For most individuals, gum disease is mild and bleeding on brushing is simply an indication that their hygiene habits (brushing flossing, regular professional cleans) have lapsed. This type of inflammation is called gingivitis and is reversible with good hygiene habits.

However, for others bleeding and receding gums, bad breath, loose teeth and progressive gaps in between the teeth are common symptoms of a serious form of gum disease called Periodontitis. Periodontitis if left unmanaged, will eventually cause loss of teeth and bone support, make treatment options like implants unviable and create oral disability, where normal functions like eating and aesthetics are compromised. This is the type of gum disease is of greatest concern to OVERALL general health and an individual’s risk for periodontitis, has been shown to increase with age.

Periodontitis is best diagnosed during a full dental check up and there is no substitute for this in obtaining an accurate diagnosis and customised treatment plan.

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OFF-THE-SHELF TEETH WHITENING
Let’s face it, we’ve all been sucked in by nifty infomercials and ads for DIY home teeth whitening. It may be sheer gullibility (or vanity) on my part, but I can speak from experience when I say I have probably tried out every home teeth whitening product on the market! From whitening toothpaste to pens, the results I obtained, although sometimes detectable, were often limited and transient. A myriad of studies have demonstrated that DIY home teeth whitening products, through their low concentration of peroxides and their abrasive particle compositions, may have some effect for patients with heavy superficial staining from smoking or coffee but generally they don’t achieve any significant change to the base shade of the teeth.

The reason is simple: most DIY home teeth whitening products are forbidden, by law, to administer a high strength of peroxide, so the whitening potency of these gels is necessarily limited. Also, these products wash off or are diluted by saliva or water, thus reducing essential contact time with your teeth. You will gain minty fresh breath but very limited alteration to your tooth colour!

So how can you get around this? Quite simply, speak to your dentist!

Teeth whitening supervised or performed by a dentist is increasingly popular, effective, affordable and (most importantly) safe. The products used are of a significantly higher strength and are designed to maximise contact with your teeth.

Your starting point is to raise the topic with your dentist and we’ll guide you from there. Once your teeth have been thoroughly examined and cleaned, the choice of which whitening approach to take depends on the causes of your teeth staining (e.g. smoking, or antibiotic staining), your time-frame for achieving results, and your budget. The choices we offer at Smile Solutions are twofold: dentist-supervised at-home whitening and in-chair whitening.

SUPERVISED AT-HOME WHITENING
The at-home bleaching process begins with your dentist taking moulds of your upper and lower teeth to make CUSTOM-fitted bleaching trays for you. Once you have received the trays, the procedure is very simple. Either on a daily or nightly basis you will need to wear your trays containing the appropriate whitening gel, as provided by your dentist. The duration of wear can range from one hour per day (while you watch TV or read) to overnight (while you sleep). This procedure is repeated daily or nightly for a few weeks.

Home teeth whitening has many advantages. It places the control in your hands, allowing you to dictate how ‘white’ your teeth become before you move on to the maintenance phase. As your maintenance system, it allows you to touch up the whiteness of your teeth. And finally it allows more ‘sensitive’ patients to tailor their whitening procedure to their comfort.

IN-CHAIR WHITENING
An alternative to at-home whitening is in-chair whitening, performed at the dentist. In-chair whitening is also known as professional whitening or power bleaching. It typically involves the use of a high-strength peroxide activated by a gentle ‘blue spectrum’ light.

At Lakeside Dental Spa, we can offer you the world’s most requested power bleaching option: Zoom teeth whitening. This procedure is carried out in a single visit, suitable for our time-poor and busy patients. The results of the power bleaching procedures can be enhanced and maintained in conjunction with at-home whitening or through annual or bi-annual visits to the dentist.

The post Home Teeth Whitening versus Having Your Teeth Whitened at the Dentist appeared first on Lakeside Dental Spa.

If you are one of the lucky ones, and discolouration is your only concern, dentist-supervised teeth whitening alone may be a simple, safe, cost-effective and ‘conservative’ approach to enhancing your smile.

However, if the shade, shape, size and position of your teeth are all less than desirable, then veneers may be your best cosmetic option.

Veneers can be made from one of two types of material: composite or porcelain. Composite veneers are made of a plastic material that is bonded to the teeth and shaped by the dentist in the mouth to create the desired appearance. Composite veneers are cost-effective but they do stain, need more maintenance (e.g. smoothing and polishing, or repairs) and have a shorter lifespan than porcelain veneers.

Porcelain veneers are wafer-thin ceramic facings bonded to the outside surfaces of your teeth to modify their colour, shape, size and length as required. Unlike composite veneers, porcelain veneers do necessitate modification of your natural teeth. However, they don’t stain readily, are very strong, have an average lifespan of 10 to 15 years and require very little or no maintenance. Possibly one of the greatest advantages of porcelain veneers is their natural appearance, enabling them to blend in with the rest of the teeth. When done well, they should markedly enhance the features and beauty of your smile while being virtually undetectable.

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Common causes of mouth ulcers include:

• Trauma – rubbing against a sharp tooth, biting one’s cheek, or burns from hot food (e.g. melted cheese or hot soup)
• Psychological stress
• Nutritional deficiencies – such as lack of Vitamin B12, zinc, folic acid and iron
• Gastrointestinal tract diseases – e.g. Celiac disease, Crohn’s
• Impaired immunity
• Recurrent aphthous stomatitis (RAS or Canker sores) – the cause of which is not completely understood but is characterised by regular ulcers and affects one-fifth of the population.

Once an ulcer forms, it is very hard to treat. However, the following mouth ulcer treatments and mouth ulcer remedies can alleviate symptoms.

• Treat the cause of trauma by having your dentist polish up any sharp tooth or rough denture.
• Take L-Lysine tablets as directed, to promote healing of the ulcer.
• Use (as directed) a mouthwash such as Bonjela or Difflam purchased from your local pharmacy.
• Use a salt or sodium bicarbonate mouthwash prepared by dissolving one teaspoon of salt or sodium bicarbonate in a glass of water.

Importantly, you are strongly advised to see your dentist or doctor to investigate any mouth ulcer that:

• is very large
• takes longer than 2 to 3 weeks to heal
• causes extreme, intolerable pain
• is associated with high fever and a general feeling of ill health
• frequently recurs.

The post The cause of mouth ulcers and their usual treatments appeared first on Lakeside Dental Spa.

But the material aspect of this branch of dentistry is only half the story. Dealing with facial aesthetics on a day-to-day basis, cosmetic dentists develop a level of sophistication and intuitiveness that gives them an ‘eye’ for, and knowledge of, the anatomical considerations in play.

Combining the two – science and art – is particularly important when it comes to facial injectables. This term encompasses the use of botulinum toxin and dermal fillers. The former, also known as Botox®, is used to alleviate pain and tension associated with bruxism and temporomandibular joint dysfunction; and the latter is used to correct fine lines, enhance shape and increase volume of the skin and facial features.

In order to administer both botulinum toxin and dermal fillers safely and effectively, it is imperative that the practitioner has in-depth knowledge in three main areas:

1. Facial anatomy

Dentists are trained in the anatomy of the oral and maxillofacial region. In fact, the depth of their training is equal to, if not much greater than, that of any other group of health care professionals offering facial injectables, as it goes without saying that intimate knowledge of the head and neck is fundamental to the day-to-day practice of dentistry.

2. The dynamics of facial expression

With their comprehensive training in anatomy, dentists are eminently qualified in the areas of smile design, local anaesthesia and dental procedures with implications for facial expression.

3. Facial aesthetics

Designing a smile to enhance the harmony and appeal of the face is the crux of cosmetic dentistry. Speaking from experience, I know that the presence of wrinkles in the peri oral tissues, lack of fullness of the lips and asymmetries in facial features can limit the aesthetics of the final result. Hence, having the tool of facial injectables in the armamentarium of a dentist who already deals with facial aesthetics can only enhance the overall outcome.

Although a relatively new concept for many people, the administering of botulinum toxin and dermal fillers by cosmetic dentists is a natural progression of the existing knowledge and training base of these practitioners, as well as being an extension to their skill set in facial aesthetics.

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We always start off with a consultation to get an idea of the candidate’s expectations. Then we carry out a complete dental assessment to ensure that the patient’s teeth are healthy and sound in readiness for the process. Finally, we discuss the expected outcomes and the different systems that are available.

Candidates should be aware that the results of whitening typically last 18 to 24 months, with some rebound (loss of whiteness) to be expected during the initial treatment.

Of the two methods that we make available, probably the most often requested is the at-home whitening system, worn in an individually fabricated tray. In preparation for this, we take impressions of the patient’s teeth, make up custom-fitted trays, and give the patient a whitening gel to take home and apply for around 30 to 60 minutes each day. Depending on the gel itself, some formulations are worn overnight. The course of treatment is usually two to three weeks.

The second option involves having the patient come to Lakeside Dental Spa where we do the whitening for them; this is called in-chair bleaching. With the in-chair procedure we use a stronger peroxide, so we are able to achieve a slightly greater “wow” factor than the take-home kit can produce.

The option I favour is a combination of the above two methods, with in-chair bleaching maintained over time by at-home whitening.

For either of these options, a prior dental assessment is crucial. I don’t offer any in-chair bleaching or at-home whitening until I have done a full assessment of the patient’s dental health. I first check that the patient does not have any open cavities and that they have sufficient enamel to prevent any prolonged sensitivity. I also make sure that I’ve tailored the whitening peroxide strength to the patient’s tolerance level. For people with a high level of sensitivity, I use a lower concentration of peroxide.

As you can see, a lot of knowledge and research has gone into the science of teeth whitening; it’s not as simple as is sometimes made out. Many of the over-the-counter products are relatively safe – in that the level of peroxide they contain is very low or non-existent. Instead, such products contain abrasives that help remove external staining from the teeth.

My patients often ask me whether the abrasive ingredients in proprietary products can be harmful. I always warn them that any abrasive can cause wear and tear to tooth enamel if not properly used. While off-the-shelf products are generally safe in this regard, they should be used with some caution and strictly according to the manufacturer’s instructions. It’s also of great concern when people purchase these products, either online or over the counter, without having a clean bill of dental health and without the supervision of a qualified dentist. And then there is the unpredictability of the whitening outcome achieved using these products.

In my opinion, an even greater risk is presented by the high concentrations of peroxide often used by beauty salons and solariums. Such strong products can cause damage when administered by people without appropriate training and experience in dentistry.

Not only that, people who have had their teeth whitened at a salon or a solarium often express disappointment with the results. One patient who came to me for remedial care had substantial burning and gum damage after teeth whitening that she said had been done by a beautician at a solarium.

So our advice is to play it safe: seek the trained services of a qualified dentist before embarking on any teeth whitening treatment.

Dr Kat Marhfour

BDSc (Hons) (Melb)
General Dental Care

The post What should I know about teeth whitening? appeared first on Lakeside Dental Spa.

Doctor Kat Marhfour discusses the most popular current methods of teeth whitening.
What are the different teeth whitening options available?

At Lakeside Dental Spa we have been doing whitening for over 5 years using the take home system. We see great results within 10-14 days with our day-white whitening system using a mild bleaching gel. Home whitening with custom fitted trays worn over your teeth for 30 minutes each day still remains one of the most popular whitening options for patients.

Tell us a bit about the process.  

To get started we take impressions of your teeth to make your trays. Then we provide you with instructions about how to use them safely and most effectively. Under our supervision this technique is totally safe for your teeth and gums, and results are generally achieved within several days.

Are there any options available if I want to have my teeth whitened immediately without the hassle of wearing the trays at home? 

Many of our patients opt to do in chair whitening procedures, which enables us to do whitening for them within an hour. We use the most recognised whitening system in the world, namely Zoom Advance Power.

You can just lie back and relax in tranquil surrounds and listen to music or watch a DVD while having your teeth whitened by 6-8 shades in your lunch break.

And will whitening remove all the marks on my teeth? 

Not entirely, there are certain stains or marks in the tooth enamel that whitening products cannot change. In these cases the most aesthetically pleasing results may be porcelain veneers.

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