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Ask The Expert about Beautiful, Healthy Smiles What: 'Ask The Expert' Q&A with Dr. Greg Sherman |
Dr. Greg Sherman |
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Welcome Dr. Sherman to Speaking of Women's Health's Ask The Expert Series and thanks for being December's expert.
As we do every month, we received many questions from our web viewers. We selected those that represent almost all of the questions submitted. So let's get started.
1. Many of our web readers submitted questions about the efficacy and safety of various tooth whitening products. Please offer impartial information on OTC counter gels, strips, trays and paint-on products along with systems offered by dentists.
Questions included:
What are the effects on tooth enamel?
What are the effects if whitening products are used while a patient is taking prescribed drugs?
Will whitening products act the same with at different periods of one's life?
What are some of the effects if used by a person who has gingivitis or gum disease of any kind?
Does having porcelain, gold, or amalgam fillings change the effectiveness?
Answer - Dr. Sherman: OTC tooth whitening products can be very effective. It is very important to select a product which is approved by the American Dental Association. These products do have some control over the contents of the whiteners and the percentages of active ingredients.
As far as selecting which product is the most effective in the tooth whitening proces
s that would be dependent on which method is the easiest for the individual to use. Bleaching procedures supervised by your dentist tend to be better controlled and customized for the patient. The time it requires to lighten your teeth is typically shorter because higher concentrations of bleach can be used. Also, there are more options available to the patient. The patient has the option of bleaching overnight or for periods of 30 minutes.
Bleaching has proved to have no negative effects on tooth enamel if supervised by a dentist. The whitening process works well on all age groups. The older patient will probably have to spend more time bleaching, than a young patient. It is not desirable to bleach teeth on patients who exhibit gum disease. The bleaching trays and gel may be irritating to the unhealthy gums.
Last, porcelain gold and amalgam fillings are not affected by the bleaching process. All of these restorations will exhibit no color changes during the bleaching process.
2. My dentist informed me that if I continue to drink coffee and tea that I will not be able to whiten my teeth. Is this true? Is there anything that I can use to keep my teeth white?
I just cannot give up coffee or tea. My problem teeth are the two teeth (total 4) on each side of my two front teeth. My two front teeth are caps.
Answer - Dr. Sherman: Coffee and tea drinkers are able to bleach their teeth. It is more difficult. The time which it takes to get your teeth whitened to the desired shade will be longer.
Maintaining the white teeth will be dependent on the intake of coffee and tea. Caps (porcelain crowns) do not bleach. If natural teeth surround existing dental work, there is no guarantee that the bleached teeth will match the existing dental work. Sometimes the existing dental work will have to be updated to match the new whitened shade of the teeth.
3. How often should women see the dentist? Answer - Dr. Sherman: Women should see a dentist at least every six months. At these visits the teeth will be cleaned and the health of the teeth, gums, and soft tissue will be evaluated. It will be determined at these periodic visits when the next visit is necessary.
4. Here's an interesting question - I'm in my mid 50's is it too late for braces? Answer - Dr. Sherman: It is never too late to have your teeth straightened. Not only do you benefit from transitioning to a beautiful smile, but more importantly, the health of the gum tissue will improve. By repositioning the teeth, the gum tissue is more easily cleaned and plaque accumulation is decreased. There is an alternative to traditional braces. Instead of wearing brackets and wires, customized trays are worn that are virtually invisible. This is a great solution for an active individual who is seeking orthodontic treatment.
5. My daughter is prone to cavities. She is lactose intolerant. Please recommend foods, supplements and / or vitamins to help build healthy teeth. Also, what should she avoid? Answer - Dr. Sherman: The fact that your daughter is lactose intolerant should not affect the long term health of her teeth. If she is cavity prone her oral hygiene should be closely evaluated. This would include brushing with a high fluoride toothpaste at least twice a day, daily flossing, and visiting the dentist every 3 to 4 months to monitor her hygiene. Also, her diet should be evaluated.
6. How do toothpastes that claim to strengthen enamel work? How effective are those products? Answer - Dr. Sherman: The toothpastes that claim to strengthen enamel attempt to remineralize the tooth. Testing has been promising, but at this point independent tests have not been conclusive.
7. I have a partial denture. If I have the rest of my teeth whitened how can I whiten the denture so they will match? Answer - Dr. Sherman: The teeth on the partial will not bleach. To whiten the teeth on the partial you have to change the teeth on the partial. The teeth can easily be changed in a dental lab.
8. How long after having dental implants should the gum be healed enough to place the crown? Also, is it necessary to wear a temporary denture over the implants while the gum is healing or is it best to leave it uncovered while in the healing process is taking place? Do you have any idea if a receded jaw bone has any hope of being repaired? Answer - Dr. Sherman: With the techniques and the implant system that we use at the Cosmetic & Implant Dental Center, the final crowns can be placed three months after implant placement. We can place immediate fixed temporary crowns. It is not necessary to wear a temporary denture while the gums are healing. Again, a fixed temporary can be placed that does not put any pressure on the gums. Today with the new bone materials that we are using it is possible to rebuild bone that has been lost due to gum disease or resorption after extractions.
9. Have there been any studies about a link between hormones and gum disease? Answer - Dr. Sherman: There has been research relating elevated hormone levels of progesterone and estrogen to gum disease. It has been noted that the elevated hormone levels makes the gums much more sensitive to accumulated plaque resulting in sensitive, swollen, and bleeding gums. These elevated hormone levels occur during different life cycles I women; for example, the onset of puberty, menstruation, and pregnancy. During these periods it is very important to practice increased hygiene.
Answer - Dr. Sherman: It is common to see the front teeth shift as we mature. Teeth tend to want to push forward as time goes on. As this occurs, the front teeth become crooked. This can be corrected by orthodontic treatment. Today, that can be accomplished by braces or customized removable trays. If the shifting of the teeth gets severe, loss of bone can occur. It is important to note that once the teeth have been realigned, it is necessary to wear a retainer which holds the teeth in position.
11. Due to a terrible experience with an orthodontist I have been extremely reluctant to visit a dentist for years. I only go when I absolutely have to. Are there new methods of decreasing discomfort? I have sensitive gums and know I need to return to a dentist to prevent gum disease. Answer - Dr. Sherman: Currently, the dental patient can have treatment rendered and be totally comfortable. This is due to newer variations of Novocain which can provide a deeper anesthesia. Also numbing gels are applied to the gum tissue prior to injection to make the injection painless. Last, for the patient who is nervous, the dentist can medicate you so that you will be extremely relaxed and in some cases sleeping. We also, in selected situations, bring in an anesthesiologist to do I.V. sedation.
12. I have had an upper partial and a lower partial for quite some time. I was interested in getting implants instead of having the partials. Is it possible to have this procedure done in order to restore my smile? I feel self conscious most of the time because of the partials. Answer - Dr. Sherman: For many patients, implant dentistry is the best solution to eliminating dentures and partials. My patients over the past thirty years tell us that implants to replace partials and dentures are the best treatment for them. They can enjoy all the foods they like and have a more attractive smile. They are no longer self conscious.
13. I have diabetes and my teeth are really bad. I have missing teeth, loose teeth with exposed roots in some places and gums that have receded. Answer - Dr. Sherman: I know that all my teeth need to be pulled, I have been to the dentist and had x-rays taken. It's been a combination of things that has lead to the decline of my teeth even though I brush them constantly. But the other side of that is when I have gone to the dentist I have been made to feel awful because of the health of my teeth. What are your suggestions? My advice is for you to consider removing all the teeth because you will be reducing the bacteria that are associated with your teeth. Stay controlled as far as the blood sugar level and after healing has dental implants placed to restore health, function and esthetics.
14. I have had implants in my lower jaw for about 15 yrs now and they are failing badly. The gums have receded around the implants and my doc wants to remove them. I am now afraid to go back to the dentist and don't want to be toothless. I am 63 but feel and act younger and am very active. I also have upper dentures which I hate. I have spent a fortune on my mouth but God saw fit to grant me a great husband of 42 years and wonderful children and grandchildren. They are beautiful and loving and put up with my being self conscious. I do not know what to do now. If the implants are pulled out of my jaw, what am I left with? I was down sized from my job last year also, so cannot afford another $15,000 on my mouth anyway. Answer - Dr. Sherman: Implant design, techniques and materials have changed dramatically over the past several years. My suggestion is to remove your present, failing implants, place artificial bone and after healing, do the new implant procedures. There are various implant treatments which vary in cost. Consult an implant dentist to get a better understanding of your options.
15. I was recently told that my nearly 11 year old daughter suffers from a hereditary condition where she was born with no adult molars. She had all of her baby teeth and her pediatric dentist has sealed them to ensure they will last as long as they possibly can. My questions are: * How long should we expect these baby teeth to last? The pediatric dentist is expecting somewhere near the age of 30. Any suggestions or advice would be greatly appreciated. Answer - Dr. Sherman: Keep the baby teeth molars as long as possible. Average age is between 20-45 years. When they become loose, then single implants are the best option. Fees will vary and change by the time she will need this treatment.
So that question concludes our Ask The Expert session for this month. Thank you Dr. Sherman for joining us and answering our web visitor's questions. Join us in January for our next Ask The Expert session with Jaleigh White of 53 Bank when our topic will be 'Getting Your Financial House in Order.' We'll see you then! Lisa Turner, SWH Online Editor
10. I am 68 years old. For the past 20 years I have noticed that some of my center front teeth are starting to overlap. I had perfectly spaced teeth as a child and young adult. What's happening? Is it bone loss in my jaw? And can anything be done about it?
* Is there anything else we could be doing now to make them last longer, besides brushing at least twice a day, flossing, visiting the dentist for cleanings, checkups, and fluoride treatments every 6 months?
* Can (or should) children with this condition have braces if their teeth are crooked?
* Should she lose one of these molars earlier, what should we do? Should we go for single implants? What are our options?
* Should she be seeing a specialist other than her pediatric dentist?
* Lastly, how much should we plan these implants or treatments costing us in the long run? We feel we need to be prepared financially since we will do whatever we need to ensure a healthy, beautiful smile for her.
