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FAQ's

Whitening

Q. How can I get the yellow out of my teeth?

A. The first step is to get a professional cleaning and tooth polishing to remove superficial stains. This will help your dentist evaluate the type and amount of "real" discolouration present in your teeth. Then, an appropriate bleaching technique is recommended. Subsequent follow-up may be recommended to maintain your new tooth colour

Q. I have dark stains, what can be done?

A. A good cleaning in the dental office is a good start. Many times, the "home bleach technique" is most adequate and effective. If your teeth are very dark it may take up to three months at home.

Q. My old fillings in the front have turned dark. Can they be bleached?

A. Bonding and composite resin fillings do not bleach. Usually, polishing may help, but if not, you can have the surface of the fillings redone. Otherwise, it's time to replace with newer bonding or porcelain laminates for longer lasting results. Remember, only replace these fillings after bleaching in order to match the new, improved colour of your own natural tooth.

Q. How long does bleaching last?

A. Each person is different. It depends on many factors including your diet, the original colour of your teeth, and each individual tooth’s ability to absorb the bleaching products.

Q. Is there more than one way to bleach?

A. Yes. The in–office option is an external light source or new laser techniques. An at-home matrix or nightguard used with a carbamide peroxide gel will also bleach teeth.

Q. I have one dark tooth in the front. Will regular at-home bleaching make it lighter?

A. External bleaching may not help. Internal bleaching may be the solution if the tooth has had the nerve removed (root canal treatment). If not, consider bonding, porcelain veneering, or capping the tooth to mask the darkness.

Q. I have been smoking for years –– can my teeth be whiter?

A. Yes. Our external bleaching may or may not help. If not, the teeth can be covered with a light composite resin bonding or beautiful "stick on" porcelain laminates. However, continued heavy smoking will unfortunately shorten the longevity of any treatment result.

Q. Does a special whitening toothpaste really lighten teeth?

A. Most "whitening toothpastes" remove some surface stains, but they will not bleach the teeth as effectively as bleaching gels or solutions do that contain the bleaching agent carbamide peroxide. Even if the toothpaste does contain some bleaching chemicals, the length of time in which the paste is in contact with the teeth is insignificant compared with using a bleaching solution and a form fitted matrix or especially an in-office treatment. Also, these toothpastes may have harmful abrasives that can wear away tooth structure over time.

Perio

Q. I have a "gummy" smile . . . can anything be done?

A. Yes! Cosmetic gum raising and/or tissue sculpting is an excellent choice. Sometimes orthodontics can help, as well as orthognathic surgery. You need to get a consultation with a good cosmetically-trained prosthodontist / restorative dentist, periodontist, surgeon and an orthodontist. Your best bet is to visit a dental office that networks in a way that these specialists can work together.

Q. My gums have shrunk making my teeth look larger; what can be done?

A. Sometimes a gum graft can be done to cover sensitive roots and stop the downward progression of your gums. New techniques with little discomfort and great results are available. You may also need bonding, or other restorative treatment, as part of the treatment plan.

Q. There is a dark line on my tooth at the gum line –– what causes that?

A. Usually a metal margin on a crown or a dark root. Look for a dentist who makes crowns with "porcelain margins or all ceramic crowns." Visit the dentist to determine the exact cause and best solution.

Q. My gums bleed when I brush or floss. Is this normal?

A. No! A thorough soft tissue evaluation including x-rays, with a prophylaxis (cleaning) and good homecare instructions are an essential beginning. Usually bleeding is a beginning symptom of gingivitis or periodontal disease, and may require conventional gum surgery if necessary. Seek a dentist who can do different forms of treatment from simple cleaning of the teeth to antibiotic therapy, and, as a last resort, surgery.

Q. How often should I have my teeth cleaned?

A. Each person is different...twice a year is usual, but most patients need to have a professional dental cleaning every 3 to 4 months. Decay and gum disease are caused by bacteria in a colony that takes about 8–10 weeks to become destructive. This must be removed or broken up within this base period.

Q. Why do I need to have x–rays? Won’t they cause cancer?

A. X–rays show a variety of things not seen by a visual exam, including bone loss, tooth decay, impacted teeth, some tumors, and cysts. Most dental x–ray machines today are low dosage. For instance, an entire set of complete x–rays is equal to one conventional x–ray using 90% less radiation.

Q. My son chews tobacco –– will it cause cancer?

A. It sure can! Chewing tobacco has an even higher risk than cigarettes because of the concentration of tobacco. Chewing tobacco is a high–risk cancer producer.

Restorative

Q. My crown in the front doesn’t match my teeth –– it looks fake. What can be done?

A. This is the hardest thing to do in dentistry – match a single front tooth. Look for an excellent cosmetic dentist who works with a "master ceramist" in his or her office. Sometimes it is necessary to do more than one tooth. In that case, bonding or porcelain laminates might be the answer. Remember, it takes a great deal of artistry involved on the part of the dentist and ceramist.

Q. What’s a cap? What’s a crown?

A. A cap and a crown are the same thing. The entire tooth surface is reduced and usually replaced with artificial material such as porcelain or porcelain bonded to metal.

The soft tissue around the upper front teeth is inflamed because of ill-fitting crowns. These crowns were removed. Provisional crowns were fitted and gum treatment was done. The final crowns preserve the health of the soft tissue and give the patient a confident smile.

Q. I’ve lost a tooth. What can be done?

A. Today’s dentistry offers many options.

Q. What’s the difference between bonding and porcelain laminate veneers?

A. Bonding is a tooth–coloured plastic (composite) resin material and is done in one visit (little tooth reduction, no anesthesia required). Porcelain laminate veneers can mask dark stains better with less long–term chipping than bonding. They are made by a ceramist and do not stain, offering greater choice in colour, shape, and vitality. They do require only two office visits.

Q. What’s the difference in cost between bonding and veneers?

A. Generally bonding is 1/2 to 1/3 of the cost of veneers or crowns. Your best bet is to review the fee range and advantages/disadvantages for all procedures described in a book called Change Your Smile (Quintessence Publishing Company).

Q. How long does a bonding/veneer last?

A. On the average, bonding lasts three to eight years. Porcelain laminate veneers lasts four to twelve years or more.

Q. Why should I spend a lot of money on a root canal? Why not just pull the tooth?

A. Losing a tooth can be the beginning of many more lost teeth. Saving the tooth maintains space, keeps other teeth from shifting, and eliminates the need and cost of a bridge or implant and crown. Although seemingly expensive, it is actually quite cost effective.

Q. I have so many dental problems, sometimes I think I should just pull out all my teeth and get dentures.

A. To be able to wear a denture comfortably requires sufficient retention. Bone is invariably lost when teeth are pulled and then continues to reabsorb and shrink back, resulting in poor–fitting loose dentures. These consistently require remaking and never function as natural teeth. Taste, speech and overall functions are severely compromised. Most times, if even the root can be saved, a good dentist can give a patient good functioning and esthetically pleasing, long–lasting teeth. Today, dental implants used to anchor a denture add stability and are an ideal choice for most denture patients.

Q. I have a space between my two front teeth. How can it be closed?

A. There are several ways in which this can be corrected:

Q. My teeth are too small –– can I have bigger teeth?

A. Yes. it’s possible either with composite resin bonding, porcelain laminate veneers or full crowns if they break or are already broken. Have a consultation which will include a diagnostic wax–up to see how you can look with long or perhaps wide teeth.

Q. My "eye" teeth are too pointed. Help! I look like a vampire!

A. Cosmetic contouring or reshaping your natural teeth would be the best possible procedure for this. It only takes one quick, painless appointment to improve your look.

Q. My teeth are uneven, what can I do?

A. Cosmetic contouring, porcelain laminate veneers, orthodontics, bonding, or crowns can be used to correct this.

Q. I was hit in the mouth and my teeth are broken, chipped, and cracked. What can I do?

A. Translumination or an intraoral camera can be used to determine the extent of the cracks. Your possible choices to correct the problem would be:

Q. I have big dark silver fillings . . . can they be made tooth-coloured?

A. Yes. Possible tooth coloured replacement choices include:

Amalgam fillings replaced with porcelain inlays.

Q. My teeth stick out in the front. Are braces my only option?

A. No. Many times a compromise can be suggested after a cosmetic consultation.

Possible options include:

Keep in mind that orthodontics is usually the best choice for these situations.

Q. My teeth don’t show when I smile.

A. Orthodontics is your best bet –– the teeth can usually be brought down enough to show. However, at times orthognathic surgery may be suggested as well.

Bonding or porcelain laminate veneers or full crowns are a possible compromise.

The soft tissue around the upper front teeth is inflamed because of ill-fitting crowns. These crowns were removed. Provisional crowns were fitted and gum treatment was done. The final crowns preserve the health of the soft tissue and give the patient a confident smile.

Halitosis

Q. What can I do about bad breath?

A. It may be coming from your teeth or gums, but usually it's from bacteria colonizing on the back of the tongue. A comprehensive breath evaluation and bacterial culture can determine the best form of treatment. There are remedies available today to combat this problem. Mouth rinses (chlorine dioxide) and tongue scrapers help get rid of the bacteria that cause these odours.

Orthodontics:

Q. I’m in my 50’s. Am I too old for braces?

A. No. Many adults are choosing tooth-coloured ceramic braces which hardly show. A removable appliance may even work with certain patient problems. Orthodontics is usually the most cost-effective treatment because treatment means eliminating the cosmetic problem while retaining your natural teeth. Restorative treatment always has a "life expectancy" on any restorations, meaning you will have to continually pursue whatever treatment you choose.

Q. My chin recedes. Is there anything that can make me look normal, besides a chin implant?

A. My teeth are loose.

Q. Have a teeth cleaning (prophylaxis), full mouth x–rays, and periodontal probing to determine why they are loose. Chances are you will want to have a consultation with a periodontist to help determine the cause and develop a plan to treat the condition.

Q. My denture makes me look old and it doesn’t fit well. Is there anything that can be done?

A. The first step is to arrange for a cosmetic evaluation as your lipline (smileline) can be evaluated and proposed correction can be shown to you. This way you can be certain you will like the look of the new dentures. Implants offer a marvelous advantage.

The stability of a lower denture is greatly enhanced through the utilisation of implants

Implants

Q. I’ve heard about dental implants, what are they?

A. They are an excellent means of replacing missing teeth. The titanium implant osseointegrates (biologically binds) to the bone, and a full crown goes on top. The result is a natural looking secure means of replacing teeth.

Q. My dentist told me II’ve lost bone in my jaw. . . can it be re-grown?

A. Often the lost bone can be restored –– bony ridges can be augmented and even places where there is no bone can be improved considerably. These procedures are called "guided bone regeneration," or "bone grafts". Ask your dentist if you are a candidate.

Q. How do I know if I am a good candidate for implants?

A. An evaluation with diagnostic records and a CT–Scan which is a 3–dimensional type x–ray that accurately measures the amount of bone remaining to anchor the implants.

Q. How long do implants last?

A. Statistics indicate that they may last in excess of 35 years. Once successfully integrated with the surrounding bone, implants have a long–term potential as natural teeth, if properly taken care of.

Q. How long have implants been around?

A. The current cylinder type of titanium has been used in excess of 30 years. Implants were invented in 1957 in Stockholm, Sweden. They were then tested in the 1960’s and introduced in Europe and the U.S. in the 1970’s and early 1980’s. Implants are safe and provide for an excellent option for people with missing teeth.

Q. What is the success rate of implants?

A. Highly successful. Implants boast low infection potential, no rejection by the body, ninety-five to ninety–eight percent success rate for the lower jaw, and eighty–six to ninety–two percent success rate for the upper jaw. However, implants must be maintained by the patient with proper oral hygiene and frequent dental exams and cleanings.

Example 1

Implants have been used to support a lower full arch fixed reconstruction

Example 2

The missing premolar tooth has been restored with a single tooth implant. The integrity of the adjacent teeth has been maintained.

Example 3


This 18 year old girl was born with a missing lateral incisor. Orthodontic treatment was done to provide the correct space for the placement of an implant. A Maryland–bridge was used as an interim restoration. The final metal ceramic crown was constructed on the implant fixture and has produced a cosmetically pleasing result.

Example 4


This patient is a 40 year old female who lost her front teeth in a motor car accident. A multi–disciplinary approach to treatment which included implant dentistry has produced a beautiful smile and a very happy patient.

Example 5

Other Treatments:

Q. My jaw looks unbalanced / out of proportion. . . . Can anything be done for me?

A. Yes. Orthognathic surgery can be quite effective in correcting this condition.

Q. My jaw locks, pops, creaks or clicks.

A. This requires a visit to a dentist or oral surgeon who treats temporomandibular problems. Sometimes these problems require no treatment.

Q. I need a face lift and some dental work . . . which should I do first?

A. Do the dental treatment first and optimize your smile. That way, you will not have someone tugging on your lip or cheeks.

Q. My smile is crooked.

A. No problem. Although orthodontics is the ideal way to correct this condition, sometimes an alternative method using restorative treatment with bonding, laminating, or full crowns can make a pleasing result.