Posts for: October, 2013

By James B. Howell, D.M.D.
October 28, 2013
Category: Dental Procedures
EndtheEmbarrassmentofStainedTeethwithWhitening

You have a beautiful smile, but you hesitate to show it because of your stained teeth. Fortunately, whitening techniques could take away that embarrassment.

There are two basic types of tooth staining or discoloration: extrinsic, in which the stain is on the surface of the teeth and mostly caused by substances like coffee, wine or tobacco; and intrinsic, which occurs deep within the tooth, caused by such factors as aging, previous dental treatments and fillings, the use of antibiotics (tetracycline, predominantly), or over-exposure to fluoride.

Whitening or bleaching is an effective and relatively affordable solution for many instances of both intrinsic and extrinsic staining. Bleaching solutions are available in over-the-counter (OTC) home kits or as a professional application in the dental office.

Most bleaching solutions use carbamide peroxide, a chemical compound that is effective in removing most stains. OTC home applications contain carbamide peroxide (or an equivalent) in concentrations of about 10% as opposed to 15-35% found in professional solutions. Though less costly than a professional application, OTC products take longer (usually up to three weeks) to achieve desired results. With its stronger solution, a professional application in our office can achieve the same level of brightness in only one or two visits. We may also use special lighting to accelerate the chemical process, as well as rubber dams or gels to protect gums and soft tissues from solution irritation during the procedure.

Although effective, whitening isn't a permanent solution — over time the effect will fade, usually six months to a year depending on how you care for your teeth. Matching tooth color can also be difficult in some cases, especially if you have a mix of natural teeth and artificial crowns or bridges. And, whitening may not be adequate for some types of staining.

Regardless of which application you wish to use — OTC or professional — it's a good idea to visit us first for a professional consultation. We can recommend whether whitening is a good choice for your particular type and level of staining, or if some other option like porcelain veneers might be the better choice. Regardless, there are solutions to the problem of staining, and a way to gain a brighter smile.

If you would like more information on bleaching, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Whitening.”


By James B. Howell, D.M.D.
October 18, 2013
Category: Oral Health
ActressJennieGarthSharesTipsforMakingOralHealthFun

Plenty of parents use little tricks to persuade young ones to eat their vegetables, wash their hands, or get to bed on time. But when actress Jennie Garth wanted to help her kids develop healthy dental habits, she took it a step further, as she explained in a recent interview on Fox News.

“Oh my gosh, there's a froggy in your teeth!” the star of the '90s hit series Beverly Hills 90210 would tell her kids. “I've got to get him out!”

When her children — daughters Luca, Lola, and Fiona — spit out the toothpaste, Garth would surreptitiously slip a small toy frog into the sink and pretend it had come from one of their mouths. This amused the kids so much that they became engaged in the game, and let her brush their teeth for as long as necessary.

Garth's certainly got the right idea. Teaching children to develop good oral hygiene habits as early as possible helps set them up for a lifetime of superior dental health. Parents should establish a brushing routine with their kids starting around age 2, when the mouth is becoming filled with teeth. A soft, child's size toothbrush with a pea-sized dab of fluoride toothpaste and plenty of parental help is good for toddlers. By around age 6, when they've developed more manual dexterity, the kids can start taking over the job themselves.

Here's another tip: It's easy to find out how good a cleaning job your kids are doing on their own teeth. Over-the counter products are available that use a system of color coding to identify the presence of bacterial plaque. With these, you can periodically check whether children are brushing effectively. Another way of checking is less precise, but it works anywhere: Just teach them to run their tongue over their teeth. If the teeth fell nice and smooth, they're probably clean, too. If not... it's time to pull out the frog.

And don't forget about the importance of regular dental checkups — both for your kids and yourself. “Like anything, I think our kids mirror what we do,” says Garth. We couldn't agree more.

If you need more information about helping kids develop good oral hygiene — or if it's time for a checkup — don't hesitate to contact us and schedule an appointment. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”


TeethWhiteningTreatmentsFiveFactsYouShouldKnow

If you're looking to improve the appearance of your smile, tooth whitening treatments — whether done at home or in our office — are a popular option. Here are the answers to some questions that many people ask before they begin the process.

Q: Are commonly used tooth-whitening methods safe?

A: Yes — provided they are used as directed. A large body of research has shown that using the correct concentration of peroxide — the bleach that whitens teeth — for the proper amount of time is not known to cause any major health problems. However, there have been cases where poor-quality bleaching solutions and/or excessive usage have caused deterioration of tooth enamel and extreme gum sensitivity. Always follow our office's recommendation.

Q: Does this mean I have to have in-office treatments to whiten my teeth?

A: No. But you should come in for a thorough dental examination, with x-rays, before you begin whitening treatments. Why? Because if there is trouble with the underlying tooth structure, then whitening the tooth is like painting over rusty metal: It hides the symptom, but doesn't fix the problem. Abscesses and root-canal problems are just two of the underlying causes of tooth discoloration that should be treated before teeth are whitened.

Q: What are some different methods for whitening teeth, and how long do they take?

A: The fastest is in-office whitening treatments, using a strong bleaching solution and appropriate gum protection. Next comes the cost-effective method of at-home bleaching with custom-made flexible plastic trays (sometimes called nightguard vital bleaching.) If you're not in a hurry, over-the-counter (OTC) products can do the same thing — given enough time. One study comparing different whitening treatments found that a six-shade improvement in whitening was accomplished by three in-office treatments. A week was needed for custom-tray bleach applications, or 16 daily applications of OTC products, to achieve comparable results.

Q: Can any tooth be made bright white?

A: No. Every tooth has a maximum level of whiteness, beyond which it can't get any lighter. Furthermore, fillings, crowns and other dental restorations can't be lightened with bleach — another reason to talk to our office; we can help you achieve the best possible look for your particular smile.

Q: How long will my white teeth last?

A: It depends. No whitening method is permanent, but the typical result lasts for up to two years. To preserve that bright smile, you can take some positive steps: Avoid tobacco and beverages that stain, like red wine, tea and coffee; keep up with regular cleanings in our office; and, practice good oral hygiene at home. You can also have a touch-up treatment once or twice a year.

If you need more information about tooth whitening, or you're ready to start the process, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Important Teeth Whitening Questions Answered.”




Louisville, KY Cosmetic Dentistry
James B. Howell, D.M.D.
3936 Dutchmans Lane
Louisville, KY 40207
(502) 899-7766

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