Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

Tooth decay (also called dental cavities or dental caries) –  The destruction of the surfaces (dentin and/or enamel) of a tooth and infiltration of bacteria into tooth structure. Tooth decay results from the action of bacteria that live in plaque. Plaque is a sticky, whitish film formed by bacteria and food debris which adheres to the pellicle (a protein layer on the tooth surface). The plaque bacteria sticking to tooth enamel breakdown the sugar and starch from food particles in the mouth to produce acid.

Only Cake, Candy, and  Sugary Drinks Cause Tooth Decay.

Myth, but it’s almost a fact.

Guess what sugar is? You guessed it a carbohydrate. White rice, french fries, bagels, chips and fruits are all carbohydrates. The stickier the carb, like white rice, caramel, or fruit gummies, the longer they stay lodged between teeth and stuck in grooves. The truth is that the acid produced by the bacteria while breaking down carbohydrates is what causes tooth decay. The bacteria makes the acid when you eat anything with carbohydrates that stick and stay on your teeth. The resulting acid melts through the strong outer enamel and allows bacteria to enter into the inner layer (dentin). The bacteria are not visible to the eye, and the breakdown is slow and steady forming a hole, better known as a cavity.

An important fact to know: It is not the amount of carbohydrates you consume that end up causing tooth decay, but the length of time your teeth are exposed. If you eat a high amount of carbohydrates for lunch, that’s one big exposure. But if you spend the day sipping sugary drinks, chewing on gummy bears, sucking on tic tacs, that continuous exposure is far more unhealthy for your teeth. Dentists have a saying, “sip all day and get tooth decay“.

All Dental Restorations Need to be Replaced Every Few Years.

Myth.

An amalgam or composite filling needs to be replaced only if it breaks down or a cavity forms around it, or if the tooth breaks or fractures. If none of those problems occur, you can keep the same filling for quite a long time. Most dental restorations do have a life expectancy but it depends on each individual. Tooth wear due to clenching or grinding, diet, and dental hygiene habits,  play a huge role in how long these restorations last, some last more than 50 years! Maintaining proper oral hygiene and maintenance  will help your dental restorations last longer.

Once You Get a Tooth Capped, the Tooth Can’t Decay.

Myth.

A Cap or a crown covers and protects underlying tooth structure. However, the area where the crown edge ends and tooth is not covered ( the margin), is where bacteria like to stick. It is the least smooth part of the tooth, and where bacteria can break the seal between the tooth and crown. Once the seal breaks, bacteria can move up and under the crown to slowly breakdown tooth and root structure. A dentist always checks margins around teeth to try to find breaks in margins, however, when breakdown occurs in between teeth it is harder to detect and  usually decays much further before it can be detected on an x-ray.

When You get a Root Canal, the Roots are Removed and the Tooth Can’t Decay.

Myth.

A root canal treatment does not remove roots, what is removed are the nerves, blood vessels, bacteria, and debris from inside of the roots. The dentist then fills and seals the roots with a rubbery filling and sealing paste. This prevents bacteria from re-entering a tooth. Once the root canal is completed, the tooth should heal, and usually be covered and protected with a crown to help prevent cracking. Tooth decay can happen, just as in any tooth.

Children are more prone to Tooth Decay than Adults.

Myth.

Advances in pediatric dentistry have allowed us to cut childhood tooth decay in half over the last 20 years. These advances include sealants, fluoridated water, dietary consultations, and preventive care. As we see advances in pediatric dentistry, and decreases in tooth decay a different population has had increases in tooth decay. Seniors have an increase in cavities due to an increase in advances in pharmacology, limited dexterity, insufficient professional cleanings, and dry mouth. Many medications have a side effect of causing dry mouth which increases the risk of tooth decay.

If You Have Tooth Decay, You Can Feel it.

Myth.

Tooth decay may or may not cause any symptoms. Everyone and each individual tooth varies in it’s pain threshold. The pain associated with tooth decay may be detected very early in some and when it is in a more advanced stage and is actually causing damage to the nerve in others. Allowing tooth decay to progress untreated can and will lead to much more expensive and extensive dental procedures, like root canals and oral surgery. That’s why regular dental examinations are so important.

Teeth can only repair themselves when initial enamel breakdown is occurring, and the bacteria have not entered the dentin. Some enamel can repair with natural calcium remineralization and some can harden and repair with fluoride . Persistent bacteria will cause a cavity to forms which will continue to grow and progress into the tooth, eventually working its way into the dentin and then the nerve of the tooth.

Cavities Are More Likely Between Teeth.

Fact.

Any place in the mouth where you cannot reach and bacteria can hide is a place for tooth decay to form. That is why brushing, flossing, and using an antibacterial and fluoride rinse (such as Purple Listerine) are so important. They allow you to reach areas brushing alone cannot. Flossing is one of the few ways to get in between teeth and properly avoid tooth decay between teeth.

Chips and Cracks in Teeth Lead to Decay.

Fact.

Cracks and chips in teeth can create a hiding place for bacteria and make those areas more prone to tooth decay. Using a fluoride rinse can reduce the risk of tooth decay.

Sensitive Teeth Means You Have Decay.

Myth.

Tooth sensitivity could just mean you have hypersensitive teeth, or gum recession has exposed some root.

You could also have a cracked or broken tooth or could need a root canal. There are many things, including tooth decay, that could lead to sensitive teeth. If your teeth are sensitive you should schedule a dental examination to make sure it is not something serious.

Cavities Are the Only Reason for Root Canals.

Myth.

Root Canal treatment is caused by a variety of things including tooth decay. Root canal treatment is needed if the nerve inside a tooth is damaged which can be a result of decay or trauma.  Trauma can result from accidents, grinding, clenching, biting into a very hard object (piercings, hard candy, etc.), ice chewing, etc.

You Don’t Need to Worry About Cavities in Baby Teeth.

Myth. 

Baby teeth are needed to hold the space for permanent teeth. Also, tooth decay in baby teeth can develop into serious pain, dental abscess and serious infection. On occasion the infection can spread to other parts of the body and has even caused death if left untreated.

Brushing, Flossing, and Rinsing and a Healthy Diet Is the Best Way to Prevent Cavities.

Fact. 

Definitely. Preventive dentistry is the key to staying cavity free. The bacteria must be removed from the teeth.

Brush twice a day with a fluoridated toothpaste, and floss and rinse daily. Antimicrobial rinses target bacteria, reducing plaque, bad breath, and the severity of gingivitis. Rinses with fluoride make teeth more resistant to tooth decay. If bacteria are removed daily from every area of your tooth. Eat healthy foods, and limit exposure to carbohydrates.

Tooth Decay Conclusion

There are many misconceptions about what causes tooth decay and what doesn’t. The facts remain, A healthy diet, and proper oral hygiene will not only help you prevent tooth decay, but keep your whole body healthier.

At home dental hygiene care is critical to having good dental health and studies have shown it is also linked to our overall health. The best way to get adults to maintain their

dental hygiene to teach them proper habits as kids. One of the simplest things we do as part of our dental hygiene regimen is brushing. But did you know most of us do not remove all the plaque and bacteria properly. Parents should help with brushing, and/or check to see that the child has done a good job.  There is a way to ensure your kids are removing all the plaque and bacteria while brushing. Dentists have been using dyes for years called disclosing solutions to show patients what they have been missing. Disclosing solutions are a powerful, effective learning tool.

 Options for Disclosing and Detecting Plaque

There are many different solutions available. These include:

-Red-cote Disclosing Solution and tablets. Red-Cote Disclosants highlight harmful bacteria and plaque on the tooth surface. By staining these areas red, it shows patients areas where more brushing and flossing are needed. It is non-toxic and comes in a cherry flavor. These dyes also cause a lingering stain on the tongue and sometimes, lips for hours. Therefore, use on the weekend to give more time for the red solution to dissipate

-2 tone Disclosing Solution. Cherry-flavored 2-Tone Disclosing Solution works safely and dramatically. Stains new plaque red and old plaque blue to identify areas continually missed. Dye washes away easily.

-GUM Plak-Chek. The Plak-Chek is a virtually invisible plaque disclosing system that works for both children and adults. This solution works under a special blue light which fluoresces the dye under light. In this system, the dye is invisible in natural light yet glows green on plaque covered tooth surfaces when illuminated by the hand held blue light. Kind of fun for kids, but more difficult to visualize and finish cleaning the remaining plaque.

-Listerine agent blue. This rinse can be used before or after tooth brushing. After rinsing with Listerine agent blue, kids will notice their teeth turning blue. This is important so kids can pay attention to removing all the blue tint as they brush. If they left any behind they know they need to go back and continue brushing. Works wonders for improving oral hygiene technique as well as self awareness for children of taking care of their own teeth. The blue discloser is not quite as “scary” looking as the bright red dyes.

Conclusion

Disclosing solutions are helpful tools to maintain good dental hygiene. Some tools will work better with different individuals. The key is to find what works for you and use it regularly. Once good habits are formed, and the proper techniques have been learned to keep your mouth it’s cleanest, your overall dental health will improve. Remember,your dental health effects your overall health. So, teach your kids how to be their healthiest from a young age. As always, visit your dentist regularly for dental examinations and professional cleanings to ensure your optimal dental health.

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

 

Porcelain crowns have been a staple in cosmetic dentistry for years. It gives the dentist and patient a much more aesthetic appearance as a final product. In the past crowns and bridges were traditionally made of porcelain fused to metal (PFM). With the development of modern porcelain, which are incredibly strong and reflect light similar to natural teeth, full porcelain crowns can be used in most areas in which porcelain fused to metal crowns were used. This is especially true in a cosmetic area of the mouth.

Porcelain crowns are very versatile and used in many ways. The cosmetic enhancement use of porcelain crowns include, changing color of teeth, closing gaps between teeth, fixing teeth that are crooked or crowded, changing shape or size of teeth. Porcelain crowns are also used to cover and protect damaged teeth, (tooth that has a root canal, broken, cracked, large fillings), and to act as a new tooth in the case of dental implants. Their versatility gives the dentist a greater flexibility in using them to fix potential issues for the patient.

cosmetic dentist emax crown

Emax Porcelain Crowns

The first step often times includes impressions for study models and photos. The patient and dentist can then discuss and plan what the end result should be. The treatment includes preparation of the tooth surface for the porcelain crowns. The outer enamel and sometimes a bit of  the dentin are removed. This allows room for the porcelain crowns to fit over the teeth and be in perfect cosmetic alignment with the others. Impressions are taken of the newly reshaped teeth and temporary crowns are made.  The porcelain crowns are custom made in the laboratory. The porcelain crowns are then cemented or bonded onto the teeth using an adhesive bonding material. The placement of the porcelain crown will normally take about 30 minutes (depends on amount of porcelain crowns being placed). Once completed,  the patient can eat normally and enjoy the benefits of a beautiful new porcelain crown that matches and blends perfectly with the patients existing teeth. Only you and the dentist should know anything was done.

Advantages of All Porcelain Crowns

-No PFM gray or black lines at the Gum Line of Teeth. You may have noticed a person with a dark line in the gum area along a PFM crown edge. With PFM crowns, the soft tissue around the tooth can recede over time. This allows a reveal of the metal framework underneath. This cannot happen with an all porcelain crowns because they are metal free.

-Perfect Fit. Porcelain crowns are created in state of the art facilities. Porcelain crowns will fit so well you will even forget they are present.

-Cosmetically Perfect Match. All porcelain crowns have the ability with modern porcelains to match your existing shade of tooth color as well as mimic the light reflecting properties of your natural teeth. Porcelain crowns will be undetectable to anyone but you and your dentist. Dental porcelain can be shaped custom colored and sculpted to closely copy the look of your own natural tooth enamel. All the while providing the desired strength and resilience.

Some disadvantages of an all porcelain crowns:

-Higher cost over traditional PFM crowns.

-Durability. While porcelain crowns are very durable, they do not have the flexibility of natural teeth, they can fracture. Avoiding certain foods may be necessary. For example, Biting into sandwich with a hard bread. Patients who grind and clench their teeth will need to be fitted with a mouth guard to protect the porcelain crown from unnecessary and excessive pressures.

-Porcelain crowns may need a bit more reduction of tooth structure than traditional PFM crowns.

-Sensitivity may happen for a short time, (hot, cold sensitivity), especially with bonded porcelain crowns.

Follow-up Maintenance of All Porcelain Crowns

The maintenance of porcelain crowns is actually very easy.  They require routine brushing with non-abrasive fluoride toothpaste and regular flossing as well as regular visits to the dentist. A follow-up appointment will be scheduled to evaluate the porcelain crowns about 2-4 weeks after they are placed in the mouth This allows the dentist to review the work with tissues all healed and see how your oral tissues are reacting to the crowns. Even if you think the crowns are successful, this appointment is an important part of your future oral health.
There are several types of all porcelain crowns generally used in dental offices today. They have all proven to give the best cosmetic dental results.
-Zirconia Crowns or Lava Crowns (made by 3M Espe). This type of all porcelain crowns are made out of a zirconium core with porcelain pressed or layered over the crown to follow the natural contours of teeth. These crowns offer good strength and durability. Due to great strength, the material can be used to make a bridge.
-Procera Crowns (made by Nobel Biocare). These are made of an Alumina core with porcelain pressed or layered over the crown to follow the natural contours of the teeth. These crowns offer great strength and durability and are esthetically quite beautiful. Often used in the back of the mouth, (premolars, molars), these are cemented in with traditional cement and have less post-placement sensitivity.
-Empress II Crowns (made by Ivoclar Vivadent).These highly cosmetic porcelain crowns are used in the front of the mouth. They are used mostly for cosmetics, are very beautiful, but can fracture.
-eMAX Crowns or IPS e.MAX Crowns (made by Ivoclar Vivadent). These porcelain crowns are entirely made out of porcelain without a underlying framework. The absence of this framework offers a great advantage over Zirconia crowns, Lava crowns and Procera crowns in that e.MAX crowns allow for more light transmission through the crown translating to a more superior cosmetic dental result. The strength of these porcelain crowns is such that they can be used in any area of the mouth, can be made thinner than most porcelains, and can be used for an implant without much worry of fracture.
Cosmetic Dentistry is the art and science of creating a beautiful smile. The all porcelain crowns are just one more tool that the dentist can use to give you that smile you’ve always dreamed of.
Procera Porcelain CrownsLava Crowns Ivoclar VivadentPorcelain Crowns 3M Espe