My Blog

Posts for: December, 2012

By Dr. Patrick H. Collins
December 29, 2012
Category: Dental Procedures
Tags: teeth whitening  
WhiteningaDiscoloredToothfromtheInsideOut

If you have discolored teeth, the cause is often staining on the enamel surfaces from foods, beverages, or smoking. But tooth discoloration may also originate deep within the root of a tooth. Sometimes this happens to a tooth that had to have earlier root canal treatment because of injury or decay.

In such cases the living pulp tissue and its blood vessels and nerves had to be removed from the root canals, resulting in the death of the dentin layer, which makes up most of the tooth's body. Over time this caused the dentin to darken. The color may come from remains of blood that was left in the tissue, or from filling materials left in the root canal that are showing through.

Since these stains are caused internally (intrinsic) and not on the outside of the tooth (extrinsic) they must be whitened from the inside. This is usually done by putting a bleaching agent into the empty chamber from which the pulp was removed. Usually the bleaching agent is a substance called sodium perborate.

When it is mixed with a solution of hydrogen peroxide, sodium perborate slowly bleaches the color from the tooth's internal material. It is considered to be safe and reliable for this use.

The work begins by taking x-ray images to make sure that the root canal is correctly sealed and the bone is healthy. After this, we will make a small hole in the back of the tooth through which the root canal space will be cleaned. The root canal space will be sealed and the bleach will be applied in a putty-like form and sealed off from the rest of your mouth. Every few days this procedure will be repeated until the bleaching reaches the desired level.

At this point a tooth-colored composite resin will be used to seal the small hole that was made in the dentin to insert the bleach. After the tooth has reached the level of whiteness that matches it to your other teeth, veneers or crowns must sometimes be used to repair the surface if it is chipped or misshapen, for example.

Contact us today to schedule an appointment to discuss your questions about whitening internally discolored teeth. You can also learn more by reading the Dear Doctor magazine article “Whitening Traumatized Teeth.”


By Dr. Patrick H. Collins
December 19, 2012
Category: Dental Procedures
Tags: oral health   root canal  
QuestionsToAskBeforeGettingRootCanalTreatment

Hearing the news that you need a root canal often causes anxiety for most people given all the bad press this procedure has received (e.g., “I'd rather have a root canal than...”). However, the truth is that root canal treatment relieves pain; it doesn't cause it. And it is typically highly successful. The real pain occurs for most people when decay is left untreated or the nerve in a tooth under a very large filling becomes infected and dies.

For these reasons, we have put together the following list of questions you should consider asking prior to having a root canal or endodontic (“endo” – inside: “dontic” – tooth) treatment.

  • Am I a good candidate for root canal treatment?
  • Does it hurt to have a root canal?
  • What can I expect if I do not have a root canal treatment?
  • Are there any other treatment options for me given my situation? If so, what are they?
  • Do you do root canal treatment or should I see a specialist?
  • How long will the entire process take from my first appointment until my root canal treatment has healed?
  • Will the pain I am in immediately subside after a root canal or will it take some time?
  • Will I need or receive any type of sedation while having the treatment?
  • Are there any risks associated with root canal treatment? If so, what are they?
  • How long can I expect my natural tooth to last after root canal treatment?
  • What could happen to cause a root canal to require a second treatment?
  • How much will my root canal cost?
  • Will my insurance cover all or a portion of the cost?
  • Will the tooth be as strong after root canal treatment, or will it need a crown?
  • Will there be any special maintenance required on an ongoing basis after I have a root canal?

To learn more about root canals, continue reading the Dear Doctor article, “I'd Rather Have A Root Canal.” Or if you feel you may need a root canal or other dental procedure, contact us today to schedule a consultation.


By Dr. Patrick H. Collins
December 14, 2012
Category: Oral Health
Tags: oral health   tmd   tmj  
UnderstandingTemporomandibularDisorderTMD

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is a condition that is unusual in that it frequently is quite hard to diagnose, because it often mimics many other conditions. For this reason, many healthcare professionals refer to it as “the great imposter.” The condition arises when there are problems inside the temporomandibular joint and the muscles that attach to it causing pain. The pain is most often due to muscle spasm, thereby limiting the ability to open and close the jaw and to function normally. TMD can impact anyone and has a wide range of similar symptoms.

One of the common causes of TMD is stress, and it may manifest itself through clenching or grinding of teeth while awake or asleep. These habits are often completely subconscious until pointed out by a dental professional or sleeping partner. With stress-induced TMD, the pain often comes and goes in cycles. In other words, it may be present when you are stressed, seem to disappear for a while, and then reappear when you are stressed again. Another cause of TMD can be from an injury or trauma, such as a blow to the jaw. However, regardless of the cause of TMD, the pain is real and needs to be treated properly.

If you feel that you might have TMD, please let us know so that we can address your concerns, starting with a full history and conducting a thorough examination. Or if you are in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”


By Dr. Patrick H. Collins
December 05, 2012
Category: Oral Health
WaysYouCanMinimizeToothSensitivity

If you have ever suffered from tooth sensitivity, you know all too well how real the pain can be — anything from a slight twinge to pain that can be downright excruciating. Sensitivity may be experienced several times throughout the day or just every once in a while. However, as we say, a little knowledge can go a long way. And we can provide you with the know-how and steps to help minimize your tooth sensitivity.

One of the first steps we will take is to review your brushing habits, as an improper brushing technique can not only cause tooth sensitivity, but it also can make the sensitivity worse once it is present. We will teach you how to remove dental plaque safely without damaging your delicate gum tissues, which can cause gum recession leaving the dentin exposed. Another step we may take is to provide you with a special toothpaste containing fluoride or one specifically targeted to sensitive teeth. The fluoride increases the strength of tooth surfaces and thus makes teeth more resistant to acid attack and sensitive to sweets. Or if the sensitivity is severe and/or constant, we may need to apply a barrier to cover the sensitive areas. These barriers may range from concentrated fluoride varnishes to bonded filling materials to cover the sensitive areas. If the pain is severe and constant, it may be possible that the pulpal tissue containing the nerves in your tooth are inflamed and you may need a root canal treatment to relieve your pain and save the tooth.

If you are experiencing tooth sensitivity or have questions about this condition, please contact us to schedule an appointment. Or you can learn more about this topic by reading the article “Sensitive Teeth.”