In Office Whitening

Hello again friends! It has been a while. I have been busy since my last post. I am now the proud owner of South Shore Smiles, my very own dental office in Braintree, MA!

There are many whitening options out there. Just take a stroll through your local pharmacy or supermarket dental aisle, and you will know exactly what I mean. Specifically, there are many take home whitening treatments such as trays, gels, strips, etc. Many consumers do find success in varying degrees with these products, and I encourage them to continue with the whitening regimen that works best for them.

I am writing tonight specifically about the consistent success that I have had with Zoom in-office whitening. Now the makers of Zoom claim to whiten up to eight shades lighter in one visit. I don't know if I have seen that just yet, but I will say that in just over one hour, I really have noticed some very obvious improvements.

My friend Ruby visited me over the weekend from DC. We have known each other since we were 12 years old with brace faces in junior high school :) I took her to my new office for Zoom whitening, because now I finally have the opportunity to treat my friends to fun stuff like this! 

Here she is at the start of the process, with the barriers in place, ready to go:

And here is Ruby after round 3 of 4 fifteen minute sessions, all done on the low light activation setting:

She was pretty happy with the results! We might have achieved even whiter results if she had used the medium or high light activation setting.

Just in case, I had her take some Advil one hour before whitening, and sent her home with custom trays and a desensitizing gel. I like to do this for all my patients because once in a while, temporary sensitivity can occur. If you have a history of sensitive teeth, or are have questions about sensitive teeth after whitening, make sure that you talk to your dentist about your concerns before trying any products or treatments. 

Showing love for your team and your teeth

For those of you out there who play any sports that involve physical contact, I highly recommend a mouth guard if you don't already have one! I have seen too many dental injuries resulting from a hand, foreign object, or floor to the face. Prevention is key! You can save yourself a significant amount of time and money by wearing a properly fitting custom made mouth guard, rather than trying to treat a tooth after it is already broken or missing. Mouth guards have been shown to reduce the risk of concussions as well.

Here is a mouthguard I recently made for a college student:

Yes, your mouth guard can double as a fashion statement! Mouth guards can be made in different levels of thickness, offering different levels of protection depending on the level of physical contact involved with the sport you play. A properly fitting mouth guard can avoid headaches down the road!

Extensive Decay on Maxillary Anterior Teeth

A young man comes to me regarding his maxillary anterior teeth, #7-10. He does not like the way they look, and wants to know what he can do about it. 

Clinically and radiographically, these teeth present with large existing composite restorations, and display extensive facial, lingual, and interproximal recurrent decay. Treatment options were discussed with the patient. Due to very little remaining healthy tooth structure, single unit full coverage all-ceramic crowns were indicated. 

Teeth #7-10 were prepared, all decay was removed, an impression was taken, and temporary crowns were fabricated. His aesthetic wishes were discussed, and we made sure that he was happy with the way his provisionals appeared. 

The permanent crowns were delivered a couple of weeks later. Occlusion and contacts were checked, margins were flush, and the patient was happy with his new smile!

Replacing a Retained Primary Tooth

Dental implants and bridges are common prostheses used to restore missing teeth. In the case below, this gentleman had a retained primary, aka baby tooth #H, which was never replaced by the permanent adult tooth #11, the left canine. Recently, tooth #H became increasingly mobile and was causing pain, resulting in the need for extraction. 

The patient's permanent canine, tooth #11, was in fact impacted, and still unexposed in his maxilla. We discussed his options: forced eruption using orthodontics, extracting the impacted canine and placing an implant, or a bridge. After a thorough evaluation taking the patient's wishes into account, we decided to replace the missing tooth with a three-unit bridge.

Above, the teeth on either side of the edentulous space were prepared for a bridge. 

With good oral habits, the bridge should last for years.

Fractured central incisors

I've noticed that the majority of patients coming to me with an emergency are usually either in pain, or have fractured a tooth. Specifically a front tooth. The case below is something that I see quite often. 

This young lady was having a drink at a bar, and the beer bottle was knocked into her right central incisor, tooth #8. She wasn't in any pain, but was really self-conscious about her appearance. I noticed and asked her about her left central incisor, tooth #9, which had a chip as well. She stated that it's been there for as long as she could remember. After taking a radiograph to make sure the root of tooth #8 was unaffected, I got to work.

I selected a shade that would match her own teeth. Local anesthesia was not necessary, as the fracture didn't appear to be close to the nerve inside the tooth, and there was minimal preparation needed prior to restoring it. I evaluated the size and shape of her teeth, and placed a composite restoration on #8. The chip on #9 was restored with composite as well in order to achieve a more symmetrical smile and in turn, enhancing aesthetics.

She seemed very happy with the final result, which made my day!