Posts for: April, 2012

By Dr. Hartmann D.D.S
April 28, 2012
Category: Dental Procedures
HowDoesToothBleachingWork

When you have your teeth bleached in a dental office, the results almost seem like magic. Let's push aside the magician's cape and see what is really happening in professionally-applied, in-office tooth whitening.

How do teeth become discolored?
A tooth's enamel covering is mostly composed of mineral crystals. At a microscopic level, you can see a framework or matrix of organic (living) matter interspersed between the crystals of enamel creating a very irregular surface capable of retaining stains. Chromagenic (color generating) organic compounds can become part of this organic matrix resulting in tooth staining. They can be bleached without affecting the mineral structure of the tooth's enamel.

As people get older and their teeth wear, the enamel loses its youthful translucency and the underlying layer, called dentin, thickens and becomes more yellow. Such changes to the actual tooth structure are called intrinsic staining. Other causes of intrinsic discoloration are exposure to high levels of fluoride or tetracycline antibiotic administration during childhood, tooth decay, or root canal problems, among others. Discoloration can also be caused by external staining from certain foods, drinks, or tobacco products. Such surface stains are called extrinsic staining.

Behind the Magic
Materials used for tooth bleaching are hydrogen peroxide and carbamide peroxide. Peroxides are commonly used as bleach, and you may have seen them used as hair bleaches, for example. Hydrogen peroxide is a strong oxidizing agent that attacks the organic molecules responsible for tooth discoloration, bleaching them until they lose their color. Carbamide peroxide also contains urea, which is a compound that permits the peroxide to remain in contact with the teeth for longer amounts of time without harming them.

Often called power bleaching, the in-office technique uses a high concentration of peroxide solution (35-45% hydrogen peroxide), placed directly on the teeth in the form of a gel. A heat or light source may enhance the peroxide release. The gel is applied with trays custom fitted to your mouth, and specific barriers are applied to protect sensitive gum tissue from the solution. Results show teeth becoming up to ten shades lighter in about an hour.

In-office bleaching under the supervision of my staff and me is recommended if you have severely stained teeth, and particularly if you are about to have veneers or crowns made. It's a way to rediscover the pearly translucency of your youthful smile.

Contact us today to schedule an appointment to discuss your questions about tooth bleaching. You can also learn more by reading the Dear Doctor magazine article “Teeth Whitening.”


By Dr. Hartmann D.D.S
April 20, 2012
Category: Oral Health
Tags: dentures  
TipsforMaintainingandCaringforYourDentures

Cleaning dentures is an important part of wearing them. However, did you know that recent research has revealed a link between denture hygiene and overall health? The evidence shows that oral bacteria have been implicated in chronic obstructive pulmonary (lung) disease, bacterial endocarditis (“endo” – inside; “card” – heart), generalized infections of the respiratory tract and other systemic diseases. While it is never our intent to frighten you, we feel it is important that we share some important tips on maintaining and caring for your dentures so that your oral health does not negatively impact your general health.

Our first tip focuses on fit, as denture slippage is an experience that anyone who wears dentures dreads. So if your dentures seem to slip or you have started increasing the amount of adhesive you are using to achieve the same level of denture retention that you had when first fitted, you need to make an appointment with us soon. Otherwise, an ill-fitting denture can cause discomfort, embarrassment and contribute to other oral health issues.

Next, we must focus on cleaning your dentures. It is critical that you clean your dentures daily. However, you should never use harmful or abrasive cleansers. Nor should you ever place your dentures into boiling water! The best method for cleaning is to soak them daily in a non-abrasive denture cleaner. And when you remove them, gently brush them with a soft-bristled toothbrush.

Our last tip concerns how long you wear your dentures each day. Even if your dentures are extremely comfortable — for example, you forget they are in — you should not wear them 24 hours a day. Why? Because you will develop a chronic yeast infection called, “denture stomatitis” due to stagnation that develops under dentures when the lubricating and antibacterial effects of saliva are impeded. Unfortunately, the constant pressure on the gum tissues caused by wearing dentures can accelerate jawbone loss over time. Give your mouth and tissues a rest by sleeping without your dentures in your mouth.

To learn more tips, continue reading the Dear Doctor magazine article “Top Ten Tips For Denture Care & Maintenance.” Or you can contact us today to schedule an appointment to discuss your questions.


DontLiketheDrillNowTheresDrill-FreeCosmeticDentistry

If you have a tooth that just doesn't look good because of decay or injury, a porcelain laminate veneer is probably a good way to make it look as good as it ever did — and maybe even better! Dental veneers are composed of thin layers of dental ceramic material. They essentially replace the original tooth enamel and require preparation of the tooth by removing a small amount of enamel to allow room for the placement of the veneer.

Recently, more and more dentists have been using minimal prep or prepless techniques that do not require this preparation. In such cases, the porcelain is bonded directly to the outer layer of the tooth's enamel. Highly skilled dental technicians can design a custom-fit veneer that feathers into the tooth just short of the gum line.

Prepless techniques cannot be used in all situations, but when they are used appropriately the results are beautiful and very stable. Should you get prepless veneers? The following is a list of advantages and disadvantages of prepless veneers.

Advantages of prepless veneers include:

  • Tooth preparation or reduction is not needed, leaving the original tooth whole.
  • They are not placed under the gum tissue, eliminating the possibility that the restorations negatively impact the gum tissue.
  • They can be used to change the appearance of teeth that are too small or misshapen making the teeth look larger and eliminate unwanted spacing.
  • They can be used to “lengthen” teeth that have been worn down by grinding.
  • Since the underlying tooth has not been reduced, prepless veneers are reversible and practically risk-free.

Disadvantages include:

  • There are many cosmetic situations in which they cannot be used, and traditional veneers (requiring preparation) must be used instead.
  • Prepless veneers cannot be used in cases in which orthodontic treatment is recommended to move the teeth, such as improper tooth position, poor bite, or a poor facial profile.
  • Since they are added on to existing tooth structure, they do not work for teeth that are relatively large or in a forward position in a smile.
  • They do not usually work for lower teeth because of space restrictions.
  • They cannot replace lost or damaged enamel.

Working with prepless veneers requires special skills and training. Please discuss our credentials and experience with us when you inquire about this technique. We can assess your specific situation and let you know whether restoration without the drill is appropriate for you.

Contact us today to schedule an appointment to discuss your questions about prepless veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Veneers Without the Drill.”


By Dr. Hartmann D.D.S
April 04, 2012
Category: Dental Procedures
Tags: root canal  
TakeaNewLookatRootCanalTreatment

The term “root canal” strikes fear into many dental patients. But rest assured that this procedure is the best solution to many severe dental problems. It can be pain-free and will actually relieve pain and suffering from infections and dental injuries.

Why would you need root canal treatment? This procedure becomes necessary when the pulp, the nerve tissue on the inside of a tooth's root, becomes inflamed or infected because of deep decay, or when it has suffered a severe injury as a result of an accident or blow to the mouth. The pulp is composed of living tissues including nerves and blood vessels.

Root canal treatment may be necessary if you have a wide variety of signs or symptoms. The pain can feel sharp or intense when biting down, or linger after eating hot or cold foods. Sometimes it can be a dull ache or there may be tenderness and swelling in your gums near the site of the infection.

After trauma, the pulp of a tooth can be exposed or damaged because a tooth has fractured or cracked, necessitating root canal treatment. And the procedure is often needed for permanent teeth that have been dislodged or knocked out.

What exactly is root canal treatment? Root canal treatment is also called endodontic treatment, from the Greek roots “endo” meaning “inside” and “odont” meaning “tooth.” During the procedure, the area is numbed to relieve pain. A small opening is created in the chewing surface of the tooth and very small instruments are used to remove dead and dying tissue from the inside. The pulp is needed during a tooth's growth and development, but a mature tooth can survive without it. The canal is disinfected and then sealed with filling materials. Sometimes root canal specialists use microscopes to work at an intricate level of detail on these tiny areas of the tooth's root.

By having root canal treatment, you prevent inflammation and infection from spreading from the root of a particular tooth to other nearby tissues. Infection can result in resorption, an eating away of the root and its anchoring bone, and you could lose your tooth or teeth. So please don't hesitate when we recommend this treatment. It's not as bad as you think, and you will feel significantly better afterwards.

Contact us today to schedule an appointment to discuss your questions about root canal treatment. You can also learn more by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Trauma & Nerve Damage to Teeth.”




Gina Piccioni, D.M.D. and John G. Hartmann, D.D.S.

River Forest, IL Dentist

River Forest Dental Studio

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