The “Hollywood Smile” — dazzlingly white — is associated in our society with youth, health and vitality. Achieving that smile through either professional or home whitening applications has become very popular. Teeth become discolored or dull for a number of reasons. It can be something intrinsic with the teeth — changes in enamel or dental structure during development, inherited disorders, heavy exposure to fluoride or tetracycline, or changes in mineral structure or wear due to aging. It can also be extrinsic, resulting from environmental or lifestyle causes. Eating foods with tannins (red wine, coffee or tea) or carotene pigments found in plant foods like oranges or carrots, or using tobacco may all cause staining. Most modern applications involve an oxidizing chemical (usually hydrogen peroxide) that bleaches the teeth. Professional applications in a dentist’s office use high concentrations of hydrogen peroxide (usually 35 to 45%) applied directly to the teeth with control measures to protect the lips and gums. This type of application can lighten the color of teeth up to ten shades. There are a number of home options too: whitening strips, “Paint on” or “Brush on” whitening, and even whitening gum. We can also provide you with a “Take home” kit that resembles the professional application but is generally less expensive. Although all these home applications are generally safe and effective, they typically take longer for results (several repeated days as opposed to about one hour for an office application), and not always to the same level of lightness as the professional. Just about anyone can be a candidate for a whitening application. However, if you have thinner than normal dentin and more porous enamel, or suffer from gum recession or enamel loss, then whitening may increase tooth sensitivity. And, whitening is not a permanent solution: the brightness will fade over time, usually within a year. You can slow the fading by avoiding foods and habits that contribute to staining. It’s also possible to touch up the initial whitening once or twice a year to extend the life of your new, bright smile. If you would like more information on teeth whitening, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Whitening.”
Today’s cosmetic dentist can bring amazing transformations to their patient’s smiles. That’s because we now have a versatile array of materials and processes that precisely replicate the appearance of natural teeth. Two of the most useful are porcelain veneers and crowns. Although different in structure and function, veneers and crowns both utilize a material known as dental porcelain, a ceramic material that can be shaped to resemble an individual patient’s natural tooth shape, with the same color, hue saturation and translucence as the original or surrounding teeth. As the name implies, veneers are a thin layer of dental porcelain that adheres to the outer surface of a tooth, essentially as a replacement for enamel. They solve a number of esthetic issues patients have with their teeth, especially those in front: poor color, shape and contours; broken teeth; poor tooth position; and staining that can’t be removed with conventional bleaching. They most often require minimal tooth preparation, as only 1 mm or less of tooth enamel needs to be removed. Occasionally, no tooth reduction is required. However, they are not a good solution where there is not an adequate amount of tooth structure to work with. In this case, a crown may be the best choice. A crown (or cap) covers the remaining tooth structure completely, reinforcing the remaining tooth structure 360°. This is an excellent choice for patients who have lost a large amount of tooth structure due to decay, trauma or grinding habits that have eroded the enamel. To determine if you are a true candidate for either of these applications you should undergo a smile analysis in our office. During this process it’s even possible to create a diagnostic mock-up — a “trial smile,” if you will — with temporary tooth-colored materials applied to your teeth and then photographed for your review. The smile analysis helps us recommend the best solution for you and in turn will help you make an informed choice on the right application for you. Although either option may not be feasible in all situations, they may just be the right choice to change your smile for the better. If you would like more information on how porcelain veneers and crowns can help transform your smile, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”
Billions of bacteria live in each of our mouths, sharing a common environment with teeth and soft tissues. Most of the time, they coexist in symbiotic balance. But sometimes that balance becomes disrupted, leading to a destructive condition known as periodontal disease. From the Latin peri (“around”) and the Greek odont (“tooth”), periodontal refers to the tissues that are around the teeth. When they become diseased, it’s a serious matter; and not just because of potential tooth loss — there is evidence that periodontal disease has links to cardiovascular disease and, for pregnant women, low birth weights in pre-term babies. There are a number of factors that can increase your risk of developing periodontal disease, like smoking, poor nutrition, and your systemic health. The biggest factor, however, is increased bacterial plaque due to poor oral hygiene practices. Periodontal disease is progressive. As unhealthy bacteria levels increase, the bacteria eventually cause bone loss, the gums separate from the teeth and create what is referred to as periodontal pockets. As the pockets deepen around the teeth, plaque and tartar become extremely difficult to remove, even if you resume a proper hygiene routine. At this stage, treating the disease will require a different approach. And if left untreated, the teeth will most likely continue to lose bone and eventually be lost. Through a dental exam, we can determine the presence and extent of the disease and recommend a treatment strategy. Besides lifestyle changes and better hygiene habits, this strategy might also include treatment with antibiotics, a thorough mechanical cleaning to remove tartar and plaque, surgical techniques to remove infected tissue, or occlusal bite therapy. Above all, prevention is the key. Through proper dental hygiene and regular dental exams and cleanings, stopping periodontal disease from beginning in the first place is your best defense. If you would like more information on the treatment of periodontal disease, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Understanding Gum Disease.”
Orthodontic treatment (commonly known as braces) can be a lengthy process to re-align your teeth to a more functional and aesthetic position. Once the orthodontic devices are removed, however, the treatment isn’t finished. Wearing a retainer is the final step to ensuring that the re-alignment doesn’t eventually fail. It’s designed to do just what its name implies — to “retain” the teeth’s new position and prevent a relapse to the old. This can happen because of the way teeth fit into the jaw bone. The teeth are joined to the bone by the periodontal ligament, which works somewhat like a hammock: the ligament’s fibers act like threads that fit into the tooth on one side and into the bone on the other, and hold the teeth in place. As living tissue, the ligament’s cell structure is dynamic and can adapt to the gentle pressure applied by an orthodontic device. However, once this pressure subsides after the device is removed “muscle memory” can cause the ligament to resist the new position and pull the teeth back to their original setting. The retainer helps hold the teeth in the new position while the bone and ligament continue to mature and stabilize around the teeth. There are two basic types of retainers; the one recommended for you will depend on your age and the extent of your orthodontic treatment. One type is a removable device that is typically worn around the clock initially, but may eventually only need to be worn at night or for even a lesser interval of time. The other type is attached permanently behind the teeth and can only be removed by an orthodontist. Permanent retainers have the benefit of not being as visible as the removable type, and there’s no bother with putting them in and taking them out. You may consider wearing a retainer a nuisance especially after months of orthodontic treatment. But consider it the last lap in a long race — only by finishing can you achieve that winning smile. If you would like more information on the use of a retainer, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”

Answering Common Questions on TMJ Disorders

Posted by Cindy Sumarauw on  June 27, 2013
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Category: jaw pain, tmd, tmj
You have probably heard a lot of people talk about TMJ disorders, but do you know what it all means? How do you know if you are suffering from a TMJ disorder? Below are answers to some common questions about TMJ disorders. What is a TMJ disorder?First, we should explain that TMJ actually refers to the Temporomandibular Joint, which is the formal name for your jaw joint(s). TMD stands for Temporomandibular Disorders, which is the correct name for the muscle and/or joint symptoms that commonly arise when there is TMJ pain and dysfunction. You may have heard people refer to the actual disorder as TMJ, but this name is incorrect. When I experience TMJ pain, what exactly is happening?Let’s first understand all of the parts that play a role in your pain. The temporomandibular joints connect your mandible (lower jaw) to your skull on both the left and right sides, which makes the lower jaw the only bone in the body with completely symmetrical joints at both ends. There is a ball-and-socket relationship between your jaw and your skull on both sides, but the unique part is the presence of a cushioning disk between the two surfaces in each joint. Each TMJ has a disk between the ball (condyle) and socket (fossa), and this sometimes ends up being an especially important area when trouble arises. So, how do I know if I have TMD?You can never be absolutely sure, but here are some symptoms you should be sure to share with us during your examination: Clicking. You may experience a clicking sound in the jaw, usually due to a shift in the position of the disk inside the joint. However, if you do not have pain or limited jaw function, this symptom may be insignificant. Muscle Pain. The next symptom is jaw muscle pain, usually in the cheeks or temples. If the muscle is sore or stiff in the morning, this pain is usually related to clenching or grinding in your sleep. However, there are more complex muscle pains that can spread to your head and neck. TMJ Pain. This third symptom refers to pain actually inside one or both of your jaw joints, technically described as arthritis of the TMJ. If diagnosed, what can I expect from treatment?We will first need to assess the damage to your TMJ, and from there we will recommend a course of treatment to relieve your pain. Treatment may range from hot or cold compresses and anti-inflammatory medications to physical therapy or a bite guard. We may also advise you to do jaw exercises at home. In general, we will do our best to treat your issue without orthodontic treatment or surgery. If you would like more information about TMD, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Seeking Relief from TMD.”
While genetics certainly plays a role in a person’s susceptibility to various forms of cancer (including oral cancer), there are lifestyle factors that also play a role. In the case of developing oral cancer, there are a number of prominent lifestyle changes you can make to help reduce your risk: protect yourself from too much sun exposure; avoid the use of any type of tobacco (smoke and smokeless); limit your intake of alcoholic beverages to a moderate level; abstain from risky sexual behavior; and eat a diet rich in fresh fruit and vegetables, as well as other whole foods. That last lifestyle change not only reduces your level of negative exposure from the environment, it may also provide a positive effect as well. For example, normal cellular function produces unstable molecules known as “free radicals” that can damage the DNA structure within the cell; this could be a precursor to the development of cancer. There are natural substances, however, that can help protect cells against the damage caused by free radicals. These are known as “antioxidants” and they are abundant in many plant-based foods. You, of course, may know them by other names: vitamins, carotenoids (found in red and orange fruits and vegetables) or fiber, to name a few. A well-balanced diet can provide these and other kinds of cancer-fighting nutrients. And, it’s important that you eat the source of these nutrients — fresh plant-based foods. Studies have shown that dietary supplements can’t match the effectiveness of actually eating fruit and vegetables. Besides lowering your cancer risk, a plant-based, whole food diet will also result in better oral health. Diets heavy in processed foods with high amounts of sugar or other bacteria-friendly substances inhibit good oral health. If you would like more information on the role of diet in reducing your risk to cancer, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”
As a parent, hearing that your child has a cavity is almost worse than hearing that you have a cavity. You wonder if the cavity is your fault — did you fail to teach your child proper oral hygiene? Should you have spent more time teaching him how to brush? Well, luckily, there are several ways, in addition to diligent oral hygiene, to protect your children’s teeth from decay. When your children are young, the newly erupted enamel of their teeth is more permeable and therefore more susceptible to tooth decay. As the enamel matures, it becomes stronger and more resistant to decay. Until this point, it is very important to protect the surfaces of your child’s newly erupting teeth. One way to protect the enamel is with fluoride, which makes the surface of enamel harder and less vulnerable to acid attack and decay. However, because of the deep pits and fissures in the teeth, they are still at high risk for decay and may need further protection. In these cases, we might recommend sealants, protective coatings placed in the pits and fissures of teeth to prevent decay. In doing so, these invisible coatings actually “seal” them from attack. The procedure is usually completely painless, and only occasionally, a very small amount of tooth enamel is removed. Though some children feel a quick tinge of cold during the procedure, this mild feeling is not enough to demand the use of numbing injections. Generally, we will use sealants when we examine your child and find that decay is starting or likely to start in a tooth. However, in cases where children have a high risk of cavities, we may seal all permanent molar teeth and many baby molar teeth soon after eruption. If you would like more information about sealants, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Sealants for Children.”
Whether it’s a chipped tooth or a cut in your mouth, there is nothing pleasant about experiencing a dental injury. The good news is that advances in modern dentistry ensure that we’ll be able to fix the issue with minimal discomfort and maximum results. If you’ve suffered a chipped tooth as a result of an unfortunate accident, composite resin bonding may be the ideal solution to your problem. The procedure is simple and painless and, most importantly, you’ll surely be pleased with the results. Here’s how it works. The bonding is actually a tooth-colored material that is a combination of plastic and glass. The composites come in a wide range of colors that allow us to create a bonding that is nearly identical to your natural tooth. Once we have the composite material, we will bond it to the tooth by slightly roughening the tooth so that the resin fills in small cuts in the tooth surface. We’ll utilize a special light to activate the resin, helping it bond and set. Finally, we’ll polish and buff your tooth for a smooth, natural finish. The procedure will involve very little preparation (drilling) of the tooth structure. In addition, since placing composite resin does not require us to outsource to a laboratory, we can usually complete this procedure in just one short visit. Composite resin bonding is an excellent solution for small chips to your tooth, but the more tooth structure that is lost, the less effective they become. While the material is durable, it is not as strong as the tooth structure it replaces. There are therefore, some disadvantages. A large amount of resin may not stand up to biting force over time, and the composite can also stain as it ages. When you come to our office for an appointment, we will evaluate whether porcelain restoration might be more suitable for a long-term material solution. If you would like more information about bonding, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Repairing Chipped Teeth.”
Once you’ve decided to make over your smile, you’re embarking on an exciting journey to restore your smile and your confidence. As experts in cosmetic dentistry, you should consider us partners on this journey, here to help not only fulfill your vision, but also answer any questions while making you feel at ease throughout the process. Today there are many options for making over your smile, and when we meet for an initial consultation, we’ll discuss many of them with you. Until then, you might have some questions about cosmetic dentistry. What is a cosmetic dentist?We are restorative dentists who are experts in the art of smile design. We have put a great deal of emphasis on studying the concepts of smile design and the innovative materials used for a smile makeover. We have made it our life’s work to remain up-to-date on the latest innovations in dentistry. What is the difference between cosmetic and restorative dentistry?There is some overlap between cosmetic and restorative dentistry. However, a cosmetic dentist goes beyond restoring your teeth to their proper function — our goal is to achieve the most optimal esthetic result and satisfy the vision that you have for your smile. What can I expect at the initial consultation?Before you come in for the initial consultation, ask yourself some important questions: Do you dislike the color of your teeth? Do you have chips or cracks that need to be fixed? Do you have crooked teeth or spaces between teeth that you would like eliminated? The goal of this first appointment will be to determine exactly what you want out of your smile makeover. We suggest that you bring in photos to show us what you would like your future smile to look like. We will also conduct a thorough examination to determine if your cosmetic issues are the result of any underlying health issues. During this examination, we’ll be doing a Smile Analysis, studying all of the elements of your smile, from teeth to gums and jaws. From there, we’ll walk through treatment options, including pricing and timelines, and develop a plan of action. If you would like more information about cosmetic dentistry and the procedures we may recommend for your smile makeover, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry.”
Braces have traditionally been seen as a “rite of passage” for teenagers, and while most teenagers learned to “em-brace” their orthodontics, in some situations, braces were less appealing. For example, like many people, you may have old prom and homecoming photos featuring beautiful dresses, tuxedos and a mouth full of metal braces. Luckily, thanks to modern technology, your teen has more options than ever before, including clear aligners. Clear aligners use a system of clear, removable trays to gradually straighten teeth. Each individual aligner is slightly different than the previous one and made of a virtually invisible plastic that completely covers the teeth. When worn for 22 hours per day for a two-week period before moving on to the next aligner, teeth can be moved into the desired position. This movement can take anywhere from 6 to 24 months, and aligners can be taken out for eating, drinking and other short periods of time. Technology is really at its finest when it comes to Invisalign clear aligners. They are computer-generated, based on photographs, models of your teen’s teeth and x-rays. The models are sent to a laboratory where a computer creates a 3D image, and we manipulate each tooth on the screen into a new position until they are all properly aligned. Special software then simulates the movement of your teen’s teeth and essentially creates the course of treatment. Finally, we create plastic aligners for each step of the movement. Technology is also responsible for making clear aligners a better option for teenagers over the past few years. Originally, teens were not seen as good candidates for clear aligners because their second molars have not fully grown into position and also because it was assumed, since the aligners are removable, teenagers might not be as diligent about wearing the aligners as adults. Technology is responsible for a solution for both of these issues. Eruption tabs serve as space-holders for teeth that haven’t grown in, and clear aligners for teens have compliance indicators built-in that fade with time as each aligner is worn. When you bring your teenager into our office for an initial consultation, we’ll evaluate whether clear aligners will be an appropriate solution for his orthodontic needs. If you would like more information about clear aligners, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Clear Aligners for Teenagers.”
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