Posts for: September, 2012

By Arnold Cutler, D.D.S.
September 26, 2012
Category: Dental Procedures
TheArtistBehindPorcelainVeneers

While we have gained recognition for our role in creating gorgeous smiles with porcelain veneers, the often overlooked or unknown key contributors in this process are the dental laboratory technicians. These behind-the-scenes artists are the trained professionals in the art of using dental porcelain to hand-craft veneers and crowns into near exact replicas of natural teeth in shine, opacity, translucence and shape.

Through the use of precise molds and excellent communication skills, we share detailed information with the laboratory technician to create veneers or crowns specifically for enhancing and improving your smile. In fact, communication must be so exact that it often demands correct lighting, cameras and computers to produce optimal results. This process also requires a variety of colors, shapes and translucency, created so that once we cement them into place, they appear as beautiful natural teeth. If your veneers are part of a smile restoration or makeover and you are getting them for several front teeth, the end results are typically brighter and whiter than your natural teeth. However, they must blend with surrounding teeth if those teeth are not also receiving veneers. So it is often recommended to have your natural teeth whitened before the veneers are replaced.

Good dental porcelains in the right hands can make for spectacular tooth imitations by mimicking tooth enamel perfectly. And now that you have these facts, you begin to understand all of the expertise, artistry, and the technology required by laboratory technicians to produce the most dazzling porcelain veneers.

To learn more about porcelain veneers, continue reading the Dear Doctor article, “Smile Design Enhanced With Porcelain Veneers.” Or if you are ready to see what cosmetic dentistry can do for you, contact us to schedule a consultation.


By Arnold Cutler, D.D.S.
September 18, 2012
Category: Dental Procedures
Tags: teeth whitening  
WhiteningaDiscoloredToothfromtheInsideOut

If you have discolored teeth, the cause is often staining on the enamel surfaces from foods, beverages, or smoking. But tooth discoloration may also originate deep within the root of a tooth. Sometimes this happens to a tooth that had to have earlier root canal treatment because of injury or decay.

In such cases the living pulp tissue and its blood vessels and nerves had to be removed from the root canals, resulting in the death of the dentin layer, which makes up most of the tooth's body. Over time this caused the dentin to darken. The color may come from remains of blood that was left in the tissue, or from filling materials left in the root canal that are showing through.

Since these stains are caused internally (intrinsic) and not on the outside of the tooth (extrinsic) they must be whitened from the inside. This is usually done by putting a bleaching agent into the empty chamber from which the pulp was removed. Usually the bleaching agent is a substance called sodium perborate.

When it is mixed with a solution of hydrogen peroxide, sodium perborate slowly bleaches the color from the tooth's internal material. It is considered to be safe and reliable for this use.

The work begins by taking x-ray images to make sure that the root canal is correctly sealed and the bone is healthy. After this, we will make a small hole in the back of the tooth through which the root canal space will be cleaned. The root canal space will be sealed and the bleach will be applied in a putty-like form and sealed off from the rest of your mouth. Every few days this procedure will be repeated until the bleaching reaches the desired level.

At this point a tooth-colored composite resin will be used to seal the small hole that was made in the dentin to insert the bleach. After the tooth has reached the level of whiteness that matches it to your other teeth, veneers or crowns must sometimes be used to repair the surface if it is chipped or misshapen, for example.

Contact us today to schedule an appointment to discuss your questions about whitening internally discolored teeth. You can also learn more by reading the Dear Doctor magazine article “Whitening Traumatized Teeth.”


By Arnold Cutler, D.D.S.
September 10, 2012
Category: Oral Health
Tags: fluoride  
UnderstandingtheLatestNewsonFluoride

Guidelines regarding the concentration of fluoride in water have recently been changed by the US Government's Department of Health and Human Services (HHS) and the Environmental Protection Agency (EPA). These agencies recommended a reduction of fluoride in water supplies to 0.7mg/L, modifying the original recommendations provided in 1962 by the US Public Health Service.

What is fluoride, and why add it to water supplies?
Fluoride is a chemical form of fluorine, a naturally occurring element. For decades, scientists have carried out studies on the effects of fluoride in water, and they have proved that fluoride strengthens tooth surfaces and makes them resistant to decay. A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The Center for Disease Control (CDC) says that fluoridated water is one of the ten most effective public health measures of the 20th Century. The optimal amount of fluoride necessary to make teeth resistant to decay turns out to be between 0.7 and 1.20 milligrams per liter (mg/L). A certain amount of fluoride occurs naturally in water supplies, and communities have added fluoride to bring the amount up to the optimal recommendations.

How does fluoride you drink get into your teeth?
The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface.

What about fluoride from other sources?
Americans now have access to many sources of fluoride in addition to the water they drink. These include foods, beverages and toothpaste. As a result, dentists have begun to notice an increased prevalence of a condition known as Dental Fluorosis.

What is Dental Fluorosis?
Dental Fluorosis can occur when teeth, particularly in children, receive too much fluoride. This condition is a mottling or uneven staining of the tooth surface enamel. There may be small white spots or extensive brownish discolorations. The mottled enamel is still resistant to decay, but it may be unattractive in appearance.

What is the idea behind the new guidelines?
With the new guidelines, fluoride is kept at the lower end of the scale of the optimal concentration for strengthening teeth against decay. At this end, there is room to add consumption of fluoride from other sources such as foods or toothpaste. In short, it is the best of both worlds.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can learn more by reading the Dear Doctor magazine articles “Fluoride & Fluoridation in Dentistry” and “New Fluoride Recommendations.”




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