You've just had porcelain laminate veneers placed on your teeth to improve their appearance, color and shape. Now what? How do you maintain them and keep them looking their best?

A dental porcelain veneer is a thin layer of porcelain that is bonded to a tooth, replacing the enamel (the outermost layer of a tooth). Dental porcelain is a glass-like substance that can be used to mimic natural tooth enamel perfectly because of its bright, reflective and translucent (see-through) qualities.

To look after your veneers, it is important to maintain the health of the teeth on which they were placed, and of the surrounding gums.

• About a week after your veneers have been placed, return to our office so that we can check them to make sure they are functioning well.
• Brush and floss regularly using non-abrasive fluoride toothpaste; make sure you remove biofilm, the film of bacteria that collects on the teeth, every day. Flossing or brushing will not harm your veneers.
• We recommend regular dental checkups to review the state of your veneers and your dental health in general.

Porcelain is a ceramic glass-like material, and like glass it is strong but brittle and can fracture when placed under too much stress.

• You can eat almost all foods without harming your veneers, but avoid biting into hard things like candy apples.
• Many people habitually grind or clench their teeth. If you are one of them, let us know. We can make a protective bite guard that you can wear to reduce stress placed on your teeth (and your veneers) while you sleep.

With good dental hygiene, and regular dental check-ups porcelain veneers can last from seven to twenty years or even longer. This makes them a good solution that will improve your smile for years to come.

Contact us today to schedule an appointment or to discuss your questions about porcelain laminate veneers. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced with Porcelain Veneers.”

You've probably brushed your teeth every day since early childhood when your parents handed you your first toothbrush. But do you really know if you're doing it effectively and removing disease causing bacterial plaque or biofilm? Let's take a look at the basics of tooth brushing.

What is the goal of brushing and flossing your teeth? While it is true that brushing your teeth freshens your breath and removes stains from the surfaces of your teeth, the principal goal of tooth brushing is to remove dental bacterial plaque. This biofilm grows in the nooks and crannies of your teeth, and especially at the gum line — regardless of what you eat or drink. If left on your teeth, this bacterial film can cause gingivitis (inflammation of your gums). It can progress to periodontal disease, affecting the supporting bone of your teeth and even result in tooth loss. This means that flossing should also be an important part of your daily dental hygiene routine to remove plaque from the protected areas between your teeth.

Can you actually brush too much? More is not always better and can be damaging. We advise you to use a soft brush and to brush gently. It does not take force to remove plaque, and using a toothbrush too vigorously can damage your gums and cause them to recede (shrink away from your teeth), causing sensitivity and tooth wear. It takes between 12 and 24 hours for plaque to form on your teeth, so you don't need to brush more than twice a day and floss once a day.

How do you know when you've done a good job? A good test is that your teeth should feel like you've just had a professional cleaning. Your tongue is a great evaluator — just feel for smoothness at the gum line.

Is a powered toothbrush better than a manual one? An evidence-based study comparing all the research available found little difference between power and manual toothbrushes. The conclusion was that some powered toothbrushes with a rotation-oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushes. But as we say, “it's not the brush, it's the hand that holds it.”

Come to our office for a demonstration. Any brush, whether electric or hand-powered, requires professional demonstration and training so that you know how to remove plaque correctly. Bring your toothbrush with you on your next visit to our office, so we can see your brushing technique and make sure you are doing it correctly for the most efficient plaque removal. And don't be embarrassed — nobody really knows how to brush effectively until they're shown!

Contact us today to schedule an appointment or to discuss your questions about tooth brushing and oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Manual vs Powered Toothbrushes.”

The ailment we commonly called gum disease is actually series of related diseases, all of which involve the tissues that surround the teeth. It's sometimes thought of as a “silent” malady, because its symptoms — bad breath, soreness, or bleeding of the gums — may be masked by other conditions. Or, they may simply be disregarded.

But don't ignore these symptoms! Left untreated, periodontitis can have serious health consequences. Here are five things you should know about this disease.

Gum disease is a chronic inflammatory disease.

That means it's a disease related to a natural response of the body's immune system (inflammation), and it develops over time (chronic). Gingivitis, an inflammation of the gums, may be the first step in the disease's progression. Left untreated, it can be followed by destruction of the periodontal ligament (which helps hold the tooth in place), loss of the supporting bone, and ultimately tooth loss. But it doesn't stop there.

The effects of gum disease aren't confined to the mouth.

In fact, recent research has suggested a connection between periodontal disease and chronic diseases in the whole body. There is evidence that severe periodontal disease is linked to an increased risk of cardiovascular diseases (like heart attack and stroke), pregnancy complications, and other conditions. It is also believed to have an adverse effect on blood-sugar control in diabetics.

Gum disease is caused by the bacteria in dental plaque.

Oral bacteria tend to build up in a colony of living organisms called a biofilm. Of the many types of bacteria that live in the mouth, only a relatively few are harmful. When oral biofilms are not regularly disturbed by brushing and flossing, the disease-causing types tend to predominate. Once it gains a foothold, treating gum disease can become more difficult.

Prevention is the best defense.

Good personal oral hygiene, carried out on a daily basis, is probably the best defense against many forms of periodontal disease. Proper brushing and flossing is effective in disrupting the growth of dental plaques. Lifestyle changes — like quitting smoking and reducing stress — are also associated with lessening your chance of developing the disease. Genetics also seems to play a part, so those with a family history of periodontitis should pay special attention to preventive measures.

Prompt, effective treatment is critical.

Bleeding of the gums is never a normal occurrence. But sometimes this (and other symptoms of gum disease) may be overlooked. During routine dental checkups, we can detect the early signs of periodontal disease. We can then recommend an appropriate treatment, from routine scaling and root planing (a cleaning of the teeth) to other therapies. So, besides brushing and flossing regularly, don't neglect regular examinations — they're the best way to stop this disease before it becomes more serious.

If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”

Most dental treatment has a cosmetic aspect to it since in the act of “restoring” teeth they are made to look better. The word “cosmetic” comes from roots meaning, “to adorn, dress and embellish.” Here are some terms and cosmetic dental techniques that could change your smile.

• The best and easiest way to remove stains on your teeth? Make an appointment to see a dental hygienist to remove unwanted stains from coffee, tea, red wine, that can discolor the outer surfaces of your teeth. Your teeth will look better and be healthier as a result.
• Dental office or home whitening? Dull, dingy and discolored teeth can be whitened with over-the-counter products at home, or professionally in our office. If you use the home method, be sure to follow the manufacturers' instructions carefully to make sure you don't overdo it. In our office we can use stronger bleaching solutions with special precautions to protect your gums and other tissues and achieve whiter teeth more quickly.
• Cosmetic change for back teeth? Tooth-colored composite resin filling materials are a relatively inexpensive way to replace tooth structure that has been damaged (by decay or otherwise) with non-metallic materials that bond to your natural teeth, match their color and make them stronger. (Sometimes metal restorations, like gold are advised for people who grind their teeth.)
• Cosmetic change for front teeth? Tooth-colored composite resin restorative filling materials — can be bonded directly to natural tooth structure becoming “one” with it. Used to replace tooth structure damaged by decay or injury such as chipped teeth, they are especially useful for front teeth in the smile zone. And they actually strengthen the teeth as well as providing highly cosmetic tooth restorations. In artistic hands nobody will know your teeth have been changed, except you and your dentist.
• Porcelain Veneers are thin layers of glass-like ceramic material that replaces the original tooth enamel. Veneering a tooth often involves some enamel reshaping or removal to accommodate the veneer. Veneers are bonded to the underlying tooth, but can be made brighter and whiter than your own enamel to cosmetically enhance your smile.
• Porcelain Crowns are similar to veneers in their cosmetic appearance but they cover the entire surface of a tooth, replacing tooth structure that has been damaged, lost or has become very discolored.
• Clear Aligners are a newer technique used in orthodontics (tooth movement) to move teeth into better position to enhance cosmetic change and improve biting function. A series of clear plastic trays is used to gradually move teeth to more attractive and functional positions.
• Dental Implants replace the roots of missing teeth. They are placed into the jawbone and become fused with it. Once implants have integrated with the bone, crowns are attached that look, function and feel just like stand alone natural teeth.

Contact us today to schedule an appointment or to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry: A time for change.”

Cancer is never a pleasant topic. Yet, rather than wish it away, many people have chosen to take an active and positive role in the prevention and early detection of the disease. Did you know that you and your dentist, working together, can help identify a major class of cancers in the early stages? Let's spend a few moments discussing oral cancer.

Oral cancer is dangerous. Although it accounts for a relatively small percentage of all cancers, it isn't usually detected until it has reached a late stage. And at that point, the odds aren't great: only 58% survive 5 years after treatment, a rate far less than that of many better-known cancers. It is estimated that in the United States, this disease kills one person every hour, every day.

Oral cancer used to be thought of as an older person's disease — and it still primarily strikes those over 40 years of age. But a disturbing number of young people have been diagnosed with the illness in recent years, making them the fastest-growing segment among oral cancer patients. This is due to the sexually-transmitted Human Papilloma Virus (HPV16). So, while long-time tobacco users and heavy drinkers still need screenings, most young people do too.

What's the good news? When it's detected early, the survival rate of oral cancer goes up to 80% or better. And having an oral cancer screening is part of doing something you should be doing anyway — getting regular dental checkups. That's one more reason why coming in to our office regularly for your routine examination is so important.

Of course, if you notice any abnormal sores or color changes in the tissue around your mouth, lips, tongue or throat — especially if they don't go away in 2-3 weeks — come in and see us right away. They could be just cold sores — or not.

An oral cancer exam is fast and painless. It involves a visual inspection of the mouth and surrounding area (face, lips, throat, etc.), during which we may also feel for lumps. We'll also gently pull your tongue from side to side, and check underneath it for early signs of a problem. If needed, we can schedule a biopsy for any suspicious areas. Sound easy? It is! So don't ignore it — remember that early detection could save your life.

If you would like more information about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”