Posts for: April, 2016
Home whitening kits are a popular way to turn a dull smile into a dazzling one. But these self-applied products only work for teeth with outer enamel stains — if the discoloration originates inside a tooth, you’ll need professional treatment.
Known as “intrinsic staining,” this type of discoloration most often occurs within a tooth’s pulp or dentin layers. There are a number of causes like tooth trauma or tetracycline use at an early age. A root canal treatment used to remove infection from deep within a tooth can also cause discoloration: sometimes blood pigments left after tissue removal or the filling materials themselves can stain a tooth’s interior.
Intrinsic staining can often be treated by placing a bleaching agent, usually sodium perborate, into the tooth’s pulp chamber. But before undertaking this procedure on a tooth that’s undergone a root canal treatment,Â we want to first ensure the filling is intact and still adequately sealing the tooth from infection. We also want to make sure the supporting bone is also healthy.
If all’s well, we access the pulp in the same way as the root canal treatment, and preferably through the same access hole. We then clean out the pulp chamber of any stained matter and then ensure the root canals remain filled and sealed off from the pulp chamber.
We can then place the bleaching agent into the pulp, a process that will need to be repeated every three or four days to achieve the desired level of brightness. After each session we place a cotton pellet over the opening and held in place with a temporary adhesive; we can easily remove and re-apply this covering during subsequent sessions. Once we’ve achieved the desired color change, we seal the tooth with a permanent filling and restore the access cavity with a tooth-colored composite resin material bonded to the enamel and dentin.
There are other options for an intrinsically stained tooth like veneers or crowns that outwardly cover the discoloration. Internal bleaching, however, is a more conservative approach that causes less alteration of the tooth. If successful, it can restore a stained tooth to a brighter, more attractive shade.
If you would like more information on internal bleaching, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Whitening Traumatized Teeth.”
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.