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Whitening Traumatized Teeth

FAQ 1. Is Flossing REALLY Important?

Honesty is the best policy! Here at Clatskanie Dental, we won't judge you. We're here to educate you & help you reach your oral health goals!

So...is flossing REALLY important?

Flossing cleans the surfaces in between the teeth that you can't reach with a toothbrush. The American Dental Association recommends people clean in between their teeth daily, but flossing is just one modality. When used correctly, people can achieve the same oral hygiene using small interdental brushes or oral irrigators (aka 'water flossers").

Cleaning between the teeth can reduce harmful inflammation and therefore lower your risk of PERIODONTAL DISEASE, which is said to affect at least 50% of Americans.

Still unsure? Ask your Dentist before implementing any new oral hygiene regimen.

Learn more here:
http://www.ada.org/en/science-research/science-in-the-news/the-medical-benefit-of-daily-flossing-called-into-question

 


FAQ 2. How Can I Make Dental Care More Affordable?

How a Health Savings Account (HSA) May Reduce Your Dental Costs*

WHY open a HSA?

To help save you money on dental or medical care!

WHAT is a HSA?

A Health Savings Account is a separate account you or your employer can put money into before taxes are taken out, which may save you money on your dental care.

WHO can open a HSA?

You may ask your employer if they offer HSA to employees or you may apply for your own HSA through your financial institution or bank.

Interested in opening a HSA? Contact your employer or financial institution/bank for more information!

To learn more, see article: click here


FAQ 3. Painless Dental Injections: Fact or Myth?

Can getting a dental injection really be a 'painless' experience?

At Clatskanie Dental Clinic, we think it can! Let's explore why we believe this and why you should care.

What do most people dread about going to the dentist: the injection! However, there are actually quite a few techniques your dentist can implement to make the injection 'painless.' Here at Clatskanie Dental, Dr. Ross uses 3 distinct methods to ensure you have the most comfortable injection possible:

  • We Warm It Up: We warm the dental anesthetic so that it is near body temperature. Your body can interpret cold substances as pain, so this helps the body absorb the anesthetic more comfortably.
  • We Go Slow: We administer the anesthetic very slowly, which gives the body more time to adjust and therefore reduces the chance of it feeling painful.
  • Remember To Breath: Most people forget to breathe during dental injections because they're afraid. We gently remind you to breathe during the injection, which calms our patients. Also, the body interprets pain less during exhalation so you don't feel it as much.
  • Topical Agent: Our topical agent is very effective at "pre-numbing" the area, making the injection even more painless!

We strive to make our patients feel as comfortable as possible and we know dental fear is real. If you're suffering from dental pain and are avoiding going to the dentist because you're afraid, you're not alone!

We want to help you in any way we can. Let us help you by calling us today to schedule a complimentary DENTIST MEET AND GREET so you can get to know us!

FAQ 5. Can a Dental cleaning really lower my risk of heart disease?

For decades, medical researchers have hypothesized the link between oral health and whole-body systemic health. Is this link still considered ambiguous in the medical community or is there hard evidence to prove that poor oral health leads to systemic deterioration? Recent studies published in the Journal of Clinical Periodontology (2013), Journal of Oral Science (2016) and Journal of Cardiology (2010) suggest the answer is clear in regards to the link between oral health and cardiovascular disease (CVD).

Oral Disease

Have you or a family member ever been told by your dentist that you need a “deep cleaning?” According to the CDC (2010), 1 in 2 Americans (47.2%) have moderate to severe periodontitis. Once you hit age 65 your odds of developing periodontitis skyrocket to 70%. Periodontitis is caused by harmful bacteria such as Porphyromonas gingivalis that, through multiple complex processes, illicit production of host immune and inflammatory chemicals that lead to the deterioration of the endothelial cells of the gums and subsequent bone supporting the teeth, similar to the way termites eat and destroy wood, potentially leading to serious acute infections and eventual tooth loss. Although periodontitis is an incurable condition, treatment modalities have shown to be effective long-term in slowing the progression and stabilizing the condition. The traditional treatment for periodontitis is non-surgical periodontal therapy, aka a “deep cleaning”, performed at your dentist’s office. Periodontal therapy, depending on the severity and presence of co-morbidities such as diabetes, may include adjunctive treatments such as local antibiotics that help treat the diseased tissue directly or even laser therapy.

Cardiovascular Disease

Heart disease is the number one cause of death in Americans, killing over 600,000 people every single year (CDC 2017). Atherosclerosis, an immune and inflammatory disease that presents as dysfunctional thickening of blood vessels, presents in patients with cardiovascular disease (CVD). The process by which atherosclerosis, or blood vessel thickening, takes place is multifaceted. Basically, as plaques build up in the arteries, endothelial cell breakdown leads to foam cell formation that narrows the blood vessel leading to blood flow blockage. These atherosclerotic plaques may burst open, potentially causing a blood clot that can block the flow of blood causing a thrombotic stroke. The destructive inflammatory processes involved in CVD lead to increased cardiovascular risk markers such as destructive inflammatory blood markers (CRP, fibrinogen, interleukin-6), increased systolic and diastolic blood pressure, increased left ventricular mass (an enlarged heart), and arterial stiffness (thickened blood vessels). Biomarker interleukin-6 is especially correlated with cerebral ischemia (stroke).

Oral-systemic Link

So, what is the connection between periodontitis and the number one killer, heart disease? Both diseases exhibit a mechanism of endothelial (blood vessel wall) breakdown which leads to increased inflammatory biomarkers CRP, IL-6, haptoglobin and leukocytes, which present as bone and soft tissue destruction around teeth (periodontitis) and blood vessel thickening and subsequent heart blockage or stroke (atherosclerotic cardiovascular disease). The microbiological processes and components involved in both processes are analogous and the bacteria P gingivalis is present in most (64%) atherosclerotic plaques seen in patients with cardiovascular disease. Because research to find a causal relationship between oral bacteria and heart disease is extremely difficult and complex, as technologies improve medical researchers are finding more and more correlative and causative relationships between certain biomarkers. In a 6-month randomized clinical trial, non-surgical periodontal therapy was shown effective in reducing levels of systemic inflammatory markers such as ESR and triglycerides (significant reduction), as well as reduction in CRP and total cholesterol (moderate reduction). Periodontal therapy helps to stabilize these biomarkers up to 6-months post-operatively in patients with periodontitis.

In a 2013 study published by the Journal of Clinical Periodontology, non-surgical periodontal therapy (deep cleaning) was shown to significantly reduce all cardiovascular risk markers evaluated, including systemic inflammation plasma markers (CRP, fibrinogen and interleukin-6), systolic and diastolic blood pressure, left ventricular mass (heart enlargement) and arterial stiffness, which lead to a lower cardiovascular risk. Scaling and root planing, aka “deep cleaning”, was shown to produce an even greater systemic reduction of inflammatory markers seen in patients who receive adjunctive therapies such as local administration of antibiotics such as minocycline.

Rainier Dentist


Online Dental Education Library

Our goal here at Clatskanie Dental Clinic is to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Feel free to use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.  Call us today at (503) 728-2137

Have questions for Dr. Ross?  Call her at (503) 728-2137

 

Doctor whitening traumatized teeth.Teeth whitening is one of the most popular cosmetic dental treatments — and it's easy to see why. Having whiter teeth can make you look years younger, and the procedure itself is among the most conservative (and cost-effective) cosmetic treatments dentistry offers. Sometimes, however, achieving a pleasing, even shade of lightness can be challenging; this is particularly true when a tooth that needs to be lightened has been subjected to an injury (dental trauma) in the past.

Dental trauma encompasses any damage to the tooth that's caused by an external agent, whether accidental or intended. It may be due to a fall, a sports injury — or even a past orthodontic procedure. According to some studies, around a quarter of Americans aged 6 to 50 years old have experienced some traumatic dental injury, with most occurring before age 19. Traumatized teeth may react to whitening procedures differently from undamaged teeth, which can make them difficult to treat. However, several effective treatments are available.

Diagnosing a Discolored Tooth

The first step in the process of lightening a traumatized tooth is a thorough exam to find out what's causing the dark staining — and one of the first things we will determine is whether or not the tooth's pulp is “vital,” or alive. This is readily revealed by radiographs (x-rays) or other tests. If the tooth is still vital, external bleaching can often yield satisfactory results — even if it's just one tooth that needs to be whitened. In-office treatments or take-home trays are effective, but office procedures generally take much less time to produce good results.

In many cases, however, discoloration of a traumatized tooth is itself an indication that the nerves in the tooth's pulp have died. In this case, before whitening treatment can start, a root canal procedure will be necessary to remove the dead or dying tissue and prevent infection. It can also happen that a tooth that appeared normal will begin to discolor many months (or years) after a root canal has been performed. In either situation, it may be possible to whiten a non-vital tooth with a procedure called internal bleaching.

Whitening From the Inside Out

Whitening traumatized teeth.Because a non-vital tooth's stains are intrinsic (inside, rather than outside, the tooth), we need to put the bleaching agent itself inside the tooth. Internal bleaching is a routine procedure, here's how it works:

Access to the pulp chamber (the small passageway in the tooth's center) will be gained by making a small hole in the back of the tooth. Then, any debris from the chamber will be removed and rinsed away, and a special cement will be added to prevent the bleaching agent from leaking into the tooth's roots.

Next, some bleaching agent (commonly sodium perborate) will be placed in the empty pulp chamber, and temporarily seal it in. At this point, you can get up and leave the office… which is why this procedure is sometimes called the “walking bleach” technique. However, you'll return in a few days for another round of bleaching; it may take up to four visits to get the degree of lightening you want.

When the tooth reaches the desired color change, a more permanent restoration will be placed on the tooth to seal that little hole — usually a tooth-colored filling material of composite resin. Many times, this relatively conservative procedure will give your tooth all the lightening it needs. If it's not enough, the tooth can be bleached externally as well, or you can even consider a veneer or crown. The goal is to recommend the most appropriate cosmetic dental procedure, and get you the best possible results.

Related Articles

Whitening Traumatized Teeth - Dear Doctor Magazine

Whitening Traumatized Teeth Sometimes teeth that have had root canal treatment darken over time. These teeth may not respond to the usual methods of whitening, but they can often be successfully bleached from the inside. This offers a more conservative option than using a veneer or crown to cover the discoloration... Read Article


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