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Your Questions Answered

I was recently asked to participate on the Everyday Health Dental Expert panel. Here are some short answers to the questions they asked their expert panel.

1. Do over-the-counter teeth-whitening products work as well as
professional options?

In some cases over the counter whitening products do help achieve the results the patient is looking for.  In office bleaching procedures are usually more reliable, (they use a more concentrated whitening agent) and reduce the risk that the whitening agent will be applied incorrectly.

2. Can blueberries, coffee, and red wine really stain teeth?

Absolutely.  Especially following whitening procedures.  The surface of the tooth is more susceptible to staining immediately after the whitening has been done.

3. What's the latest in braces technology?

There are two techniques that have changed the way teeth can be moved and better positioned.

Invisible Braces. Invisalign and Clear Correct both use clear, plastic aligners instead of the traditional brackets, bands and wires to move teeth into better alignment.  A series of trays are custom fit to move the teeth according to the parameters set by the dentist.  The trays are changed every 2-4 weeks depending on the movement of the teeth involved.  Treatment may be no faster than conventional “braces” and the aligners cannot be used in every instance.  But the metal traditionally seen when patients have orthodontic treatment is not evident when speaking or smiling.

Lingual Braces.  Lingual braces are placed on the back surfaces of the teeth so the traditional bands, brackets and wires are not visible on the front of the teeth when patients talk, laugh or smile.  Special molds are taken by the dentist, and the wires and brackets are often times custom, computer designed to achieve the desired tooth movement.

4. Fill us in on the pros and cons of veneers.

Porcelain veneers are often times the most conservative way to achieve beautiful, long lasting,  world class esthetic results. Because they are made of porcelain and most times translucent, they allow light to pass through the tooth structure resulting in very “life like” and “natural” restorations.  Veneers allow dentists to alter the size, shape, color and alignment of teeth in a very conservative way.  Sometimes the natural teeth under the veneer do not need any alteration at all.

The only downside to porcelain veneers is that often times the underlying tooth structure does need to be altered; but most times only .3mm-.5mm. needs to be removed from the front surface of the tooth.  Porcelain veneers are durable and stain resistant.

5. What are some of the most out-there cosmetic dentistry procedures?

In recent years due to reality TV, one day smile makeovers have become popular. Since many people do not have the financial option of veneers and/or crowns they opt for other laternative such as Snap On Smile.

6. Is there a connection between oral health and other health
conditions?

There is no longer any question that there is a definitive connection between oral health and other health conditions.  Recent research has addressed the relationships between periodontal (gum) disease and heart problems; gum problems and diabetes; gum disease and kidney disease; bone deterioration after dental surgery in patients that take bisphosphonates; and sleep apnea and jaw position.

Several of my colleagues and I have recently formed the New York Dental Medical Collaborative to help educate and collaborate with our medical colleagues at New York Presbyterian Hospital and Weill Cornell Medical School about many of these connections.

7. Besides brushing and flossing, what should we be doing to take care of
our teeth?

Limit sweets, limit carbonated beverages, stop smoking or chewing tobacco.  In patients who are cavity prone, fluoride rinses or topical application of fluoride at the dentist’s office should be considered.

8. Which oral symptoms shouldn't be ignored?

Well, obviously pain or swelling in or around the oral cavity should never be ignored when they occur  But changes in the color of the intra-oral tissues, small bumps or bruises that don’t heal over a 2-3 week period of time are also  conditions that should not be ignored.

9. What are the biggest misconceptions about dental health?

I think one of the biggest misconceptions is that dental treatment has to be painful.  With the latest and newest techniques for dental anesthesia many are finding that they are pleasantly surprised when their expectations of pain and discomfort are not realized.

Some people think taking care of “baby teeth” is not important since they are going to be replaced by the “adult” teeth once they fall out.  Proper care of the deciduous teeth (baby teeth) is important to prevent pain and to allow the permanent, adult teeth to eventually grow into the proper position once the baby teeth come out.

Some feel they only need to see a dentist when they are in pain.  Unfortunately, by the time “it hurts” it’s often too late to treat the problem with a simple solution.  Preventive care helps maintain dental health and keep the cost of treatment down.

A final misconception is that it’s inevitable that our teeth will fall out and we will need “false teeth”.  Modern day dentistry is dedicated to saving teeth by keeping the teeth and gums healthy. The idea of dentures is something most of us can avoid with regular care and routine check ups.

10. Why have amalgam fillings been under scrutiny?

Some, both in and out of dentistry, feel that the mercury in silver amalgam fillings can be deleterious to one’s health.  However, according to the FDA and the American Dental Association, there have never been scientific studies that definitively show that the mercury in dental amalgam is harmful to humans.  There are other alternatives to amalgam fillings including gold, composite resin and porcelain which patients can consider if they want to eliminate silver amalgam fillings.

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