10 Toothbrushing Mistakes You Make Every Day

I’ve written many blogs about the relationship of oral hygiene and systemic diseases, such as heart disease and diabetes.  Good oral hygiene is the key to keeping a beautiful smile your entire life, as well as maintaining your overall health.  But even if you’re brushing your teeth every day, you’re probably making these mistakes.  

1. You Keep Your Toothbrush Too Long

Most people don’t know this, but toothbrushes have a very short life-span—3 to 4  months.  A good rule of thumb is to change your toothbrush on the first day of every season of the year.  Frayed and broken bristles won’t keep your teeth clean—these are signs it’s time to let go. 

2. You Don’t Brush Long Enough

I know you have a lot to accomplish, but listen up! Your teeth should be brushed for a full two minutes, twice per day. Most of us fall short —the average time most people spend brushing is 45 seconds. If you’re racing through cleaning, try setting a timer.  Many electric toothbrushes have timers to insure you brush long enough.  That’s 30 seconds per quadrant, front and back, using the proper technique.

3. You Brush Too Hard

Be gentle with your teeth. You may think brushing harder will remove more leftover food and the bacteria that loves to eat it, but a gentle brushing is all that’s needed. Too much pressure may wear down the hard outer shell on your teeth and damage your gums.

4. You Brush Too Soon After Eating

If you feel the need to clean your teeth after eating or drinking, wait at least 30 minutes before brushing—especially if you have had something acidic like lemons, grapefruit or soda.   Brushing too soon after eating acidic foods can expose your teeth to unnecessary wear when they are in a vulnerable state, and the enamel is subject to damage, before your pH levels return to near normal.  Drink water or chew sugarless gum with to help clean your mouth while you are waiting to brush.

5. You Store Your Toothbrush Incorrectly

When you’re done brushing, keep your toothbrush upright and let it air dry in the open. Don’t keep your toothbrush in a closed container, where germs have more opportunity to grow, and if your toothbrush is in a holder next to another, keep them separated so they don’t touch one another.

6. Your Bristles are Too Hard

Soft bristles are the way to go. You don’t want to use medium or hard bristles because these may wear down the outer shell of your teeth and may cause sensitivity when eating or drinking cold food and beverages.

7. You Use Improper Brushing Technique

Get your best brush with these steps: First, place your toothbrush at a 45-degree angle to the gums. Then, gently move the brush back and forth in short (tooth-wide) strokes. Next, brush the outer surfaces, the inner surfaces, and the chewing surfaces of the teeth. Finally, To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up-and-down strokes.

8. You Brush at the Wrong Time of Day

Many people brush only once a day, first thing in the morning.  We suggest you brush twice a day, with the last time being right before bed, which is the longest time your mouth will be in an unaltered state (and dirty unless cleaned).  You wouldn’t take a shower before your workout and not after it.

9. You Don’t Brush All The Important Parts

Many of us neglect to brush our tongue when we brush our teeth. Even though your tongue doesn’t need as much brushing as your teeth, a few regular toothbrush strokes are necessary to rid your mouth of bacteria that causes bad breath.  Alternatively you might try a tongue scraper and gently scrape your tongue.  You’ll be surprised what comes off.

10. You Don’t Floss

Dental floss is a tool that should not be overlooked.  In fact, if you don’t use it you’re missing a third of your tooth surface. By using dental floss every day, you’ll prevent tartar from forming.  And in case you forgot that old saying: “You don’t have to floss all your teeth, just the ones you want to keep.”

Have more questions?  Schedule an appointment with your West Hartford dentist.  You can call Dr. Basil today at 860-561-2121, or request an appointment online.

Keep smiling,  

Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

Have You Gotten the Most from Your Benefits This Year?

Now that December is here, it won’t be long until we’re taking down our calendars for 2017 and replacing them with ones for 2018. For most, the focus of the month is primarily on gift giving and holiday preparations, but there’s something else you should add to your year-end checklist: one last checkup with your dentist. Why should you include a dental appointment in your December activities? There are a few reasons.

Yearly Maximum

Your insurance company allots a yearly maximum to help you pay for certain kinds of services and procedures. Unfortunately, that money doesn’t rollover from one year to the next. Any amount you don’t use, you will lose at the end of the year.

Deductible

Your deductible will be renewed every year, too. Before your insurance provider will start covering your care, you have to meet your deductible. In many cases, this amount is around $50.

Insurance Fees

Additionally, you may find that your premiums and co-pays from one year to another are different. But without knowing what they’ll be for 2018, it’s a good idea to take advantage of what you already have before it changes.

Another New Year is almost upon us, but there may still be time to schedule an appointment with your West Hartford dentist. Call Dr. Basil today at 860-561-2121, or request an appointment online.

Keep smiling,  

Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

Thanksgiving "Do"s and "Don't"s For Your Smile

Happy Thanksgiving! Family, festivities and food are just a few of the reasons to love Thanksgiving. While the food may be in abundance at the Turkey Day table, the smiles are too. But protect your smiles at the big feast by choosing the right foods for your teeth. Here are some dental "Do"s and "Don’t"s to keep in mind:

Thanksgiving Drinks

Do have: Water. It’s the best option for your teeth and gums, plus it can help you keep from overeating. Almost as good is tea. Try green, black or herbal tea — all of which have bacteria-killing properties and/or antioxidants, and tea leaves are a natural source of fluoride.

Don’t have: Sugary sodas and mouth-drying alcohol are the worst for your teeth on Thanksgiving. Sugar feeds the bacteria in your mouth, which in turn release acids that cause cavities. Significant alcohol intake results in xerostomia, or a decrease of the saliva in your mouth, which means you’re not able to wash away as much food. Dry mouth can also lead to bad breath.

Thanksgiving Appetizers

Do have: Cheese plates, naked nuts, deli meats, and vegetables platters are great options. Cheese and nuts both have have protein and calcium to help strengthen your teeth, and chewing on raw vegetables helps produce saliva to wash away bacteria.

Don’t have: Candied nuts. They are probably the worst choice far as Thanksgiving appetizers go. The stickiness transfers from nuts to teeth and helps food particles stick to crevices where they can cause cavities. The calorie count also adds up fast, so you’ll get also take a hit on the scale.

Thanksgiving Main Dishes

Do have: Turkey is your go-to, dental-health-friendly option on the Thanksgiving table. Not only is it unarguably the main attraction of the Thanksgiving table, turkey is loaded with protein, making it a favorite for both your body and smile. Protein has phosphorus in it, and when phosphorus mixes with calcium and vitamin D, it creates strong bones and teeth. So even though eating a Thanksgiving feast can make you sleepy, you can rest assured that turkey is a healthy option for a great smile.

Don’t have: Stuffing, rolls and sugary candied yams are probably the worst offenders for your teeth because they’re loaded with starch — prime food for cavity-causing bacteria. Limit your portions of these foods, and make sure to wash them down with some water.

Thanksgiving Desserts

Do have: Pumpkin pie is actually a great choice, thanks to pumpkin’s vitamin C and calcium. It’s still got a fair amount of sugar, of course, so be sure to wash it down with another glass of water.

Don’t have: As delicious as it is, pecan pie is basically a dental perfect storm. Crammed full of sugar and sticky, chewy pecans, it’s almost perfectly designed to cause cavities!

What If You Just Can't Help It

OK. Nobody’s perfect. I’ve been known to partake in some of the worst offenders on this list, but luckily, the solution is simple: about 30 minutes after you’ve eaten, step away from the festivities for two minutes and brush your teeth. If you want extra credit — and especially if you’ve eaten any of the stickiest desserts — partake in an extra flossing session too. You’ll undo any potential for damage and come out with fresh breath!

Dental Care Year-Round From Dr. Elzbieta W. Basil, DMD

Our expert dental team can help you take care of your teeth year-round at either of our two locations in West Hartford Center and Downtown New Britain. We’re thankful for our patients of all ages, and we’d love to have you join our family. For more information  schedule an appointment or call 860-561-2121.


Keep smiling,  

Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

How to Get Someone to Brush Their Teeth

Recently I had a young woman patient ask me about her new husband. Apparently he is perfect in every way except one.  He refuses to brush his teeth, and his mouth odor is driving her crazy (despite his use of mints)--so much so that it is interfering with her desire to be intimate with him. She asked me about how to get him to brush his teeth.

Getting someone to brush their teeth seems like one of those things that you shouldn’t have to do, but the unfortunate reality is that dental hygiene is not high on the priority list for many people. Years of bad habits formed as a child carry over into adult life and can affect relationships with friends and family, and especially with significant others, including spouses and fiancees.

But, it’s not too late to help someone change those unhealthy habits. Here are some strategies that may help change the conversation around oral health in your house.

Provide Data

From sleep trackers to fitness watches, people love tracking their performance. Why should teeth be any different?

Take some pictures of the person’s teeth and show them what they look like to the outside world. We often do not see ourselves in the way that others see us, and the new perspective may be eye opening enough to change their mind.

You’ll also have a starting point to track progress over time. Commit to taking new photos every month or even every week to help them see how things are progressing as their dental habits improve.

Here are some numbers that may help fuel the visual evidence. According to the Oral Health Foundation:

• 66 percent of adults have visible plaque on their teeth
• 74 percent of adults have had at least one tooth extracted
• 29 percent of adults have regular tooth pain
  

No one should want to be part of these statistics. With a few simple behavior changes, your significant other does not have to be.

Be Honest

No one likes to tell someone else that they have bad breath or unsightly teeth, especially when it’s someone you love. However, sometimes honesty really is the best medicine. Tiptoeing around the issue is not going to incite long-term change.

Note that being honest is not the same as being mean. You can communicate your thoughts and feelings in a calm and rational way. If he or she starts to get defensive or angry, remind them that you are just trying to help and change their life (and yours) for the better.

If you do not feel comfortable having a conversation like this in person, write down your thoughts and then make time to for a discussion about them. Being open with your feelings may also get to the root of why he or she does not take care of his teeth.
And, remember that these changes take time. You will likely need to have some version of the conversation multiple times as you work through the behavior change. Continue to provide positive reinforcement when they do brush their teeth and gently remind them when they do not.

Appeal to their Logic
The failure to invest only a few minutes per day in their oral health can have dramatic impact on your loved one’s life. As someone who loves them, if you notice their poor hygiene, certainly others will, too. This might affect their other interpersonal relationships, and their career advancement.

I also wrote a recent article about about how inflammatory cells from bacteria growing in your mouth can lead to or worsen Heart Disease, Diabetes, Alzheimer's, Arthritis, Cancer and Pregnancy Problems, which are all very serious, life-threatening conditions. These risks can be reduced by simple changes and investing about 2 minutes twice per day as part of a routine.

But let’s assume they aren’t concerned about getting any diseases. The lack of basic oral hygiene will most certainly lead to thousands of dollars of future dental treatments, tooth loss, dentures, and pain. And why? This can all be avoided.

Call for Reinforcement

If they won’t listen to you, no matter how eloquent your thoughts or how much information you provide, it might be time to consult a dentist. A dentist can offer an objective and professional opinion that may resonate better than what you or other friends and family members say.

Make an appointment and go with them to visit the dentist. Our team at Dr. Elzbieta W. Basil, DMD, with offices in West Hartford Center and Downtown New Britain, has heard it all when it comes to people who do not take care of their teeth, so we’re ready for whatever your significant other might have up their sleeve.

If you suspect that there might be depression or other mental issues at the heart of the dental behavior, you should also consult a therapist to help them work through them.

These issues are never easy to tackle, but a little effort and perseverance now will reap lifelong benefits for you and your family.

Keep smiling,


Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

Is Your Mouth Making You Sick?

Did you know that putting off dental visits could be ruining your health?   It's logical...your mouth is the gateway into your body.

The common thread between gum disease and chronic health conditions is inflammation — the body’s natural response to an infection or injury. The build-up of inflammatory substances in the blood seems to worsen heart disease, diabetes, and other chronic conditions, an increase your chances of getting cancer. Eliminating the gum infection may dampen that harmful response throughout the body.

Gum disease—which begins when the sticky, bacteria-laden film known as plaque builds up around your teeth—is closely linked to premature birth, heart disease, diabetes, and other chronic health problems. A recent report in the American Journal of Preventive Medicine finds that treating gum disease (also called periodontal disease) can lead to better health — as evidenced by lower health care costs and fewer hospitalizations — among people with common health conditions.

The study looked at health and dental insurance records from nearly 339,000 people, all of whom had periodontal disease and one of five conditions: type 2 diabetes, cardiovascular disease, cerebrovascular disease (usually a stroke), rheumatoid arthritis, or pregnancy. Researchers found that people with four of the five conditions (all except rheumatoid arthritis) who had at least one periodontal disease treatment had lower medical costs and fewer hospitalizations within four years of the treatment compared with people who weren’t treated.

The savings were especially striking — 74% lower — among pregnant women. The savings came from avoiding the costs associated with premature births, which has been linked to periodontal disease, and other complications. People with cardiovascular disease and diabetes who had their periodontitis treated had health-care costs that were between 20% and 40% lower.

Recently, it was demonstrated that women with gum disease are 14% more likely to develop cancer than those with healthy teeth and gums, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.  The link appears to be strongest for esophageal cancer, but associations were also found between poor oral health and lung, gallbladder, breast, and skin cancer.

Important Tip: Daily tooth brushing and flossing can prevent and even reverse the earliest form of gum disease, called gingivitis.

Left untreated, gingivitis can turn into periodontal disease. The gums pull back from the root of the tooth, creating a tiny pocket that gradually widens. Eventually, the infection and inflammation attack the tissue that holds the tooth to the jawbone, which can cause the tooth to loosen and possibly fall out.

A dentist or hygienist can treat periodontal disease by cleaning the teeth above and below the gum line, a procedure known as scaling and root planning (SRP). They use manual scalers or ultrasound devices to scrape away hardened plaque (tartar). This does not require any sedation in both my West Hartford Center dental office and DowntownNew Britain dental office.

As I always tell you, brush and floss every day to keep your gums healthy. Be on the lookout for these signs of gum disease—especially if you’re pregnant or have a history of heart disease, stroke, or type 2 diabetes—and seek treatment.

Signs of gum disease

Any of these signs can be a clue that you have periodontal disease:

• swollen, red, or tender gums
• gums that bleed easily
• pus between the teeth and gums
• bad breath
• buildup of hard brown deposits along the gum line
• loose teeth or teeth that are moving apart
• changes in the way dental appliances fit.

If you have any of these issues, and especially if you have a family history of cardiovascular disease, diabetes or stroke, or if you might be pregnant, contact my office for a checkup. Your loved ones will be glad you did.

Keep smiling,


Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

Dental Implants - Why It's Crucial To Replace Missing Teeth

What is a Dental Implant?

Before we get into the importance of replacing teeth, let's address the most common question first: what exactly is a dental implant anyway? A dental implant is a tiny, but extremely strong, titanium alloy screw which is used while surgically replacing damaged or missing natural teeth.  It is drilled into the jawbone, so that the screw can firmly connect the artificial teeth or any other dental prosthesis to the jaw.

In addition to its use in replacing broken/missing teeth, implants can also be used to provide support to loose, removable dentures.  They're the next best thing to having your own natural teeth, and I find them to be so desirable, that I've placed them in members of my own family.

Now that you know what a dental implant is exactly, let's take a look at why replacing lost or badly damaged teeth is important in the first place. 

Appearance

Superficial as it may sound to someone who has all their teeth, even a single missing tooth can put a lot of emotional stress on us. In varying degrees, we are all somewhat concerned about our appearance, and it affects our confidence as well.

To lose your perfect smile because of a missing tooth or two can cause depression and loss of confidence, which in turn may affect your work and personal life. It has been found that dental implants are often effective in boosting the patient's morale and overall confidence. Since there is no externally visible difference between a replaced tooth and a natural one after the procedure, it does actually affect physical appearance positively.

Oral Health

As soon as a tooth is lost, the balance in your entire dental structure is disturbed. The created gap allows for the remaining teeth (especially the ones nearest to the gap) to tilt and shift as a result of even the most normal regular chewing.

This could lead to further oral problems down the line, especially if the distorted structure of the teeth interferes with the patient's chewing abilities. It isn't uncommon to see someone lose multiple teeth over the years as a result of this and more often than not, the bone loss occurs in the same row, side by side.

The Comfort

If you have all your teeth intact, then you probably don't have any idea how it feels when a particularly hard piece of food comes in-between the exposed root of the missing molar and an existing one.

Let's just say that it isn't a very comfortable experience and once that keeps happening almost every time you try to eat, it's not rare to see people giving up on meat and other previously loved food sources to alleviate themselves from the continuous pain and discomfort. In a way, losing your ability to properly chew food can potentially stop you from enjoying a very big part of your life.

Dental prosthetics with the proper dental implant to support it can dramatically change the life of someone who is missing teeth. However, it is important that the procedure is carried out by a reputable dentist like Dr. Elzbieta W. Basil, DMD with offices in West Hartford Center and Downtown New Britain. A lot depends on the skill of the dentist/dentists involved and it is a complex procedure; so, it is best to not take any risks with this one.  For a free consultation, you can make an appointment.

And the best news: dental implants have a success rate over 95%.

Keep smiling,





Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

Tooth Whitening: Your Options Explained

Did you know that tooth-whitening has become the number one cosmetic dental procedure in America?  And for good reason.  Most people can achieve noticeable, even dramatic, results without much effort or cost.  

Whether you are getting ready for a big event, interview or you expect to be in front of the camera, a whiter smile makes you look younger and makes your smile appear more radiant and appealing.  There are many teeth whitening systems and products including whitening toothpastes, over-the-counter gels, rinses, strips, trays, and whitening products obtained from a dentist.  I’ll go over all of your options in this article.

Should You Whiten Your Teeth?

Teeth whitening is ideal for people who have healthy, unrestored teeth (no fillings) and gums. If your teeth have been competently restored, whitening is not a problem, except that the filling might stand out if it was color-matched to darkened teeth.  Individuals with yellow tones to their teeth respond best. But this cosmetic procedure is not recommended for everyone.

Whitening is not recommended or will be less successful in the following circumstances:

·       Age and pregnancy issues. Bleaching is not recommended in children under the age of 16. This is because the pulp chamber, or nerve of the tooth, is enlarged until this age. Teeth whitening under this condition could irritate the pulp or cause it to become sensitive. Teeth whitening is also not recommended in pregnant or lactating women.

·       Sensitive teeth and allergies. Individuals with sensitive teeth and gums, receding gums, and/or defective restorations should consult with their dentist prior to using a tooth-whitening system. Anyone allergic to peroxide (the whitening agent) should not use a bleaching product.

·       Gum disease, worn enamel, cavities, and exposed roots. Individuals with gum disease or teeth with worn enamel are generally discouraged from undergoing a tooth-whitening procedure. Cavities need to be treated before undergoing any whitening procedure. This is because the whitening solutions penetrate into any existing decay and the inner areas of the tooth, which can cause sensitivity. Also, whitening procedures will not work on exposed tooth roots, because roots do not have an enamel layer.

·       Fillings, crowns, and other restorations. Tooth-colored fillings and resin composite materials used in dental restorations (crowns, veneers, bonding, bridges) do not whiten. Therefore, using a whitening agent on teeth that contain restorations will result in uneven whitening -- in this case, making the teeth without restorations appear lighter than those with restorations. Any whitening procedure should be done prior to the placement of restorations.

·       People with numerous restorations that would result in uneven whitening may be better off considering bonding, veneers, or crowns rather than a tooth whitening system. Ask your dentist what strategy is best for you.

·       Unrealistic expectations. Individuals who expect their teeth to be a new "blinding white" may be disappointed with their results. Smokers need to be aware that their results will be limited unless they refrain from continued smoking, particularly during the bleaching process. A healthy guide to is to achieve a shade slightly whiter than the whites of your eyes.

·       Darkly stained teeth. Yellowish teeth respond well to bleaching, brownish-colored teeth respond less well and grayish-hue or purple-stained teeth may not respond to bleaching at all. Blue-gray staining caused by the antibiotic tetracycline is more difficult to lighten and may require up to six months of home treatments or several in-office appointments to successfully lighten. Teeth that have dark stains may be better candidates for another lightening option, such as veneers, bonding, or crowns. Your dentist can discuss the options best suited for you.

Whitening Systems Compared

Whitening Toothpastes

All toothpastes help remove surface stains, because they contain mild abrasives. Some whitening toothpastes contain gentle polishing or chemical agents that provide additional stain removal effectiveness. Whitening toothpastes can help remove surface stains only and do not contain bleach; over-the-counter and professional whitening products contain carbamide peroxide or hydrogen peroxide that helps lighten the color deep in the tooth.

Whitening Power:  1 shade lighter

Whitening Rinses

Among the newest whitening products available are whitening rinses. Like most mouthwashes, they freshen breath and help reduce dental plaque and gum disease. But these products also include ingredients, such as hydrogen peroxide in some, which whiten teeth. Manufacturers say it may take 12 weeks to see results. You just swish them around in your mouth for 60 seconds twice a day before brushing your teeth. However, some experts say that rinses may not be as effective as other over-the-counter whitening products. Because a whitening rinse is only in contact with the teeth for such a short time -- just two minutes a day compared to 30 minutes for many strips -- it may have less of an effect.

Whitening Power:  1 shade lighter (maybe)

Over-the-Counter Whitening Strips and Gels

Whitening gels are clear, peroxide-based gels applied with a small brush directly to the surface of your teeth. Instructions vary depending on the strength of the peroxide. Follow the directions on the product carefully. Initial results are seen in a few days and final results are sustained for about four months.

Whitening strips are very thin, transparent strips that are coated with a peroxide-based whitening gel. The strips should be applied according to the instructions on the label. Initial results are seen in a few days and final results are sustained for about four months.

Personally, I find the results to be less than optimal because of (a) the incomplete contact with the tooth surface, (b) the likelihood of ingestion of the bleaching material, and (c) the exposure to outside surfaces of the bleaching compound.

Whitening Power: 3 (spotty) shades lighter

Tray-Based Tooth Whiteners

Tray-based tooth whitening systems, purchased either over-the-counter or from a dentist, involve filling a mouthguard-like tray with a gel whitening solution -- which contains a peroxide-bleaching agent. The tray is worn for a period of time, generally from a couple of hours a day to every day during the night for up to four weeks and even longer (depending on the degree of discoloration and desired level of whitening).

Whitening Power: An average of 3 to 5 shades lighter 

In-Office Whitening

In-office bleaching provides the quickest way to whiten teeth. With in-office bleaching, the whitening product is applied directly to the teeth.  There is complete contact with all visible tooth surfaces. These products can be used in combination with a special activating light. Results are seen in only one, 30- to 60-minute treatment.  However, with in-office bleaching, dramatic results can be seen after the first treatment. This type of whitening is also the most expensive approach.

Whitening Power: An average of 8 shades lighter

At Home vs. Dentist Supervised?

Do-it-yourself methods aren't the same as getting your teeth whitened by a professional. You'll want to consider a few important differences.

Strength of bleaching agent. Over-the-counter products and dentist-supervised at-home products usually contain a lower strength bleaching agent, with about a 10% to 22% carbamide peroxide content, which is equivalent to about 3% hydrogen peroxide. In-office, professionally applied tooth whitening products contain hydrogen peroxide in concentrations ranging from 15% to 43%.

Mouthpiece trays. With dentist-supervised at-home bleaching products, your dentist will take an impression of your teeth and make a mouthpiece tray that is customized to exactly fit your teeth. This customization allows for maximum contact between the whitening gel, which is applied to the mouthpiece tray, and the teeth. A custom-made tray also minimizes the gel's contact with gum tissue.

Over-the-counter whitening products also contain a mouthpiece tray, but the "one-size-fits-all" approach means that the fit will not be exact. Ill-fitting trays can irritate the gum and soft tissue by allowing more bleaching gel to seep onto these tissues. With in-office procedures, you'll get the bleaching agent applied directly to your teeth.

Additional protective measures. In the office setting, your dentist will apply either a gel to the gum tissue or use a rubber shield (which slides over the teeth) prior to treatment to protect your gums and oral cavities from the effects of the bleaching. Over-the-counter products don't provide these extra protective measures.

Costs. Over-the-counter bleaching systems are the least expensive option, with in-office whitening being the costliest.

Supervised vs. unsupervised process. First, your dentist can perform an oral exam and consider your complete medical history, which can be helpful in determining if bleaching is an appropriate course of treatment based on the type and extent of stains, and the number and location of restorations. Your dentist can then better match the type of stain with the best treatment, if appropriate, to lighten those stains.

When your dentist does it, he'll likely want to see you a couple of times to clear up any questions about the directions, to make sure the customized tray fits properly, to check your gums for signs of irritation, and to generally see how the process is working. With over-the-counter bleaching products, you're on your own.

How Long Do Whitening Effects Last?

Teeth whitening is not permanent. People who expose their teeth to foods and beverages that cause staining may see the whiteness start to fade in as little as one month. Those who avoid foods and beverages that stain may be able to wait one year or longer before another whitening treatment or touch-up is needed.

The degree of whiteness will vary from individual to individual depending on the condition of the teeth, the level of staining, and the type of bleaching system used.

Risks Associated With Whitening

The two side effects that occur most often with teeth whitening are a temporary increase in tooth sensitivity and mild irritation of the soft tissues of the mouth, particularly the gums. Tooth sensitivity often occurs during early stages of the bleaching treatment. Tissue irritation most commonly results from an ill-fitting mouthpiece tray rather than the tooth-bleaching agent. Both of these conditions usually are temporary and disappear within 1 to 3 days of stopping or completing treatment.

If you do experience sensitivity, you can reduce or eliminate it by:

• Wearing the tray for a shorter period of time (for example, two 30-minute sessions vs. two 60-minute sessions).
• Stop whitening your teeth for 2 to 3 days to allow teeth to adjust to the process.
• Ask your dentist or pharmacist for a high fluoride-containing product, which can help remineralize your teeth. Apply the fluoride product to the tray and wear for 4 minutes prior to and following the whitening agent.
• Brush teeth with a toothpaste made for sensitive teeth. These toothpastes contain potassium nitrate, which helps soothe the teeth's nerve endings.

Whitening Product Safety

Some whitening products you get through dentists' offices as well as professionally applied (in-office) bleaching products have the American Dental Association (ADA) Seal of Acceptance, which tells you that the product meets ADA guidelines for safety and effectiveness. Currently, only dentist-dispensed home-use products containing 10% carbamide peroxide and office-applied products containing 35% hydrogen peroxide have this seal.

Over-the-counter bleaching products are not endorsed by the ADA, because the organization believes that professional consultation is important to ensuring safe and effective use. No whitening products using lasers are on the ADA's list of accepted products.

Several whitening toothpastes available in drugstores have received the seal, too. You can find a list at www.ada.org.

Not all manufacturers seek the ADA's Seal of Acceptance. This is a voluntary program that requires considerable expense and time on the part of a manufacturer. Just because a product doesn't have the seal does not necessarily mean that the product isn't safe and effective.

Teeth whiteners are not drugs and therefore aren't regulated by the FDA.

If you'd like to talk about your whitening options, schedule a free consultation.

Keep smiling,





Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121