Orange County's Oral Health

Teeth Whitening at Home

2008-12-29T08:26:00.000-08:00

STORY BY
Erika Hargrove

When all your friends tromped to their dentists to have their teeth whitened, you thought that absurd. Not for wanting blinding smiles, but for bothering to—and paying for—dental appointments, handmade bleaching trays...well, that's what drugstores are for.
Right there on Aisle 8 sit zillions of Advanced Tooth Whitening Systems! Each one more Advanced! than the other. Oscar-winning smiles from the comfort of your couch.
But experts at The University of Texas Dental Branch at Houston are siding with your wiser friends. In short: until you've talked to your dentist, don't try this at home. It could save your teeth—or your life.

Bite the Bullet–Call Your Dentist

Joe C. Ontiveros, D.D.S., M.S., director of esthetic dentistry at the UT Dental Branch, lent credence to the controversy and concerns dentists are now having about over-the-counter (OTC) whitening products and their possible connection to oral cancers and other serious oral diseases. The concern about these products stems from peroxide's known capability of producing free radicals, which have been implicated in various biological consequences, Ontiveros said.
“The foremost reason to see your dentist before bleaching is to have an oral exam performed. The dentist can determine the cause of discolored teeth, screen for periodontal disease, check for decay, assess the condition of existing restorations and identify any exposed roots,” he added.
If you have tooth or gum sensitivity, your tooth roots might be exposed from receding gums. Bleaching can make it worse.

The concentration of certain chemicals in tooth whiteners can also vary from product to product, causing potential damage and susceptibility to cancers and disease. Individuals can be protected from overexposure to these chemicals by a dentist who can monitor the levels and adjust the whitening procedure appropriately.

Kathy O'Keefe, D.D.S., M.S., clinical associate professor at the Dental Branch, who also works in private practice in Houston , acknowledges that one of the possible dangers to the at-home systems are the one-size-fits-all bleaching trays that simply cannot keep the bleaching product from leaking into the mouth.

“At a dental office, an impression is made of the patients' teeth first, so when the tray is made, it wraps around the teeth and therefore the bleach stays in the concentrated area,” she says.
Another reason to make that appointment is that some people will not get that blinding white smile no matter what product they use—particularly those with tetracycline stains that run through the entire tooth. In those cases, porcelain veneers, crafted by an esthetic dentist are used. And those patients with veneers cannot use OTC bleaching products because the chemicals will change the surface of the veneer.

Addicted to Whiter White

Researchers also have found that consumers often can't resist the desire for whiter teeth, leading to abuse of over-the-counter products. O'Keefe says her office has a built-in system that helps to prevent such behavior. “We only sell two boxes of bleach at a time,” O'Keefe says. “This way we can monitor how much the patient uses.” Jessica Neff, a senior manager in development for a large over-the-counter tooth whitening company, says she went through a period where she tried products that were painful, damaging, inconvenient or just simply ineffective.
Neff admits that she was a “victim” of the whitening craze that boomed about five years ago. Addicted to “whiter than white,” Neff says “I was constantly going from one system to the next, looking for the best way to brighten my smile, until I finally realized I was ruining the substructures of my teeth.”

Neff now uses the product she promotes, a topically-applied whitener designed by a New York esthetic dentist. And even though Neff believes her product is a safe, revolutionary system, she says the company still recommends consulting a dentist before use.
Brown Teeth and First Impressions Tooth whitening is recommended by job recruiters, dating services, meddling grandmothers and both men's and women's magazines as the easiest, most cost-effective way to make one personal change that will catapult a first, second and third impression.

“Procter and Gamble completed a study regarding tooth brightness and appearance. An overwhelming majority (90 percent) of these surveyed viewed people with whiter teeth as healthier and more attractive,” Ontiveros says. “Many people feel this may influence professional advancement and personal relationships.” Neff says that a recent report by Mintel, a supplier of product and consumer intelligence, showed that there are largely more females, along with 18-24 year olds, concerned about oral appearance issues, such as whitening.
For that reason, researchers say, these groups will be watched more closely when evaluating the possible connection between oral cancer and whiteners.

Bleaching is Safe... the Right Way

Ontiveros makes it clear that the general idea of whitening your teeth to remove natural discoloration is safe and can be effective. In fact, a large number of clinical trials in humans over the last 10 years have demonstrated the safety of bleaching. “Hydrogen peroxide exposure from tooth whiteners is limited to the oral cavity and is incapable of reaching systemic levels,” he says. “Human saliva also contains many protective enzymes, which help prevent potential damage to cells during oxidative reactions in the oral cavity.”

Although a direct connection between oral cancers and over-the-counter tooth whitening has not been made, enough factors are present to have researchers looking for more and to have you looking for your friends—so you can tell them they were right all along.

FAQ for oral health for women

2008-11-17T15:53:00.000-08:00

Frequently asked questions regarding Woman’s oral health

What is oral health?
Good oral health does not just mean you have pretty teeth. Your whole mouth needs care to be in good health. The word “oral” refers to the mouth, which includes your teeth, gums, jawbone, and supporting tissues. Taking good care of your oral health can prevent disease in your mouth. Oral health can also affect the health of your body. It is easy to take your oral health for granted. But good oral health is key to your overall health.

How might problems in your mouth be linked to health problems in other parts of your body?
The health of your mouth can be a sign of your body’s health. Mouth problems are not just cavities, toothaches, and crooked or stained teeth. Many diseases, such as diabetes, HIV, cancer, and some eating disorders, can cause oral health problems. For instance, people with diabetes can develop tooth and gum problems if their blood sugar stays high. Regular dental exams help you maintain good oral health and avoid related health problems.
What are the most common oral health problems?
The most common oral health problems are cavities and gum disease.

Dental cavities
We are all at risk of tooth decay, or cavities. Bacteria (germs) that naturally live in our mouths use sugar in food to make acids. Over time, the acids destroy the outside layer of your teeth. Then holes and other tooth damage occur.

Gum diseases
Gum diseases are infections caused by bacteria, along with mucus and other particles that form a sticky plaque on your teeth. Plaque that is left on teeth hardens and forms tartar. Gingivitis (jin-juh-VEYE-tuhss) is a mild form of gum disease. It causes red, swollen gums. It can also make the gums bleed easily. Gingivitis can be caused by plaque buildup. And the longer plaque and tartar stay on teeth, the more harm they do. Most gingivitis can be treated with daily brushing and flossing and regular cleanings at the dentist’s office. This form of gum disease does not lead to loss of bone or tissue around the teeth. But if it is not treated, it can advance to periodontitis (pair-ee-oh-don-TEYE-tuhss). Then the gums pull away from the teeth and form infected “pockets.” You may also lose supporting bone. If you have periodontitis, see your dentist for treatment. Otherwise your teeth may loosen over time and need to be removed. Your risk of gum disease is higher if you: smoke or have a disease such as diabetes or HIV/AIDS Normal, healthy gumsHealthy gums and bone anchor teeth firmly in place. PeriodontitisPlaque left on teeth hardens into tartar. As plaque and tartar build up, the gums pull away from the teeth and pockets form between the teeth and gums. Bone supporting the teeth may get infected and start to weaken. Advanced periodontitisThe gums recede further, destroying more bone and the ligament around the tooth. Teeth may become loose and need to be removed.

What are some other problems I might have with my mouth?

Burning mouth. People with this condition describe a burning feeling in the mouth or tongue. It is most common in postmenopausal women. The cause is unknown, but might be linked to:
hormones
dry mouth
taste problems
nutritional deficiencies
use of ACE inhibitors (blood pressure medicines)
Talk to your doctor or dentist if you have burning mouth. Treatment depends on the cause—if it can be determined—and might include menopausal hormone therapy, vitamin supplements, or pain or other medicines. Cold sores. These small, painful sores are caused by herpes simplex virus type 1. Once you are exposed to the virus, it can hide in your body for years. Things that trigger the virus and lead to cold sores include:
getting too much sun
having a cold or infection
having your period
feeling stressed
Cold sores can spread from person to person. They most often form on the lips and sometimes under the nose or chin. The sores heal in about 7 to 10 days without scarring. You can buy over-the-counter drugs to put on cold sores to help relieve pain. If you get cold sores a lot, talk with your doctor or dentist about a prescription for an antiviral drug. These drugs can help reduce healing time and the number of new sores. Canker sores. These sores are small ulcers inside the mouth. They have a white or gray base and a red border. Women are more likely than men to have canker sores that recur. The cause of canker sores is unknown. Risk factors include:
fatigue
stress
your period
a cut on the inside of your cheek or on your tongue
allergies
celiac disease
Crohn’s disease
Canker sores most often heal on their own in 1 to 3 weeks. See your dentist if you get a large sore (larger than a half inch). You may need medicine to treat it.
To help with pain:
avoid hot, spicy foods
use mild mouthwashes or salt water
try over-the-counter coatings or pain medicines
No proven way exists to prevent canker sores. If you get them often, talk with your dentist.
Thrush, called oral candidiasis (kan-dih-DEYE-uh-suhss). These fungal infections appear as red or white lesions, flat or slightly raised, in the mouth or throat. They can be caused by overgrowth of the fungus Candida. This fungus lives naturally in your mouth. Your risk of getting thrush increases if:
you have a weak immune system
you don’t make enough saliva
you take antibiotics
Treatment includes antifungal mouthwash or lozenges. If the infection spreads or your immune system is weak, you may need antifungal medicine.
Thrush is common among:
denture wearers
people who are very young or elderly
people with dry mouth
If you wear dentures, clean and remove them at bedtime. Talk with your dentist about medicines that may be helpful if you have thrush. Dry mouth, called xerostomia (ZEER-oh-STOM-mee-uh). This problem happens when you don’t have enough saliva in your mouth. Some reasons why people get dry mouth include:
side effect of medicines or medical treatment
health problems, such as saliva and salivary gland disorders and rheumatoid arthritis
blockage of a salivary gland
Dry mouth may make it hard to eat, swallow, taste, and speak. If left untreated, it can lead to cavities. This is because saliva helps rid your mouth of bits of food and helps stop acid from forming plaque on your teeth. Treatment of dry mouth depends on the cause and can range from medicines to diet changes. To lessen the dryness, use artificial saliva, suck on sugarless candy, and use a humidifier.
Bad breath, called halitosis (hal-lih-TOH-suhss). Bad-smelling breath can be caused by several things, including:
poor oral hygiene
some foods
dentures
gum disease
dry mouth
tobacco use
respiratory, digestive, or other health problems
some medicines
Practicing good oral hygiene and avoiding tobacco and some foods often helps people with bad-smelling breath. But if doing so doesn’t seem to help or if you always need mouthwash to hide bad breath, talk to your dentist.
Oral cancer. This cancer can affect any part of the mouth. If you smoke or chew tobacco, you are at higher risk. Alcohol use along with smoking raises your risk even more. Yet more than 25 percent of oral cancer affects nonsmokers. Oral cancer most often occurs after age 40. It isn’t always painful. So it may go undetected until the late stages. Ask your doctor to check for signs of oral cancer during your regular checkup. Oral cancer often starts as a tiny white or red spot or sore anywhere in the mouth. Other signs include:
a sore that bleeds easily or does not heal
a color change in the mouth
a lump, rough spot, or other change
pain, tenderness, or numbness anywhere in the mouth or on the lips
problems chewing, swallowing, speaking, or moving the jaw or tongue
a change in the way the teeth fit together
Oral problems from cancer therapies. Treatments such as chemotherapy or radiation to the head and neck can cause dry mouth, tooth decay, painful mouth sores, and cracked, peeling lips. Get a complete dental exam before starting cancer treatment.

As a woman, why do I have to worry about oral health?

Everyone needs to take care of their oral health. But female hormones can lead to an increase in some problems, such as:
cold sores and canker sores
dry mouth
changes in taste
higher risk of gum disease
Taking good care of your teeth and gums can help you avoid or lessen oral health problems.

I’m pregnant. Do I need to take special care of my mouth?

Yes! If you are pregnant, you have special oral health needs.
Before you become pregnant, it is best to have dental checkups every 6 months. You want to keep your mouth in good health before your pregnancy.
If you are pregnant and have not had regular checkups:
Have a complete oral exam early in your pregnancy. Because you are pregnant, your dentist might not take routine x-rays. But if you need x-rays, the health risk to your unborn baby is small. Remember dental work during pregnancy is safe. The best time for treatment is between the 14th and 20th weeks. In the last months, you might be uncomfortable sitting in a dental chair. Have all needed dental treatments. If you avoid treatment, you may risk your and your baby’s health. Use good oral hygiene to control your risk of gum diseases. Pregnant women may have changes in taste and develop red, swollen gums that bleed easily. This condition is called pregnancy gingivitis. Both poor oral hygiene and higher hormone levels can cause pregnancy gingivitis. Until now, it was thought that having gum disease could raise your risk of having a low-birth-weight baby. Researchers have not been able to confirm this link, but studies are still under way to learn more.

I’m a new mother. What can I do for my baby’s oral health?

You can do a lot! Below are some things you need to know about your baby’s oral health.
The same germs that cause tooth decay in your mouth can be passed to your baby. Do not put your baby’s items, such as toys, spoons, bottles, or pacifiers in your mouth. Wipe your baby’s teeth and gums with a clean gauze pad or baby toothbrush after each nursing and feeding. This can help remove sugars found in milk that can cause tooth decay. If you bottle-feed your baby, try to finish bottle weaning by age 1. Avoid giving your baby bottles or pacifiers at naps and bedtime. Sucking on a bottle when lying down can harm your baby’s teeth. All babies should visit a dentist by age 1. The dentist will screen for problems in your baby’s mouth. You will also be shown how to care for your child’s teeth and mouth. Talk with your doctor about the best water choices for infants. Fluoride is good for teeth. But too much fluoride can harm development of tooth enamel in infants. I’m confused!

What type of toothpaste or mouthwash should I use?

Many types of toothpastes line the store shelves. Some say they’re made for whitening, others for reducing gingivitis and plaque, and others for sensitive teeth. Before choosing toothpaste for your family, know the basics. As long as toothpaste contains fluoride and its box has the American Dental Association’s (ADA) seal of acceptance, it is good for your oral health. Beyond that, choosing toothpastes is a personal choice. Mouthwashes claim to freshen your breath. But they really only mask breath odor for a few hours. If you always need to use a mouthwash to hide bad breath, see your dentist.

I’m not happy with the stains on my teeth. How can I safely whiten them?
Safe whitening options vary in price and how well they work:
Chair side bleaching or “power bleaching.” (free for new patients at Advance Dental Art of OC- go to www.advancedentalart.com/oc for more details) In your dentist’s office, he or she applies a gel or rubber shield to protect your gums and oral tissues. Then bleach is put on your teeth. Ask if the bleaching agents have the ADA seal. A special light or a laser may be used to help the bleach work better. But no products that use lasers are accepted right now by the ADA. With this method you may have to go for more than one visit. You will see results right away (about five shades brighter). It works well on a range of stains. Dentist-dispensed and over-the-counter bleaching products. These products are for home use. They contain peroxide(s), which bleach the tooth enamel. Most come in a gel and are placed in a mouth guard or tray that fits inside your mouth. How long you use them depends on the results you’re looking for and if you are sensitive to the bleach. Some products are used twice a day for 2 weeks, and others are used overnight for 1 to 2 weeks. They help many types of staining. Your teeth turn about six shades brighter with long-lasting results. But only the dentist-dispensed solutions have the ADA seal. Over-the-counter whitening products. These products are for home use and include whitening strips, paint-on products, gels, and trays. They have a low amount of peroxide. You wear some during the day and apply some at night before bedtime. They can help staining due to age and certain foods. Your teeth turn about two shades brighter for up to 6 months. For better results, have a cleaning at the dentist before you use these products. These gels and trays do not have the ADA seal.

Whitening toothpastes. All toothpastes help remove surface stain through mild abrasives. "Whitening" toothpastes that have the ADA seal have special polishing agents that remove even more stains. Unlike bleaches, these products do not change the actual color of teeth. They help surface stains only. You might see short-term results that are one to two shades brighter.
Products used to whiten teeth can make teeth more sensitive. They can also bother your gums. These side effects most often go away after you stop using the product. Before using whitening products, talk with your dentist. He or she can help you decide which method is best for the type of stains on your teeth. Not all products work on all people. Options offered by your dentist can be expensive, so ask your dentist to fully explain the results you can really expect. Keep in mind that whitening your teeth does not make your mouth any healthier.

What small, easy steps can I take to have a healthy smile?

1. Brush your teeth at least twice each day with fluoride toothpaste.

Aim for first thing in the morning and before going to bed. Once a day, use floss or an interdental cleaner to clean food your toothbrush missed. Make sure you:
Drink water that contains added fluoride if you can. Fluoride protects against dental decay. Most public water systems in the United States have added fluoride. Check with your community’s water or health department to find out if there is fluoride in your water. You also may want to use a fluoride mouth rinse, along with brushing and flossing, to help prevent tooth decay. Gently brush all sides of your teeth with a soft-bristled brush. Round and short back-and-forth strokes work best. Take time to brush along the gum line, and lightly brush your tongue to help remove plaque and food. Ask your dentist or dental hygienist to show you the best way to floss your teeth. Change your toothbrush every 3 months, or earlier if the toothbrush looks worn or the bristles spread out. A new toothbrush removes more plaque. If you wear dentures, be sure to remove them at night and clean them before putting them back in the next morning.

2. Have a healthy lifestyle.

Eat healthy meals. Cut down on tooth decay by brushing after meals. Avoid snacking on sugary or starchy foods between meals.
Don’t smoke. It raises your risk of gum disease, oral and throat cancers, and oral fungal infections. It also affects the color of your teeth and the smell of your breath.
Limit alcohol use to one drink per day for women. Heavy alcohol use raises your risk of oral and throat cancers. Using alcohol and tobacco together raises your risk of oral cancers more than using one alone.
Limit how much of soda you drink. Even diet soda contains acids that can erode tooth enamel.

3. Get regular checkups.

Have an oral exam once or twice a year. Your dentist may recommend more or fewer visits depending on your oral health. At most routine visits, the dentist and a dental hygienist will treat you. During regular checkups, dentists look for signs of diseases, infections, problems, injuries, and oral cancer.
See your dentist right away if
your gums bleed often
you see any red or white patches on the gums, tongue, or floor of the mouth
you have mouth or jaw pain that won’t go away
you have sores that do not heal within 2 weeks
you have problems swallowing or chewing
Besides your dentist, other types of dental providers include:
Dental hygienists: Members of the dental staff who clean gums and teeth and teach patients how to maintain good oral health.
Periodontists: Dentists who treat gum disease and place dental implants.
Oral surgeons: Dentists who operate on your mouth and supporting tissues.
Orthodontists: Dentists who straighten teeth and align jaws.
Endodontists: Dentists who perform root canals.
Prosthodontists: Dentists trained in restoring and replacing teeth.

4. Follow your dentist’s advice.

Your dentist may suggest ways to keep your mouth healthy. He or she can teach you how to properly floss or brush. Follow any recommended steps or treatments to keep your mouth healthy.

5. If you have another health problem, think about how it may affect your oral health.

For instance, if you take medicines that give you a dry mouth, ask your doctor or nurse if there are other drugs you can use. Have an oral exam before starting cancer treatment. And if you have diabetes, practice good oral hygiene to prevent gum disease.

2008-11-17T15:32:00.000-08:00

Tips and Techniques for Eliminating Bad Breath

Brush and Floss Your Teeth Properly

Brushing and flossing are two of the most crucial elements for attacking bad breath. Bad breath is caused by bacteria which live on our teeth and gums. These bacteria feast on food particles left on our teeth creating volatile sulfur compounds (VSC). These sulfur compounds give breath its foul odor.
Brushing and flossing remove bacteria and the food bacteria feast on so that they can no longer create volatile sulfur compounds. Unfortunately, many people do not brush long enough to remove bacteria from their teeth. It takes 2-3 minutes to brush all tooth surfaces yet most people spend less than a minute brushing their teeth.
Worse yet, few people take the time to floss allowing odor producing bacteria to grow rampantly in the spaces between your teeth. Brushing without flossing is like washing only 70% of your body when you bathe - the other 30% remains dirty.

Clean Your Tongue

While brushing and flossing are crucial first steps, brushing and flossing do not always eliminate bad breath. This is because odor causing bacteria hide deep within the crevices of the tongue.
Ironically, many of these bacteria are anaerobic meaning they can not live in oxygen. How do these bacteria live in the mouth then? They live safe from oxygen under a protective layer of mucous, food particles and proteins.
Cleaning your tongue with a tongue cleaner can remove this layer and much of the bacteria which resides on your tongue. Remember to clean near the back of the tongue where most of the bacteria resides but be careful not to gag yourself.

Drink Plenty Water

A dry mouth represents the ideal home for odor causing bacteria which flourish in this type of environment. Saliva normally keeps the mouth moist. Additionally, saliva helps wash away the food particles bacteria feed on and dissolves odorous volatile sulfur compounds. Actions which dry the mouth or reduce saliva flow can increase bad breath odor. These include:
The use of prescription medications including antihistamines and decongestants
Excessive talking
Exercising
Dieting
Drinking alcohol or using mouthwashes containing a high amount of alcohol
Smoking
By drinking water we stimulate saliva flow, wash away left-over food particles, and moisten the mouth making it less hospitable to odor causing bacteria.

Use Chlorine Dioxide Mouthwashes

Mouthwashes containing chlorine dioxide are the latest advance against bad breath. Conventional mouthwashes at best only temporarily mask bad breath odor. At worst, conventional mouthwashes can make the situation worse by drying out the mouth making it more hospitable to odor producing bacteria.
Chlorine dioxide has been used for years to sanitize water supplies. In these mouthwashes the chlorine dioxide directly attacks the volatile sulfur compounds responsible for bad breath.

Chew Sugarless Gum

If you can't brush after a meal or snack consider chewing sugarless gum. This chewing action helps cleanse the teeth and stimulates the flow of saliva. Saliva in turn further helps to cleanse the mouth and dissolves odorous volatile sulfur compounds. Make sure, however, to use gum which does not contain sugar .

Check for Signs of Gingivitis and Other Dental Problems

Periodontal disease is a bacterial infection of the gums and ligaments which support the teeth. Periodontal disease creates new hiding spots in the gums for odor causing bacteria. Signs that you may have periodontal disease include:
Red or swollen gums
Loose teeth
Sensitive teeth
Pus coming from around the teeth
Pain on chewing
Tender gums
Bleeding gums.
When dentists treat periodontal disease they can eliminate the bad breath associated with it.

Get a Dental Check-Up at Twice Once a Year

A semi-annual dental check-up is a good idea for all adults. This is because people often do not become away of dental problems until considerable damage has occurred. A dentist can recognize potentially damaging problems early. In addition, the dentist can diagnose other problems which cause bad breath including abscesses, periodontal disease, and impacted teeth.

For More information go to advancedentalart.com