“Do I Have Gum Disease?”

Posted by drgracesun on February 7, 2009 under Healthy Smile | Be the First to Comment

Gum disease is silent – it creeps up on you slowly, gives no symptoms apart from little signs, and does not hurt – by the time you feel something, it could be very bad news!

Gingivitis , the first stage of gum disease causing inflammation around the gums affects over 50% of America’s population! See blood when rinsing your mouth after brushing? If so, you’ve got gingivitis. Bacterial biofilms, also known as plaque, as well as tartar adhere to tooth surfaces throughout the day. These bacterial substances build up in the small gaps between your teeth and produce toxins that cause the periodontal tissues like the gum and supporting bone to inflame. Over the years, this inflammation can cause deep pockets between the teeth and gums and loss of bone around the teeth, which is when gingivitis progresses to periodontitis. Gingivitis is reversible, but periodontitis can only be managed after treatment. Early detection, treatment and prevention is the key to save your teeth!

The loss of bone around the teeth can cause serious structure issues within the jaw; eventually leading to tooth loss. The signs of gum disease include red and swollen gums, blood appearing when brushing or flossing, mouth sores, bad breath, loose teeth and gum recession .

The causes of gum disease, besides the bacterial factors, are systemic and host resistance which needs to be revealed, such as stress, medication, hormonal changes, illness, bad habits (smoking, poor hygiene, poor diet), genetic history, etc… There are different approaches to treat the disease.

The mouth-body connection has been a hot topic for the past decade. We have learned about the association of gum disease with other chronic inflammatory conditions, such as diabetes, cardiovascular disease and alzheimer’s disease. Believe it or not, gum disease can even cause your physical health to deteriorate into a stroke, endangering a pregnancy.

So be kind to yourself! Treat those bleeding gums! Cosult with your dental professional. Treatments provided from a dental professional include cleaning up the “bad stuff” through deep scaling , root planning, laser gum treatment, medication applied locally or systemically, home care education and home care programs. Please take action to treat bleeding gums!

“How Long Will It Last? Bonding vs. Veneers”

Posted by drgracesun on January 30, 2009 under Beautiful Smile | Read the First Comment

“Does it hurt? How long will it last? How long will it take? How much does it cost?”

These are common questions from patients looking for cosmetic dentistry.

If you’re interested in cosmetic dentistry to get yourself a winning smile, whether the problem is mis-alignment, cracked or chipping teeth, unsightly spacing, uneven or dark colored dentition, uneven or too much (or not enough) smile showing, or even gum erosion, the eternal question always arises: What would be the best solution?

In the past, crowns were the primary choice for masking tooth problems, but since the late 1980s, cosmetic dentistry has offered both bonding and veneers to improve your smile. This leads to the eternal question: “Bonding or veneers?”

Dental bonding involves the application of a durable composite material directly to the surface of the tooth, by your dentist, which is then sculpted and artistically shaped to the exact look the patient desires, to blend naturally and seamlessly with the patient’s existing teeth. A laser (or high intensity light) is then used to cure the composite material, hardening and reinforcing it to the surface of the tooth. This bonding technique has many applications, not only for aesthetic uses but also for prosthodontics and pediatric dentistry. The advantages to dental bonding are a quick treatment time (can be completed in one office visit after a consultation), and a relatively low cost per tooth when compared with porcelain veneers. Durability of bonding will be affected by the oral environment. Since composite bonding is a mixture of quartz particle (70% – 80% filled) and resin, discoloration and breakage is inevitable if your mouth has a high acidic pH value (if you are a soda drinker, lemon lover or candy sucker), if the bonding was not supported by a solid tooth structure, or if you are a night grinder.

Porcelain veneers are fabricated in the laboratory. They are 100% filled with hard mineral particles, and are fired at a high temperature with a vacuum (to procure the best physical properties to sustain the veneer’s strength in the harsh oral environment). Compared to bonding, there is more procedural work involved with porcelain veneers. There are different techniques to fabricate the veneer pieces (which call for different methods of preparation for the tooth); the pressing technique produces a stronger veneer, but requires 0.8mm thickness of the veneer. The porcelain powder build-up technique can produce super thin veneers (0.3mm), which produces a very conservative look on your tooth structure, while at the same time keeping a natural silhouette. The veneer piece lays on top of the tooth structure and is similar to a press-on nail. They chemically adhere to the tooth with bonding composite cement; since porcelain is acid resistant and stronger in physical properties than composite material, this restoration provides long-term service. When getting the veneers, the first visit consists of preparation and imprints f the teeth (which might involve anesthetic ). After this, you will leave the office with temporary veneers which look like natural teeth. A wafer-thin veneer is then crafted out of porcelain which is seamlessly cemented to the front side of the tooth on the second visit. In addition to straightening teeth, porcelain veneers can close gaps between teeth, whiten teeth that do not respond well to bleaching , and can also be used to protect damaged tooth surfaces. The advantages to porcelain veneers over bonding is that veneers are much longer lasting (and stronger) than composite bonding material.

Whether you decide to invest in dental bonding or porcelain veneers, make sure you have all work done at a reputable dentist, preferably at a practice which has its own in-house ceramic lab. When ceramic work is done by an in-house lab with an in-house ceramist, any changes that need to be made to the length or color of the veneers can be done without requiring an additional office visit. Remember, the result of the cosmetic procedures are truly varied depending on the ability of the dentist, ceramist, your clinical situation and the communication between all parties involved. Do your research!

Both bonding and veneers are additive procedures, depending on the position, alignment and shape of your teeth, which is the foundation for any new restorations. This foundation will need to be in the right fundamental situation to receive restorations to result in a fabulous smile. In other words, sometimes, you do not need to do much to your own teeth before applying cosmetic restorations. It might be necessary to reduce or modify the tooth structure before anything can be added onto it to make it look perfect.

There is some risk involved with cosmetic bonding or veneers, so be cautious with any cosmetic procedure. A comprehensive evaluation of your present dental condition is absolutely necessary as a first step; blue prints of your teeth and of your prospective dental project are needed to establish clear verbal communication between all parties involved (including you), including possible mock-up or wax-up models to preview possible changes, which could avoid costly mistakes.

Do your homework: finding the right dental professional, discussing every aspect of your dental needs, understanding the pros and cons of each procedure, and making an educated decision will ensure you get the smile you’ve always wanted.

“Why Do I Grind My Teeth?” (Bruxism)

Posted by drgracesun on January 27, 2009 under Healthy Smile, Information | 3 Comments to Read

When I examine a patient’s mouth,  I often inform them “You have been grinding your teeth at night! If  you’re grinding at night as well,  please take a vacation – doctor’s orders!” We laugh, then get serious about what was just said. Common responses from patients include:

“How do you know that I grind my teeth?”

“Why do I grind my teeth?”

“I sleep with my mouth open; I do not grind my teeth!”

“Yes, I know, but I do not want to wear a night guard !”

Let’s have a discussion.

Teeth grinding is a multifactorial phenomenon, it can originate from bite problems, posture problems, stress, diet or even certain oral medications. You may experience one or multiple symptoms of night grinding, including sensitive teeth, receding gums, teeth chipping, teeth movement, flat teeth, broken teeth, damaged dental restorations (such as fillings), and even headaches and a sore jaw .

Usually, during the day, there is space between your upper and lower teeth – the teeth are not in contact, they come in contact only when they are being used to chew food. Eating food exerts approximately 5 – 10 pounds per square inch of loading force. This is normal and will not create wear and tear issues in the tooth structure. At night however, during sleep, facial muscle contractions (like the Masseter muscle) generate a much greater force, anywhere from 300 to 500 or even up to 1000 pounds per square inch of force! This is very powerful, and very destructive.

So how do we fix the problem? Management of night grinding can be approached from several angles. By wearing a night guard, immediate protection is provided when sleeping. The design of the night guard can be as simple as a thin coat of silicon rubber material which is custom-molded to fit over your teeth, or can be highly specialized to help realign your jaw when made from acrylic. Ask your dentist about this.

Grinding your teeth at night (bruxism ) occurs during the REM (Rapid Eye Movement) cycle of sleep, for light sleepers. If restful sleep can be induced, the REM cycle of sleep can be reduced, contributing to a more peaceful night for your mind and also your body (including your facial muscular system). This means less grinding!

Achieving restful sleep can be tricky, there are many techniques: meditation to clear your mind in preperation for a restful night of sleep, deep and slow breathing, and cutting out sugar and caffeine in the PM hours will all be helpful.