Having been an Invisalign provider for over four years, I continue to be enthusiastic about this process. I have completed my Invisalign Certification part I and part II and In cooperation with Metrodentist.net have started a New York Invisalign Study Club for my dental colleagues in New York City. Our first meeting is tonight! As with any new technology there seem to be frequent changes and improvements in the process and there is a definite need for Invisalign providers to keep current with these.
I have used Invisalign primarily to correct crowding and close spaces. It also has been effective at intruding over erupted anterior teeth. The company is continually improving the treatment protocols to achieve more predictable and faster results and as a cosmetic dentist I am excited about using this developing modality as one of my tools to help my patients achieve a better smile.
I look forward to tonight's meeting and to discussing our ongoing cases with each other and seeing the results of our Invisalign treatment of our respective patients.
Thursday, February 25, 2010
Saturday, February 20, 2010
Have there been any improvements to Zoom Teeth Whitening?
Getting your smile brighter has just gotten easier! In our office we used to schedule a two hour session for Zoom Whitening. Often we ran over this time. Now Discus Dental has introduced a new Whitening package and simplified the process. Included in each Zoom whitening kit is an easier (and safer) to use mouth retractor and a simplified system for isolation of the soft tissues. The initial set up is now easier and takes less time.
Steps no longer recommended are pre-treating the teeth with a desensitizing solution and no fluoride treatment is suggested after the session is completed. Both of these steps seemed unnecessary to me in the first place, but since the company recommended them, our office always included them with Zoom Whitening treatments.
Considering these simplifications, we will be scheduling only an hour and a half and the actual bleaching time will be about an hour.
Steps no longer recommended are pre-treating the teeth with a desensitizing solution and no fluoride treatment is suggested after the session is completed. Both of these steps seemed unnecessary to me in the first place, but since the company recommended them, our office always included them with Zoom Whitening treatments.
Considering these simplifications, we will be scheduling only an hour and a half and the actual bleaching time will be about an hour.
Monday, February 15, 2010
Does preparing a tooth for a crown weaken a tooth?
Molar teeth that have extensive tooth structure missing usually are strengthened by crowning them. Molars experience a great deal of vertical loading during a patient’s lifetime and crowns often strengthen these teeth and make them less likely to experience a fracture.
Premolars and anterior teeth present a different set of problems for a dentist. Preparing a tooth for a crown may make a tooth more vulnerable to horizontal loading (although it usually strengthens a tooth’s ability to with stand vertical forces). This fact has different significance depending on whether an anterior or posterior tooth is involved.
Teeth in general experience both vertical and horizontal loading forces, but the anterior teeth ( the canines, laterals and centrals)and even premolar teeth can experience a greater proportion of horizontal force vectors. Overtime crowned anterior teeth do seem to have a higher propensity to sustain a fracture of the tooth holding a crown, as compared to crowned posterior molars. Another factor involved maybe the fact that anterior and premolar teeth have less tooth structure in the first place as compared to molar teeth.
Consequently, when preparing either anterior or premolar teeth, care must be taken to conserve tooth structure so that the resulting restored tooth will be able to withstand the horizontal forces that will be placed on it. This can be a challenge for some teeth that have had large fillings in them prior to their being crowned.
One of the reasons that veneers or bonding are good for restoring anterior teeth is that they do not involve removing as much tooth structure as the preparation required for a traditional crown.
Premolars and anterior teeth present a different set of problems for a dentist. Preparing a tooth for a crown may make a tooth more vulnerable to horizontal loading (although it usually strengthens a tooth’s ability to with stand vertical forces). This fact has different significance depending on whether an anterior or posterior tooth is involved.
Teeth in general experience both vertical and horizontal loading forces, but the anterior teeth ( the canines, laterals and centrals)and even premolar teeth can experience a greater proportion of horizontal force vectors. Overtime crowned anterior teeth do seem to have a higher propensity to sustain a fracture of the tooth holding a crown, as compared to crowned posterior molars. Another factor involved maybe the fact that anterior and premolar teeth have less tooth structure in the first place as compared to molar teeth.
Consequently, when preparing either anterior or premolar teeth, care must be taken to conserve tooth structure so that the resulting restored tooth will be able to withstand the horizontal forces that will be placed on it. This can be a challenge for some teeth that have had large fillings in them prior to their being crowned.
One of the reasons that veneers or bonding are good for restoring anterior teeth is that they do not involve removing as much tooth structure as the preparation required for a traditional crown.
Thursday, February 11, 2010
Why do teeth hurt after bleaching?
No one knows for sure, but it maybe the result of temporary dehydration of the teeth. Teeth have water content and dehydrated teeth can become sensitive to air and cold water. Bleaching solutions often use hydrogen peroxide or carbamide peroxide as their active ingredient. It could be that the peroxide is replacing some of the water in the teeth and then evaporating, leaving freshly bleached teeth temporarily dehydrated.
How long does teeth bleaching last?
People often ask:How long does the result of tooth whitening last?
Usually teeth stay noticeably whitened for at least several years but over time the degree of whitening may gradually decrease. Patients often feel the need to 'touch up' their whitening from time to time. This is relatively easy to do if they have had bleaching trays made and usually involves using their trays and touch up gel for a night or two.
Occasionally I have observed some patients who don't have as long lasting results as others. This may be related to their dietary habits or possibly some other factor that is not presently well understood by the dental community.
Usually teeth stay noticeably whitened for at least several years but over time the degree of whitening may gradually decrease. Patients often feel the need to 'touch up' their whitening from time to time. This is relatively easy to do if they have had bleaching trays made and usually involves using their trays and touch up gel for a night or two.
Occasionally I have observed some patients who don't have as long lasting results as others. This may be related to their dietary habits or possibly some other factor that is not presently well understood by the dental community.
Friday, February 05, 2010
What can be done to make a night guard more comfortable?
Often occlusal night guards are made by a dental laboratory for dental patients that are too bulky or open the bite too much. These night =guards are recommended for patients who may be bruxing or grinding their teeth at night but they must fit well to be comfortably worn.
Usually it is necessary to adjust these to make them more wearable. If these devices were inserted as made by dental laboratories, without appropriate adjustments, they could not be comfortably worn.
Since night guards are usually made either of acrylic or vinyl, they are easily adjusted with an acrylic cutting bur . Often bulky night guards can be thinned out to make them more wearable. Another feature of night guards that often needs adjustment is the bite. Night guards should not open the patient bite by more than 3 mm and If the opening created by the night guard is more , it also usually requires adjustment.
Once adjustments have been made the night guard is polished and given to the patient to try out and take home. If a patient has problems wearing the night guard they should be able return at a later date to discuss their problem(s) and have any additional adjustment that the dentist feels are indicated.
Usually it is necessary to adjust these to make them more wearable. If these devices were inserted as made by dental laboratories, without appropriate adjustments, they could not be comfortably worn.
Since night guards are usually made either of acrylic or vinyl, they are easily adjusted with an acrylic cutting bur . Often bulky night guards can be thinned out to make them more wearable. Another feature of night guards that often needs adjustment is the bite. Night guards should not open the patient bite by more than 3 mm and If the opening created by the night guard is more , it also usually requires adjustment.
Once adjustments have been made the night guard is polished and given to the patient to try out and take home. If a patient has problems wearing the night guard they should be able return at a later date to discuss their problem(s) and have any additional adjustment that the dentist feels are indicated.
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