Call Us Today! 989-799-9133

Browsing 3 posts in sensitivity.

Tooth whitening at the mall…have you seen the light?

Articles-mall-whitening4

Have you ever gone to a mall and seen the kiosks for tooth whitening?  They are almost always cheaper than the tooth whitening at your dentist’s office and they do use that blue light that they used on “Extreme Makeover.”  Why not give it a try?

Mall whitening does use the same chemical (hydrogen peroxide gel) as dentist office whitening. Actually, over-the-counter whitening strips like Crest Whitestrips also use this ingredient.  We all use hydrogen peroxide because it works.  However, I can think of a few problems that can be avoided if you whiten your teeth at the dentist’s office.

  • Some people aren’t good candidates for whitening.  If you’ve had fillings, crowns or bridge work on your front teeth whitening might not be a great choice for you.  Often it can be a great choice in combination with a well thought out treatment plan from your dentist.  Will the folks in the mall tell you this?
  • Whitening causes sensitivity.  If you whiten you will probably notice cold and sometimes sweet causing some pain.  This is normal due to the chemical process that goes on when you whiten and is usually not long lasting.  There are treatments prior to and after whitening that can reduce this sensitivity significantly.  Your dentist can best help you with this.
  • Who is going to help you if you have a problem?  Can the folks at the kiosk see you for follow up treatment, apply desensitizers or help you?  Before you have whitening done in the mall ask them if there’s a number you can call if you have an emergency.  Then email me a photo of their face after you’ve asked them. :-)
    • FYI…if you or anyone you know ever has a problem with whitening whether it was done at the mall or a dentist’s office I am HAPPY to help.  I’m available to treat emergencies at (989) 488-7665.  Just because I think mall whitening is unwise I will NEVER say I told you so!
  • The light doesn’t do anything.  Peer reviewed research has proven over and over again that the light does nothing to enhance the whitening process.  Mall kiosks aren’t the only ones who have decided to use this marketing technique.  Many dentists have paid a fair amount of money for bleaching lights that don’t do anything, but they will use them to market the service.  This is dishonest.  Period.
  • The people running the kiosks aren’t dentists.  They are not trained to diagnose or treat dental conditions.  The technicality that they cite for being able to do bleaching without proper training is that they never apply the whitening chemicals to the teeth.  They simply fill the trays and hand them to their “patients.”
  • The chemicals that are used to whiten teeth are serious.  They aren’t dangerous when handled properly but they can cause burns to the lips and gums.  The protocols for in office bleaching at the dentist office focus on reducing this risk by isolating the teeth from the lips and gums.
  • In-chair whitening alone yields less dramatic results.  Most of the dramatic whitening (and sensitivity) from “in chair” bleaching comes from dehydrating the teeth.  “In chair” can jump start good results, but long lasting whitening is going to require that you add “in home” trays.  The best trays are custom made by a dental office.

Why do people choose to do whitening in the mall?  My best guess is because of the cost.  Whitening in the dental office can be expensive.  We charge $440 for whitening.  This includes pre-appointment impressions for densensitizing/whitening trays, an in-chair whitening treatment (if you choose) and at home whitening supplies along with any follow up treatment you might need.  But if you mention that you read about whitening on our website and you can get the same whitening for $299*!

Teeth_whitening_420-420x0  Did I mention that our in chair whitening treatment allows you to watch television while you whiten and enjoy our sparkling personalities?  Also, you won’t have to wear silly orange glasses.

Tell me what you think!  I would love to know your thoughts on this entry or the website as a whole.  Feel free to comment here or email me at alan@meadfamilydental.com.

The story of sensitivity part II, the solution

Finger-in-dyke

In yesterday’s entry I neglected to mention that dentinal sensitivity isn’t the only cause of tooth sensitivity. There can be many other causes of tooth pain including having a cavity, injury to the nerve of the tooth from trauma or tooth decay, or a fractured tooth to mention a few.  The sensitivity that I’m talking about here is due to exposure of the dentin layer from tooth erosion or gum recession.

So you’ve got these microscopic tubes (called “dentinal tubules“)in your teeth that cause pain when the liquid in them moves around. This liquid moves back and forth because the outer cover of the tooth has worn off.  So what’s the solution? Simply put, you put a cover back on the tubes.  There are several ways to go about it.

One very common way is to use a “sensitive tooth” toothpaste.  Just about every company that makes toothpaste makes one and they all have potassium nitrate as an ingredient.  Potassium nitrate acts to plug the opening of the tubules from the outside.  Plugging these tubes will reduce or eliminate the movement of the liquid in the tubes which should eliminate this sensitivity.  Generally you need to use the toothpaste over a period of time (often up to 2 months) before you notice a significant decrease in sensitivity. Further, you need to continue using sensitive toothpaste to continue the results.  Using this toothpaste is a noninvasive and conservative treatment using a chemical in the toothpaste.  If this doesn’t solve the problem I will often try another “chemical” solution.

Most people think of fluoride for it’s anti-cavity properties but it also treats sensitivity.  It works in a similar way to potassium nitrate to occlude the dentinal tubules.  The concentration of fluoride in tap water or toothpaste is generally too low to treat dentinal hypersensitivity, so we’ll often prescribe a higher concentration.  There are many types of higher concentration fluoride products including rinses, pastes and gels which are used at home for a period of time like the over-the-counter sensitive toothpastes.

Fluoride varnishes are my preferred chemical treatment for sensitivity.  These varnishes are placed at the dental office by a hygienist or dentist.  They are highly concentrated fluoride in a sticky matrix. Usually they have mild and pleasant flavorings and when applied feel like a little bit of fuzz on your teeth for a few hours or so.  What’s nice about them is they can be placed directly where the sensitivity is taking place.

If we can’t control sensitivity using these chemical means we sometimes try to seal the sensitive tooth surfaces.  When we place fillings and crowns we use a special kind of glue called a bonding agent.  This glue is very thin and clear.  It completely seals the surface of the tooth to close over the dentin tubes. In severe sensitivity cases we sometimes have to anesthetize the teeth in order to seal the sensitive surfaces.

Finally, there is a “surgical solution.”  In cases where there’s been a lot of gum recession you can actually have a gum graft.  This is a procedure where a dentist actually covers the exposed root surface with a piece of gingiva (or “gum”) taken from another part of the mouth (usually the palate).  This actually closes the tubules by covering them up with what was originally there in the first place.

If you have trouble with tooth sensitivity I would recommend that you have a dentist take a look.  In many cases these conservative treatments can be helpful but it’s important to rule out other tooth problems before you try them.  If you’d like to have me take I look I would encourage you to make an appointment with us!  You can call the office at (989) 799-9133 or you can email me at alan@meadfamilydental.com.  I would be happy to answer questions or help you treat your sensitive teeth!

The story of sensitivity, part I: the problem

 

Does the thought of biting into an ice cream cone give you shivers? Do you relate to commercials for Sensodyne toothpaste better than you’d like?  You might be suffering from dentinal sensitivity or hypersensitive teeth.

The part of  your tooth that is above the gum line is called the crown of the tooth.  Generally this part of the tooth is covered by the hardest substance in the body…the enamel.  Underneath this enamel layer is the dentin.  Dentin is less hard than enamel and contains microscopic funnel shaped tubes that contain a water like fluid.  These tubes connect the nerve of the tooth (a.k.a “the pulp“) to the outer layer of the tooth.  If the enamel layer has been breeched or eroded away these tubes actually open into the mouth.  This is where we can run into problems.

Wait…it gets worse.  The root is the part of the tooth that is embedded in your jaw bone.  This is the part of the that you can’t see when you have normal healthy gums but you can start to see if you have recession.  The root has dentin too, but is covered in the much less durable cementum.  So once your gums start to recede the part of the tooth that is exposed is much more likely to wear away with normal eating and brushing.  

If the dentin is exposed through loss of enamel or gum recession the little tubes full of water are open to the mouth.  When this water moves in and out through the tubes, it causes the nerve of the tooth to fire off a painful signal.  

Water can move in these tubules due to:

  • dehydration (breathing in dry air, for instance)
  • temperature changes (eating ice cream, drinking coffee or taking a deep breath of mid-winter Michigan air) 
  • chemical changes from diet (sweet stuff like candy or acidic stuff like fruit juice)

Do you have dentinal sensitivity?  Would you like to know if anything can be done to help?  If so, stay tuned for “The story of sensitivity part II, the solution.”