The following statements are
provided by the American Dental
Association. Association. Possible side effects are
italicized.
Whitening products may
be administered by
dentists in the dental
office, dispensed by
dentists for home-use,
or purchased
over-the-counter (OTC).
Peroxide-containing
whitening products (OTC)
Carbamide peroxide, used
in many OTC whitening
products, breaks down
into hydrogen peroxide
and urea, with hydrogen
peroxide being the
active whitening agent.
A whitening product
containing 10 percent
carbamide peroxide
yields approximately 3.5
percent hydrogen
peroxide.
The most commonly
observed side effects
with peroxide-based
bleaching agents are
tooth sensitivity and
occasional irritation of
soft tissues in the
mouth, particularly the
gums. Tooth sensitivity
often occurs during
early stages of
bleaching treatment.
Tooth sensitivity and
tissue irritation are
usually temporary and
stop after the
treatment.
Dentist-applied
whitening products
Many different
professionally applied
tooth whitening products
are used by dentists.
These products use
hydrogen peroxide in
concentrations ranging
from 25 percent to 40
percent. Dr. Fina uses
36% hydrogen peroxide.
This is ten times as
strong as compared to
available OTC products,
so much more effective
whitening is available
at the dentist. As with
OTC products,
tooth sensitivity and
tissue irritation can
occur during treatment,
but are usually
temporary and stop
within 24 hours after
treatment.
Safety of
whitening products
If concentrated
whitening products are
used in excess, teeth
can become porous and
enamel can break down.
When products are
overused the surfaces of
teeth and the
surrounding gums can be
weakened and brake down.
Teeth can even become
almost translucent
rather than white, so
heeding the
recommendations of the
dentist and the
instructions for the
product is advisable.
Summary
We recommend that if you
choose to use a
whitening product, you
do so after consultation
with Dr. Fina. This is
especially important for
patients with many
fillings, crowns, and
extremely dark stains. A
thorough oral
examination is essential
to determine if
bleaching is an
appropriate course of
treatment. You and Dr.
Fina together can
determine the most
appropriate treatment.
How do we treat gum disease?
How Dr. Fina
treats gum
disease is
largely
dependent upon
the stage of
your infection
and the amount
of deterioration
involving your
gums, teeth,
supporting
tissues and
bone.
After reviewing your x-rays and
performing a thorough
periodontal exam, Dr. Fina will
discuss your treatment options,
answer questions, and explain
what happens:
Non-Surgical
Treatment
The most well-known type of non-surgical treatment is known as scaling and root planning. This under-the-gum procedure involves a careful removal of plaque and tartar from the tooth roots. During this procedure, your hygienist will remove harmful bacteria and irritants from deep beneath your gums to prevent plaque from accumulating again.
Surgical
Treatment
A recommended
periodontist may
perform
periodontal
surgery to
eliminate bone
infections or to
regenerate lost
bone. The most
common surgical
treatments
include pocket
reduction and
bone
regeneration.
Maintenance
after Surgical
or Non-Surgical
Gum Treatment
After gum
treatment,
regular dental
checkups are
highly
recommended to
keep your teeth
in good shape.
Also recommended
are excellent
home care
including
regular
flossing.
Do I grind my teeth?
Stressed out by the fast pace of
life? Our dental practice sees
evidence of this every day.
Tooth wear can lead to
sensitivity to heat and cold,
loose teeth, fractures, facial
pain, and debilitating
headaches. All this can occur
while you sleep from grinding
your teeth. Dentists call this
bruxism. As many as 90% of us
grind our teeth each night. On
the average we have five
episodes per night. Not everyone
shows dental deterioration right
away, depending on differences
in enamel strength. The bite
force, in any case, is so
powerful - over 200 pounds per
square inch - and the noise is
fearful, you cannot physically
duplicate this phenomenon when
you're wide awake. While you're
sleeping, a lot of damage is
being done.
Bruxing seems to be associated
with the REM stage of sleep,
when dreaming and rapid eye
movement occur. There is some
evidence that a bite out of
alignment contributes to bruxing,
but most agree stress is the
problem. Most people learn about
a bruxing habit from the spouse
who has to put up with the
noise. More clues: waking up in
the morning with sore jaw joints
or muscle fatigue, loose teeth.
Come see us for an evaluation.
Our practice can relieve the
damages of bruxism with a custom
dental appliance. We also
recommend physical therapy,
sometimes muscle relaxants. The
best solution, though: learning
how to handle the stress in your
life.
Are amalgam fillings dangerous?
All the media coverage about
amalgams causes people sincere
anxiety. We'd like to cast a
little light on the subject of
mercury, a component of amalgam
and, if we can, allay your
fears.
Scores of
legitimate, verifiable studies
have addressed the issue of
mercury at one time or another
in the past 100 years. The
findings:
·
Mercury vapors are all
around us, all the time.
·
There's more mercury in
a can of tuna fish than
in a filling.
·
Though a like amount of
mercury is combined with
other metals to obtain a
filling alloy, the
resulting amalgam has
different
characteristics than any
of its parts. The
mercury in amalgam
becomes inert, with only
a trace of vapors after
placement.
·
Over the life of a
filling, amalgams do
break down. For patients
with an average of seven
fillings, the daily
intake of mercury
amounts to about 0.3
micrograms. According to
the World Health
Organization, a safe
daily threshold of
exposure is 300 to 500
micrograms.
But are these fillings safe?
Norway, Denmark and Sweden have
banned the use of amalgam.
However, these bans are in place
primarily over the issue of
environmental concerns. In the
USA, strict regulations for the
disposal of amalgam are enforced
in most states and require
dentists to have filters to
clean dental waste water. There
never has been a study that can
prove anything is absolutely
safe for every individual. This
means, as doctors, we keep up
with scientifically based
research and testing, and keep
an open mind to alternative
materials.
This issue is subjective. If you
prefer to have fillings with
another material, we are happy
to accommodate you. We will also
outline the risks associated
with removing your old fillings,
the costs, and the pros and cons
of an alternative material. We
encourage you to talk with us
about your concerns.
Are you a good candidate for Laughing Gas?
Although nitrous oxide (laughing
gas) is a safe option for most
dental patients, some
considerations should be taken
before undergoing this
treatment. Make sure you discuss
your full medical history with
your dentist. If you fall into
any of the groups listed below,
thoroughly weigh the pros and
cons of using laughing gas
before opting to use this agent:
·
History
of
chronic
obstructive
pulmonary
diseases
·
Severe
emotional
issues
·
Drug
dependency
·
First
trimester
of
pregnancy
·
Treatment
with
bleomycin
sulfate
(also
known as
blenoxane,
this
agent is
used to
treat
cancer)
It should be noted that
regardless of your situation,
Dr. Fina and his staff are there
to help you make an informed
decision.
What is OIL PULLING? Is it beneficial for tooth care?
Oil pulling is the process of
swishing a tablespoon of cooking
oil around your mouth. The
benefit of oil pulling is a
reduction the bacterial load in
your mouth. Due to the
hydrophobic nature of the
bacterial cell membrane, the
cells are drawn into the cooking
oil. After swishing until the
oil becomes milky and then
spitting out the oil, the
bacteria go with it. This
reduces the bacteria available
to contribute to tooth decay and
gum disease.
Some people have used sesame or
sunflower oils, but these oils
are high in inflammation
producing omega 6 fats. Coconut
oil is preferable because it
contains lauric acid which is
anti-inflammatory in oral
tissues.
Should I be oil pulling? Oil
pulling can serve as an adjunct to other forms of dental
care, but is not considered a
substitute. 10-20 minutes of
swishing with coconut oil is the
recommended protocol. More
research and larger scale
studies are needed to establish
the scientific legitimacy of oil
pulling. However, the American Dental Association does not recommend oil pulling because there are no reliable, peer-reviewed scientific studies showing improvement in oral health.
What values of INR (blood clotting time) are acceptable to do dental work including extractions?
The recommendations of the
Committee for Standards in
Hematology in 2011 are as
follows:
1)
The risk of significant
bleeding in patients on
oral anticoagulants and
with a stable INR in the
therapeutic range 2-4 is
very small.
2)
The risk of thrombosis
may be increased in
patients in whom oral
anticoagulants are
temporarily
discontinued.
3)
Oral anticoagulants
should not be
discontinued in the
majority of patients
needing dental
extractions.
4)
Patients with the
following conditions
need to have extractions
done either by a
specialist or in a
hospital:
patients on oral
anticoagulants with
co-existing medical
problems e.g. liver
disease, renal disease,
thrombocytopenia or who
are taking anti-platelet
medication. Such
patients may have an
increased risk of
bleeding.
As with any trauma to
the mouth, you should
consult with us
immediately to determine
if treatment is
required. We will
examine the area and
take necessary x-rays.
If you are in pain from
a broken, cracked or
chipped tooth, you may
want to take an over the
counter
anti-inflammatory pain
reliever such as Advil
or aspirin. If possible,
keep any part of the
tooth that has broken
off and bring it with
you to your appointment.
Avoid chewing on the
injured tooth and avoid
extreme temperatures.
I have a chipped, cracked, or broken tooth. What should I do?
If there is no pain and
the chip is small, it's
up to you to decide if,
when and how the tooth
should be repaired.
Depending on the size of
the chip, it can be
smoothed or cosmetically
corrected. Ask us to
explain the options
available to you. If a
filling or artificial
tooth becomes chipped,
it should be replaced.
Cracked or broken teeth
should be repaired as
soon as possible to
prevent further damage.
Keep in mind that cracks
are not always visible,
even on x-rays. Symptoms
may involve pain while
chewing and sensitivity
to cold and possibly hot
foods and liquids as
well as air, which may
over time, become more
pronounced. ;
My tooth is knocked out. What should I do?
To improve the
chances of the tooth
being saved, Dr. Fina
suggests the following:
·
Handle the tooth
carefully. Avoid
touching the root of the
tooth (the part of the
tooth that was embedded
in the gum).
·
If the tooth is dirty,
hold it by the upper
part (the crown) and
rinse it off with milk
or contact lens
solution until most of
the dirt is washed
away. If you don't have
either of those
available, then it is
best to leave the tooth
alone. Wiping it off
with a handkerchief or
shirttail may cause
additional damage to
the microscopic cells
still on the root
surface.
·
It is important to keep
the tooth moist. If
possible, drop it into a
glass of milk. If no
milk is available, then
place the tooth in the
mouth between the cheek
and gum.
·
A young child who has
had a tooth knocked out
may not be able to
safely "store" the tooth
in his or her mouth
without swallowing it,
so don't give the tooth
to a young child for
safe-keeping in his or
her mouth. Place the
tooth in milk or have
the child spit into a
container and place the
tooth in the cup with
the saliva. The most
important thing is to
keep the tooth moist.
Use a cup of water if
nothing else is
available.
·
See Dr. Fina as quickly as possible. If getting to the office immediately after a tooth has been knocked out is impossible, then you may want to try slipping the tooth back into its socket. In many cases, it will slip right in. Make sure it's facing the right way. Don't try to force it into the socket. If it doesn't go back into place easily and without pressure, then its better just to hold it between the cheek and gum or to keep it in milk, saliva or water.
I have a partly dislodged tooth. What should I do?
Sometimes a tooth is
knocked loose or comes
partway out of its
socket because of an
injury. We call this an
extruded tooth. If the
tooth is not broken, and
the nerve and blood
vessels are still
attached, the tooth may
be saved. To save the
tooth, you need to
contact us right away.
Leave the tooth in your
mouth even though it is
partially out of the
socket. Take an over the
counter pain reliever
and apply a cold pack to
relieve pain until you
reach our office.
I lost filling or crown. What should I do?
Sometimes fillings or
crowns fall out. In some
cases, a filling or
crown may become loose
because there is decay
underneath it. The decay
destroys part of the
tooth, so it no longer
has a tight hold on the
crown or filling. These
situations are rarely an
emergency. However, it
can be painful because
the exposed tooth tissue
is often sensitive to
temperature, pressure or
air. If you lose a
crown, put it in a safe
place and make an
appointment to see us as
soon as possible.
Don't wait too long.
What is left of the
tooth will not be as
strong as your crown. It
could be damaged more
without the crown to
protect it. Also, when a
crown is missing for a
long time, your teeth
may move into the space
where the crown was. If
this happens your crown
may no longer fit.
I have a lot of pain. What should I do?
Any injury to the gums
or teeth can be very
painful. At other times,
you may have dental pain
and not know why. For
example, sudden pain may
be caused by pieces of
food that come in
contact with a decayed
area of the tooth. Food,
heat or cold may create
pressure near the nerve
and cause pain. The
nerve inside the tooth
also may be exposed if
you lose a filling or
crown.
Pain that gets worse
over time can also be
caused by food that's
stuck between your tooth
and gum. If you don't
brush and floss well,
the bits of food remain.
Bacteria multiply in
this area, and an
infection of the tooth
and gum may develop.
This type of infection
is called an abscess. It
can be at the root end
of the tooth (in bone)
or in the gums. An
abscess can be a serious
health problem if it is
not treated. If swelling
inside or outside of the
mouth is occurring, you
need to seek help
immediately either
through our office or
your medical doctor.
Call us to make an
appointment
so that we can evaluate
the cause of your pain
and get you back to
health quickly.
I have an injury to my lip and/or gum. What should I do?
Trauma to the lips,
tongue and inside of the
mouth is quite common.
The soft flesh of the
lips and their exposed
location make them
vulnerable to injury.
Any cut inside the mouth
usually bleeds heavily
because of the rich
supply of blood to the
area.
Many lip and tongue
injuries occur during
sports activities. They
often can be prevented
through the use of a
mouth guard. We can
create a professional,
custom fit mouth guard
for you.
Contact our
office for
more information.
At home, you can clean
injured skin surfaces
with mild soapy water
and a soft, clean cloth.
To clean cuts inside the
mouth, rinse with salt
water or a hydrogen
peroxide solution (one
part hydrogen peroxide
and one part water). Be
sure not to swallow this
peroxide rinse. However,
do not be concerned if
it foams. This is what
the rinse normally does
when it contacts mouth
tissue.
If your lip is swollen
or bruised, apply a cold
compress. If there is
bleeding, apply pressure
with a clean cloth for
at least 5 minutes.
Using ice can help limit
swelling, bleeding and
discomfort. Wrap crushed
ice in clean gauze or a
clean piece of cloth and
hold it on the affected
area.
Braces Questions
Who can benefit from clear braces?
Any of the following conditions can be effectively treated with clear braces:
1)
Crowding
2)
Spacing
3)
Overbite
4)
Underbite
5)
Rotated
teeth
Clear aligners or traditional metal braces – Which should I choose?
In cases where ClearCorrect is
not suitable, for example with
extreme tooth movements or
complex bite misalignments,
traditional metal braces are
used.
Is there a differences between ClearCorrect and Invisalign?
Only minor differences occur
between the two equivalent
methods. ClearCorrect costs the
dentist somewhat less and we
pass the savings on to you.
CEREC Questions
What is a CEREC Crown Machine?
The acronym CEREC stands for
Chairside Economical Restoration
of Esthetic Ceramics. This
complex machine can generate
high-quality dental restorations
with the aid of 3D computer
technology.
What are the benefits of a CEREC crown?
Crafted from metal-free,
porcelain materials, CEREC
crowns won’t crack or leak over
time, blend with your natural
teeth, and allow for more
conservative repairs. They also
eliminate the need for messy
impressions, temporary
restoration, and a second visit.
Patients appreciate the
convenience of having their
crown, inlay, or onlay designed
and placed in a single visit.
How do I get my CEREC crown?
First, Dr. Fina will create a 3D
image of your tooth. Using this
data, the CEREC machine
generates a model of your custom
crown. Patients can listen to
music, relax, and wait while the
CEREC unit mills the
restoration. Your dentist will
then place the final crown
before you leave our office.
Denture Questions
What should I expect with my first denture?
Your first denture will be a challenge,
one you'll want to approach slowly. All the benefits of a
comfortable, functional denture will come to you--with
practice.
Learning new denture skills takes a little time and motivation. Here's what to expect.
A denture is rigid, but it rests on soft tissue. So it's going to move. And the softer the tissue, the more mobility. You'll learn to compensate for this.
For stability, the denture base is extended in the mouth. Chewing on one side has a tendency to dislodge the other side. Remember to place foods on both sides of your mouth and chew with balanced force.
At first you may lose tactile
sense that tells you what size
food is and where things are
while you're chewing. You may
even bite your cheek and this is
something you'll learn not to
do. Expect to have an increased
saliva flow, as your body is
adjusting to the denture. You'll
just have to swallow more for a
day or two.
With natural teeth, most of us
rest the tongue just behind the
lower front teeth. But if you
have a habit of moving your
tongue back, you'll lift a lower
denture out. Your tongue needs
retraining. With practice, you
won't even think about it.
And you may notice you sound a
little different at first.
Speech problems associated with
a denture are among the first
you'll learn to conquer.
Denture wearing takes practice
to master. It's important to
remember that each person learns
to handle a denture at his or
her own pace. Be patient, and
don't be too hard on yourself.
Please call if you're having any
difficulties.
Do I need a new denture?
If your denture has some miles
on it and you've noticed it
doesn't fit well anymore, it's
time to consider a new denture.
A new denture can bring new
function--and a more youthful
appearance, too.
The fact is, your mouth is always changing. The ridges that support a denture recede. You may have noticed this. The upper denture will move up and back, the lower denture settles down. Your facial appearance is altered. This is due to the natural resorption of your jaw bone with time in the absence of teeth. A settling denture may cause your chin to approach your nose at as much as 1/16th inch per year. On top of that, the bite often goes awry, moving the upper teeth back behind the lowers. Your facial structure shifts over time, your cheeks sag a little, new wrinkles around the mouth appear. Diagonal lines run from the nose to the corners of the mouth.
This transformation is not
caused by a bad denture, but an
old denture. Dr. Fina’s office
can rework your denture by
extending the base to compensate
for the shrinkage in gum tissue.
This moves the front teeth
forward to their original
position. This can take years
off of your appearance.
You can't expect dentures to
last more than 5 to 10 years and
still give you a natural look.
But by replacing dentures as
your mouth changes, you'll enjoy
renewed function and, by the
way, a youthful fullness to your
face. Please give us a call to
schedule an appointment to
assess your denture's fit.
Are your dentures causing you to shy away from people?
Are you a denture wearer who's
afraid to be seen in public
because you think your denture
is unattractive? Do you find
yourself eating alone because
you can't eat certain foods
gracefully? Do you wear your
lower denture in your pocket?
Ill-fitting dentures that slip
can cause embarrassment, of
course. But if you can't trust
your denture, you may become
susceptible to social isolation.
Maybe you feel uncomfortable out
and about, or live in fear of a
denture accident in the company
of friends and family. Some
people give in to the real
desolation of life with a bad
denture.
Well, don't do it. Start fresh.
Dr. Fina can help you regain
function, comfort, and a natural
appearance by replacing or
refitting your denture. In fact,
with the right fit, most denture
wearers can eat anything that's
put in front of them, and look
good doing it.
If you recognize reclusive
behavior in yourself or a
friend, please call our office.
We'll evaluate your denture and
find a way to make it work
again--so you can get on with
life.
Oral Cancer Questions
What does oral cancer look like?
The most common symptoms of oral
cancer are a sore in the mouth
that doesn’t heal, or pain that
doesn’t go away. Cancer sores
are often characterized by
irregular borders, uneven
textures, or changing coloration
across the sore. During an oral
cancer exam we look for sores,
red patches, leukoplakia
(hardened, raised white or gray
areas), and lumps. Other
symptoms are:
sore throat or a feeling
that something is caught
in the throat
trouble chewing or
swallowing
numbness of the tongue
or jaw
loosening of the teeth
or pain around the teeth
Dr. Fina may suggest a biopsy
which is a sampling of the soft
tissue in the mouth and
subsequent microscopic tissue
analysis.
There are several possible
treatments that can be used
alone or in combination
depending on the severity of the
growth. Surgery is the usual
first treatment and this may be
followed by radiation therapy
and/or chemotherapy.
How can I help prevent oral cancer in my mouth?
It is important to note that
around 75 percent of oral
cancers are linked with
modifiable behaviors such as
smoking, tobacco use and
excessive alcohol consumption.
Your dentist can provide
literature and education on
making lifestyle changes and
smoking cessation. When oral
cancer is diagnosed in its
earliest stages, treatment is
generally very effective. Any
noticeable abnormalities in the
tongue, gums, mouth or
surrounding area should be
evaluated by Dr. Fina as quickly
as possible. During the oral
cancer exam, he and your dental
hygienist will be scrutinizing
the maxillofacial and oral
regions carefully for signs of
pathologic changes.
