-based whitening treatment, use energy that comes in a wide range of electro-magnetic waves, which could cover from the UV range into the infrared (heat) range, which could pose a health risk. Also, arc lamps can cause pulpal inflammation, leading to heightened gum sensitivity. The laser whitening process takes about 1 hour, providing instant gratification of the whitening results and the convenience of minimum work at home.
For the best teeth whitening results, I usually recommend my patients use a combination of in-office laser whitening, and usage of our take home kit, allowing for touch-up treatment by the patient at the convenience of one’s own time and own place. Once the desired bleaching result is reached, with proper care, it can last up to 3 years. If touch-up bleaching is needed, the time investment is extremely low (almost instant).
Remember, your smile is the gateway to your heart! Let it shine!
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