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Whiter Teeth Whitening

August 17, 2018

Filed under: Blog,Teeth Whitening — drtimmerman @ 12:57 pm

To be completely honest, most dentists have an incomplete idea on teeth whitening (was that PC enough?). Most are only trained to take impressions and make flimsy trays to make take home kits. Honestly, that isn’t enough for MOST people.

Teeth whitening depends on 3 factors:
• Gel concentration
• Frequency
• Duration


Conservative Smile Makeover

January 18, 2017

Filed under: Blog,Cosmetic Dentistry,Smile Makeovers,Teeth Whitening — Tags: — drtimmerman @ 7:47 am

Conservative Smile Makeover

A conservative smile makeover is sometimes unsatisfactory. While it is not uncommon to treat MANY teeth when doing a complete smile makeover, sometimes we can be creative to be conservative. Combining treatments can give a fantastic outcome, if not ideal. Most people, when making over their smile, want whiter teeth, better shapes, and better alignment. This led to the process commonly called “ABB”, or “Align, Bleach, and Bond.”

Align, Bleach, Veneer

In this case shared here, instead of “bonding” (a term often incorrectly used to describe composite tooth colored material bonded to teeth), there were 3 veneers already in place, the two front upper centrals, and the lower lateral (looks short, making an uneven gumline).

Simply remaking the veneers wouldn’t be enough, the color wasn’t bright enough, so whitening of the other teeth was needed. But the lower tooth situation wouldn’t be solved simply by replacing the veneer, and contouring the gums wouldn’t last due to the alignment. The existing veneer on the lower tooth was driving the patient crazy due to how thick it was to make it “appear” in alignment so the tooth needed to move (or be extracted and a bridge or implant placed, a pretty extreme option).

Braces for a single tooth

When given the option of braces AGAIN (earlier in life, orthodontic treatment had been completed), the patient was reluctant (nice way of saying REF– USED). But the idea of an Inman Aligner, for less cost and less time, was a game changer. Gentle movement with a removable device allowed the tooth to move into place in a matter of weeks.

Single tooth porcelain veneer

Once in alignment, a single veneer was need to finish the case. With some laser contouring of the gums and a final retainer, our patient had a new smile: Whiter, straighter, and more ideal shapes.
And saved THOUSANDS of dollars.

Dr Oz doesn’t know Teeth Whitening

June 8, 2015

Filed under: Blog,Teeth Whitening — drtimmerman @ 9:02 am
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Recently Dr Oz blogged about dental care, from fighting cavities to whitening teeth. He was close, but NOT correct.

Just like getting stock tips from your waitress, be careful about dental advice from anyone NOT a dentist. WHERE you get your information DOES matter.

I feel it is MY obligation to set things straight.

His main point seems to be that anything that stimulates salivary flow is enough to rinse plaque and fight decay. Really? Brush and floss.  There is NO substitute.  Add professional cleanings 2-4 times per year.  There isn’t a magic replacement, nothing in a bottle.

He also suggests raisins will do the trick is wrong too. New studies show that they may affect strep mutans, the bacteria that cause decay.

However, raisins are a sticky sugar, so while he says the stimulation of the salivary flow will help, sticky sugars… well… stick!  Increased salivary flow won’t help enough.  By this reasoning, sticky coconut rice with palm sugar and mango would help too.  Plaque with sticky sugars makes holes (cavities).  Bacteria in plaque feed on the sugars (fementable carbohydrates) and secrete acid as a byproduct.  Brushing and flossing is how to fight them.

If you chewed gummy bears all day long, you wouldn’t be fighting decay.  At all.  Even WITH the increased salivary flow.

The more disturbing advice is his method to whiten teeth.  A slurry of lemon juice and baking soda.  Acid mixed with abrasive base.  For those that missed high school chemistry, pH concentration ranges from 0-14.  Neutral is 7 (water), closer to zero is acidic and closer to 14 is alkaline (or basic).  Coca cola has a pH of around 2, as does Gatorade… and lemon juice.  Acid from plaque is how we get cavities, so generally speaking, “Acid is bad.”

Baking soda is alkaline, or a base, so it will neutralize acid if enough is used.  So while you are trying to use an acid, those very properties may not be what you are hoping for.  What is worse is that the soda is abrasive.  The abrasives will remove plaque, but also enamel, especially if the enamel has been softened from acid.

Gritty toothpaste in the dental office is abrasive as well.  However, this is only used 2 times per year on average, not enough to be a concern.

Daily use would be a different story.

Whitening is dependent on 3 factors when using a bleaching agent (usually a peroxide gel): concentration (8%?  22%?), frequency (daily?  once?) and duration (one hour?  8 hours while sleeping?).  There are no shortcuts. If you want to whiten your teeth, do it right.

Dr Oz is clearly an educated man.  He is very smart and has received an awful lot of training.  But just being smart isn’t enough to validate every piece of advice given.  While he is smart, I would not want him designing a commercial jet.  He just isn’t trained in that field.

While I AM a doctor, I would never give advice outside of my field of expertise.  I will advise people in regards to oral health, but I would never speculate on how you should care for your colon.