Dentalnews (en)

Does cleaning matter before bleaching?

Usually, yes!

When bleaching, the gums should not be inflamed, since inflamed gums bleed easily!
Blood may react with bleaching gel, moreover the gel is diluted and starts flowing uncontrollably around the mouth.

If you have a plaque problem on the insides of your teeth, or if you are a heavy smoker you should have your teeth cleaned before you undergo bleaching!

You should also go to a dentist if your gums are dark red instead of pale pink and the papilla are swollen – you may have parodontitis!

Check whether your gums are inflamed or healthy:
If your gums are pale pink and dimpled like an orange then your gums are healthy, and if you have very little or no plaque on the insides of your lower teeth, then you can have bleaching done right away.

How much does it cost to get bleaching done by a dentist?

Professional tooth whitening (bleaching) by a dentist costs between 200€ to 900€ in Central Europe.

Tea, coffee, red wine, tobacco, cola and natural ageing makes teeth darker or spotty. Bleaching can make your natural teeth whiter without complications.

Does bleaching damage the enamel or the teeth?

Professional whitening is performed using active oxygen, which decolorizes the pigments found in the teeth. None of the enamel is removed, ground away or dissolved.

A glass of freshly squeezed orange juice is more liable to damage the enamel than professional bleaching.
Bleaching compared – before and after. If you brush your teeth after eating sour food or fruits, this may rub off some of the enamel, as certain foods can soften up the enamel.

After eating, you should always wait at least half an hour before brushing your teeth – then you’ll always have something to smile about!

Inflammation of the gums!

The gums recede and easily start bleeding during brushing. This is often due to loose dental crowns.

There are various different methods to prepare a tooth for a crown.

The easiest and quickest method is the tangent cut (first picture). In the upper right corner you can see the sanding edges outlined in yellow. The problem with this cutting method is that the edges of the crown taper off to a very thin edge. The ceramic part can break off (red arrow).

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To prevent this from happening, the dental technician leaves more space at the edge of the crown (second picture), leading to unsightly bulges at the edges (blue circles). To hide these edges from the patient, the tooth is cut so that the edges end up under the gums.

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Click to see a video on tangent cuts!

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All this leads to bleeding gums, and gums which inflame easily – sometimes a gum pocket may develop, and a gum fistula. In the third picture you can clearly see a livid edge to the upper right incisor (red arrow). This develops due to the tangent cut of the crown, when bits of food accumulate around the protruding edge, they provide a good breeding ground for bacteria, which in turn cause inflammation of the gums. This then causes the gums to recede.

Healthy gums do not bleed!

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On the left in the picture you can see the pale pink gums hugging the tooth tightly (green arrow). This is what healthy gums look like: if a concave cut is made into the tooth – known as a groove cut (fourth picture), then nothing sticks out, since the dental technician has enough space for the ceramic part.

Bits of food cannot get stuck, since nothing sticks out beyond the edge of the tooth – so there is no risk of inflammation! Check your gums after getting a crown, if they are red and start bleeding easily, then there is something wrong with the crown!

Find out more about dental crowns here!

Are lasers really of any use in treating periodontosis? No, and moreover, it’s called periodontitis!

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Many patients have high expectations when it comes to perio treatment using lasers. Pseudo-scientific media reports only contribute to this trend, but whether this is actually true is a different matter.

We took a closer look at the individual claims, and came up with the following (somewhat disappointing) results:

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Lasers used in surgery (also known as flap operations)
Not suitable currently, as it is impossible to predict the depth effects of the laser. If dentine or bone is exposed to radiation, this may lead to tissue damage. Moreover, the base which supports the teeth  – the desmodont – may suffer irreversible damage.
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Lasers used in dental cleaning (scaling)
Not suitable currently, as the lasers usually used (argon-, ion-, Nd:YAG, Co2-lasers) cannot accurately target plaque or concrements.
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Lasers used in disinfection (anti-microbial effect)
Unsuitable, since the number of germs only goes down for a short while, moreover, studies show that compared to normal dental cleaning, lasers do more damage to the teeth.
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Lasers used in bio-stimulation (helping along the healing process)
Unsuitable, based on numerous double-bind studies, it can be assumed that bio-stimulation using lasers is ineffectual, any therapeutic effects observed can be attributed to placebo effects.

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Don’t bother paying good money for laser treatment, the only person who benefits from this is your dentist!
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Click here to learn more about periodontitis and see periodontal treatment performed!

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Source: 2009_Laser-Paro

Dentists often forget to tell patients what to do after getting dental work!
So here are some advices after dental treatment.

What should you watch out for?
What rules are there to follow?

The suggestions below are general information. If your pharmacist gives you other instructions, then you should follow them!

The Dental News team wishes you a speedy recovery, these tips will help you smile again!

• Leave the swab in for another half hour after treatment, then you can spit it out, unless your dentist has given you other instructions
• Keep the area which has been operated cool, e.g. using a Cool Pack (ice), not directly on the skin, but wrapped in e.g. a towel
• Do not eat as long as the area is still numb, and remember to chew on the other side
• Avoid nicotine and alcohol, as well as spicy, crumbly or raw foods, and milk products for the first three days after the operation
• Do not pull on your lip/cheek, no „peeking in front of the mirror“
• Do not start cleaning your teeth again until two days later (do not use a toothbrush around the wound, but use a cotton swab dipped in 3% H2O2).
• Use mouthwash containing chlorhexidine (e.g. Chlorhexamed) twice a day (not longer than 2 weeks) and several times a day using 3% H2O2 dissolved in water. Rinsing out your mouth using chamomile tea also helps speed up healing.
• Do not point the oral irrigator at the area treated!
• Bruises or swelling in the face (intensifying up to 4 days after treatment), as well as difficulty opening the mouth and a temperature of up to 38.5° C are common after treatment and are no cause for concern
• Avoid sunlight and physical exertion the first couple of days after treatment (no sauna, no sports, no hiking …)
• For operations in the upper jaw and opening of the maxillary cavity no blowing your nose for 8 weeks; do not hold your nose shut when sneezing

Before getting braces, the base needs to be cleaned!

Should you be considering correcting the positioning of your teeth, then you should consider this: before you get braces, your whole mouth needs to be „inflammation-free“.

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What does this mean?

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It means that there should be no

• Inflammation of the bone around the root – the so-called source
• periodontitis
• osteomyelitis
• cavities
• faulty root treatment

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Once the base is cleared of any inflammation, treatment using braces can begin! An x-ray can show the status of your teeth and mouth.

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