TOOTH PAIN Archives - Smile Brilliant

Why you need a sports mouthguard

Esmy Ornelas — Thu, 25 Apr 2024 04:48:45 +0000

Mouthguards protect you from more than just sports injuries! This article reviews the benefits of protecting your teeth with a mouthguard.

If you played sports in high school, there’s a good chance you wore a mouthguard to prevent concussions. What you probably didn’t know, is just how much these mouthguards protected your teeth and absorbed impact to your jaw (TMJ). As it turns out, mouthguards don’t stop in high school! Mouthguards go on to protect the teeth and jaws of many adults. Let’s look at the different types.

How do mouthguards work?

Mouthguards are not all constructed the same, but they serve the same purpose, to protect the teeth and absorb the impact of clenching and grinding from the jaws. Bruxism, or clenching and grinding, has a significant impact on the teeth and jaws and is a multifactorial habit stemming from factors like anxiety, stress, and teeth that are not properly aligned ^[1]. Mouthguards work by forming a barrier between the upper and lower teeth, preventing them from grinding against one another. They also absorb and redistribute shock that would be transmitted through the base of the skull to the brain, preventing concussions during sports or any kind of traumatic impact ^[2]. Clenching/grinding and over-exertion of the TMJ occur outside of sports and sleeping too. Many people clench and grind their teeth when stressed, paying bills, working on a computer, and when working out and lifting weights. Depending on the time and frequency of these habits, some mouthguards may be better suited than others.

Are there different types? Is custom better?

If you buy a mouthguard at a sporting goods store, it’s likely to cost about $15-$30. If you get one at your dentist’s office it will cost about $500.00 and up. Why the difference? A couple of reasons. One is that a night guard made in your dentist’s office will be custom fit to your teeth. It will require a few trips as they will have to take impressions of your teeth and send them off to a lab. Once the mouth guard is in, the dentist will have you try it on and will adjust it if needed to ensure it fits comfortably. The goal is for it to fit snugly on the teeth and require a little force to pop it out. Mouthguards bought at the store entail a much simpler process. You buy them… and then you wear them! While it’s nice to skip the impressions and extra visits to the dentist, they are not custom-fit to your teeth and can’t be adjusted if they don’t fit properly. If mouthguards are uncomfortable, people are less likely to wear them. Another reason custom-fit guards are so expensive is the materials. Custom, lab-built mouthguards are much more durable and can withstand a lot more force, meaning they will last longer than those purchased over the counter.

Why do dentists call it a night guard?

It may seem confusing to hear the terms mouthguard and night guard used interchangeably but they are essentially the same thing, barriers to prevent teeth grinding and TMJ exertion. Dentists commonly see signs of clenching and grinding through wear facets in a patient’s teeth and the complaint of a sore jaw and headaches. While they are called night guards, patients are still encouraged to wear them whenever they’re prone to clenching and grinding their teeth like when exercising, doing paperwork, or working on a computer.

Mouthguards work wonders in alleviating TMJ pain and pressure in those who clench and grind their teeth. Whether you decide to buy one over the counter or invest in one custom-built for you, your teeth and jaw will thank you for taking the load off!

Esmy Ornelas

Esmy Ornelas is a registered Dental Hygienist, writer, educator, and consultant with 10 years of experience in dentistry. She is passionate about education, empowering hygienists to advance their careers in and out of the operatory, and about community. She has written for RDH Magazine, the RDH Graduate, and is a full-time professor of Dental Hygiene and Assisting at Rose State College in Oklahoma.

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References

Green J. I. (2017). The Role of Mouthguards in Preventing and Reducing Sports-related Trauma. Primary dental journal, 6(2), 27–34. https://doi.org/10.1308/205016817821281738
Shetty, S., Pitti, V., Satish Babu, C. L., Surendra Kumar, G. P., & Deepthi, B. C. (2010). Bruxism: a literature review. Journal of Indian Prosthodontic Society, 10(3), 141–148. https://doi.org/10.1007/s13191-011-0041-5

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Why does sugar cause cavities? The science of sugar, acidity, and decay

Rachel Stroble — Tue, 07 Nov 2023 07:07:11 +0000

Find out from a dental hygienist how sugar actually affects the teeth and why it leads to cavities as well as how you can protect your teeth without cutting sugar out completely.

The effect of sugar on your mouth

Sugary foods and drinks can wreak havoc on your oral health. The bad bacteria that live in your mouth love sugar! They metabolize it and create acid as a by-product^[4]. Even among sugary foods, not all are created equal. Sticky foods such as gummy candies stay in the mouth longer because they adhere to your teeth. Also, many sugary foods and beverages are also acidic. For instance, sodas and energy drinks are very acidic. This is the perfect storm—the bad bacteria that love sugar also love acid! In this environment, these bacteria grow and multiply quickly. Acid leaches minerals out of your teeth and encourages cavity formation as sugar promotes bacterial growth.^[3]. Furthermore, even though diet drinks may be sugar-free, they are often still quite acidic. It’s a good idea to treat them as if they contain sugar, in terms of how you consume them, to reduce your risk of cavities.

How acid damages your teeth

Acid is the enemy of teeth. Our teeth are made of minerals, primarily calcium and phosphate, and acid actually dissolves these minerals out of the tooth enamel, leaving the teeth weak and demineralized ^[5]. After an area of your enamel is demineralized, the bacteria are able to move deeper into the tooth, where they secrete more acid. This is how cavities form. The bacteria are basically burrowing into the teeth, destroying tooth structure as they go. To make matters worse, the more acidic your mouth is, the more bad bacteria you probably have. The more bad bacteria you have, the more acidic your mouth becomes!

Frequency and duration of consumption matter

Yes, what you eat and drink does matter! However, did you know how you consume it makes a difference too? If you are sipping on a sugary drink over a long period of time, you are essentially bathing your teeth in acid. Even if you aren’t drinking a large amount of the beverage, frequent exposure means that your teeth suffer a more prolonged acid attack ^[2]. Let’s all be honest. Most people are not going to be swearing off candy and soda altogether. Enjoy your snacks, but enjoy them in moderation, and in one sitting (20 minutes or less). It’s also a good idea to drink water when you are finished to help rinse away residual food debris and sugar.

Good oral hygiene helps

One of the best things you can do to prevent dental disease, including cavities, is to keep your mouth clean! Brushing and cleaning in between your teeth by using floss, a water flosser, or interdental brush, dramatically decreases how much bacteria is in your mouth because you are removing biofilm (plaque). Ideally, everyone should brush twice per day and clean between their teeth once per day. The lower the level of bad bacteria you have, the lower your risk of cavities and gum disease ^[4]. Additionally, chewing sugar-free gum after consuming sugary foods or drinks helps to stimulate saliva flow. Saliva helps to neutralize the pH of the mouth and rinse away some of the residual sugars and food particles ^[1]. You don’t have to give up sugar for the sake of your teeth, but you can be smarter about how you consume it!

Rachel Stroble

Rachel Stroble is a researcher, professor of dental hygiene at Rose State College in Oklahoma, and registered dental hygienist with 10 years of experience in dentistry. She supports education in the classroom with her own students, in the professional community through the development and presentation of continuing education courses, and you may have seen her articles in RDH Magazine, Today’s RDH, and the Oklahoma Dental Association Journal.

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Dodds, M., Roland, S., Edgar, M. et al. Saliva A review of its role in maintaining oral health and preventing dental disease. BDJ Team 2, 15123 (2015). https://doi.org/10.1038/bdjteam.2015.123
Ireland, R., & Yeung, C. A., (2020) Stephan’s curve. In A Dictionary of Dentistry (2nd ed.). Oxford University Press.
Kulshrestha, S., Khan, S., Hasan, S., Khan, M. E., Misba, L., & Khan, A. U. (2015). Calcium fluoride nanoparticles induced suppression of Streptococcus mutans biofilm: An in vitro and in vivo approach. Applied Microbiology and Biotechnology, 100(4), 1901–1914. https://doi.org/10.1007/s00253-015-7154-4
Scannapieco, F. A., & Dongari‐Bagtzoglou, A. (2021). Dysbiosis revisited: Understanding the role of the oral microbiome in the pathogenesis of gingivitis and periodontitis: A critical assessment. Journal of Periodontology (1970), 92(8), 1071–1078. https://doi.org/10.1002/JPER.21-0120
Tarcísio Jorge Leitão, Jaime, A. C., & Livia Maria Andaló Tenuta. (2018). Kinetics of calcium binding to dental biofilm bacteria. PLoS One, 13(1)
https://doi-org.argo.library.okstate.edu/10.1371/journal.pone.0191284

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Professional teeth whitening at the dentist

Kari Carter-Cherelus — Tue, 10 Oct 2023 12:18:16 +0000

Find out what teeth whitening at the dentist is really like, expectations, costs & concerns along with realistic alternatives from a dental hygienist.

Professional teeth whitening is something that many consider to brighten their smile. It can be efficient, safe, and an effective choice for most individuals who are good candidates for the procedure ^[1] Prior to having professional whitening treatments a thorough discussion with your dental professional is strongly encouraged to produce the best results and the least incidences of potential side effects.

Prior to whitening:

A through professional exam is necessary prior to proceeding with in-office whitening procedures.^[2] Your dentist will also review any areas of your teeth that the whitening gel will not penetrate: such as areas that have porcelain or bonded restorations, areas exposed to tetracycline antibiotics during tooth formation, or areas that is dark due to trauma.^[2]Although almost everyone wants a bright white smile, what’s important is to make sure your mouth is healthy first.Whitening when cavities, exposed roots, or if there is active gum inflammation could lead to discomfort and increased risks of tooth sensitivity. Whitening substances can not penetrate hard calculus buildup or plaque therefore it is recommended that prior to whitening you visit your dental hygienist first. Whitening can be a great way to brighten your smile if proper precautions are taken.

In-office whitening

In-office professional whitening treatments a dental professional will apply a whitening agent to your teeth. Typically the whitening agent is left on for 15-to 30 minute increments ^[1] The entire appointment usually is no longer than an hour and a half.^[1]

Types of in-office whitening treatments:

A high concentration hydrogen peroxide gel applied by a syringe
A hydrogen periodic gel combined with a high-intensity light. The light is applied by a lamp or laser like device that sits directly outside your mouth facing your teeth.

The Process:

A dental professional will use a tooth shade chart to determine the current shade of your teeth. They will discuss with you how many shades lighter your smile may become after whitening.^[1]
A dental professional will then polish your teeth and remove any plaque and stains from your teeth. ^[1]
A dental professional will use tools to keep your mouth open. To ensure the whitening agent doesn’t touch any fleshy parts of your mouth like your gums, cheeks or tongue, a barrier will be placed around all delicate areas^[1]
A dental professional will then apply the whitening agent to your teeth incrementally and might use light activation throughout the treatment.^[1]
Once the whitening process is complete, the barriers will be removed and your mouth is gently rinsed. A dental professional may apply fluoride or a desensitizing gel treatment, which will help mitigate any potential sensitivity you might experience.^[1]
A dental professional will discuss with you regarding if your teeth have reached your desired shade and will provide you with aftercare instructions. Following these instructions are key to allowing the whitening agents to sink into the pores of the teeth and prevent shade rebound. After whitening, your teeth are dehydrated. This makes them extra susceptible to liquid and food stains. Lifestyle habits you’ll need to practice for the next day include not eating brightly colored foods and resisting coffee and red wine.^[1]
Custom fit take-home bleach trays may be made as a follow up treatment, so that you can maintain your new bright smile at home and prevent future staining.^[1]

Take-Home trays

Professional in-office whitening deliver fast results whereas take home trays require more time whitening in order achieve the desired results.^[2] These trays may also be used as a follow up treatment after in-office whitening to maintain the results, or the treatment that your dental professional distributes to you instead of in-office whitening.^[2] You will receive whitening gel to use with the trays that will whiten your teeth.

Cost:In-office professional whitening may range in costs from $800-$1000.(3) Custom take-home trays may often range in cost from $300 to $600.(3) Most dental insurance companies considered teeth whitening to be a cosmetic procedure and choose not to provide a benefit for it to the patient.^[3]

Time: In-office whitening is usually completed in one or two appointments. Each session usually totals 60 to 90 minutes long and is done in increments of time^[2] Custom fit trays can be worn to touch up the results after treatment. If the trays are being worn to whiten the teeth instead of doing in-office whitening, then the time period the wearer must wear the trays can be from a few days to a few weeks.

Longevity: Whitening treatments last longer when you follow a good oral care routine and avoid ingesting products that cause a lot of staining.^[2] Foods and beverages that contribute to staining are coffee, red wine, and soda.^[2] Using take-home trays can maintain the brightness and help to remove certain stains that can occur overtime.

Common Concerns:One common concern regarding whitening is tooth sensitivity. If you normally experience tooth sensitivity it is important that you relay that information to your dental professional. This will help them to determine which treatment and whitening gels will work best for you. To reduce the risk of sensitivity associated with tooth whitening, you may be provided with desensitizing gels or fluoride gels to use either alone or with custom fit trays prior to and after whitening treatments.^[3] Prior to an in-office treatment you might be advised to use a nonsteroidal anti-inflammatory drugs to help reduce tooth sensitivity during the treatment.^[3] Many locations such as salons, kiosks, and spas are now offering whitening services^[4]The law varies regarding the legalities of non dental professionals administering the treatment.^[4] The concern for many dental professionals is that the patient may be unaware of any cavities, gum inflammation, or exposed roots present in their mouths leading to sensitivity. The patient may also be unaware if the procedure is being done legally in a nondental establishment or not. It is strongly recommended that an individual that is interested in professional whitening services contact their dental office and have an examination so as to answer all possible questions and concerns.^[4] We love to help our patients achieve a bright smile however we also want to help them have great results with the least number of side effects as possible.

Kari Carter-Cherelus

Kari Carter-Cherelus RDH, DA is a registered Dental Hygienist, writer, consultant, coach, international keynote speaker, with 23 years of experience in dentistry. She is passionate about helping others recover from burnout, improving organization’s work culture, and helping her clients to improve their mindset. She authored the book The Ultimate Guide For Dental Hygienist Burnout, and has written for RDH Graduate, RDH Magazine, and Inside Dental Hygiene.

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Professional Teeth Whitening: Everything You Need to Know. Willardsen, Joseph. (2022, June 27).https://www.forbes.com/health/body/professional-teeth-whitening-guide/
Professional Teeth Whitening:Everything You Need to Know. Shinde, Emily. (2022, Jun 27). ://www.forbes.com/health/body/professional-teeth-whitening-guide/
ADA. Whitening.://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/whitening
Unregulated teeth whitening dangers. (2012, March 21). https://www.dentalproductsreport.com/view/unregulated-teeth-whitening-dangers

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How to brush your teeth to avoid damage

Kari Carter-Cherelus — Wed, 16 Aug 2023 07:05:22 +0000

Proper brushing, soft bristles, and regular care prevent dental issues. Optimal oral health shields against systemic diseases; invest in your oral health each day for a healthier future.

Dental hygienists teach their patients daily how to improve their oral hygiene techniques. Good oral hygiene is important for your overall well being, the prevention of cavities and gum disease. Your oral health can impact serious health conditions such as heart disease and diabetes.^[2] An important part of oral hygiene instruction is teaching patients how to brush effectively. Brushing incorrectly or with the wrong toothbrush can prove harmful to your teeth and your gums.

The proper brushing technique is to place your toothbrush at a 45 degree angle towards your gum line. Gently move your toothbrush in a circular motion. Brush upwards when you are brushing your teeth at the top of your mouth and brush downwards when you are brushing the bottom teeth. It’s important to brush all the surfaces of your teeth. These surfaces include the outer surfaces which our closest to your cheeks, inner surfaces closest to your tongue, and the surfaces that you use to chew with^[2] To brush the inside surfaces of your front teeth tilt the toothbrush vertically and brush using up-and down strokes.^[2]

You should brush your teeth at least twice a day with a soft-bristled toothbrush so as to remove the plaque acids that contribute to dental cavities. It is important to replace your toothbrush every three months or sooner. Most toothbrushes have indicator bristles that start fading to indicate that replacement is needed. If your bristles start to flare out that is and indication that it is time to replace your toothbrush as a worn out toothbrush won’t be effective in helping you to keep your teeth clean.^[1]

Although you can purchase a medium or a hard toothbrush, these are not recommended as they are known to contribute to damaging the gums, root surfaces, and tooth enamel.^[2] The risk of damaging these structure increases if you brush too hard or aggressively causing toothbrush abrasion.^[2]^[3] If we damage our tooth enamel we may become more susceptible to tooth decay as bacteria can penetrate damaged areas in our teeth more easily. Toothbrush abrasion can also contribute to tooth discoloration as well as painful sensitivity to temperatures and sweets.^[3] If you experience this your dentist will be able to go over various restorative options such as a filling, crown, or a veneer.^[3] The dentist will help alleviate pain or discomfort and recommend future prevention techniques.

Toothbrushes: disposable manual or electric?

Either a manual or a disposable toothbrush will be effective in removing plaque buildup if the user is using the proper brushing technique and brushing regularly.^[2] There are however some advantages to using an electric toothbrush. Some individuals find that using an electric toothbrush helps them to properly clean all their teeth surfaces properly.^[2] Use of an electric toothbrush can help individuals or their caregivers when there is an issue with limited hand mobility due to arthritis, Parkinson’s, or other ailments.^[2] Some electric toothbrushes have built-in timers, pressure indicators, and other features that help the user.^[2] Brushing and flossing can help to keep harmful oral bacteria under control that would otherwise overgrow and contribute to tooth decay, gum disease, oral infections, and harm our overall health and wellness.^[4] You can help protect your health by maintaining your oral health and making sure you see your dentist regularly.^[4] Caring for your oral health in an investment that worthwhile and benefits your overall health.^[4]

Kari Carter-Cherelus

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Combat sudden tooth pain: uncover causes & solutions

Kari Carter-Cherelus — Fri, 11 Aug 2023 06:24:40 +0000

Sudden tooth pain requires a visit to your dental provider to determine & treat the cause. Learn possible causes, prevention and treatment essentials from a dental hygienist.

Tooth pain is often hard for one to ignore regardless if it is sharp, sudden, dull, or a constant ache.^[1] The most common causes of tooth pain is an active tooth infection, decay, injury, or tooth loss.^[1] At times pain might originate from other areas such as the jaw joint, ears, sinuses, and even from heart problems that radiate to your teeth and present as tooth pain.^[1] Most causes of tooth pain are treatable by your dentist.^[3]

What causes tooth sensitivity?

A toothache occurs when the pulp (central portion of the tooth) becomes sensitive to pain, often due to inflammation.^[1] Common causes of pulpal inflammation are dental cavities, trauma, teeth grinding, gum disease, or infection.^[1]

You might be experiencing pain due to having a cracked tooth. This can occur due to clenching or grinding your teeth or even chewing on hard foods such as ice, nuts, or hard candy^[2]Some other causes of a cracked tooth are pressure from clenching or grinding your teeth, large fillings that weaken the tooth’s integrity, or trauma to the mouth.^[2]

Complications of a cracked tooth

You should not ignore pain in your teeth as doing so could lead to complications. Infection from your tooth can spread to the bone, gums, and enter into your bloodstream. Your dentist will determine what treatment may be needed to treat your toothache by finding out what is causing the discomfort. Antibiotics will be prescribed if there is an infection present around the tooth, you have a fever, or swelling of the jaw is present^[1]

Symptoms of a dental infection or a cracked tooth are a fever, pain when chewing, swollen gums, sensitivity to hot and cold food or beverages, and sore lymph nodes^[2]

How tooth pain is treated

The dentist may recommend possible procedures such as fillings, extractions, root canal therapy, occlusal guard, or crowns.

Fillings – A plastic resin restoration that is placed that resembles the natural look of the tooth is used to fill the crack and restore the tooth to its functionality.^[2]
Extraction- When the tooth is extremely decayed, cracked, or damaged then it will need to be extracted or permanently removed^[2]
Root Canal Therapy- when decay or a crack extends into the pulp a root canal is need to remove the damaged pulp and restore the integrity of the tooth, preventing further damage or infection.^[2]
Occlusal Guard – prevents damage to your teeth that can be caused by grinding and clenching
Crown – a dental crown is usually made of porcelain or ceramic and fits over the tooth.^[2]

Sometimes the dentist might recommend not to proceed with any treatment. If a patient has a hairline crack in the enamel of their teeth that doesn’t produce pain or negatively affect their appearance no treatment might be needed.^[2]

How to prevent a toothache

Avoid chewing hard foods and use a mouth guard if you clench or grind your teeth. If you play contact sports wear a sports mouthguard to protect your teeth from injury.^[2] Visiting your dentist regularly for preventative care can help your healthcare professional to address concerns when they are small and manageable^[2] Receiving prompt treatment can help you reduce the risks of losing your tooth, further damage, and preventing harmful infection from spreading.^[2] Brushing twice a day and flossing daily will help to prevent dental diseases that contribute to tooth problems.

Kari Carter-Cherelus

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How sports mouthguards prevent concussions & protect teeth

Rachel Stroble — Wed, 19 Jul 2023 06:09:57 +0000

Custom sports guards protect teeth from direct trauma and cushion them from rattling together, reducing secondary impact and traumatic injury to the brain.

When you think of mouthguards, you may think of appliances that help to prevent the wear and tear that can happen to the teeth at night when you clench and grind , or you may think of the guards that professional athletes wear to protect their teeth from incoming hockey pucks, elbows, or basketballs. One thing you may not know is that sports mouth guards do more than protect athletes’ smiles; they help to protect their brains as well.

What is the origin of sports mouth guards?

Sports mouth guards have been around for more than a century. The first sport to require mouthguards was boxing in the 1920’s ^[4]. Even though this type of protective equipment is becoming increasingly more common, it is still optional in many sports, despite the risk the athletes endure if they choose to not wear them.

How do mouth guards protect the teeth?

Healthy children’s teeth help to ensure a good developmental pathway for the formation and eruption of healthy adult teeth. Childhood and adolescent dental health can set the stage for lifelong oral health… or the lack thereof. Dental sports injuries comprise up to 40% of children’s injuries ^[4]. The good news is that there is something we can do about that. Sports guards protect teeth from being chipped, broken, or even avulsed (knocked out) during sporting activities.

Who should wear sports guards?

Any person participating in sports with a high risk of dental or brain injury should wear a mouth guard ^[2, ^4]. A few examples of this type of sport would include basketball, baseball, rugby, soccer, football, and martial arts. Whether the athlete is 5 years old or 85 years old, injury knows no age limit. Everyone should aim to protect their oral health.

But…how is the brain involved?

When an athlete receives a hit to the head, the teeth rattle together, creating a secondary blow that reverberates throughout the skull and the brain. By placing a quality cushioning layer between the teeth (i.e., a mouth guard), the secondary shock wave can be substantially reduced or eliminated. Studies show that proper use of a mouth guard during impact sports can reduce the incidence of concussion ^[3] The more we learn about the long-term effects of concussions on the brain, the clearer the importance of protecting our brains becomes.
Concussions can lead to traumatic brain injury. In 2019, a shocking 15% of the entire high school student population in the United States reported concussions related to recreational events within the preceding 12 months ^[1]

What to look for in a sports mouth guard

Some mouth guards are better than others! While purchasing an off-the-shelf guard will provide some protection, it’s important to note that not one size fits all. An athlete should shop for a mouth guard like they shop for a well-fitting pair of shoes.Even among members of the same team, the needs are different. To receive the biggest benefit, all athletes alike should seek out a custom-fit mouth guard.Custom-fit guards will offer the most comfort, safety, and accommodation of oral anatomy, such as arch size and muscle attachments.Different materials and fabrication techniques can be used to meet the needs of each person ^[5]

Rachel Stroble

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Centers for Disease Control and Prevention. (2022, December 15). Traumatic brain injury and concussion.
https://www.cdc.gov/traumaticbraininjury/index.html
Knapik, J. J., Hoedebecke, B. L., Rogers, G. G., Sharp, M. A., & Marshall, S. W. (2019). Effectiveness of mouthguards for the prevention of orofacial injuries and concussions in sports: Systematic review and meta-analysis. Sports Medicine, 49(8), 1217–1232.
https://doi.org/10.1007/s40279-019-01121-w
Ono, Y., Tanaka, Y., Sako, K., Tanaka, M., & Fujimoto, J. (2020). Association between sports-related concussion and mouthguard use among college sports players: A case-control study based on propensity score matching. International Journal of Environmental Research and Public Health, 17(12), 4493. https://doi.org/10.3390/ijerph17124493
Parker, K., Marlow, B., Patel, N., & Gill, D. S. (2017). A review of mouthguards:Effectiveness, types, characteristics and indications for use. British Dental Journal, 222(8), 629–633. https://doi.org/10.1038/sj.bdj.2017.365
Roberts, H. W., (2023). Sports mouthguard overview: Materials, fabrication techniques, existing standards, and future research needs. Dental Traumatology, 39(2), 101–108. https://doi.org/10.1111/edt.12809

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Why custom-fitted whitening trays are still the best in 2023

Rachel Stroble — Wed, 05 Jul 2023 07:31:27 +0000

Custom whitening trays are the most effective because they are fitted to keep the whitening agent in perfect contact with every angle of the teeth. To complement the whitening application, the trays can deliver desensitizing gel treatments that nourish the teeth and soothe sensitivity, providing the most comfortable whitening experience.

Has the new year brought new advances in whitening or are the tried and true options still the best? Read on to find out.

In-office teeth whitening options

The most common type of in-office teeth whitening is the application of a professional strength whitening gel. With this method, check retractors are placed to hold the lips and cheeks away from the teeth. Then, a special material is placed onto the gums to protect them. In some cases, a high-intensity light is then placed close to your mouth to help increase the effect of the whitening gel. While this method of whitening is fast and effective, it is also pricier than some other options, often costing several hundred dollars. Furthermore, tooth sensitivity can be more severe with this type of whitening than with other options.

Over the counter teeth whitening

There are numerous over the counter products for tooth whitening, including toothpastes, strips, non-custom-fit trays, light activated whitening trays, paint on gels in the form of pens and even gels applied with a small spatula. While many of these options produce results, they also come with drawbacks. For instance, paint-on products can be cumbersome to apply. Furthermore, whitening strips and non-custom-fit trays apply peroxide gel not only to the teeth, but to the gums as well. While peroxide gel is perfectly safe when applied to the teeth, it causes irritation, burning, and even sloughing when applied to gums.

What to avoid

There are safe ways to whiten your teeth, and then there are methods that are downright harmful. Avoid DIY whitening techniques, especially those that include mixing together ingredients from your kitchen. One common example on the internet includes mixing lemon juice with an abrasive like salt, and using this concoction to brush your teeth. This is incredibly harmful to your teeth! Lemons are very acidic and eat away at your enamel, causing permanent damage. It’s also best to avoid ultra-abrasive whitening toothpastes. Always look for the American Dental Association’s seal of approval on toothpaste packaging, which ensures the paste you have chosen is safe and effective ^[1].

Why custom-fit whitening trays are still the best option

Even though there are more whitening options available than ever, the best choice is still custom-fit whitening trays. They are crafted in order to fit you and only you! They are designed to protect your gums from the peroxide gel by keeping it from squishing up over your gums to keep you comfortable. This method of whitening also causes less tooth sensitivity than in-office whitening. There are even options available for sensitive teeth, such as the addition of a desensitizing toothpaste or gel. Custom-fit trays are safe, effective, and more comfortable than the other options out there.

Pro tips for whitening your teeth

Brush your teeth gently with a toothbrush dampened with water before bleaching. This will remove any plaque that could get in the way without adding any barrier between the gel and your teeth. Apply a very small amount of whitening gel into the trays. The gel should not squish up onto your gums. If it does, you’ve used too much. After removing the trays, clean them well and brush your teeth with toothpaste. Try to avoid staining foods and drinks for two or three days after whitening to protect your newly white smile. Lastly, whitening on a regular basis after you have achieved your desired shade (once per month if you are prone to staining, or less often if you aren’t) will help to keep your smile stunning!

Rachel Stroble

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American Dental Association. (n.d.) ADA Seal of Acceptance. https://www.ada.org/resources/research/science-and-research-institute/ada-seal-of-acceptance

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Answers to the 4 most commonly asked questions about cavities

Rachel Stroble — Mon, 22 May 2023 06:51:58 +0000

Most of us have had a cavity at some point. Maybe it required a filling, maybe it didn’t. But why? Find out how cavities develop, when they really need treatment, and how to prevent them in the future!

What are cavities?

Cavities are also called dental decay or dental caries. They are caused by bad bacteria and an acidic oral environment ^[3]. Additionally, frequent exposure to sugary foods and drinks increases the risk of cavities. In the early stages of a cavity, it may appear white and chalky if it is in an easily visible area. Next, cavities may appear brown, and then black. Over time, cavities appear as a hole in the tooth. However, even if you do not see a hole in your tooth, you could have a substantial cavity! Sometimes, they start small and burrow under the enamel, causing large amounts of damage.

Do cavities always hurt?

Teeth are made of three main layers. The enamel, or the outer surface of the tooth, is the hardest substance in your body. The next layer is dentin, a slightly softer layer. The third layer is the pulp, or the nerve and blood supply of the tooth. When cavities are just beginning in the enamel, you probably won’t feel pain ^[1]. Once they progress into the dentin, you may start to have tooth sensitivity to cold or sweets. By the time most people have pain, the cavity has progressed all the way into the pulp of the tooth! If your cavity is this advanced, you will probably need more complex dental treatment. It’s also important to know that there are other dental conditions that can cause pain, so be sure to see a dentist if your mouth is hurting.

How do I know if I need a filling?

Regular preventive dental visits are important to protect your dental and whole-body health ^[4]^[5]! During the earliest stages of dental decay, your dental healthcare professional is your best asset in identifying cavities. X-rays and special magnification eyewear are two of the ways your dental team can detect cavities when they are still very small. During this stage, simpler treatment may be possible to repair the damage. If you have noticed that you have a hole in your tooth, you need dental care! A filling or other treatment may be recommended. The earlier you catch dental decay, the more conservative your dentist will be able to be. Depending on how advanced your cavity is, you may need something more in-depth, such as a crown or root canal.

What can I do to prevent cavities in the future?

In addition to seeing your dental team two to four times annually, depending on your oral condition, one of the best things you can do at home to prevent cavities is to brush your teeth twice per day for two minutes each time and to clean in between the teeth with floss or other methods at least once per day. Also, toothpaste and mouthwash with fluoride help prevent cavities by strengthening the teeth ^[2]. Be sure to read the instructions on your dental products to be sure you are getting the maximum benefit from them!

Rachel Stroble

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Boyd, L. D., Mallonee, L. F., Wyche, C. J., Halaris, J. F., (2021). Wilkins’ Clinical practice of the dental hygienist. Jones and Bartlett Learning
Horst, J. A., Tanzer, J. M., & Milgrom, P. M. (2018). Fluorides and Other Preventive Strategies for Tooth Decay. Dental clinics of North America, 62(2), 207–234. https://doi.org/10.1016/j.cden.2017.11.003
Institute for Quality and Efficiency in Health Care (2020, February 27). Tooth decay: Overview. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK279514/
Little, J. W., Miller, C. S., Rhodus, N. L., & Little, J. W. (2018). Little and Falace’s dental management of the medically compromised patient (Ninth edition.). Elsevier.
Maurer, K., Rahming, S., & Prvulovic, D. (2018). Dental health in advanced age and Alzheimer’s disease: A possible link with bacterial toxins entering the brain? Psychiatry Research.

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7 tips to handle tooth sensitivity caused by whitening

Kari Carter-Cherelus — Wed, 10 May 2023 13:02:51 +0000

As much as we want to whiten our teeth, we’re often scared of tooth pain associated with the process, particularly if we already suffer from daily tooth sensitivity. Understanding what causes sensitivity and preparing for it while whitening is the key to comfortable whitening! Find out how here.

Dental patients have increasingly desired a more attractive smile to help boost their confidence that is whiter or brighter. This desire has especially increased with the rise of virtual meetings as individuals’ teeth are more noticeable on screen. Over the past few decades there has been a steady influx of whitening products on the market, yet there still remains only two main options to whiten your teeth.

What are my options?

Your options are to either have professionally administered (in-office) teeth whitening services or self administer at-home whitening products. Several popular in-office treatments use heat and/or light to speed up the treatment and to intensify the whitening process.^[1] In-office treatments tend to deliver the most dramatic results in the least amount of time, therefore they are more costly.^[1] Self administered at-home teeth whitening products can include custom fitted trays that you use to apply whitening gels to, strips, rinses, chewing gums, or paint-on films.^[2] This method usually delivers results within a few days to a few weeks and can be less costly yet more time consuming.

Teeth whitening & tooth sensitivity

Most dental patients are interested in having a brighter smile, however they may be wary of treatment as they may have heard that whitening products can cause tooth sensitivity.^[1] Whitening products use peroxide based (carbamide or hydrogen peroxides) whitening agents in varying percentages to lift the stains from the pores of the teeth.^[1] There is a risk of temporary tooth sensitivity with whitening treatments. This risk is possibly due to the pulp (nerve of the tooth) becoming exposed to peroxide during the procedure resulting in inflammation. When a tooth’s pulp is irritated it can cause pain to the individual.^[1]^[3] Tooth sensitivity is more common with the use of higher concentrations of peroxides in the whitening products and leaving the product on for longer lengths of time.^[2] Some patients feel sensitivity during treatment immediately during the initial procedure (in-office treatments), or within two to three days after starting treatment (at-home treatments).^[2] Tooth sensitivity usually resolves within four days post-treatment.^[2]

Handling sensitivity while whitening

There are several approaches one can explore to help prevent and treat sensitivity prior to using treatments, as well afterwards to help speed up ones recovery.^[2] Prior to using whitening treatments, some have found that using nonsteroidal anti-inflammatory drugs and the pretreatment of 5% potassium nitrate and 2% sodium fluoride or desensitizing gels can help reduce dental sensitivity.^[2]

Never whiten your teeth longer that the time that is recommended on the products instructions or provided by your dentist.^[3]
If you experience sensitivity with at-home whitening try to shorten the application time or give your teeth breaks between treatments by skipping days instead of consecutively whitening.^[3]
Limit foods and drinks that are either very hot or cold during treatment to minimize your symptoms.^[3]
Use a whitening product that contains a lower amount of peroxide.^[3]
Use fluoride rinses, desensitizing gels, and/or sensitivity toothpaste prior to and during treatment.^[3]
Use a soft bristled toothbrush.^[3]
Stay in contact with your dentist if problems arise so that the sensitivity can be mitigated.^[3] Your dentist can apply desensitizing products in the office if necessary.

Homecare is important

After whitening your teeth you can extend the benefits and reduce stains by practicing good dental homecare habits such as brushing at least at twice a day and flossing daily^[4]. Try to avoid foods and drinks that have the potential to cause staining especially after initially whitening. Examples of stain causing products are teas, coffee, carbonated beverages, sports drinks, sauces, and berries. If you do consume these products, brushing your teeth 30-60 minutes afterwards or rinsing your teeth with water can reduce staining.^[4] If a brighter smile is what you desire it is within reach following these tips.

Due to the risks of tooth sensitivity it is advised that you consult your dentist first to discuss options that would work best for you. Your dental professional can help determine if you are a candidate for whitening treatments and determine what your best treatment options are. Some patients regularly have teeth sensitivity without having whitening procedures done. They may need to take extra precautions as it can make their teeth especially uncomfortable.^[1] It is important to follow the instructions when doing at-home treatments so as to reduce the risk of burning or temporarily bleaching the gum tissue.^[1]

Kari Carter-Cherelus

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The little-known secret to teeth whitening – low pH

Lacy Walker — Tue, 02 May 2023 06:57:11 +0000

All teeth whitening is not created equal: a particular whitening product’s pH can directly influence its efficacy. Depending on what and how you use it, teeth whitening can actually lower oral pH, leading to risk of decay and tooth sensitivity. So it’s important to choose a quality product and closely follow the directions to safely & effectively whiten your teeth.

Teeth whitening is a popular cosmetic procedure that can improve the appearance of your smile. There are many reasons why you might want to whiten your teeth. Maybe you’ve just noticed that your teeth have lost their luster over time. Or perhaps you’re getting ready for a big event like a wedding or job interview. Whatever the reason, there are several ways to achieve whiter teeth.

However, it is important to remember that it can also influence your oral pH level. The whitening process uses chemical agents like hydrogen peroxide and carbamide peroxide to oxidize the molecules in the enamel that cause discoloration. These agents are effective in whitening teeth but can also slightly decrease the mouth’s pH level.

Oral pH is Important

The mouth can become an acidic environment, which can lead to tooth decay and other problems. The pH scale ranges from 0 to 14, with 7 being neutral, and the pH balance in the mouth should be slightly alkaline. A balanced pH helps maintain healthy teeth and gums by preventing cavities and reducing gum disease risk. When the pH falls below 5.2, enamel demineralization and root resorption have been reported.^[1]^[2]

According to a study that measured the pH of 26 whitening products, the pH of these products ranged from 3.67 (highly acidic) to 11.13 (highly basic). ^[1]^[2] To keep your mouth’s pH level balanced, it is essential to practice good oral hygiene habits, such as brushing and cleaning in between the teeth twice a day and using an alcohol-free mouthwash.

Teeth whitening alters oral pH

Whitening teeth can help improve the look of your smile and boost your confidence, but it’s important to speak to your dentist before using any whitening products. The bleaching agents’ pH is a factor that can directly influence the whitening process. Teeth whitening products can lower the pH, leading to enamel erosion and increased tooth sensitivity.

The pH of some whitening products is acidic primarily to increase the shelf life, and manufacturers have paid attention to the acidity of bleaching gels because low oral pH can produce various harmful effects on the structure and properties of the tooth.^[3] The effectiveness of dental bleaching is influenced by several factors, such as the bleaching system used, bleaching agent concentration, application time, and light application.^[4]

Safely use teeth whitening products

When teeth whitening products are used incorrectly, they can strip away the natural protective layers on your teeth, making them more vulnerable to acids and bacteria. This increase in the mouth’s acidity can cause cavities, enamel erosion, and tooth sensitivity. To help minimize this risk, following the directions on the whitening product you are using is important, in addition to discussing with your dentist any potential risks before starting any whitening treatment.

If you experience sensitivity, your dentist may suggest using a potassium nitrate product. Potassium nitrate helps those with sensitive teeth by blocking the pain signal resulting in less pain and sensitivity, and can be found in over-the-counter and prescription dental products.

If you have active periodontal disease or gingivitis, it is highly recommended to treat the infection first before proceeding with any whitening procedure, as it can irritate your gums further. Maintaining oral pH balance, healthy gums, and choosing a tooth whitening product for your needs under the direction of a dentist are some of the key components of a healthy, beautiful-looking smile.

Lacy Walker

LACY WALKER, RDH, BS, CDA, FAAOSH - dental hygienist, speaker, owner of Shared Hygiene, LLC, & writer w/ 25 years of experience in the dental field working in a psychiatric hospital, cosmetic, restorative, DSO, and periodontal practices. Lacy is the CE Director for A Tale of Two Hygienists podcast & Public Relations Chair for the AADH. She has a passion for the oral-systemic connection & is published in DACE, RDH Magazine, & DrBicuspid. Lacy is an approved provider of CE credits through AADH.

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Price, R.B. (2000) Download pdf | the ph of tooth whitening products – researchgate. https://www.researchgate.net/publication/12282985_The_PH_of_tooth_whitening_products
Price, R., Sedarous, M. and Hiltz, G.S. (2000) The pH of Tooth-Whitening Products, The pH of tooth-whitening products. Available at: https://www.cda-adc.ca/jcda/vol-66/issue-8/421.html
WIJETUNGA, C.L. et al. (2021) Effect of ph of bleaching agent on tooth bleaching action in vitro, Dental Materials Journal. The Japanese Society for Dental Materials and Devices. https://www.jstage.jst.go.jp/article/dmj/40/3/40_2020-191/_pdf
Soares, A. F., Soares Bombonatti, J. F., Alencar, M. S., Consolmagno, E. C., Honório, H. M., & Lia Mondelli, R. F. (2016). Influence of pH, bleaching agents, and acid etching on surface wear of bovine enamel. Journal of Applied Oral Science, 24(1), 24-30. https://doi.org/10.1590/1678-775720150281

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