Having a whiter, brighter smile can do wonders for improving self-confidence, career opportunities, and interpersonal relationships, as demonstrated in numerous scientific studies. In fact, according to a poll conducted on behalf of the American Academy of Cosmetic Dentistry (AACD), the following was revealed:

• 99.7% of Americans believe a smile is an important social asset.
• 74% feel an unattractive smile can hurt chances for career success.
• 50% of all people polled were unsatisfied with their smile.

These statistics demonstrate why you should have a solid understanding about any cosmetic procedure — even teeth whitening — before making your decision to proceed. To help you ensure that you have the facts, we created the following list of questions.

• Am I a good candidate for tooth whitening?
• How much will the entire process cost?
• Does my insurance cover the cost (or any portion of the cost)?
• How does teeth whitening work?
• Is bleaching teeth safe?
• Will the bleaching agents damage tooth enamel?
• Can whitening treatments make my teeth sensitive?
• How does your professional bleaching differ from home whitening?
• What type of bleach and strength will you use?
• How long can I expect the results to last?
• What will the bleach do to my gums, filings, crowns, veneers, and/or bridgework?

Please note that we may cover most or all of these questions during your initial consultation; however, we encourage you to bring this list with you to ensure you get the answers you need so that you can make the best decision. To learn more now, continue reading the Dear Doctor article, “Teeth Whitening: Brighter, Lighter, Whiter....” Or, you can contact us to discuss your questions or to schedule an appointment.

As the Baby Boomer generation moves into its 60s, more and more of us are concerned with looking younger. We do it with vitamins, diet, exercise, makeup, cosmetic surgery, and yes, even with cosmetic dentistry.

In recent years we have learned a lot about how aging affects the soft tissues and bones of your face. This has led to an approach to orthodontics that considers not only the teeth and jaws, but also the continuing growth of the bones and soft tissues of the face.

We used to think that growth stopped when people reached their late teens or early 20s. However, recent studies have shown that some kinds of growth continue throughout a person's lifetime. Your bones and facial structures change as much between the ages of 25 and 42 as they do between 18 and 25.

As you age your facial profile flattens, your nose becomes more prominent, the lower part of your face becomes shorter, and your lips become thinner. By studying these changes we have learned to consider them when planning orthodontic treatment. Modern orthodontics treats the entire face, not just the teeth.

The science of orthodontics is dedicated to slowly moving the teeth within the jaws to better functional and aesthetic positions, using standard braces or clear aligners. Sometimes the upper and lower jaws are so far out of alignment that more extreme treatment is needed. In such cases orthognathic (from ortho, meaning straight and gnathos, meaning jaw) surgery may be required to achieve the best results. Orthognathic surgery was once considered a drastic procedure, but it has become easier to manage during and following surgery and is now considered a more normal treatment option, like a facelift. Since the nose becomes more prominent as part of the aging process, the surgery is sometimes combined with rhinoplasty, or reshaping of the nose.

This new approach to orthodontics and cosmetic dentistry — taking into consideration the normal changes that occur as a person's face ages throughout life — requires teamwork among a general dentist, an orthodontist, and an oral surgeon. The results are a long-lasting change that holds back the clock on aging.

Contact us today to schedule an appointment to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Understanding Aging Makes Beauty Timeless.”

If you don't like your smile when you look in the mirror, or feel self-conscious because your teeth are discolored, there are a variety of whitening procedures that can help you obtain the smile of your dreams.

Choosing the Right White: With strips, trays and toothpastes all claiming to be the best tooth whitening systems, it can be hard to choose how to whiten your teeth. Our office can help you decide the best approach based on your individual needs, time constraints and budget. Whiteners may not correct all types of discolorations.

Whitening in Our Office: This procedure is called chair-side or professional bleaching and may require more than one office visit. Each visit may take from 30 minutes to one hour. We use an in-office whitening gel that is professionally applied to your teeth and activated by a light source, giving you significantly whiter teeth in less than an hour. Typically, teeth with a yellowish hue respond best to whitening.

Whitening Your Teeth at Home: If you are an adult who practices good oral hygiene and doesn't suffer from periodontal disease, our office can help you decide whether an at-home whitening system, or having your teeth whitened in our office best meets your needs. If you decide to go with an at-home system, you will wear a custom-made whitening tray that looks like a thin, transparent night guard. You fill the tray with a mild whitening gel and need to wear the gel filled tray for a specified period of time each day (per our office's instructions). This procedure must be continued over a period of time that generally extends from 2-4 weeks.

Whitening Products Found in Stores: If you are considering over-the-counter whitening products we can also recommend products that will offer you the best results. Whitening toothpastes that have the American Dental Association (ADA) Seal of Acceptance contain special chemical or polishing agents that generally provide some stain removal effect.

Contact us today to schedule an appointment or to discuss any questions that you may have regarding teeth whitening. Read more about this topic in the Dear Doctor magazine article “Teeth Whitening.”

While the long-term success rate for a dental implant is well over 95%, there are factors that can compromise their success. For this reason, our office has put together this list so that you can be prepared should you ever need a dental implant. We feel that by providing our patients with this type of easy-to-understand information, we can educate, address any concerns and help produce the best results.

The three most common categories for classifying factors that influence dental implant success are: general health concerns, local factors and maintenance issues. As you may suspect, general health concerns include factors such as:

• Whether or not you smoke or use tobacco products.
• Certain prescription and over-the-counter medications you are currently taking or have recently taken.
• If you have or have a family history of osteoporosis (“osteo” – bone; “porosis” – sponge-like).
• If your medical history includes any cancer or radiation treatment to the jaws.
• Or if you have a compromised immune (resistance) system.

The second category is “local factors” and includes bone quantity and quality — there must be sufficient bone to anchor implants. Other considerations that fall into this category include whether or not you clench or grind your teeth or have additional bite concerns, as all of these can have negative impacts on both the short and long-term success of an implant.

The last category concerns maintenance. While dental implants are superior works of technology that can last a lifetime and produce results that are nearly identical to natural teeth in looks and durability, they do require routine maintenance. This includes daily cleaning (brushing and flossing) and routine visits to our office for evaluation and professional care to make sure they are functioning properly.

To learn more on this subject, continue reading the Dear Doctor magazine article “Factors which can influence implant success.” You can also contact us today to schedule an appointment to discuss your questions about dental implants.

A veneer is a thin layer of dental ceramic tooth-colored restorative material, usually made of porcelain, which replaces some of the tooth's enamel and is physically bonded to it.

You might want to consider porcelain veneers:

10. If your teeth are severely discolored. (For best results we may recommend that your teeth be whitened before veneering them.)
9. If your teeth cannot be evenly whitened or matched by other means.
8. If your teeth are misshapen or worn, you can change their size or shape for optimum aesthetic appeal.
7. If you don't want to have your teeth prepared (drilled), prepless veneers may be an option to change your smile.
6. If you want as little natural tooth structure prepared as possible to improve your smile.
5. If you would like something temporary first to “test-drive” your new smile, then:
4. “Provisional veneers” allow you to try out your new smile and give us feedback before the final permanent veneers are placed.
3. If you want to improve your smile for just one tooth or even multiple teeth.
2. If you want long-lasting restorations — veneers can last from seven to twenty years or more.

And the top reason is:

1. Porcelain laminate veneers are among the most aesthetic ways to create a more beautiful, yet normal, looking smile.

Tell us what you want to change about your current smile, and we can tell you whether veneers are right for you. Contact us today to schedule an appointment or to discuss your questions about cosmetic dentistry. You can learn more by reading about porcelain veneers in Dear Doctor magazine.

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.”