timberlake dental

White Spots on Your Teeth? Here’s What You Need to Know!

Every wants white teeth, but we generally want them uniformly white, not just peppered here and there with white splotches or lines.  There are a few common causes of these isolated white spots, and this blog will explore each one, including ways you can help lessen their appearance.

Causes of White Spots

In general, an isolated white spot on tooth enamel is an indication that there is a problem with that area of enamel.  The matrix of minerals in a white spot is different from that in the rest of the tooth.  In most cases, white spots are weaker and more susceptible to cavities because of this change in the mineral content.  Here are the three most common causes of white spots.

  1. Demineralization of the Enamel due to Plaque Buildup

Demineralization is a big word for softened or weakened, when it comes to tooth enamel.  This occurs as the result of damage from the acid produced by bacteria in the mouth.  These bacteria collect in large clumps within dental plaque, so when plaque remains on the teeth for any extended period of time, the bacteria can soften enamel through their acid production.

This occurs most commonly in two areas: a) around orthodontic brackets, and b) near the gumline.

When people wear braces, the brackets provide an easy collection area for plaque and a very difficult environment to clean.  When patients in braces do not adequately clean around each bracket, and plaque stays on the teeth, the result is demineralization.  Unfortunately, it is almost imperceptible until the braces come off.  Then you can see a small outline of where the brackets were, created by lines of demineralization or “white spots”.

Another difficult area to clean is the area where the gums meet each tooth.  If the toothbrush bristles do not touch the gumline during brushing, or if a person suffers from dry mouth leading to excessive plaque buildup in this area, small crescent-shaped white spots can result.

These white spots are 100% preventable!

  1. Enamel Defects

Some white spots result from an incomplete or defective formation of enamel when the body makes a tooth, before it ever comes into the mouth.  These enamel defects may be the result of health problems, like a high fever, when the permanent tooth is forming.  They can also occur when a developing permanent tooth sustains damage from an injury to a baby tooth.  Regardless of the cause, this type of white spot is almost impossible to prevent.

Depending on the cause, the shape and size of the white spot will vary.

  1. Too Much Fluoride

Fluoride is a naturally occurring mineral that can help strengthen tooth enamel and resist cavities.  However, there can be too much of a good thing!  There are some areas of the country in which the high levels of natural fluoride in the ground leads to too much fluoride in the drinking water.  If someone receives too much fluoride while a tooth is forming, the tooth may develop white splotches or stripes.

This condition is called fluorosis and can also lead to brown or gray spots.  Unlike the white spots of demineralization or enamel defects, fluorosis white spots are usually not weaker areas on the tooth.  In some cases, these teeth are actually more resistant to cavities.

How to Make White Spots Less Obvious

There are several techniques you can use to improve the appearance of white spots.  It is important to understand the cause of your white spots before you attempt to improve them.

  1. Demineralization of the Enamel due to Plaque Buildup

The way to fight white spots caused by demineralization is to work toward re-mineralization.  You can remineralize teeth by applying certain minerals on a consistent basis.  Your dentist will have information on specific techniques available for fighting your demineralization.  These will include: professional fluoride treatments, prescription pastes or gels containing minerals like calcium and phosphate, or unique toothpastes containing nano-hydroxyapatite.

While attempting to remineralize areas on the teeth, having great oral hygiene and keeping up with consistent professional teeth cleanings is of the utmost importance.  In order to remineralize, you not only have to work on the areas that have already demineralized; you have to keep the plaque away so new areas do not form!

  1. Enamel Defects

Many enamel defects will require dental restorations if the surface is not intact.  If a pit, crack or depression is present, your dentist will restore it with a perfectly matching, tooth-colored filling.

If the surface of the defect is intact and only discolored, then there are some different treatment options available for improving the appearance.  These are generally non-invasive and give a good long-term result.  You can always opt to cover the defect with a veneer, which is slightly more invasive but provides perfect long-term coverage.

  1. Too Much Fluoride

You can alter the appearance of splotchy fluorosis with teeth whitening.  It is very important to note that the appearance of the white spots may get worse (more obvious) before it gets better.  At first, during the teeth whitening process, everything will whiten evenly, meaning white spots will get whiter, too.  Then, the rest of the tooth will start to catch up.

After consistent teeth whitening, the overall appearance of your teeth will even out, looking consistently bright and white.

Fluorosis is difficult to whiten, so you definitely want to utilize the supervision of your dentist and his professional whitening products to get the best result!

More Questions about White Spots?

Call 940-382-1750 today to schedule a consultation with Dr. Chowning.  He can investigate your specific white spots to determine the best course of action in improving their appearance.

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Tonsil Stones: What Are They, and Why Do I Get Them?

To be frank, tonsil stones are gross.  If you have never experienced them, count your lucky stars.  They feel weird, they smell bad, and they put you at risk for infections!

What are Tonsils?

Tonsils are lumps of lymphatic tissue (part of your immune system) at the back of the mouth.  They come in all sizes, and some patients have very large tonsils that can even affect breathing.  Tonsils are corrugated, meaning they are rough-textured with deep pockets and grooves on the surface.  They contain lots of white blood cells and work to keep germs from entering the body through the nose and mouth.

The palatine tonsils are the ones you can see through the mouth.  There are others, not easily visible, above the roof of the mouth and below the back of the tongue.  Inflamed or infected tonsils are often the cause of sore throats and fevers.

What are Tonsil Stones?

Tonsil stones are small pieces of hardened (calcified) material that collect in the deep pits and grooves of the tonsils.  They are very similar to the hard tartar buildup that accumulates on your teeth.  They contain bacteria, exfoliated tissue cells from the lining of your mouth, and food debris.  This collection of debris can be an irritant to the soft tissue of the tonsil, leading to swelling and redness.

What Causes Tonsil Stones?

The exact cause of tonsil stones is the collection of debris that hardens.  However, there are several risk factors that can increase the likelihood that you will suffer from tonsil stones.

  1. Groovy tonsillar anatomy – Some tonsils just have deeper pits and grooves than others. This makes them more likely to collect debris and more difficult for you to clean that debris.
  2. Inadequate oral hygiene – If there is more debris in your mouth, there is also more debris that could collect in the tonsillar grooves. More plaque and tartar buildup on the teeth increases your risk for tonsil stones.
  3. High mineral levels – Just as some patients are more prone to stones in their kidneys, gallbladders and salivary glands, they can be more prone to tonsil stones. In some cases, higher mineral levels in saliva cause quicker hardening of soft buildup into stones.

How Do I Get Rid of Them?

Whatever you do, you should NOT attempt to remove them with your fingernails or metal instruments!  You are VERY likely to cause inflammation and infection this way.

If you feel a tonsil stone in the back of your throat, the best tactic is gargling with warm salt water several times throughout the day.  This will generally dislodge the stone.  If you are prone to tonsil stones, you should add gargling salt water to your daily routine to keep the deep tonsillar grooves flushed out regularly.

If you have a tonsil stone that is not dislodging on its own and has surrounding inflammation or infection, see your medical doctor immediately!

See your dentist regularly to consistently reduce the plaque, bacteria and food debris in your mouth.  This will reduce the likelihood of developing tonsil stones.

More Questions about Tonsil Stones?

Call 940-382-1750 today to schedule a consultation with Dr. Chowning.  He can answer any questions you have about tonsil stones and help you take steps to keep them away!

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How Acid Reflux Affects the Mouth

Acid reflux is a condition that affects millions of Americans, both adults and children.  Also referred to as GERD (gastroesophageal reflux disease), acid reflux allows stomach acid to escape from the stomach, creeping up into both the esophagus and the mouth.

Acid reflux is a case of a broken one-way “door”.  There is a “door”, called a sphincter, between the esophagus and the stomach.  It should only go one way, allowing the contents of the esophagus into the stomach, but preventing anything in the stomach from going backwards (upward) into the esophagus.  In acid reflux, this sphincter does not do its job well, so acid seeps out of the stomach, going the wrong way.

Why is Stomach Acid Bad for the Mouth?

Remember your pH scale from middle school science class?  On this scale of 0 to 14, the lower the number is, the more acidic, and the higher a number is, the more basic or alkaline.  Neutral is at pH 7.0.  A healthy mouth ranges from 7.5-8.5, so it should be slightly basic or alkaline.  This pH is maintained by an adequate amount of healthy saliva.

Stomach acid, by contrast, falls between 1 and 3 on the pH scale, making it an extremely strong acid.  For comparison’s sake, consider that battery acid is also about 1 on the pH scale.  It is dangerous!

Inside the stomach, this acid is a good thing.  It is an important part of the digestive process, breaking down food and releasing important nutrients.  Outside the stomach, it is harmful.

Stomach acid has an erosive effect on both hard and soft tissues.  The pain of “heartburn” is the result of irritation of the lining of the esophagus by this strong acid.  Only the lining of the stomach is tough enough to withstand stomach acid!

What Symptoms in the Mouth Result from Acid Reflux?

Many people mistakenly assume that acid reflux stops in the esophagus.  Unfortunately, it does not.  The acid easily makes it up into the mouth and causes a lot of damage.  Not everyone who has acid reflux experiences heartburn.  For this reason, there are some cases in which your dentist is the first one to notice that you could have a problem by what he sees in your mouth!

Soft Tissues

Just as stomach acid irritates the lining tissue of the esophagus, it can also irritate the soft tissue lining the inside of the mouth.  This can cause a general tenderness or soreness inside the mouth, a burning or tingling on the tongue, and a sore throat.

Teeth

Most notable, to a dentist anyway, is acid erosion on the teeth.  Enamel is the protective coating of our teeth.  It is the hardest substance in the body, and it only has one major enemy: ACID.  Acid weakens, softens and etches enamel in the same way it can etch glass.

Tooth enamel begins softening at a pH lower than 5.5.  Stomach acid is far lower than that.  In people with acid reflux, the overall pH of the mouth consistently falls below that threshold, thus putting the teeth at constant risk for erosion.  Not only does the acid itself wear away enamel via erosion; it also makes the environment more conducive to cavity-causing bacteria.  Patients with acid reflux have a much higher cavity risk than someone without.

Medications

Many patients with chronic acid reflux take prescription medication to manage it.  The problem with these medications is that most of them cause dry mouth as a side effect.  A dry mouth means your body is not producing enough saliva.  Remember that saliva is a good thing and our body’s defense against acid.  Without it, the teeth and tissues are even more susceptible to damage from acid.

What Can I Do to Protect my Mouth if I Have Acid Reflux?

There are several important steps you must take if you suffer from consistent acid reflux!  Following these tips will protect your teeth and save you money.

  1. Never miss a dental visit!

Dr. Chowning can catch the early signs of enamel erosion and help guide you into the necessary changes to stop it in its tracks.  He and his wonderful dental hygienists will help you prevent further damage and lower your cavity risk.

  1. Work with your medical doctor and a nutritionist if necessary to reduce your acid reflux.

We can fight the acid in the mouth, but preventing the reflux is a much better tactic.  Commit to making any dietary changes and taking prescribed medications as needed to control the acid reflux itself.

  1. Avoid acidic beverages, like sodas, sports drinks, alcohol, and coffee.

Your mouth is acidic enough.  Don’t make it worse by adding acidic drinks!  Drink water only, or even better, alkaline water.  This will help neutralize the pH of your mouth.

  1. Chew sugar-free gum between meals to stimulate saliva.

Chewing flavored gum causes your body to naturally produce saliva, which is our best defense against any kind of acid in the mouth.  Make sure it is sugar-free, though!  Otherwise, you could actually increase your cavity risk.

  1. Consider professional fluoride treatments at your dental visits.

These high-powered fluoride treatments are scientifically proven to strengthen and harden enamel, making it more resistant to the attacks of acid.

Do You or a Loved One Suffer from Acid Reflux?

Call 940-382-1750 today to schedule your visit with Dr. Chowning.  He will help you address any oral concerns that result from acid reflux, protecting your teeth for a lifetime!

 

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Toddler Tooth Care

We love that Denton is a town full of growing families!  And at Timberlake Dental, we love caring for the entire family.  This week’s blog is full of important information about caring for your toddlers’ teeth!

What Am I Supposed to Do to Care for My Toddler’s Teeth?

Baby teeth are just as important as permanent teeth, and they need the same kind of care.  Because baby teeth have thinner enamel than permanent teeth, it is actually easier for a toddler to get a cavity than for an adult.  There are two important components of caring for your toddler’s teeth.

  1. Nutritional Concerns

Because it is easier for cavities to form on baby teeth, it is essential that you limit your child’s intake of sugary drinks.  Obviously, sodas are bad for a toddler.  Most people do not realize that many juice boxes and sports drinks are just as bad because they have as much sugar as a soda does.

Sweets or candies should be limited to dessert time as close to a meal as possible.  In between meals, your toddler should drink only water.  If your little one takes a sippy cup to bed, make sure it, too, has only water in it.  Even milk has enough sugar in it to cause cavities if your child sips on it throughout the night.

  1. Oral Hygiene

No toddler is capable of taking care of his or her own teeth.  They lack the manual dexterity necessary to clean all surfaces of all the teeth.  For this reason, you have to brush and floss for them.

Wait . . . What?!?  I’m Supposed to Floss my Toddler’s Teeth?

Yes!  Both brushing and flossing are essential to keep your kids’ teeth clean and cavity-free.  Some of you may have an “out”, though.  Many children have small gaps between their teeth.  You do NOT have to floss the teeth that have gaps.  You only need to floss where two teeth touch each other.

Both brushing and flossing are easiest to do by sitting on the floor and having your child lay his or her head in your lap.  As you look down into the mouth, you will be able to easily see what you are doing.  Because they are laying back, it is important to only use a very small amount  of toothpaste and no water (so they do not choke).

When Will my Toddler Stop Teething?

Teething is a real pain . . . for both the toddler and the parent.  Most children have all of their baby teeth in their mouths by age 2 years old.  However, some children are slower to develop and can experience teething and tooth eruption up to age 3.

Teething rings and other toys that can be frozen are wonderfully soothing to sore gums.  In severe cases, you can administer children’s Tylenol or Motrin according to the manufacturer’s instructions.

What Do I Do if my Toddler Falls and Damages Her Mouth?

As little ones are learning to “toddle”, they often fall.  Injuries to the mouth are very common in the toddler stage.  It is important to evaluate the injured area of the mouth quickly to determine the extent of the injury.  In most cases, only minor damage takes place.

If you see excessive bleeding, a broken or lost tooth, or a misplaced tooth, come see us ASAP.  If the injury happens after hours, call our office phone number (940-382-1750), which has the information to reach Dr. Chowning in an emergency.

When Does my Toddler Need to See a Dentist?

As soon as he or she can sit still in the dental chair!

We love seeing children as early as possible in order to give them a good experience at the dentist.  It is great to bring kids to easy short visits of your own so you can set an example for them.  You show them that you are not scared, and therefore, they will not be scared.  You show them how to sit still in the chair, lean back, and open your mouth so that the dentist can take a look around.  Then they will understand what is expected of them when it is their turn.

At Timberlake Dental, we see many children as young as two years old (and a few even younger than that).  We slowly ease children into the process of a professional teeth cleaning and a dental evaluation by allowing them to do a little at a time and work their way up to a full visit of their own.

More Questions about Toddler Tooth Care?

Call 940-382-1750 today to schedule a visit with Dr. Chowning.  He and our hygienists love seeing children of all ages and can answer all of your toddler tooth care questions.

 

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What to Do if You Have a Dental Emergency

Accidents happen.  Sometimes dental problems sneak up on you when you’re not prepared for them.  Regardless of the cause, emergencies are never easy.  This blog will equip you to deal with dental emergencies in the best possible way.

What Constitutes a Dental Emergency?

There are many different dental problems that occur when you least expect it.  Being able to distinguish between true emergencies and non-urgent dental problems will help you take the first step in dealing with them.

Let’s start by ruling out non-urgent dental problems.  These are the things that do warrant a dental appointment, but they do not necessitate an after-hours, expensive emergency dental appointment.

  • A loose tooth with no pain or swelling (this includes baby teeth and permanent teeth)
  • A permanent tooth coming in behind or to one side of a baby tooth
  • A toothache that does not cause any swelling
  • A chipped or broken tooth that does not expose the nerve of the tooth or cause pain

For any of these issues, please call as soon as we are open or leave us a voicemail.  We will make room for you in our schedule to see you as quickly as possible.

True Dental Emergencies

True dental emergencies are not very common, but they require immediate care.  We can divide true dental emergencies into two different categories based on who should address them: your dentist or an emergency room physician.

If you or a loved one suffer any of these problems, you should call your dentist, whoever is on call for your dentist, or an emergency dentist immediately.

  • A permanent tooth that has been completely knocked-out
  • An injury that breaks a tooth and exposes the nerve inside

The next list includes emergencies that require urgent medical care.  If you or a loved one experience any of these, please go to the nearest emergency room as quickly as possible.

  • Any swelling of the face or neck from a dental infection
  • A broken jaw
  • A dislocated jaw
  • Any large cut to the lips, cheeks or tongue that will not stop the bleeding

What to Do for a Knocked-Out Tooth

The most urgent dental emergency requiring dental treatment is a tooth that has been completely knocked out.  If this happens to you or a loved one, it is important to follow these steps:

 

  1. Call your dentist and make plans to meet him at the office as soon as possible.
  2. Find the tooth.
  3. Store the tooth in milk or saliva. Do not store it in water, and do not attempt to wash it off.
  4. Go directly to the dentist’s office.

The timing of this is the most important factor in long-term success.  The sooner the dentist re-implants the tooth into the socket, the more likely it is to succeed.

Having a good, established relationship with a dentist is important in dental emergencies.  An emergency is not the time to be scrolling through a list of dental offices, trying to find one who will see you!

What to Do about Large Swellings in the Head and Neck

This is the most life-threatening dental emergency there is, and that’s why you should head directly to an emergency room.  In rare cases, people die from tooth abscesses.  Death can be the result of a tooth infection spreading into one of three areas: the brain, the bloodstream, or the airway.

In order to prevent this dangerous spread of infection, any swelling in the head and neck needs immediate attention.  In most cases, the emergency room doctor will start intravenous antibiotics to get the medication to a functional level in the bloodstream as quickly as possible.  If you or a loved one have this type of swelling, don’t waste time calling your dentist.  Go to the nearest emergency room immediately.  Once the infection is under control, then you can seek dental care.

More Questions about Dental Emergencies?

Call our office today at 940-382-1750!  We can tell you how we handle dental emergencies in our office and what you need to do if you have one.

If you do not currently have an established relationship with a dentist, the prospect of a dental emergency is reason enough to start one.  Call to schedule a new patient visit with Dr. Chowning!

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What Exactly is a Crown?

Most people have heard of the terms “crown” and “cap” in regard to dentistry (they are interchangeable, and dentists prefer the term crown), but few actually understand what a crown is.  This blog will explain this, along with why they are necessary, what types of crowns are available in modern dentistry, and what to expect if you are in need of one.

What is a crown?

There are actually two meanings of the word “crown” in dentistry, which can sometimes make things confusing.  We will define both here, and the rest of the blog will pertain only to the second definition.

  1. Crown – the portion of a tooth exposed to the mouth, which excludes the roots (even any root structure that is visible through gum recession). This definition describes an anatomical portion of a tooth.  The crown is covered in enamel.  Under this definition, every tooth has a crown.
  2. Crown – a dental restoration of a tooth in which all of the enamel has been removed and replaced with a new material. Crowns can be made out of metals, ceramics, or temporary materials.  A crown should completely cover the entire exposed portion of the tooth, and the edge (margin) of the crown typically rests near the gum line of the tooth.

Why do certain teeth need crowns?

  • Very large cavities – In some cases, the integrity of the tooth is undermined by a very large cavity. Once all of the decay has been removed from the tooth, there must be an adequate amount of solid, healthy tooth structure to support a filling.  If there is not enough tooth structure remaining to hold a filling, then the entire tooth must be covered by a crown in order to restore it to its proper shape for chewing.  In this situation, if a filling were placed instead of a crown, it could only be considered a short-term solution at best.
  • Fracture – The enamel covering a tooth is one solid, continuous layer. A visible fracture or crack means that the enamel is no longer able to do its job of protecting the tooth from bacteria, food, and chewing forces.  Interestingly, cracked teeth do not always cause pain.  A crown’s role in “fixing” a cracked tooth is the total replacement of the enamel layer with a new solid, continuous material, which splints the underlying tooth structure together.
  • Lack of adequate coronal tooth structure – Just as a very large cavity can deprive a tooth of the necessary amount of tooth structure, a large filling or even missing tooth structure can do the same. The crown restores the tooth to its original shape, size and strength to provide proper function.
  • Root Canal Treatment – When a tooth has had a root canal, the nerves and blood vessels have been removed from the inner, hollow chamber of the tooth. They are replaced with a filling material called gutta percha.  Because the tooth no longer has a blood supply, it no longer has a source of hydration and becomes dried out and brittle.  This brittleness makes the tooth high risk for cracking.  A crown is placed over a tooth that has had a root canal in order to prevent such cracking so that you can keep the tooth for a long time.  A root canal is a significant investment in the life of a tooth.  If the tooth is not properly covered and protected with a crown, that investment could be wasted.

What are the different types of crowns?

There are many different materials available for crowns today.  Each material has pros and cons, listed below.  What is most important is that your dentist select the proper material for each individual tooth.  At Timberlake Dental, we prioritize each patient as an individual with distinct and specific needs.  You will never get a “one size fits all” recommendation.  Our doctors take all of the pros and cons of each material into consideration when selecting the right crown for your particular needs.

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What can I expect at my dental appointment for a crown?

  • Traditional lab fabricated – If your crown is being made in a dental lab by a professional, certified dental lab technician, you will experience a two-appointment process. At the first appointment, the tooth is prepared for the crown under local anesthetic.  You should be numb and experience no discomfort during the preparation process.  Once the doctor has achieved the proper preparation for your tooth based on the crown selected, either an impression or a 3D scan is taken.  Both of these serve to communicate the exact shape of the prepared tooth from the doctor to the lab.  The lab uses this to fabricate the prescribed crown.  The process typically takes 2-3 weeks.  During that time, you will wear a provisional or temporary crown to replace the enamel and cover the tooth.  The temporary crown and your bite should feel comfortable after the initial post-operative sensitivity has worn off (on average, a few days).
    You will return for your second appointment after we have received your crown from the dental lab.  At this visit, the temporary crown is removed, the underlying tooth structure cleaned, and the new crown fitted to your tooth.  An x-ray is taken to confirm that the crown fits properly and allows no leaking of saliva or bacteria under the crown.  The bite is adjusted, if necessary, and then the crown is cemented onto the tooth.  You need to have a little caution when eating and cleaning the new crown for the first 24 hours.  Afterward, you return to business as usual, eating and cleaning it like you would a natural tooth.
  • Same-day in-house crowns – A new trend in dentistry is same-day crowns. This technology eliminates the need for two appointments, the 3 week waiting period, and a temporary crown.  The same-day crowns are made with a CAD/CAM milling machine that works with 3D technology to create a physical crown out of digital information.  One limitation to same-day crowns is that they can only be made out of one material, so they are unable to make crowns that contain two types of materials like the porcelain-fused-to-metal crowns.  They are also limited in the customization allowed to create the perfect match to your natural teeth.  For this reason, they may not be selected as the right type of crown for front teeth.
    The tooth is prepared by the dentist in the same way, and instead of having a provisional crown made, you simply wait in the office while the crown is being milled by the CAD/CAM machine.  Once it is completed, the crown is fitted to your tooth in the same process as noted above, and the same instructions apply.

Do You Need a Crown?

Call our office at 940-382-1750 to set up a consultation with Dr. Chowning.  He will discuss the reasons your specific tooth needs a crown and go over the available types of crowns with you.  Together, you will select the crown that will best fits your needs.

 

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At-Home Teeth Straightening

Why choose Invisalign® when you can order a cheap, internet version of invisible aligners and do it yourself?

If you participate in any type of social media, it is likely that you have seen advertisements for at-home teeth straightening systems like Smile Direct Club™, Snap Correct™ and Straight Teeth Direct™.  It seems as if everywhere you look, someone is promoting another DIY “teeth hack”.  We understand how tempting it is to skip the dentist and save money.  However, it is important that you know the dangers of do-it-yourself teeth straightening so that you do not cause irreversible damage to your teeth and jaws.

This article will address the significance of the dentist’s role in teeth straightening from start to finish, as well as the risks of moving the teeth without a dentist’s supervision.

The Dentist’s Role in Teeth Straightening

Start:

Before any teeth are moved, whether through traditional braces or invisible aligners, the first and most critical step in the process of evaluating the teeth is not measuring the crowding and spacing or checking the bite. It is determining the health and stability of all the teeth in a patient’s mouth.  This process must involve an in-person evaluation by a licensed dentist, dental x-rays, and measurements of the gum and bone attachment to the teeth.  Because this step is omitted from an at-home teeth straightening system, the result could be straight teeth that are riddled with cavities or loose from periodontal disease.  Both of which would necessitate more extensive and more expensive dental treatment.  Our goal for every patient is always a completely healthy smile, not just straight teeth.

  1. Assessment of cavity risk – Before any teeth straightening, Dr. Chowning will perform a thorough evaluation of your teeth in order to determine your risk for cavities. It is crucial to know where you start on the scale of cavity risk because all types of orthodontic treatment will increase that risk.  If you fall into a high-risk category, we will provide adjunctive therapy during your orthodontic treatment to prevent cavities while you are straightening and monitor your teeth closely during treatment. 
  2. Assessment of gum and bone stability – One of the most tragic phenomena we see in dentistry is a beautiful, straight, white smile built on a diseased, unstable foundation, where teeth are often loose and later lost. Keeping your teeth for a lifetime not only involves preventing cavities; it also requires healthy bone and gum tissue surrounding each tooth.  This is never more important than during orthodontic treatment.  The bone and gum tissue around a tooth must change and move with the movement of the tooth.  A healthy jaw bone will reorganize and regrow around the new position of a tooth after it has been moved.  An unhealthy bone will not regrow, leaving the tooth weakened and unstable.  Orthodontic treatment done incorrectly can worsen an already unhealthy jaw bone.

During:

While your teeth are in the process of moving, Dr. Chowning monitors the progress of the movement as well as the maintenance of teeth, gum and bone health.

  1. Monitoring the position of the teeth – Unfortunately, one of the pitfalls of orthodontic treatment is that teeth do not always go where we want them to go. In order to get the proper end result, the progress of movement should be closely evaluated at regular intervals throughout the process.  Chowning will recognize a tooth that is getting off track and redirect it before any permanent damage is caused.  Obviously, this would be impossible without a dentist supervising your treatment.
  2. Maintaining the health of the teeth, gums, and bone – Just as the initial evaluation of the health of the teeth, gums, and bone is crucial to orthodontic treatment, so is the maintenance of that health. At each progress check during your treatment, your dentist is in a position to discern any changes in your cavity risk or the stability of the gums and bone supporting your teeth.  They can then guide you in the best way to reverse these changes while continuing in your orthodontic treatment.

Finish:

  1. The end result – There is no question that the end result of orthodontics supervised by a dentist is far superior to that of any DIY or at-home system. Because of Dr. Chowning’s advanced training in teeth straightening, he knows how to position not only the portion of teeth you can see, but also the root of the tooth underneath the gums.  The position of the root affects the overall appearance of a tooth as well as the long-term stability of a tooth’s position.
  2. Stability of final result – As noted above, orthodontics involves more than just moving the outer portion of the tooth. The way to obtain a straight, beautiful smile that will be stable and long-lasting is to ensure that the roots of the teeth are aligned properly in addition to the visible part of the teeth.
  3. Retainers – At Timberlake Dental, we do not believe in a one-size-fits-all approach to retainers. There are different types of retainers made of different types of materials.  Dr. Chowning has experience in determining which retainer will give you the best long-term retention of your new smile.

Our Expertise

At Timberlake Dental, we have been creating beautiful smiles with Invisalign® for years.  With advanced training and a commitment to continuing education, you are guaranteed to receive excellent care and the smile you’ve always wanted at the hands of Dr. Chowning.  If you are interested in straightening your teeth, call our office today at 940-382-1750 to schedule a consultation with Dr. Chowning.

 

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Internal Bleaching: What is it, and Who Needs it?

It’s pretty safe to say that everyone wants white teeth.  The teeth whitening industry is worth multiple billions of dollars.  But what if you have one tooth that is darker than all the others?  What if you’ve tried teeth whitening, and that one tooth doesn’t change colors?

Then you may need internal bleaching.

What is Internal Bleaching?

Internal bleaching is pretty self explanatory: it is bleaching a tooth from the inside.  All other teeth whitening techniques work on the external surface of the teeth.  They use peroxide chemicals to oxidize dark colored compounds beneath the enamel surface.  However, they can only penetrate to a certain depth.

When external bleaching does not work, especially when one single tooth is darker than all the others, it is probably a case for internal beaching.  Internal bleaching uses the same class of peroxide chemicals for whitening; they simply act from the internal aspect of the tooth.

What Causes Darkening of a Single Tooth?

In most cases, when a single tooth is much darker than those around it, the cause is some former trauma to the tooth.  Trauma can result in a dead tooth that leads to a darkened color in a tooth.

Technically, it is the soft tissues inside the tooth that is dead.  Our teeth are hollow and contain nerves and blood vessels.  As this tissue dies, the red blood cells die and darken.  Because the hard structure of teeth is slightly translucent, this darkened color shows through.

Most of the time, this leads to a dark grey or brown discoloration of the traumatized tooth.  In other cases, the tooth turns dark yellow in color.  A dark yellow color usually indicates that the inner core of the tooth (dentin) has thickened.  Dentin is darker than enamel, so as it thickens, its natural yellow color becomes more intense and shows through the translucent enamel more easily.

The trauma that causes tooth color change can occur at any point in life, and the change in color can occur at any point in life.  For example, a women in her mid-40’s may experience a sudden color change in a front tooth that was injured in middle school basketball.  The color change can occur decades after the trauma.

In other cases, the color change can occur almost immediately.

Does Internal Bleaching on a Tooth Require a Root Canal First?

Yes!  There are two reasons that internal bleaching on a tooth MUST be preceded by a root canal treatment.

  1. The chemicals used to whiten the tooth from the inside are toxic to the nerve and blood vessel tissue. The root canal cleans out all of the soft tissue from the internal chamber of the tooth.
  2. Because the darkened color is the result of a damaged or dead nerve inside the tooth, a root canal is necessary to remove that unhealthy soft tissue.

What Does Internal Bleaching Involve?

Usually internal bleaching takes several appointments.  After the root canal, which seals the internal surface of the root, your dentist can access the inside of the tooth in order to apply the whitening gel.  After placing the whitening gel inside the tooth (from the back side of the front teeth), the dentist seals it in place with a temporary filling.

The whitening gel stays inside the tooth for 2-3 sessions of 48 hours.  After each 48 hour session, the dentist removes the temporary filling, rinses out the existing whitening gel, and reapplies a fresh layer of whitening gel.

After achieving the desired color of the single tooth, your dentist removes the temporary filling and gel and permanently seals the tooth with a final tooth-colored filling.

Is Internal Bleaching Safe?

Yes!  The whitening gel is only toxic to soft tissues like the gums, cheeks, lips, and the nerve and blood vessels in the tooth. Your dentist takes every precaution to isolate the gel to only hard tooth structure.

Because the whitening gel only touches a tooth without a nerve, there is no post-op pain or sensitivity caused by this type of teeth whitening.

Are You Interested in Internal Bleaching?

Call Timberlake Dental at 940-382-1750 today to schedule a consultation with Dr. Chowning.  He will assess your cosmetic goals and determine if internal bleaching will achieve them.

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Five Trendy Things that are Really Bad for your Teeth

With the wealth of information available to anyone with internet access comes the risk of incomplete information or misinformation.  Health and beauty blogs tout countless trendy ways to lose weight, clear your skin, and whiten your teeth.

There are a few popular trends that can have a detrimental effect on your teeth, and we want you to learn about these dangers before you find out the hard way (i.e. multiple new cavities or broken down dental work).

Apple Cider Vinegar

Fans of apple cider vinegar claim a wide range of health benefits from drinking it straight, diluting it with water or gargling it.  These claims include calming an upset stomach, curing hiccups, soothing a sore throat, lowering cholesterol, losing weight, and boosting energy.

The benefits are pretty tempting.  Here are the risks: increased chance of cavities and greater likelihood of acid erosion/damage to teeth and dental work.

The pH of apple cider vinegar is 3.3 to 3.5.  This is far below the threshold at which enamel, the hardest substance in the body, begins to dissolve.  Any prolonged contact of a strong acid with your teeth begins to weaken the enamel, making it easier for bacteria to penetrate, causing a cavity.

Strong acids also cause deterioration and breakdown of existing dental work.

A thorough rinsing with water should follow any use of apple cider vinegar in your mouth in order to bring the pH inside the mouth back to neutral.  Do not brush immediately.  Wait until your mouth returns to neutral.

Lemon Juice Detox

The most popular lemon juice detox is called the Master Cleanse, and it claims to cleanse the body of toxins and help you lose 20 pounds in 10 days.  The recipe for the recommended “lemonade” includes fresh lemon or lime juice, maple syrup, cayenne pepper and water.

There are two huge problems in this recipe: lemon juice and maple syrup.  One is an extremely strong acid, and the other is loaded with sugar.

There is another problem with the Master Cleanse, as far as teeth are concerned.  The detox calls for avoiding all solid food for 10 days, which means liquids only.

When we chew, we stimulate the production of saliva, which is our body’s natural defense against acid and bacteria.  Saliva fights cavities, gum disease, and acid erosion.  If chewing stops, and only drinking ensues, the production of saliva decreases.  This puts someone at a higher risk for the things saliva fights: cavities, gum disease, and acid erosion.

Sparkling Water

Many people drink sparkling water simply because they like it.  Others drink it in an attempt to stop drinking sodas.  Other people enjoy it as an alternative to plain water every once in a while.

Is sparkling water better for your teeth than soda?  Of course.

Is it completely risk-free?  No.

Sparkling water is acidic.  The flavored types of sparkling water typically add citric acid to create lemon, lime or orange flavors.  This makes it even more acidic; some fall into the same pH range as sodas and sports drinks.

Sipping on a sparkling water drink throughout the day creates a low pH environment in your mouth, weakening enamel and making it easier for bacteria to cause cavities.

Enjoy sparkling water during a meal so that your saliva can counteract the acid it contains.

Kombucha

Kombucha is trendy, but it is not new.  Records of “fermented tea” show that people have been drinking kombucha for over 2000 years.  Health benefits attributed to kombucha include detoxification, improved digestion, immune system stimulation, arthritis and cancer prevention, and weight loss among others.

Some people make their own kombucha, and others prefer store-bought brands.  There are two concerns with kombucha: acidity and sugar content.  One of the most important steps in making your own kombucha is monitoring the pH level.  When the pH level reaches about 3, the brewing cycle is complete, and it is ready to drink.  This pH is low enough to damage enamel, weakening it and making it vulnerable to cavity-causing bacteria.

Some store-bought brands of kombucha contain as much as 10 grams of sugar per serving, and most bottles contain more than 2 servings.  As with candy and sodas, high sugar content feeds those same cavity-causing bacteria, increasing your risk for cavities.

Activated Charcoal

There are countless new oral hygiene products containing activated charcoal.  They claim to absorb both toxins and stains, leading to healthy gums and white teeth.

In 2017, the American Dental Association published a literature review of all the current scientific studies regarding activated charcoal.  Their findings state that there is not enough evidence to deem activated charcoal products effective at removing bacterial toxins or whitening teeth.  There is also not enough evidence to confirm that activated charcoal is safe to use on your teeth.

The risk is damage to the enamel caused by abrasion.  Abrasion is the gradual wearing away of enamel by an abrasive or gritty substance.  This is like using sandpaper on your teeth.  Because many beauty blogs recommend DIY toothpastes using activated charcoal and coconut oil, the level of abrasiveness could be different for each homemade recipe.  Being unable to measure its safety means we cannot recommend it.

Are You Curious about Another Trend and Its Effects on Teeth?

Ask Dr. Chowning at your next checkup about any trends you are considering.  He will make sure you will not damage your teeth by trying a new diet or trend.  Call our office at 940-382-1750 today to schedule a consultation.

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Why Do Some Teeth Have to be Pulled?

Having tooth pulled is a relatively common experience.  Children lose twenty baby teeth, perhaps having them pulled by their parents.  Many people have their wisdom teeth extracted in their late teens or early twenties.

Aside from baby teeth and wisdom teeth, why do other teeth have to be pulled?

It’s all about prognosis.

What is Prognosis?

Prognosis is a forecast of the most likely outcome of a situation.  It is like a prediction.  When Dr. Chowning evaluates a tooth with a problem, he must consider the severity of the problem,  available treatment options,  and the likely outcome of those treatment options.

Dentists typically give a tooth a prognosis that is one of the following: good, fair, poor, or hopeless.  Good prognosis means that there is little risk for any complications, and you will keep  tooth for a very long time.  Fair prognosis includes the risk of some complications and a chance that the tooth will need more treatment in the future.  Poor prognosis means the tooth is not likely to successfully function in your mouth for any extended period of time.  Hopeless prognosis means no treatment will enable you to keep the tooth in your mouth.

What Gives a Tooth a Poor Prognosis?

The more severe a dental problem is, the lower the prognosis.  Teeth with very large cavities, deep fractures, and/or severe gum disease often carry a poor long-term prognosis.  Treatment performed on these teeth does not guarantee that they will last forever.

The reason we are cautious about giving a prognosis for teeth and their corresponding dental treatment is that we want your dental work to last.  At Timberlake Dental, we are committed to performing excellent dentistry.  We stand behind the work that we do, and with the proper care, it should last many years.

We also talk about prognosis because we want our patients to have clear expectations about their dental work.  When we do not believe that dental treatment will give a tooth many more years, that tooth has a poor long-term prognosis.

When a tooth has a poor long-term prognosis, we will always discuss the option of extracting the tooth.  We want every investment in your mouth to be a good one.

What Gives a Tooth a Hopeless Prognosis?

A hopeless prognosis means that no treatment will save the tooth in order to keep it in your mouth.  For teeth with a hopeless prognosis, extraction is the only treatment option to remove the dental disease.   The tooth must be pulled in order to ensure your overall health and safety.

How Do I Replace a Tooth That Has Been Pulled?

In most cases, you will be able to replace  pulled tooth with a dental implant.  Dental implants are the best way to restore a missing tooth because they are the only treatment option that recreates every part of a tooth.  By replacing the tooth’s root, a dental implant functions like a natural tooth.

There are other ways to replace missing teeth, including removable partials and cemented bridges.  These options require support from other teeth and, over time, weaken and damage those supporting teeth.  Dental implants stand alone.  They do not need any other teeth in order to function.

Because an implant is as close as we can get to a natural tooth, you will not miss the pulled tooth.  An implant looks and functions the same way a natural tooth does.

What if I Don’t Replace a Tooth That Has Been Pulled?

Several problems can occur when you do not replace missing tooth.

  • Reduced chewing force – When you lose a tooth, there is less surface area available for chewing. Chewing works best when you have a full complement teeth.  Chewing function diminishes when even one tooth is missing.
  • Shifting, crowding or spacing teeth – The teeth hold each or in place. When you lose a tooth, the adjacent teeth drift into that space, causing changes in the alignment of the teeth.
  • Bite changes – The pressure between upper lower teeth during biting also holds the teeth in their vertical position. When you lose tooth, the opposing tooth can move into that space.  This is particularly common when a lower tooth is missing, the upper tooth drifts downward into the gap.
  • Increased risk for damage to neighboring teeth – Teeth are designed to withstand a certain amount of force from chewing. When you lose one tooth, the teeth on both sides have to bear more of the burden of chewing than they are designed to withstand.  This leads to an increased risk for gum recession and cracked teeth.

Replacing a missing tooth is always the best long-term treatment for your mouth.

Do You Have a Tooth with a Questionable Prognosis?

Call us today at 940-382-1750 to schedule consultation with Dr. Chowning.  He will discuss the prognosis of your tooth and detail all of your treatment options.

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