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Dental X-rays are an integral part of proper dental care. Most of us pose the question…Why do I need to have x-rays?? For starters, dental x-rays give your dentist a view of many oral issues that are not visible to the naked eye. This “photograph” of your dental skeleton allows your dentist information to make a better diagnosis, find potentially dangerous issues and  keep your dental health where it should be. Without routine dental x-rays small issues can develop into much bigger ones.

Benefits Of Dental X-Rays

A dental x-ray gives your dentist a closer look at the teeth, the surrounding bones, the jaws, dental decay, infection, and disease of your oral cavity. The following are some of the benefits of dental x-rays:

-Detection Of Tooth Decay. While a dentist can see some tooth decay during your visual and manual examination, they are unable to see between the teeth, under fillings, and below the gum line. A dental x-ray can allow a much better view of damage to the teeth, and roots.

-Presence Of Tumors In The Bone. A tumor can develop undetected inside the bone. If dental x-rays are taken routinely, it often gives the dentist the ability to detect developing tumors at an early stage.  Some tumors are harmless, while others are quite aggressive leading to loss of jaw bone and teeth. The best prognosis for treatment of tumors depends upon early diagnosis.

-Diagnosis Of Periodontal Disease. One of the key tools in diagnosis periodontal disease are dental x-rays. Once periodontal disease develops past its earliest stages there will be loss of supporting bone. Using dental x-rays your dentist can see the progression and even the improvement once treatment begins. Without early diagnosis, the periodontal disease will progress, and proper treatment to slow progression will not occur.

-Infections. These will be noted on dental x-rays as dark spots in the bone. An infection in the bone can be very destructive and if left untreated can lead to facial swellings,  lost teeth, lost bone, pain, and may be potentially life threatening.

-Locate Teeth. Some teeth do not develop properly, are extremely out of position, may not be present, may have extra teeth, or tooth fragments may be impacted in the bone. It is important to know what is or is not a potential problem, and some may need to be extracted or re-directed by an orthodontist so as not to harm other teeth.

-Check For Children’s Development. Dental x-rays give your dentist the ability to check your child’s development and ensure all the teeth are developing properly. Knowledge ahead of time will help you plan ahead for space management issues (crowding), growth management issues (upper and lower jaws severely out of alignment), lack of permanent tooth development (may require maintaining baby teeth for a much longer time period), extra teeth (usually require extraction).

Are Dental X-Rays Safe?

This is a common concern especially among new parents. It is important to note that dental x-rays use very little radiation. Most people living in the United States today are exposed to a 100 times more radiation in a single year just from environmental sources. Remember not to confuse medical x-rays and dental x-rays. Medical x-rays use significant amounts of radiation while dental x-rays are extremely low radiation exposure.  Your dentist will take all the necessary precautions in limiting your exposure. This includes the following:

-Follow the ALARA Principle. ALARA stands for “As Low As Reasonably Achievable”.

-Use Of The Fastest Speed Film.

-Using As Small An X-Ray Beam As Possible.

-Use Of Lead Aprons.

-Following ADA standards of care in # and frequency with which x-rays are taken.

Dental X-Rays Conclusion

If you are concerned about dental x-ray safety speak to your dentist. A good dentist will be open to your concerns and attempt to alleviate your fears while keeping you safe. If you are seeing a new dentist for the first time, request copies of your old x-rays from your previous dentist. This may help limit new x-rays being taken but also give your new dentist a history of progression of any issues you might have been developing.

Dental x-rays are an important part of a thorough dental examination. While there may be some precautions to take, the benefits definitely outweigh the risks of not having dental x-rays. See your dentist regularly for routine dental examinations and x-rays to diagnose issues early, before they become larger, more dangerous problems.

Why do teeth change color? Our teeth can stain and darken over time for many reasons. In many instances, yellowing of the teeth comes with age,  staining of the enamel,  and the accumulation of plaque on the teeth due to poor dental hygiene. Whatever the cause, most people prefer whiter teeth as they as a sign of health and youth.

What Causes Yellowing Of Teeth?

Yellowing of teeth is due to many factors. It is different for each individual. For some, it might start with one or two teeth while, for others, it might be more pronounced. The entire tooth may not discolor in the traditional sense, either. Some teeth may exhibit spotting, pitting, or streaks of white or yellow.

Luckily, the initial yellowing of teeth does not generally cause pain or discomfort. What it can cause is a person being self conscious and trying to hide their smile. There are certain factors involved with the changes in tooth color.

-Staining. Also referred to as yellowing. The enamel of the teeth yellow or darken due to staining from coffee, red wine, soda, tobacco, and other foods and drink.

- Thin and discolored enamel.  Sometimes, thin enamel is genetic, or discolored because of issues during tooth development. Over exposure to high amounts of minerals in water or tetracycline use during tooth development as a child can cause gray or mottled looking teeth. Fevers during tooth development can also cause malformed enamel. For others with stronger enamel, wear can happen over time,  from trauma and use. This wear can be caused by aggressive brushing, physical trauma such as grinding and clenching, high exposure to acids from foods or health issues. As the enamel thins out over time, the dentin on the inside of the tooth will begin to show through. This thinner enamel will also allow more uptake of stain deeper into the teeth. The yellow color will be more prominent due to the thin enamel layer on the outside.

-Age. As we get older yellowing of teeth is quite normal. From wear and use our enamel layer will become thinner thus allowing more of the underlying tooth structure to show thru.

How To Treat Yellowing Teeth?

-Teeth WhiteningTeeth whitening products and treatments are able to whiten our teeth by removing stains and discolorations. Across the globe, teeth whitening is the most popular cosmetic dentistry procedure. It works best when teeth are stained from foods, beverages, and smoking. The results for malformed enamel can vary in effectiveness, and sometimes look worse.

There are two main types of teeth whitening: in office treatment and at home treatment. In office whitening involves application of whitening products to the teeth while in the dental office. Results up to several shades lighter are achieved the same day. The process is fast, and easy. At home procedures involve application of whitening products to the teeth by the patient daily, for approximately 1 week to 1 month. The at home process is slower to achieve results, generally less expensive, and usually easy. Both cosmetic dentistry whitening procedures are very effective, and can help you to achieve the whiter smile you have been dreaming of. Any type of whitening can cause sensitivity, which is usually short term.

-Porcelain VeneersPorcelain veneers are a great option for teeth that will not whiten the way you would like.  Mottled enamel, and tetracycline stained teeth do not evenly whiten, some of us have see through or translucent which do not whiten well either. Porcelain veneers give the cosmetic dentist the ability to change the color of teeth, keeping them natural looking and have low incidence of staining when taken care of properly.  Porcelain veneers are custom made ultra thin porcelain restorations that are bonded to the front surfaces of the teeth. Modern porcelain veneers offer a natural looking, beautiful smile. Porcelain veneers generally last between 8 to 12 years, but if cared for properly can last for much longer . The lifespan of porcelain veneers (and any dental restoration) depends upon your oral hygiene maintenance, the forces on the teeth(hard use, grinding), tooth decay, and maintaining regular dental visits.

-Porcelain CrownsPorcelain crowns give the cosmetic dentist the ability to restore a tooth to its natural look without the use of metal. This allows the dental laboratory to fabricate a tooth that reflects light just like our own natural teeth.  Porcelain crowns can be used on teeth that either already have crowns or need more extensive work. Teeth with large, deep, silver fillings, root canals, or extensive tooth decay generally have deep staining which needs to be covered with a crown to restore strength and beauty.

-Dental BondingDental bonding is the process in which tooth colored dental materials are bonded to a tooth. This might be one of the easiest cosmetic dentistry procedures to change our look. Using dental bonding we can change color, shape, size, and close any spaces that might be present. Dental bonding is generally completed in the dentist office in as little as an hour. This is especially useful when treating damaged, thin, or malformed enamel.

Conclusion

Yellowing teeth does not have to be an issue. Protect your smile by limiting acidic and highly staining foods. See your dentist to help you stop grinding and clenching habits. See your hygienist to have your cleaned teeth regularly. Maintain good oral hygiene, without being overly aggressive. If you already have deep staining or damaged enamel, see your dentist to see which options will work best for you.You can achieve the bright white smile you desire with a little help from your dentist!

Tooth eruption is a process in tooth development in which the teeth erupt into the mouth and becomes visible.

The arrival of a new tooth, or tooth eruption is a big event for most of us! As a baby, tooth eruption allows for introduction of new foods with more substance. Later on, many parents and kids look forward to a visit from the tooth fairy, and for their new “grown up” teeth to come in. It is an exciting time for parents and children alike and losing baby teeth is an important milestone in most kids and parents lives. It means they are growing up, getting bigger, and taking on more responsibility for themselves at home and school.

Tooth Eruption Facts

Humans have two sets of teeth, primary (or baby) teeth and then permanent teeth. These teeth develop in stages. The schedule is different but the development and tooth eruption of each of these sets of teeth is very much the same. Following are a few facts about tooth eruption:

-Tooth eruption tends to happen in parallel. This means that the bottom molar tooth on your left side should erupt into your mouth at about the same time as the bottom molar tooth on the right side.

-Primary tooth development begins during the 2nd trimester of a woman’s pregnancy. Primary teeth are place holders for permanent teeth.

-Loss of primary teeth due to extraction or loss of space due to breakdown of baby teeth, makes a child susceptible to malocclusion and more likely to need orthodontic treatment.

-The crown of a tooth is the first to begin forming. The roots continue to develop and lengthen even after the teeth have come through the gums.

-There are 20 primary teeth. These are usually fully erupted by age 3, and remain until around 6 years of age when they begin to fall out to make room for your permanent teeth.

-Adult teeth usually begin to erupt into the mouth between 6 and 12 years of age. Most adults have 32 permanent teeth.

-Permanent teeth are larger and take longer to erupt than primary teeth.

Tooth Eruption – Types of Teeth

A person’s teeth will vary in size, shape, and their location. Each tooth in your mouth has a job to do and that is why it is shaped the way it is and where it is located. Tooth eruption follows a definite pattern.  There are 5 types of teeth:

1) Incisors. Incisors are the eight teeth in the front of your mouth (four on top and four on bottom). These teeth are used to take bites of your food. Incisors are usually the first teeth to erupt. Primary incisors erupt at around 6 months of age.Permanent incisors should come in at  6 and 8 years of age.

2) Canines. We have four canines in our mouths. These are the next type of teeth to erupt. Canines are your sharpest teeth and are used for ripping and tearing food apart. Teeth eruption for primary canines usually occurs between 16 and 20 months of age, with the upper canines coming in just before  the lower canines. The order is reversed for permanent teeth. Lower canines erupt around age 9, with the uppers erupting at about 11-12 years of age.

3) Premolars. Primary molars are replaced by premolars. Premolars (also called bicuspids) are used for chewing and grinding of food. You have four premolars on each side of your mouth, two on the upper and two on the lower jaw. The first premolars appear around age 10 and the second premolars arrive about a year later. Premolars are generally the teeth that may need to be removed during orthodontic treatment to create space.

4) Molars. Primary molars (replaced by the permanent premolars) are also used for chewing and grinding food. Teeth eruption for these happens between 12 and 15 months of age. The first permanent molars erupt around 6 years of age while the second molars come in around 11-13 years old.

5) Third Molars. These are also referred to as “wisdom” teeth. These are the last teeth to erupt into the mouth and do not typically erupt until age 18-21 years of age. Some

Tooth Eruption Issues - Peg Laterals - Marielaina Perrone DDS

Tooth Eruption Issues – Peg Laterals

people never develop third molars at all. These molars may cause crowding and need to be removed. Other times they develop in the jaw but never erupt into the mouth. When this happens it is referred to as impacted.

Tooth Eruption Issues

-Supernumerary teeth.  Extra teeth may form and make normal tooth eruption more difficult, delayed or impacted. This happens most often in the wisdom tooth area. Another type of extra tooth is called a mesiodens. This is an extra small tooth growing right between the two upper front teeth and needs to be removed surgically. There is also Gemination, or twinning of a tooth, wherein, a double tooth forms.

-Malformed  Teeth. Tooth eruption is not always perfect. Sometimes genetics, medications etc. can cause malformed teeth. Examples are peg laterals (very small lateral incisors), mulberry molars (a molar

Fused Tooth - Marielaina Perrone DDS

Tooth Eruption Issues – Fused Tooth

that has a raspberry like appearance), Fused teeth (two different teeth which form conjoined into one tooth such as a lateral and canine),  Dens in dente (a tooth growing completely inside of another tooth).

If a tooth does not form in the primary dentition (for example a child never forms a front baby tooth), there will never be a permanent tooth to replace it. Also, tooth eruption in the lower arch in front can sometimes erupt behind the primary teeth. This is quite normal but may necessitate the need of removal of the primary teeth to aid tooth eruption.

If teeth are not erupting properly, have your dentist take an x ray. Sometimes there are developmental or genetic issues causing malformed teeth, extra teeth or lack of tooth development. It is important to monitor tooth eruption as it happens. The earlier these issues are detected, the better you can prepare for future treatment needs.

 

Primary Tooth Eruption Chart

Tooth Eruption Chart - Marielaina Perrone DDS

Tooth Eruption Chart

 

Cosmetic dentistry gives the dentist the ability to mask tetracycline staining. Tetracycline, doxycycline, minocycline are types of antibiotic that are absorbed into developing teeth causing deep stains (tetracycline staining). If tetracycline is taken by someone during functional tooth development years (age 3-10), tetracycline stains are likely to occur. Permanent teeth start developing at around three years of age and continue into the teenage years (last teeth to erupt are the wisdom teeth).  Once the teeth erupt into the mouth,

they are no longer susceptible to tetracycline staining.  A teenager can take the antibiotic and not get tetracycline staining. This is not the case for a younger person with teeth developing inside the jaw. They will get permanent tetracycline staining. Because of this, the medical community has stopped prescribing tetracycline to children under the age of 10 years old or to pregnant women (whose developing baby can also be affected by tetracycline staining). The stains have no medical implications but are very unaesthetic. Tetracycline leaves behind a dark stain that can be either striated in nature or cover the entire tooth surface. Tetracycline stained teeth are usually brown or grayish in color.

When tetracycline was approved for human use, it was not known that tetracycline would permanently stain teeth in development.  Tetracycline was developed as an alternative to Penicillin. Tetracycline is most often used to treat urinary tract infections, genital infections, acne, skin infections, and infections that cause stomach ulcers.  The tetracycline became incorporated inside the developing teeth and left the teeth permanently dark in color.

Before the development of modern cosmetic dentistry there were few alternatives to cover this esthetically.

Cosmetic dentistry has a few ways of dealing with this condition. These include teeth whitening and porcelain veneers.

Teeth Whitening and Tetracycline Staining

Teeth Whitening Tetracycline staining

Cosmetic Dentistry – Teeth Whitening for Tetracycline Staining

Teeth whitening can be very successful with tetracycline stained teeth when the staining is not very dark. Patients with minimal tetracycline staining on their teeth may have to continue to use the bleaching material daily for up to 6 months for noticeable results that will last.  There are in office and at home whitening options in cosmetic dentistry for treating these stains. Over -the -counter type whitening will not be effective at all in teeth with tetracycline staining. The longer period of whitening at home can cause sensitivity and gum problems. This procedure needs to be closely monitored by the cosmetic dentist to ensure there is no damage to the enamel or gum tissue. In some cases of more severe tetracycline staining, teeth whitening is an insufficient treatment. This is due to how deeply embedded the staining is in the patient’s tooth enamel.  Instead, porcelain veneers or dental bonding would be the standard approach to cover the remaining tetracycline staining after whitening procedures are complete.

Dental Bonding and Tetracycline Staining

Your cosmetic dentist may use dental bonding to cover the tetracycline staining that is present. By using dental bonding techniques your cosmetic dentist can mask the stains and create a new color as well as shape to your teeth. However, if the tetracycline stains are too deep and dark in the teeth, the staining may show through the dental bonding. This will create a lighter gray tooth rather than the bright, white teeth you may want. When this is the case, teeth whitening to remove as much of the tetracycline staining as possible, followed by dental bonding is a very good cosmetic dentistry treatment option.

 

Porcelain Veneers and Tetracycline Staining

Porcelain veneers are the best option we have in cosmetic dentistry for the treatment of tetracycline staining. Porcelain veneers are wafer thin and custom designed to reshape your teeth and color just the way you want it. With porcelain veneers,,  we are able to adjust the opacity of the porcelain to allow the cosmetic dentist the ability to truly mask the tetracycline staining,(pre-whitening may still be necessary for the best overall result).

Thanks to cosmetic dentistry patients no longer have to suffer from tetracycline staining. Now these patients can fully smile just like everyone else without feeling self conscious. A smile can be the first thing people notice. With cosmetic dentistry’s many advances, you no longer have to settle for tetracycline stained teeth. You now have options that can help you smile full of self confidence.

 

Tetracycline Staining

Tetracycline Staining Before Cosmetic Dentistry

tetracycline staining after cosmetic dentistry

Tetracycline Staining after Cosmetic Dentistry