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.”

While some people associate the need for root canal treatment with an injury or trauma to a tooth (which is a valid cause), it can also most commonly be caused by tooth decay that is left untreated. This is the reason why we have put together this brief guide to explain the three common stages of tooth decay that lead up to the need for a root canal.

Stage 1: During this stage, decay begins to form in the tiny grooves on the biting surface of a tooth or where the teeth contact each other. The result is loss of the surface enamel of the tooth.

Stage 2: Left untreated, the disease progresses through the enamel and into the dentin, which forms the body of the tooth. Once in the dentin, it progresses more rapidly until it reaches the pulp — the living tissue within the root canals of the tooth. The decay infects the pulp tissues, which contain the nerves of the teeth, causing pain. The end result of inflammation and infection of the pulp is that it dies.

Stage 3: As the nerve dies an infection results, which causes pain and swelling. For some people who do not regularly visit our office, this may be the first physical sign that they have a problem. But all is not lost, a successful root canal treatment, whereby the infected pulpal tissue is removed and the root canals are cleaned and sealed will not only relieve the pain, but save your tooth. So the good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, the tooth can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our office as soon as you feel you have a problem with a tooth.

If you are having pain or symptoms from a tooth or teeth, check it out with us — you may or may not need a root canal treatment. Contact our office to schedule an appointment and find out. Don't wait until it's too late. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “I'd Rather Have A Root Canal....”

Having a whiter, brighter smile can do wonders for improving self-confidence, career opportunities, and interpersonal relationships, as demonstrated in numerous scientific studies. In fact, according to a poll conducted on behalf of the American Academy of Cosmetic Dentistry (AACD), the following was revealed:

• 99.7% of Americans believe a smile is an important social asset.
• 74% feel an unattractive smile can hurt chances for career success.
• 50% of all people polled were unsatisfied with their smile.

These statistics demonstrate why you should have a solid understanding about any cosmetic procedure — even teeth whitening — before making your decision to proceed. To help you ensure that you have the facts, we created the following list of questions.

• Am I a good candidate for tooth whitening?
• How much will the entire process cost?
• Does my insurance cover the cost (or any portion of the cost)?
• How does teeth whitening work?
• Is bleaching teeth safe?
• Will the bleaching agents damage tooth enamel?
• Can whitening treatments make my teeth sensitive?
• How does your professional bleaching differ from home whitening?
• What type of bleach and strength will you use?
• How long can I expect the results to last?
• What will the bleach do to my gums, filings, crowns, veneers, and/or bridgework?

Please note that we may cover most or all of these questions during your initial consultation; however, we encourage you to bring this list with you to ensure you get the answers you need so that you can make the best decision. To learn more now, continue reading the Dear Doctor article, “Teeth Whitening: Brighter, Lighter, Whiter....” Or, you can contact us to discuss your questions or to schedule an appointment.

If an adult has lost his or her teeth (a condition called “edentulism”), full removable dentures (false teeth) can restore the person's appearance and ability to bite, chew, and talk properly. Even with our current extensive knowledge about tooth care and restoration, over 25 percent of Americans have lost all their teeth by the time they are 65.

How much do you know about dentures? Test yourself below.

How does tooth loss affect your bones?
Bone is a living substance that is constantly changing and rebuilding itself, depending on signals it receives from surrounding tissues. The bone that surrounds your teeth is called alveolar bone (from “alveolus,” meaning sac-like). To keep healthy, alveolar bone needs stimulation or function such as chewing and your teeth touching your opposing teeth. If you lose your teeth, bone begins to melt away (resorb).

How can we minimize bone loss during tooth extraction?
We can maintain bone volume by using bone grafting techniques. While this sounds scary, it is a relatively easy procedure. The principle of bone grafting is to build a sort of scaffolding on which your body begins to build and maintain its own bone. Bone loss can be prevented by the placement of a few dental implants.

How are dentures designed and created?
The dentures that look best and work best for you are based on your original teeth. We often utilize photographs of how you looked with your natural teeth, along with your input about possible changes you would like to see. First we take detailed impressions (molds) of the residual ridges in which your teeth once rested. From these we make denture bases of a light cured plastic resin. We attach horseshoe-shaped rims made of wax to the bases, to simulate the position of the teeth as we work out their design and spacing, based on both appearance and function. The prosthetic teeth are then tried out in your mouth, adjustments are made, and the dentures are processed in a dental laboratory. The final product substitutes a pink colored plastic (methyl methacrylate) to represent the gums and white plastic material as the teeth, created to make them look as natural as possible.

What is your part in the denture fitting process?
As a patient with new dentures, you must learn to use your jaw joints, ligaments, nerves, and muscles in new ways to help stabilize your dentures and to relearn to speak, bite, chew, smile, and laugh with these new structures. It takes a little practice, but with your removable dentures you can once again enjoy a complete and normal life.

Contact us today to schedule an appointment to discuss your questions about full removable dentures. You can also learn more by reading the Dear Doctor magazine article “Removable Full Dentures.”

One of the most common treatments we are asked about is a root canal and the unfortunate bad reputation associated with it. The truth is that the procedure actually relieves the pain associated with the problem and not visa versa. And here's why.

A root canal or endodontic treatment (“endo” – inside; “dont” – tooth) is a necessary procedure in which diseased pulp tissue — and the nerve, which responds by causing the pain — is removed. This is followed by cleaning and sealing the root canals. This usually results from pulp inflammation and infection as a result of a severe decay or in a heavily filled tooth. Root canal treatment is typically performed by general dentists who have taken specialized training or by endodontists, dentists who specialize in the diagnosis and treatment of root canal problems. We perform them here in our practice to save a tooth, literally, from further damage and/or loss.

Here is a quick overview of the procedure. We will begin by making a small opening in the chewing surface of your tooth so that we can access the tooth's root canal. We use small instruments to remove the dead and dying tissues of the pulp. The root canals are cleaned and disinfected. The canals are then sealed with a biocompatible filling material. Lastly, we will seal the access hole with a filling material. You will then need to get a permanent restoration or crown to protect the tooth fully.

If you feel that you have the symptoms of a root canal problem and may need a root canal treatment, contact us to schedule an appointment. And to learn more about the signs, symptoms, and what to expect after root canal treatment, read the article “Common Concerns About Root Canal Treatment.”