Dr. Urban on Today’s Dentistry/The Hollywood Smile

Have you ever looked in the mirror and wondered why your teeth aren’t as straight and bright as your favorite beautiful or gorgeous Hollywood actors? If not, then stop reading. For the rest us let me explain what goes into a great looking set of teeth and smile.

First, it starts when your parents take you to the dentist and orthodontist. Most bad bites and crooked teeth can be corrected with braces in two to three years. Take off the braces and bleach the teeth and Voila! You have a Hollywood smile.

Second (if you skipped the first step as a child), talk to your dentist about your smile. There are many types of beautiful smiles. They all have harmony and symmetry. Your dentist will evaluate your smile for lip line, tooth size, gum line, and color to develop an appropriate plan of action. Plans may include braces, bleaching, veneers, crowns, and cosmetic oral surgery.

I have many adults that have opted for braces. Yes, this takes a little longer, but it is often necessary for very badly positioned teeth. If the teeth are not too bad orthodontists can use the Invisalign clear tray method. Even with orthodontic correction your teeth may still be dark and worn.

Bleaching may be all that is needed. I use the “Sapphire” one-hour professional whitening. Other products such as Brite-Smile and Zoom are performed routinely. Take home tray bleaches are great and a little less expensive. The advantage is that you can bleach on your own quiet time and give yourself an occasional “booster” treatment when the teeth start returning to the original shade.

Veneers are thin porcelain shells that cover the front of the teeth. I try not to permanently alter healthy teeth for cosmetic work (sorry-it’s just me) so I use Lumineer veneers wherever justified. These are really thin (.3mm-.5mm) porcelain shells and are placed without the use of shots. I like them so much I have placed them on my staff and family to fill out the smile line and to permanently brighten teeth. Occasionally I must do a minor reduction of the tooth if it sticks out too far. The first veneers that were developed are thicker and require drilling back on the tooth to compensate for the added thickness.

When Lumineers cannot achieve your Hollywood smile many dentists are using ceramic fused to ceramic crowns. These crowns are brilliant and strong. They are more expensive than the old porcelain fused to metal crowns, but you will not get that dark line you see at the gum line when the tissues eventually shrink back.

Finally, oral cosmetic surgery may be required to correct gummy smiles and high lip lines.

So, if you want that “Hollywood Smile” a consultation with a dentist experienced in Cosmetic Dentistry might just start you on the road to the smile of your dreams!

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com

Lumineers

Snap On Smile

Snap-On Smile

The California Dental Association completed its annual spring scientific session in Anaheim. The lecture offerings were outstanding and very pertinent to your dental care. This week I want to report about an interesting innovative dental solution I discovered while “walking the floor”.

Dentists and patients have always been somewhat disappointed with temporary removable bridges while undergoing a long term dental solution. I think Snap-On Smile can happily offer people a beautiful temporary cosmetic solution for missing teeth, large gaps, and discolorations until they can get their dental work completed.

When a person goes to see the dentist about enhancements to their “smile profile” they will often get a mock up of what their teeth will look like after treatment. Unfortunately, the mock ups are fragile and have to be removed before they break. Recent improvements in acrylics now allow us to make a thin strong set of teeth that will snap over the existing teeth without shots and drilling.

Snap-On appliances are durable and do not stain. Some care must be taken when inserting and removing and they are not intended for a permanent fix for people’s dental problems. You can wear the appliance during the day and while eating. The appliance must be removed and cleaned when you brush your teeth. It is very difficult for anybody to tell if such an appliance is being worn.

These teeth-like appliances can be used to replace a missing front tooth, cover over crooked teeth, fill up spaces during implant placements, or for “photo shoots” and social engagements. Dentists can use these appliances to diagnose and change biting patterns to assist with more complicated problems. If porcelain veneers are not affordable the Snap-On Smile will certainly be a less costly substitute until porcelain veneers can be placed. Your teeth can be whiter and straighter until you have the ability to get your veneers.

The Snap-On Smile is made from an impression of your teeth. After the laboratory has completed the injection molding process the appliance is returned and fitted to your teeth. Your dentist will instruct you on handling and maintenance and some things you will have to do to get the maximum life expectancy from the teeth.

I am excited about the Snap-On Smile because it fills a time gap that some people require until they can get a permanent fix to their new smile.

Gum Disease and Heart Attacks

You are probably hearing through aired media and perhaps in your dental office the persuasive argument that gum disease can lead to heart attacks. But will treatment of gum disease reduce heart attacks? Unfortunately, this question cannot be clearly answered. Let’s briefly examine where the connection of gum disease and heart disease is known to exist.

There are a certain number of people in a population that have high risk factors for heart disease. This may be due to smoking, genes, life styles, “good and bad” cholesterol levels, and c-reactive proteins (CRP). CRP’s are produced as a result of damage to the inner lining of the blood vessels that supply the heart muscle. Also, C-reactive protein levels rise when chronic inflammation is present. The American Heart Association has recommended using the CRP test as one of the indicators of risk level for heart disease.

Where is the connection with gum disease? Periodontitis or gum disease is a chronic inflammatory disease process that can lead to loss of bone around the teeth. The association seems to be that the chronic inflammation component of gum disease adds to the chronic inflammatory load the body must endure. There is no good outcome to a high chronic inflammatory level.

We have to examine what underlying conditions can cause both diseases as well as the effect gum disease can have on heart disease. For example, smoking has been shown to have an overwhelming affect on gum health. In fact, studies that measure treatments for gum disease become meaningless in smokers. Smoking has also been shown to cause damage to vascular tissues and increase the risk of having a heart attack.

Other underlying conditions also include the genetic factor. Some people are more prone to inflammation and metabolic disease. Studies are mixed, but it seems that a healthy diet low in saturated fats can help minimize the harmful effects of this condition.

Let’s get back to the dental factor. We know that bleeding gums will allow bacteria into the blood stream and these bacteria can grow in damaged vessels perpetuating the heart disease process. The dentist’s role is to help control the infection and inflammation levels with gum treatments and frequent monitoring of home care.

Regular cleanings of the bacteria encrusted surfaces of your teeth is a proven method to stop the destruction caused by these bugs. Surgery may be needed from the periodontist. Maintenance is required because these bugs can double in population every twenty minutes. I have seen periodontal disease that has been in remission only to suddenly (within 6 weeks) strike up again. That is why frequent monitoring is crucial.

Will treatment of gum disease prevent heart attacks? Periodontal disease is just one pathway of inflammation that can further deteriorate the lining of the heart and blood vessels. Your dentist is a very important “team” member along with the cardiologist and physician to maintain a level of general health that will prevent heart attacks.

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com

Dr. Urban on Today’s Dentistry/Remote Access

My Impressions of Remote Area Medical

The idea of volunteering dental services in inaccessible locations is very intriguing. Last year for the first time Remote Area Medical (R.A.M) decided to drop itself right into the middle of Los Angeles. The response from the public was overwhelming. RAM provides basic medical screening, vision, and dental services. This year they returned to the Sports Arena to another huge demand.

I had the opportunity to volunteer for one morning shift on Sunday and was generally impressed by the organization and efficiency of the set up and handling of patient flow. Although my personal check-in was about 20 minutes longer than it should have been (early morning rush) I was quickly able to make my way down to the floor level of the Sports Arena. The number of volunteers that showed up that morning was magnificent. Every available dental chair had a dentist or hygienist working. My chair was in the screening area. There were about 8 dentists screening nearly 50 each for basic services such as extractions, fillings, some root canals and cleanings.

Since this was a one-stop-shop RAM is not able to provide crowns, extensive dental therapies, or dentures. Some minor denture repairs were available if time permitted. I am happy to say that a lot of your area dentists volunteered their time and weekends to support this project.

The patients were very gracious for the services RAM was able to provide. There were some grumpy types of people who did not get what they expected, but most accepted the situation. I am sure the dentists wished to do more in some cases, but, remember, we were in the middle of the Sports Arena, not in a modern dental office. Some specialty services like oral surgery and root canals were done in mobile clinics that were towed into the Sports Arena.

The attitude of the volunteers was heartwarming. Everyone I saw pitched in with more energy than they would show in their own office. It was a team, but very few of us knew or even met before this event. There was one common force that made everyone commit to a duty and give it their best. The energy came from the heart knowing that we were doing something for a greater good.

At the end of my 6 hour commitment I quietly left. There was no one to give a thanks or “atta boys”, but none was needed. It was my pleasure to take a very small part in this noble endeavor. We do live in a very nice section of the world with relative peace and stability. It is easy to forget there are others close by not so fortunate. I hope RAM returns again next year.

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com

Dr. Urban on Today’s Dentistry/Making Teeth Stronger

Last time I discussed using xylitol sweeteners to lower the incidence of tooth decay. This is good prevention. But what happens when decay first begins and teeth become sensitive? There is now a dental cream that can be applied at home that will help harden teeth by remineralizing the soft enamel of the tooth.

The active ingredient of this cream is RECALDENT™ (CPP-ACP). It is marketed by GC America Inc. in the product named MI Paste Plus. It is also available in the Trident XtraCare with Recaldent and Trident Recaldent Calcium Sugar-free tablets.

MI Paste is pleasant tasting and adheres to the tooth surface acting like a magnet for minerals to bond back onto the tooth surface. This makes the tooth tougher and more resistant to acid etching from bacteria, foods, and saliva.

Who would benefit from MI Paste? It is safe for 1 year old children to senior citizens. MI Paste is dispensed by dentists to people who have a moderate to high decay rate. It is good for people who have a high acid level in their saliva. MI Paste helps reduce the erosion caused by dry mouth. If bleaching your teeth causes them to be sensitive you should apply the cream immediately after bleaching. If you are undergoing chemotherapy or radiation therapy to the head and neck area, MI Paste will help protect the teeth during this trying time.

MI Paste without fluoride is a better dentifrice for little kids who can barely brush their teeth. When they become older they can use regular toothpaste and then apply a small amount to their teeth before school and before bedtime.

This cream is also recommended for kids wearing braces. It is very difficult to fully clean every nook and cranny while the brackets and wires are on the teeth. MI Paste helps neutralize the acid levels caused by the remaining bacteria. Despite all efforts to protect the teeth white spots may appear after removing the brackets. The cream can then be applied to help remineralize these white spots (some white spots can be the beginning of decay).

Dry mouth is a common symptom due to age, stress level, smoking, dehydration, mouth breathing, caffeine, alcohol, medication, medical condition, and chemotherapy. Erosion of the tooth surface will occur even faster if the mouth is dry. MI Paste will help restore the hardness of the enamel and reverse the erosion process.

The cream should be used until the dentist determines that the decay rate has stabilized, white spots disappear, and remineralization has occurred. Thereafter you can use the Trident products containing Recaldent to maintain the remineralized teeth. MI Paste can be purchased through your participating dentist or through Amazon.com.

If it is so wonderful, why doesn’t everyone use it? Well the need must be compelling and the cost is about five times more than an equivalent amount of over the counter toothpaste. There is one last thing about MI Paste. It is sweetened with xylitol.

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com

Dr. Urban on Today’s Dentistry/Feeling tired all the time?

Does it seem like you go to bed early, get your eight hours of sleep and still feel tired? Perhaps you are not getting the sleep you think you are. Many of us suffer from obstructive sleep apnea or OSA.

Sleep apnea is characterized by pauses in breathing from a few seconds to a minute. These pauses can occur a few times during the night or over a hundred times an hour. It can allow a low oxygen saturation level in the blood resulting in oxygen starvation of the tissues and organs. It can result in strokes, hypertension, heart disease and death.

Sleep study tests can determine the incidence of breathing cessation. A medical doctor can confirm a diagnosis of sleep apnea after carefully reviewing the results of a sleep study test. These tests monitor the blood oxygen level, REM cycles, and the frequency of obstructive episodes per hour.

You can ask yourself these questions to see if you should seek help. What are my chances of dozing when I sit and read, watch TV, sit in public places, wait for red lights while driving or sit as a passenger in a car? What is the likelihood of falling to sleep after lunch? If you are tired or fatigued easily during the day it would be very prudent to consult with your physician for advice.

Sleep apnea can be initiated from the brain or from physical factors that obstruct and collapse the breathing space. Exactly where the collapse occurs in the back of the throat can determine the treatment alternatives.

Treatments for OSA can vary from anti-snoring devices made by dentists, sleeping on specially tilted pillows, neck slings, or wearing facemasks attached to positive pressure air pumps (CPAP). As with all treatment options these CPAP pumps cannot be tolerated by everyone and may have a limited success with some individuals.

In severe cases where respiratory arrest is possible surgery may be the only option. Surgical removal of excessive soft tissues in the throat and nasal sinus surgeries have been performed to open up the airways with limited success. In the most severe cases skeletal surgeries are performed to open up airways. This type of surgery, although extensive, has had great success. It sounds like a lot of treatment, but we are talking about a life-threatening situation if left untreated.

Regardless, I hope that you can appreciate that snoring may be a sign of a more serious problem and that it should be discussed with your physician or dentist. Your dentist can do a quick airway analysis, ask a few questions, and refer you to a physician that specializes in sleep apnea. Depending upon the results you may just have a snoring problem that can be alleviated with a simple appliance. Remember that OSA is not condition about a lack of sleep, but a medical condition about a lack of oxygen.


For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com