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.

........................................................................................

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.

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,

........................................................................................

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.

........................................................................................

What to do when a crown or a bridge falls out?

April 30, 2011 alexnguyen

Crown and bridges are cemented or bonded in place. Although we can make them look exactly like the real teeth, they are not truly "permanently" attached to the teeth. They can de-bond (detach) from the teeth for many reasons, including heavy uncontrolled teeth grinding, chewing of strong sticky candies, etc... When a crown or a bridge falls out, it is best to try to:

1. Reinsert it into the exact place, EVEN if the tooth does not hurt.

2. Keep it in the exact place until you are able to see your dentist, EVEN if you cannot get to your dentist for an extended period of time.

3. Have your dentist evaluate the underlying tooth structure to make sure that decay is not the cause of the detachment.

Do not use glues such as Crazy Glue. Household glues do not work, and they will distort the fit between the tooth and the restorations.

Do not leave them out of the mouth: The adjacent teeth can easily move into the space where the crown or the bridge was occupying. When this happens, the restoration will no longer fit and the only solution may be to replace it with a new one.

As always, a little common sense will save you and your dentist both time and money.

Thanks again for reading my blog.

........................................................................................

Allergies and Toothache

April 12, 2011 alexnguyen

The arrival of Spring induces allergy symptoms such as itchy/watery eyes, excess nasal irritation and drainage, dry cough, skin rash, etc. However, there is a unique symptom which occurs sometime in conjunction with excess drainage in the sinus: Toothache on the upper molars or bicuspids. The upper bicuspid and molar roots are embedded in the sinus cavity. When the sinus cavity is filled with excess drainage from allergies, pressure from the sinus on the roots can cause a discomfort which mimics a toothache. An improper diagnosis may result in unnecessary root canal treatments to alleviate the associated pain. Careful examination and tests should be done to rule out toothache associated with sinus drainage or infection.

In this case, a regiment of antibiotics and antihistamines may very well alleviate the toothache-like problem. Yes, sometimes you can blame pollen for your toothache !

........................................................................................