Periodontal Disease: Risks, Causes, and Treatment

By: Dr. Hilliard Blank

Periodontal disease is relatively simple to prevent. Brushing and flossing twice a day will help you reduce the odds of most types of gum disease and skip the worst symptoms of periodontitis before they appear. The most common symptoms are swollen gums, gums that bleed easily during brushing and flossing, chronic bad breath, and loose adult teeth. Prevention is essential, but there are plenty of ways to identify and treat the problems of periodontal disease after onset.

Risk Factors for Periodontal Disease

Tobacco Use

Smoking and chewing tobacco damage the cells in your gums, causing decreased functioning. In particular, blood flow decreases and your natural healing ability is reduced. Weakened gum tissue is more likely to pull away from teeth, leaving more room for infection and less ability to heal.

Diabetes

A diet high in sugar promotes the growth of bacteria in the form of plaque on your teeth. Diabetes is a major risk factor for periodontal disease because of the elevated sugar levels in the bloodstream. Besides diabetes, a diet that is low in vitamins can weaken your immune system and jeopardize your oral health.

Genetics

If you have a family history of gum disease or periodontitis, you are more likely to contract the disease yourself. Check with family members or your family physician.

Treatment for Periodontal Disease

Scaling and Root Planing

Scaling and root planing targets the plaque and buildup deep within the gums. Using tools with longer necks and local anesthesia, our dentists or dental hygienists will clean deep beneath the gum line. This buried tartar is the source of the problem. It causes foul odors, fuels decay, and allows greater propagation of unhealthy bacteria in your mouth.

Antibiotics

For gingivitis and other types of gum infections, antibiotics can be used to reduce the amount of unhealthy bacteria in your gums. During root planing, we can apply an antibacterial gel directly below the gum line, which gradually dissolves over a few days. There are also antibacterial rinses that can be used over short periods of time.

Surgery

There are several types of oral surgery that treat periodontal disease. Gum surgeries reconnect the gum tissue to the tooth, restoring some of tooth’s stability. Flap procedures are common and require a periodontist. The gum is pulled back and the roots of the tooth are targeted for surgical repair to reconnect tooth ligaments with the jaw bone.

Extraction

Extraction is the final measure when all preventative measures have failed. The tooth is removed and the extraction site is thoroughly cleaned to prevent further spread of the disease. This is most necessary for loose or damaged teeth beyond salvage. A false tooth can be implanted as a replacement, but if the damage involves many teeth, dentures may be the best option.

Restoring your Bite with Dental Implants

 By: Dr. Hilliard Blank

How Much Radiation is in a Dental X-Ray?

The amount of radiation received from dental x-rays is approximately .005 millisieverts. To put this in context, the average human absorbs 3.0 millisieverts per year under natural circumstances. Even walking through the park, we are absorbing radiation from the air we breathe, telecommunication waves and electrical signals in our devices, and thousands more sources. Even the food and water we live on exposes us to trace amounts of radiation. The average dental x-ray exposes us to less than1 day of natural radiation.

There are two types of x-rays most commonly used in dental offices: standard dental x-rays and cone-beam computed tomography. Computed tomography scans, or CT scans, are the leading source of exposure to radiation in medical treatments. These scans can expose a patient to as much as 20 millisieverts at a time, or 7 years of natural radiation. At our office, we only use standard dental x-rays with digital imaging technology.

Check out this radiation exposure chart for more details on radiation from x-ray imaging.

Are Dental X-Rays Safe?

One of the most highly-debated issues in modern dentistry is the safety of x-ray imaging. A recent study attempting to link meningioma (brain cancer) to dental x-rays failed to show causal relation between the x-rays and the brain tumors. It did support the fact that excessive exposure to dental x-rays should be avoided. At our dental office in Lakeview, we use x-ray imaging only as needed to accurately diagnose and treat any issues in your oral health that cannot be observed on the surface. To be clear:

The benefits of having a clear diagnosis and an informed treatment plan for your oral health needs greatly outweigh the risks of radiation exposure from dental x-rays.

Minimizing Exposure and Maximizing Protection

At our Lakeview dental office, we prescribe x-rays for the diagnosis of problems beneath the surface of the tooth or gums. It is an essential tool in our comprehensive exam.  A full set of x-rays would only be taken every three to five years. We do not schedule more than four bitewing x-rays in a 12-month period unless there are significant problems to treat.

Our digital imaging equipment relies on the fastest capturing processes to reduce the amount of radiation exposure per image. Each patient is protected by a leaded apron to prevent any unnecessary exposure. The most important feature of each apron is the thyroid collar, which shields the throat and radiation-sensitive thyroid gland.

We go to every length necessary to protect our patients and improve their oral health. Our policies are carefully planned and conform to all of the FDA’s tips on x-ray safety. If you have any more questions or concerns, reach out to our office and we’ll help.

Assessing the Risks of X-Rays

By: Dr. Hilliard Blank

How Much Radiation is in a Dental X-Ray?

The amount of radiation received from dental x-rays is approximately .005 millisieverts. To put this in context, the average human absorbs 3.0 millisieverts per year under natural circumstances. Even walking through the park, we are absorbing radiation from the air we breathe, telecommunication waves and electrical signals in our devices, and thousands more sources. Even the food and water we live on exposes us to trace amounts of radiation. The average dental x-ray exposes us to less than1 day of natural radiation.

There are two types of x-rays most commonly used in dental offices: standard dental x-rays and cone-beam computed tomography. Computed tomography scans, or CT scans, are the leading source of exposure to radiation in medical treatments. These scans can expose a patient to as much as 20 millisieverts at a time, or 7 years of natural radiation. At our office, we only use standard dental x-rays with digital imaging technology.

Check out this radiation exposure chart for more details on radiation from x-ray imaging.

Are Dental X-Rays Safe?

One of the most highly-debated issues in modern dentistry is the safety of x-ray imaging. A recent study attempting to link meningioma (brain cancer) to dental x-rays failed to show causal relation between the x-rays and the brain tumors. It did support the fact that excessive exposure to dental x-rays should be avoided. At our dental office in Lakeview, we use x-ray imaging only as needed to accurately diagnose and treat any issues in your oral health that cannot be observed on the surface. To be clear:

The benefits of having a clear diagnosis and an informed treatment plan for your oral health needs greatly outweigh the risks of radiation exposure from dental x-rays.

Minimizing Exposure and Maximizing Protection

At our Lakeview dental office, we prescribe x-rays for the diagnosis of problems beneath the surface of the tooth or gums. It is an essential tool in our comprehensive exam.  A full set of x-rays would only be taken every three to five years. We do not schedule more than four bitewing x-rays in a 12-month period unless there are significant problems to treat.

Our digital imaging equipment relies on the fastest capturing processes to reduce the amount of radiation exposure per image. Each patient is protected by a leaded apron to prevent any unnecessary exposure. The most important feature of each apron is the thyroid collar, which shields the throat and radiation-sensitive thyroid gland.

We go to every length necessary to protect our patients and improve their oral health. Our policies are carefully planned and conform to all of the FDA’s tips on x-ray safety. If you have any more questions or concerns, reach out to our office and we’ll help.

Teeth Whitening at our Lakeview Dental Office

By: Dr. Hilliard Blank

Teeth whitening should always be comfortable and safe. At our office, we’ve been providing whitening treatments for over 20 years. Our techniques are well-developed and rely on the safest methods and least irritating types of bleach. After you’ve had whitening treatment at our office, taking the right steps will reduce your sensitivity, protect your teeth, and make the most out of your steps towards a whiter smile.

Our In-Office Bleach Brand: Ultradent

The brand of bleach we use for teeth whitening is Ultradent, a family-owned dental supply company that has been an industry leader for over 35 years. We use their Opalescence Boost power bleach because it provides highly-effective whitening power with less irritation than other brands and procedures. The Boost formula contains a 40% hydrogen peroxide gel that is chemically-activated to begin working as soon as it touches your teeth. We do not use any irritating lights or lasers in our whitening treatments because the Ultradent whitening products are strong enough to provide great results without extra treatment.

Other whitening products, like Zoom Whitening, require high-energy activation light to initiate the chemical reaction of their bleach. These treatments are often the most painful types of whitening. Not only do they strip protective proteins from your teeth, but their UV light or lasers also inflame the soft living tissue inside your teeth, or the pulp. Recent Zoom products have been upgraded to allow for different levels of intensity on the activation light for improved patient comfort, but we prefer to avoid treatments that create any unnecessary discomfort.

The procedure at our office is very straightforward. It begins with a light cleaning of your teeth. Then, a liquid dam is applied to the gums to prevent any hydrogen peroxide from touching the sensitive tissue. Once this dam has firmed up, the whitening gel is applied to the surface of tooth enamel with small syringes for precise placement. This layer of hydrogen peroxide is left in place for about 20 minutes. After the time has elapsed, the whitening gel is vacuumed off the teeth for safe removal. The bleach application process is repeated once more for a total procedure time of less than one hour.

We also provide custom trays for whitening. A replica of your bite is taken and we create a custom tray from soft plastic using this model. We provide Ultradent carbamide bleach with concentrations of 10%, 15% and 20% for your personal use. Custom trays are our most effective and comfortable type of whitening treatment.

Ways to Reduce Sensitivity after Teeth Whitening

Experiencing sensitivity after teeth whitening is to be expected for up to 48 hours after your in-office treatment. Even with take-home trays, there will be some symptoms of tooth sensitivity. Here are a few of the best ways to reduce your teeth’s sensitivity:

• Reduce use of bleach: shorten your bleaching time or pause your routine
• Use a fluoride rinse to resupply minerals to your tooth enamel
• Use a potassium nitrate gel to protect tooth enamel
• Brush with a toothpaste that reduces sensitivity

At our office, we provide another Ultradent product specifically designed to eliminate tooth sensitivity: Ultra EZ. This is a sustained-released potassium nitrate gel with fluoride that can be applied to the teeth with a syringe or a disposable tray. This treatment combines several important minerals to help teeth quickly recover their natural layers of protection. We also have other options like rinses and toothpaste.

The American Dental Association on Teeth Whitening 

According to the American Dental Association, there are limits for the concentration of bleach that should be used for teeth whitening. This applies to both in-office bleaching and take-home kits. For take-home bleaches that use carbamide peroxide, the ADA highly recommends that the concentration of bleach should not exceed 35%. If it is a variety of take-home bleach that uses hydrogen peroxide, the bleach concentration should not exceed 10%. For in office treatments, they recommend hydrogen peroxide concentrations of 25-40%. We offer bleach concentrations that are slightly higher than these recommendations for more effective whitening.

The brand of bleach we use, Ultradent, has the ADA’s Seal of Acceptance. Zoom Whitening and other types of whitening treatments that use UV or lasers are not backed by the ADA because there has been very little evidence to support the long-term effectiveness of light-activated whitening treatments.

Professional Recommendations for Over-the-Counter Whitening Products

There are dozens of new products available that promise customers whiter, brighter smiles, but not all of them are effective. The most recent advances in commercial dentistry have led to new products like whitening rinses, chewing gums and toothpastes.

• Whitening rinses do very little to whiten your teeth because of the limited amount of time they are in contact with your enamel. They may be useful for improving your overall oral hygiene, but their whitening effects will be limited.

• Chewing gum with whitening properties is also relatively ineffective. Sugarless chewing gum helps to remove plaque from your teeth by increasing saliva production and physically grabbing debris out of your teeth, but don’t count on it for a brighter smile.
• Whitening toothpastes are more effective than rinses and gums, but have a chemical formula that is more abrasive than other toothpastes. It is good to use them once in a while, but prolonged use can result in tooth sensitivity

The most effective over-the-counter whitening products are strips and trays. Whitening strips are applied directly to the teeth, usually overnight. They stick to the surface of enamel and dissolve over time. Crest White Strips are one brand that we’ve recommended for many years. Take-home trays work similarly. After finding or creating a tray that fits comfortably to your mouth, add whitening gel to the tray and wear it overnight. We offer a take-home kit from Ultradent that uses a stock tray to fit any mouth with a carbamide peroxide gel of 10% concentration. When choosing a product, be careful not to choose too high of a concentration or you may damage your gums.

Teeth Whitening – Cold, Hard Facts

By: Dr. Hilliard Blank

There are no shortcuts to a healthy mouth, but a lot of products out there are competing to offer the fastest way to a more attractive smile. Teeth whitening treatments have become increasingly popular in the last twenty years for a number of reasons. For some, they provide a valuable touch-up before a weekend of photos at a wedding, birthday party, or high school reunion. For others, they are a necessary part of daily hygiene. No matter your motivation for having a whiter smile, it’s important to be aware of the best treatments and biggest risks behind them. Preventing discoloration can be accomplished through regular brushing and visits to your dentist, but if you’re interested in a brighter smile, educate yourself and make sure you know what you’re putting into your mouth.

How Does Teeth Whitening Work?

Teeth whiteners work in a few different ways. For the most part, their chemical ingredients or polishing agents work on the surface of tooth enamel and remove any accumulated discoloration. The most frequently-used types of bleach are hydrogen peroxide and carbamide peroxide. Hydrogen peroxide is the stronger of the two, usually causing more sensitivity. Carbamide peroxide has a more neutral pH, making it less irritating to the mouth. Some specialized treatments utilize heat, lasers, or a special frequency of light in combination with traditional chemicals to provide a more powerful whitening process.  Depending on the whitening agent and delivery, the process can take between twenty minutes and several hours.

What Kinds of Treatments are Available?

Take-home Custom Trays –

Take-home custom trays are available from our office. This treatment involves taking a diagnostic model of your mouth, creating a tray with soft, durable plastic, and custom-fitting it over the teeth to stop just below the gum line. The trays are filled with a peroxide-based gel before each use and worn for up to several hours at a time. Some types of treatments can be used overnight. This is our most popular form of teeth whitening because it is the most effective and safest.

In-Office Bleach:

The in-office bleach treatment that is provided by dentists is the fastest and most immediately-apparent form of teeth whitening treatment available, but it is also the most expensive. The concentration of bleach used is the highest available on the market. The whitening product is applied directly onto the teeth using a small brush and left in place for 15 to 30 minutes. We isolate the teeth from the gums using plastic shields to prevent any misplaced peroxide from damaging your soft tissue. Depending on the dental office, there may be an additional part of the treatment involving a quick exposure to ultra-violet light or specialized lasers. At our office, we don’t use any of these additional steps for whitening because they increase the amount of sensitivity experienced.

Over-the-Counter:

This is one of the most common types of teeth whitening treatments. Over-the-counter bleach comes in many forms, but the most popular delivery systems are strips, gels, and one-size-fits all mouth trays. The user applies the treatment directly to their own teeth daily, and gradually teeth become whiter. Today, there are even more types of over-the-counter products like toothpaste, rinses, or gum that can provide similar benefits to these bleach treatments. These easily-obtained treatments are not as effective as conventional treatments, but are the most affordable. Results are not always satisfactory.  

Who Should Use Teeth Whitening?

The ideal patients for cosmetic teeth whitening are adults with healthy gums and teeth experiencing slight discoloration. As a rule of thumb, only patients that are 16 years or older should consider teeth whitening. The main risks associated with applying whiteners to teeth that are still developing are excessive irritation to the teeth’s nerves. Additionally, women that are pregnant or lactating should not use whitening treatments in order to avoid passing any potentially dangerous chemicals into the prenatal environment. Pregnant women aren’t even supposed to bleach their hair, so keeping bleach out of your mouth is just as important. If you have sensitive gums or any exposed roots, you should be careful using teeth whitening treatments to avoid causing additional sensitivity to the nerves in your teeth. Bleaching techniques are most effective on teeth with yellow stains. Teeth with brown, gray, or purplish discoloration will not have as noticeable results from whitening. Composite or porcelain materials used for veneers, crowns, and other dental restorations will not change colors.

What are the Risks of Teeth Whitening?

Sensitivity and irritation are the two primary side-effects of bleaching your teeth. The harsh chemical compounds in most treatments can make your teeth much more sensitive, but this symptom is mostly experienced immediately after the initial treatment. Most sensitivity will subside within one to two days after a treatment. A more serious concern is the issue of soft tissue irritation, including gums and lips. These types of soft tissue are much more sensitive to bleach and can be corroded or broken down if exposed to whitening agents for extended periods. This is more likely to occur with in-office bleaching techniques, which utilize the strongest concentration of bleach available. In the most extreme cases, it can cause permanent damage or recession of your gum line. If your gums or teeth are in any way compromised before bleaching, we can discuss your options and determine the degree of risk for your bleach usage.

Check back with us for the follow-up post on our Chicago Dental Blog for our favorite whitening products, tips to avoid the risks of whitening treatments, and more of our professional advice on the best way to get a bright, healthy smile!

Amalgam Fillings vs. Composite Fillings

By: Dr. Hilliard Blank

I always offer my patients a choice when it comes to the material I use to repair their teeth, but not many people are aware of the distinct benefits of each type of dental filling. When you get a cavity, there are a few ways to protect the tooth from further decay. After removing some decay and a gentle cleanup, there’s a new vacancy in your tooth that needs to be filled in order to protect the tooth’s integrity and the sensitive root underneath. The two most popular dental fillings are the silver amalgam filling and the composite resin filling. I stopped using amalgam fillings 10 years ago even though I have a few in my own mouth. But today, at least 47% of dentists still use amalgam fillings. Here are some facts to help you make an informed decision about the fillings in your mouth.

Silver Amalgam Fillings – Pros and Cons

Silver amalgam fillings are made of an alloy of mercury, silver, tin, zinc and copper. Silver fillings have been used for over 100 years because of the metal’s durability, but recently amalgam fillings have been getting a lot of attention for their potential health concerns. A few years ago, the FDA upgraded them from low risk to a moderate risk treatment due to published research on the health effects of mercury in our fillings. At my office, we take a conservative approach to amalgam removal. If the mercury-silver amalgam filling is decayed or compromised, we will replace it with a composite resin filling. We dispose of the filling in our amalgam separator to prevent the mercury from entering Chicago’s sewage and water-supply. We won’t remove amalgam fillings unless there is a compelling reason to do so.

Pros:

         ·         Metal fillings have a longer lifespan

         ·         Resistant to damage from chewing and grinding

         ·         Cheaper treatment

Cons:

         ·         Larger filling size

         ·         Metallic appearance

         ·         Possible health hazards and allergic reaction

Composite Fillings – Pros and Cons

Composite resin fillings are the most popular type of filling used in modern dental practice. I place more composite fillings than any other type of fillings. They are tooth-colored fillings that replicate the natural appearance of healthy enamel, making them a more discreet cavity treatment. They form a chemical bond with the tooth for a more reliable fit. They don’t have the same risks as mercury-silver amalgam fillings and are more attractive than metal fillings. Because composite resin fillings are so versatile, we recommend them for most types of cavities.

Pros:

         ·         Chemical bonding to enamel

         ·         Tailored to match natural color of teeth

         ·         Less tooth removed for filling

Cons:

         ·       Shorter lifespan compared to metal fillings

         ·       Longer procedure time (+20 minutes)

         ·       More post-operative sensitivity

Visit our page on our procedure for composite fillings or watch our video on fillings under “Other” for more information on dental fillings.

Get Invisalign Treatment from a Preferred Provider

By: Dr. Hilliard Blank

The days of metal braces are numbered. Modern treatments for teeth straightening that are less restrictive and more discreet are gaining popularity across the country. The foremost of these treatments is Invisalign. Invisalign is a cutting-edge product that allows anyone to improve the quality of their smile without the discomfort and embarrassment of traditional metal braces.

Through a series of custom-designed aligners, your teeth can be gradually repositioned for a more symmetrical smile. The aligners are made from a smooth, durable plastic that is transparent and almost invisible to the casual observer. They can be put in and removed with the ease of a mouth guard. Over the course of your Invisalign treatment, our office will provide you with a series of aligners that shift your teeth in two-week phases. Over months, your teeth adjust to the aligners, making a more beautiful smile and reducing any long-term problems with the shape of your bite.

People prefer Invisalign over traditional braces because it is discreet, comfortable, and more empowering than metal brackets.
 

The drawbacks of metal braces:

•  Many foods can break or damage important parts
•  Risks of injury to the lips and gums around the sharp metal pieces
•  Increased difficulty of brushing and flossing
•  Self-consciousness of metal smile

  With the clear plastic aligners of Invisalign, you can eat anything you want because the aligners are easily removed for cleaning, and no one has to know about your corrective treatment.

At our office, we’ve been providing Invisalign treatments to the Lincoln Park and Lakeview areas for years now. We’re a 2013 Invisalign Preferred Provider for Chicago residents. We will see you through the entire process, customizing your aligners and your treatment to your unique bite. Having straight teeth has more benefits than just appearances. Crooked teeth can cause significant problems over time if neglected: your jaw can shift, decay can accumulate in unreachable places, and problems with chewing may become more common. Everyone can benefit from orthodontics and it’s never too late to straighten your teeth. Check out our page on Invisalign to learn more about the process and what we can offer for you. From November 11th to November 25th, we’ll be offering a special discount for $600 off your Invisalign treatment. Schedule your consultation today!

Modern Treatments for Bruxism and Teeth Grinding

By: Dr. Hilliard Blank

Do you ever wake up with a headache and not know why? Are your jaw muscles sore for no particular reason? Does your partner tell you about a dull, scraping sound that comes from your side of the bed at night? Millions of Americans, young and old, suffer from Bruxism without even knowing it. Bruxism is a medical term for grinding or clenching your teeth. It occurs during activities that cause anxiety or tension, and many people suffer from it during their sleep. It can severely damage your teeth if left untreated, fracturing dental fillings, causing heat and cold sensitivities, and wearing down gums. Aside from dental health, teeth grinding can cause lingering headaches, tight jaw muscles, and chronic pains in the face, neck, and shoulders.

The causes for Bruxism can be complex and diverse, but the solutions are simple. There are two main reasons that people grind their teeth. Either their teeth are misaligned and their bite is uneven, or there is some type of psychological stress causing tension. We have several treatment plans for Bruxism and will help you determine the best course of action. If the problem is tooth alignment, we can reshape your bite to improve your comfort and the symmetry of your bite.

Whether or not your teeth are aligned, the primary treatment we recommend is to create a night-guard. The night guard is one of the most cost-effective treatments for Bruxism. Many insurance plans will provide coverage for this treatment. We can create a custom mold to fit any mouth and preemptively reduce the pain, discomfort, and damage of Bruxism. The night guard is designed to be easily put in and removed, with a durable outer layer and a soft inner layer that rests gently on the teeth and gums.

Without treatment, Bruxism can last for many years. In children, it is possible that the habit is outgrown by teenage years. But for others, teeth grinding can continue until the anxious feelings or stressful situations subside. The longer you wait to treat your Bruxism, the worse damage you can cause to your teeth. Call our office to find out more information about the services we can offer and our selection of modern treatments for teeth grinding.

For more information, check out our Dental Videos page and watch the night guard video under the category “Other.”