Category: Latest Blog Entries

Teeth Whitening

Teeth Whitening information by Thousand Oaks Dentist Justin Sycamore DDS

Teeth Whitening is a really interesting subject because there is a lot of misinformation out there.  Whitening is safe!  It does not damage the enamel or cause erosion of the teeth.  It does not weaken the teeth and make them vulnerable to tooth decay.  Its actually the opposite.  The whitening solution will actually reduce the number of oral bacteria, so people who regularly whiten their teeth will get fewer cavities.  It is possible to damage the gums with a whitening solution so it is important to whiten in accordance with the directions of your chosen solution.

We are a full service dental office doing a wide range of procedures but our focus in on cosmetic dentistry.  So I do a lot of whitening!  I want to go over the different types of whitening and how they effect the teeth and sensitivity.  There are 3 types of whitening that you can do.

  1.  In-Office Whitening
  2.  At home bleaching trays
  3.  Over the counter products

In-Office Whitening

This is the best way to whiten your teeth.  It takes about an hour for an in-office whitening session.  I’ve used many different whitening products over my career.   They most marketed is Zoom.  I like it a lot.  It whitens very well but in my experience it causes too much sensitivity and in some cases pain.  So recently I started using Boost.  It whitens teeth really well and with minimal sensitivity.  So that is what I am currently using.  It takes about an hour.  I cover the gums and retract the lips from the teeth to protect the skin.  I put on a very powerful hydrogen peroxide solution and it sits on the teeth for 20 minutes.  I then remove the solution and apply a freshly mixed solution for 20 more minutes.  I find that we can usually achieve the whiteness a patients desires with one session, but we occasionally will return for another hour of whitening.  The photos that I’ve attached show teeth whitened over 2 appointments.

Before and After Images of Boost Whitened Teeth

Bleaching Trays

Bleaching Trays are really great for people who whiten their teeth frequently.  It always works best to do an in-office whitening followed by at-home whitening with trays.  The custom trays are supremely important because the solution can cause damage to the gums and the lips.  So a well fitting properly trimmed tray is vital to safe whitening.  There is a upfront cost to making the custom trays but you can use them for years assuming you don’t have changes to your teeth.  My favorite type of solution for bleaching trays is Opalescence.  They make a variety of flavors and concentrations so you can choose the one that works best for you.

Custom Bleaching Trays

Over-the-Counter Products

Too often over-the-counter products exist because there is a demand for them and not because they are good products.  So you will see whitening toothpastes, mouth washes, etc.  The reality of tooth whitening is simple.  Hydrogen peroxide and carbamide peroxide will whiten teeth.  The degree of whitening depends on the concentration and amount of time the solution is in contact with the teeth.  Mouth washes and toothpastes are only in contact with the teeth for about 2 minutes so it just isn’t long enough to make a measurable effect on tooth color.  So I don’t recommend those products for whitening.

There is one type of over-the-counter product that I do recommend and that is Whitestrips.  I gave a link to Crest Whitestrips but there are a variety of manufacturers and even storebrand whitestrips which should work fairly nicely as well.  I hesitated to link to the Crest Whitestrips because it says that it will whiten as well as a professional whitening and in my experience it generally will not.  But if you consistently use whitestrips you will see a visual improvement over time.  Teeth Bleaching with White Strips

Sensitivity

All whitening products will cause sensitivity.  There is a wide variation in sensitivity among different patients and products.  But there are a few ways to minimize discomfort following a whitening.

Use a sensitive toothpaste for a few days before, during, and after the whitening treatment

I always give my patients a few sample size tubes of Sensodyne toothpaste.  It has potassium nitrate which is minimizes the sensitivity.  So brush your teeth with it and if the sensitivity is particularly bad you can actually smear the toothpaste over the sensitive teeth and leave it there.  It will surprisingly help a lot.

Take a pill

If you have no health issues that would preclude taking a pain reliever you can take your preferred pain killer.  Motrin,  Tylenol, or Aleve would all be good choices.  Again make sure that you have no health issues that would be negatively effected by taking a pain killer.  But if you can, it can really take the edge off.

Avoid cold food and drinks

Don’t even try to eat ice cream for a few days and be careful with cold drinks.  It will be annoying for a few days but it will get better.  Sensitivity is always temporary.

What’s the Deal with Wisdom Teeth?

Wisdom Tooth Removal Thousand Oaks

I get so many questions about wisdom teeth so I thought it would be a good topic to discuss.  Most of the wisdom teeth I remove are because there simply isn’t enough space!  Its so strange to remove a healthy tooth with not a speck of decay only because there is no place for the tooth but that is what happens all the time.

 

If we go back in timWisdom Teeth Skull Brain Sizee several thousand years and look at the skeletons of our ancestors we’d see that their jaws were much longer than ours.  You would also see that their skulls were smaller.  As we’ve evolved, our brains have grown bigger and extended the skull down and forward.  You can see that the increase in cranium has pushed the jaw forward.  Our faces have also flattened.  Our jaws used to be the most protrusive aspects of our faces but now it is usually the nose.   So that also limits the size of the jaw.  So simply, we’ve really benefited by our amazing, giant brains but it comes at the cost of a reduction in our mandibles.

 

Now we have a dilemma, our jaws are smaller but we still need to squeeze in the same amount of teeth.   So what do we do?  Most of the time when there is an issue we just remove the offending tooth.  Sometimes we remove preemptively.  I always recommend young people to remove their wisdom teeth before they finish their orthodontic treatment.   I have my wisdom teeth when I was 19 before they caused any problem because my dentist felt they would cause problems later.
Wisdom Teeth Swelling

Not all wisdom teeth extractions are equal!  Some wisdom teeth come out really easy.  It is usually really easy to remove a erupted/semi-erupted wisdom tooth in a 18 year old because they roots haven’t had a chance to set in.  Sometimes the wisdom teeth erupt in a position that makes them really hard to remove.  Sometime it requires cutting the gums and surrounding bone to access the tooth.  That’s why some people get their wisdom teeth removed and have no down time and others have their cheeks swell up like chipmunks!

It’s interesting to talk to dentists because there are many different philosophies to wisdom teeth.  Some dentists want to remove every wisdom tooth, others will only try save them if the patient is missing teeth and may need the wisdom tooth in the future to support a bridge.  As for myself, I’m really conservative.  I try to save all teeth, even wisdom teeth.  So if a wisdom tooth isn’t causing any problems, my recommendation is to leave it be.

-Dr. Sycamore

What’s New at Sycamore Dental?

I want to make a quick blog entry today to share a few happenings in the office and give a thank you to a very considerate patient.

It’s 2016 and things are exciting.  The amazing whitening promotion has ended but if you still have a card or mailer then we will still honor it.  January is going to have a really simple promotion.  All new patients can get an exam, x-rays and a cleaning for only $45.   So if you have been putting off your cleaning for a while then schedule an appointment this month to get it taken care of.  At that price there is no excuse!

Every once in a while I will get an email asking me general dental questions.  Sometimes I will alter that question and make it into a weekly blog entry.  So if you have any questions, you can send me an email to sycamore@sycamore.dental.  I will answer it here on the blog.

I will be going back to Ensenada in the first weekend of February for the Thousand Smiles cleft palate clinic.  It’s a really good cause.  They provide free surgical correction to children in Mexico with cleft palate and then follow it up with extensive dental treatment.  It can include implants, orthodontics, and everything else you can think of.  There is also an orphanage which buses a bunch of kids over for much needed dental care.  I’m going to be providing all types of dental services over the weekend.  If you would like to help in some way, give us a call to let us know.SAMSUNG CAMERA PICTURES

The last thing I want to mention is a big thank you to a nice patient of ours.  He has a family run business in Newbury Park, named Alfi International.  They make kitchenware and appliances right here locally.  He sent us a set of kitchen knives which are among the best I’ve ever used.   So I suggest you try their awesome knives and support local Thousand Oaks businesses!

-Dr. Sycamore

Water Fluoridation

Tooth decay is caused by bacteria.  Bacteria exists on the enamel surfaces of your teeth in plaque.  The bacteria metabolizes sugars and simple carbohydrates from the food you eat and the byproducts are acids.  These acids are trapped in the plaque and remain in contact with the enamel for up to 2 hours.

The acidic plaque causes what is called demineralization.  This is when calcium and phosphate minerals actually dissolve from the enamel.  This leaves the enamel weakened.  But all is not lost!  The teeth can remineralize!  Once the acids are neutralized the enamel will reintake the same minerals and strengthen the enamel.  We just need a neutral environment and plenty of fluoride ions.

That’s where fluoridation comes in!

This is a great 3 minute video which goes over the basics of fluoridation:

Water fluoridation has been in practice for over 70 years!

Water Fluoridation Thousand Oaks

Drinking fluoridated water keeps the teeth strong and reduces tooth decay by approximately 25% in children and adults. By preventing tooth decay, community water fluoridation has been shown to save money, both for families and the health care system.

Nearly all water contains some fluoride, but usually not enough to help prevent tooth decayor cavities. Community water systems can add the right amount of fluoride to the local drinking water to prevent tooth decay.

Community water fluoridation is recommended by nearly all public health, medical, and dental organizations including the American Dental Association, American Academy of Pediatrics, US Public Health Service, and World Health Organization. Because of its contribution to the dramatic decline in tooth decay in the United States since the 1960s, the Centers for Disease Control and Prevention (CDC) named community water fluoridation one of 10 great public health achievements of the 20th century.

What about the water we drink in Thousand Oaks?

The drinking water in Thousand Oaks actually originates in Northern California!  Its transported from the Sacramento River Delta through the California Aqueduct to the Metropolitan Water District’s Jensen Filtration Plant in Granada Hills.  It is there where it is treated, filtered and disinfected.  It is also there where it receives the perfect amount of fluoride for optimum oral health!  It is then piped directly to Thousand Oaks through the transmission facilities of Calleguas Municipal Water District.

So have no fear!  Our water is ideally fluoridated in Thousand Oaks!

What if its not enough?

Occasionally I will encourage a patient to increase his or her fluoride intake.  One way is to use a prescription toothpaste.  Sometimes I will prescribe Prevident toothpaste to be used for a time to try to remineralize some problem spots.

Fluoride Thousand Oaks