My Blog
By Steven R. Gluck, D.D.S.
June 07, 2012
Category: Dental Procedures
CommonQuestionsAboutWhiteningYourTeeth

Teeth whitening is a great way to improve your smile. For best results and to ensure your safety, teeth should be bleached under professional supervision. We can help you choose the whitening method that's right for you, and monitor the effects of your treatment. Here are some answers to frequently asked questions about this relatively inexpensive cosmetic procedure:

Is teeth whitening safe?
A lot of research has been done on teeth whitening, so we know that specific bleaching formulas, from a reputable source, are safe if used as directed and after a proper dental examination. You should be aware that tooth sensitivity is a common side effect of bleaching, but brushing with a desensitizing toothpaste containing potassium nitrate for two weeks prior to bleaching can reduce sensitivity. Using potassium nitrate during the bleaching process can also help.

Is it effective?
Professional bleaching is very effective. Peroxide goes through tooth enamel (the outermost layer) and the dentin (middle layer) to the pulp (the innermost layer) in 5 to 15 minutes. The bleach actually changes the color of the enamel and dentin, and removes stains.

How is teeth whitening done?
Basically there are three options: in-office whitening (done by a dentist), at-home bleaching with custom-made flexible plastic trays (with prescription bleach), and over-the-counter (OTC) products. Not all OTC products are equal, and the results will take longer to achieve than with professionally supervised procedures.

How long does it take?
That depends on what method you choose and, in the case of at-home whitening, how conscientious you are about following through with your course of treatment. One study found that a six-shade change required either: three in-office applications of 38% hydrogen peroxide; one week of 10% carbamide peroxide used at home nightly in a custom-made tray; or 16 daily application of 5.3% hydrogen peroxide on a whitening strip.

Will it last?
It really depends on the individual. No bleaching method can whiten teeth permanently, though some people's teeth remain white for over 10 years with no touch-up treatment. More typical results vary from six months to two years. Keeping up with your regular oral hygiene routine at home and your professional cleanings at the dentist's office will help maintain the results; so will avoiding tobacco and beverages that stain, such as red wine, tea and coffee. You can also consider a bleaching touch-up once or twice a year at home or here at the dental office.

I want to go for it! What's the first step?
Step one is a pre-bleaching dental examination to determine the cause of your tooth discoloration. We want to make sure that your discoloration is not the result of an oral health-related problem. For example bleaching will mask but not resolve issues such as abscessed teeth, decay, and root canal problems. We want your teeth not only to be beautiful, but healthy, too!

If you are interested in learning more about teeth whitening, please contact us today to schedule an appointment for a consultation. For more information on teeth whitening, please see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Tooth Whitening Safety Tips.”

By Steven R. Gluck, D.D.S.
May 30, 2012
Category: Dental Procedures
VeneersNotJustforWoodworking

You may have heard the term “veneer” with reference to woodworking, where it means a thin layer of attractive wood that covers and enhances the surface of a piece of furniture. Exactly the same principle applies to porcelain veneers used in dentistry: A thin layer of ceramic material is used to cover parts of a tooth in order to improve its structure and appearance.

Porcelain is a non-metallic ceramic material that is fired in an oven at a high temperature to make it hard and durable. Dental porcelain veneers are thin layers of ceramic that can be applied to the outside of the tooth so that the end result mimics the natural color and translucency of tooth enamel. The underlying tooth structure has to be prepared by removing a small amount of the enamel, about 1 mm, which the veneer replaces. The veneer is then bonded to the prepared surface using a light-sensitive resin.

In woodworking, a veneer may be used to match the grain between the left and right sides of a piece of furniture, creating a beautiful effect on a curve, or simply to bring the appearance of expensive wood to a backing that is less expensive.

Just as a wood veneer improves the appearance of a dresser or table, porcelain laminate veneers may be used to improve teeth that have a number of cosmetic and functional problems. These include staining that cannot be removed by tooth whitening, teeth that are too small, misshapen, chipped or spaced too far apart. After an assessment of your teeth and your smile, we can create a mock-up using temporary tooth-colored materials so you can decide whether the suggested changes will work for you, or you can make suggestions for further improvements.

Porcelain laminate veneers may not be the best solution for you if your teeth are severely stained or damaged. In cases where a large proportion of the original tooth must be replaced, porcelain crowns may be the best solution. The crown is the part of the tooth that is visible above the gum line, and it can be covered with a porcelain crown that looks exactly like a tooth in shape and color. After studying your needs, together we can decide on the most satisfactory method to restore your most attractive smile.

Contact us today to schedule an appointment to discuss your questions about porcelain veneers. You can also learn more by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”

NotJustFillingintheGapsLostTeethHaveUnexpectedConsequences

Why is it important to replace missing teeth with restorations such as dental implants? You might be surprised to find that the damage caused by missing teeth is much greater than the simple gaps left in your smile.

As the years go by, teeth lost early in adulthood cause structural changes in a person's face. By age 45 changes in facial structure are already visible in the form of sunken cheeks. By 60, cheeks and lips lose their support, resulting in an aging look. This process continues and if the teeth are not replaced, much of the structural support of the person's face is lost.

These changes are caused by loss of bone. Although it may seem static, bone is actually living tissue that needs constant stimulation to maintain its form and density. With normal stimulation it is in a constant state of resorption (breaking down) and deposition (building up). Teeth provide the needed stimulation for the bone that surrounds them (called alveolar bone) as they meet each other during biting, chewing, and speech. When the stimulation continues, the bone continues to rebuild itself. Without this stimulation, the bone resorbs, does not build up again, and loses substance.

Without stimulation, alveolar bone loses width, height, and volume. Since your teeth and their surrounding bone support your chin, cheeks, and lips, this has a powerful effect on your appearance. It may also affect your ability to chew and to speak.

As alveolar bone diminishes, the next layer of bone also begins to resorb. This is the bone of the jaw itself. The lower part of the face begins to collapse, and the cheeks become hollow. This effect is especially noticeable for people with no teeth (edentulous).

Usually the first tooth to be lost, due to infection and decay, is a molar (back tooth). In the past, a missing single back tooth was frequently replaced by a fixed partial denture (FPD). A crown is provided for each of the two teeth on the sides of the gap, called abutment teeth, to support a false tooth in the middle. However, if they are not well cared for, the abutment teeth may be the next to succumb to decay.

Today the treatment of choice is an implant. A dental implant is a tooth-root replacement made of titanium, which fuses with the bone — making it very stable. Above the gums it is covered by a crown that looks like a natural tooth. The benefit of the implant is that it continues to provide stimulation to the alveolar bone, preventing bone loss.

Implants are also a good choice in the case of multiple missing teeth. They can be used to support bridges or false teeth (dentures). The results are an improved, younger appearance and better functionality.

Contact us today to schedule an appointment to discuss your questions about missing teeth. You can also learn more by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

By Steven R. Gluck, D.D.S.
May 14, 2012
Category: Oral Health
LearntheSignsofPeriodontalDisease

Periodontal (gum) diseases are sometimes called “silent” because those who have them may not experience painful symptoms. But certain signs point to the existence of these common diseases. If you are experiencing any of the symptoms below, it is time to visit our office so these problems can be treated before they lead to serious infection and loss of teeth.

Gums that bleed during the brushing of teeth. Some people think that gums bleed from brushing too hard. In fact, healthy gum tissues will not bleed with normal brushing. The usual cause of bleeding gums is an accumulation of dental plaque in the areas where your teeth meet your gums. Plaque is a film of bacteria, called a biofilm, which accumulates on your teeth. If you are not brushing and flossing effectively, plaque irritates your gum tissues and causes an inflammation and swelling called gingivitis. This causes your gums to bleed easily on contact with a toothbrush or floss.

Gum tissues that appear red and swollen. If plaque is allowed to accumulate for 24 hours or more, the inflammation in your gum tissues becomes chronic. The continuous presence of bacteria makes it impossible for your body's natural defenses to fight the infection. Chronic inflammation leads to a breakdown of the normal attachment between the teeth and the gums, causing the formation of “pockets.” Inside these pockets the infection continues to attack the tissues that support your teeth. Eventually this can lead to a breakdown of the bone that surrounds your teeth.

Bad breath. Bad breath is another sign of accumulated plaque. The bacteria in plaque may emit gases that have an unpleasant odor.

Gums that are sensitive to hot or cold. Chronic inflammation can also cause the gums to recede, exposing the roots of the teeth in which nerves may be close to the surface, leading to sensitivity to heat and cold.

Teeth that are getting loose, or a painful area in the gums. If you experience these symptoms, the infection has progressed a long way from the “silent” stage. It is time to seek immediate professional help.

If you answered “yes” to any of the above questions, a professional dental examination is in order. With daily removal of plaque by effective brushing and flossing, along with frequent professional cleanings to remove any plaque that you were unable to catch, you will go a long way to preventing periodontal disease. Also, be aware that smoking tends to mask the effects of gum disease. Generally, if you smoke your gums will not bleed when brushing or flossing, nor will they show signs of swelling.

Contact us today to schedule an appointment to discuss your questions about gum disease. You can also learn more by reading the Dear Doctor magazine articles “Bleeding Gums” and “Warning Signs of Periodontal (Gum) Disease.”

DentalInjuriesTheTypeOfSportsYouPlayReallyMatters

When it comes to sports, all athletes need to know how to assess their risk for experiencing a sports-related injury as well as how to prevent one. The first step to accomplish this is learning how sports and activities are classified, as they define risks from little-to-no chance of injury to highly susceptible for injuries. These categories include:

  • Low velocity, non-contact sports: These sports and activities have the lowest risk, as they typically include sports where the athletes perform individually at reasonable speed without physical contact. Examples include: golf, Nordic skiing, weight lifting, running and swimming.
  • High velocity, non-contact sports: These sports and activities are those where athletes move at high rates of speed but with no contact with other participants. While there is no contact, anytime you are moving at high rates of speed, accidents can happen. Examples include: bicycling, motocross, skateboarding, skiing and snowboarding.
  • Contact sports: As the title states, these sports and activities include frequent body-to-body contact or body to equipment (e.g., a ball, glove, etc.) contact. Examples include: basketball, soccer, lacrosse, baseball and softball.
  • Collision sports: With these sports and activities, strong, forceful, body-to-body or body-to-equipment contact is a primary goal of the sport. Examples include football, ice hockey, rugby, and boxing. Without the proper protective head and mouth gear, participants are highly likely to experience an oral-facial and/or head injury.

The good news is that you can dramatically reduce the odds of serious dental and oral-facial injury by ensuring that you wear a professionally made mouthguard in addition to a helmet, facemask, or other protective gear that is appropriate to the sport. This is especially true if you participate in the high velocity, contact and collision categories. These simple steps can help reduce worries for not only players, but also for parents, caregivers and coaches. For more information, read, “An Introduction To Sports Injuries & Dentistry.” You can also download a FREE, pocket-sized guide for managing dental injuries.





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