My tooth hurts. Does it mean that I have a cavity?

August 12, 2011 alexnguyen

Today I will tell you that the answer to this blog heading is: NO ! Sometimes when a tooth comes into contact with the opposing teeth in a way that directs excess force to the neck of the tooth, this can cause micro-fracture of the enamel there. When the outside layer of the tooth (enamel) is stripped, the inside layer (dentin) is exposed. The tooth can become sensitive to substances that are cold, sweet, sour, etc...

There is no cavity in the photographs below, but the symptoms make the patient think that a cavity is there.

Take a look at the indentation (the notch) at the neck of this tooth:

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Now...

Observe how the same tooth is the only one that contacts the lower teeth when the patient moves her jaw from side to side.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

What is tetracycline stain?

June 27, 2011 alexnguyen

Tetracycline is an antibiotic. At the age of three, children have already developed tooth buds of the permanent teeth inside the jaw. When tetracycline is given to children, this drug penetrates the developing tooth buds and incorporates itself into the tooth structure. When the teeth erupt into the mouth, the result is bands of dark stains with usually a combination of brown, gray, and yellow colors. These stains make up the actual colors of the teeth and are impossible to bleach completely into normal white teeth colors.

Note: Once a tooth has erupted into the mouth and the root of that tooth has completely formed, tetracycline cannot affect that tooth. It is also a misconception that all antibiotics will cause yellowing of teeth.

The human eyes are used to seeing the smile with white teeth. Smiles with dark tetracycline teeth are not as esthetically pleasing as smiles with normal white shades of teeth.

Porcelain veneers done on tetracycline stained teeth are very difficult for many reasons. A clinician has to mask out the dark colors underneath, and create at the same time the proper tooth form, contour, texture, and details of the edges of the natural tooth.

Here are the before and after photos of a case where I used porcelain veneers to enhance a severely tetracycline stained smile. The after photo was taken two weeks after delivery. The gum tissue will continue to heal and adapt to the new porcelain, and the colors of the porcelain teeth will become even more realistic after some time. In this case the patient opted for a super white shade, yet with proper planning and execution we can still create a natural looking smile.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

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From a patient who moved to Hawaii

June 23, 2011 alexnguyen

Email dated June 23, 2011 to her parents. Aloha Dad and Momma,

Dr. Jonathan Kam is my dentist who went to college at UCLA and Stanford. He told me that he knew Dr Nguyen from conferences and his excellent reputation. In fact, when Dr Kam examined my fillings, Dr Kam asked me who did my fillings because they were some of the best fillings he had ever seen and reported he was a "filling snob." I told him Dr Nguyen in San Jose did my fillings and Dr Kam said, "Oh my gosh, I know him! He is an excellent dentist and one of the best." Dr Kam told me to tell Dr Nguyen what an excellent job he did with my fillings. So, That's the story:)

The waves were huge in Waikiki today! They were about 15 ft and yes, I surfed them! It was really fun and I had a great time surfing because it is very rare that Waikiki has big waves like today. I am really excited for Mom to come and wish you were coming too, Dad:( Hope you have a nice rest of the week and talk to you both soon.

I love you,

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How can I have a cavity if my tooth does not hurt?

June 22, 2011 alexnguyen

Your tooth will only hurt if the cavity penetrates the chamber which houses the nerve inside your tooth. A cavity begins from the outside surface of your tooth and usually balloons inwards until it penetrates the nerve. Bacteria from the cavity and temperature exposure will cause the nerve to become inflamed and eventually ... die. That's when it really hurts.

The best way to diagnose the extent of a cavity is to use proper radiographs. Regular check-ups allow your dentist to catch cavities in their early stages of development. A small cavity is much easier and inexpensive to fill, than to wait until that cavity dictates the need for root canal, build-up, and crown treatments.

The Xray below shows 3 cavities on a patient who has not been to the dentist in a number of years. This patient has no pain in her dentition, yet it is a matter of time before these cavities become big problems for her dental health.

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Name this flower, and win free teeth whitening!

June 3, 2011 alexnguyen

This beautiful flower was sent to us this week from a patient, fresh from her garden! Just for fun, you can win a free teeth whitening procedure if you are the first person to leave a message on our office voicemail or with our reception desk with the correct name of the flower. One catch though... You must be willing to come to us because we cannot deliver teeth whitening over the internet :).

Our office number is 408-867-8648