Drs. Goldstein, Garber & Salama

Dr. David Garber says: The predominant difference between the home teeth whitening kit and the one provided by the dentist is the strength of the active ingredient in the bleaching product and, most importantly, the personal monitoring of the patient for any problems that might arise in the tissue or the underlying teeth.

Good answer from Dr. Sadati, and I would just liike to add that I advise my patients to avoid eating blueberries, and suspend drinking coffee, tea, cola drinks and those that have strong pigments.

Dr. David Garber says: The essential color of the porcelain crown should stay forever. However, some of the added superficial stain may slowly abrade away.

Dr. Maurice Salama says: Yes, gum surgery can be performed easily today utilizing lasers and ultrasonic instrumentation. This can often be performed using a minimally invasive procedure (MIP), which is not painful and heals much faster.

Dr. David Garber says: The best type of crown really depends upon your specific needs. Gold crowns in the back of the mouth where no one sees them require less tooth removal or preparation, keeping your tooth considerably stronger. Today the new all zirconium crowns can do very much the same and in a tooth colored material. However, if you need optimum esthetics particularly in the front of the mouth, the all-ceramic crown, such as the lithium disilicate reinforced ones, provide for a more attractive match or blended outcome. Last, porcelain fused to metal crowns are time tested so work well, but are generally not as natural looking as all-ceramic crowns.

Dr. Ronald E. Goldstein says: If your teeth are worn, discolored, or otherwise aging you, a smile makeover can help give your face the appearance of a facelift without the surgery. By creating a younger-looking smile line you can easily look 10 to 15 years younger.  A lighter color makes a big difference as well as varying the lengths of the teeth to get rid of a worn straight across look that many older people have. And healthy-looking gum tissue also plays a major role in creating a younger look. Try to get rid of any open spaces or black triangles between your teeth if your gum has receded.

Dr. Ronald E. Goldstein says: Tooth contouring or ‘cosmetic contouring’ as it is know in the profession, can be a great compromise for mildly crowded, chipped or over-erupted teeth in creating an illusion of straightness. It’s best to choose a dentist who is a good artist and has experience in cosmetic dentistry so he or she can show you what your teeth can look like cosmetically contoured and then deliver the results.

Dr. Ronald E. Goldstein says: You can get a cavity underneath a crown if the decay is left in the underlying tooth structure when the crown was placed.  However, most areas of decay in crowned teeth occur at the gum line due either to a washout of the cement used to fasten the crown to the tooth, or to decay in the root of the tooth below where the crown is attached.

Dr. Maurice Salama says: A bad bite has been reported to cause chronic headaches and may even precipitate the migraine process. The problem is how the dentist defines what characterizes a bad bite. [It can be treated.] Most importantly, if a single tooth hits prematurely when you close, this should be adjusted or if your back teeth do not separate when you move your lower jaw forward or side to side, as in chewing or biting a sandwich, this may be a potential cause or factor.

You need to have a consultation with another dentist who may be more skilled at temporomandibular joint disfunction.  It could be the type of bite guard you are wearing because there are a number of different approaches to the problem and different designs for the appliance.  You may also be clenching or grinding during the day (subconsciously) and totally unaware you are doing it.  The rule I give my patients is “Lips together, teeth apart” and I have them make signs in their car, on their desk and at home wherever they are so it is a constant reminder not to have their teeth touch unless they are eating.  If you find your teeth are together at anytime day or night, you are clenching and may be causing the muscles to go into spasm.  At times I even have to make “day appliances” for patients who cannot stop on their own.