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Whitening Before Veneers—A Bright Idea?

May 17th, 2023

It’s time. You’ve decided. You’re going to get veneers. Whether it’s to repair a cracked or chipped tooth, to cover discoloration brought on by a root canal or medical condition, to fill in gaps between teeth, or for any other cosmetic reason, veneers can give you back your natural, confident smile.

And now you have just one more decision to make: should you whiten your teeth beforehand?

Many dental professionals find that, for most of us, the best results occur with professional whitening before veneer placement. Why?

  • Your veneers will be carefully matched to the teeth surrounding them.

You don’t want your veneers to look anything but natural, and so Dr. David Shipper and Dr. Howard Vogel will make sure that their color is indistinguishable from your other teeth. But there is one important difference between tooth enamel and veneers:

  • Teeth are porous.

As hard as it is, enamel is still porous. And the fact that teeth are porous means that teeth can discolor over time. Coffee, tea, red wine, sodas, darkly hued fruits, and fruit juices—teeth readily absorb pigments from foods. And smoking?  Not only one of the worst habits for your health, it’s one of the major causes of tooth discoloration. This is the downside of having porous enamel.

The upside? The fact that enamel is porous also means that you can brighten your smile with a whitening procedure.

  • Veneers aren’t as porous.

Veneers are generally made of porcelain or a composite resin, with some key differences between them.

Porcelain has a translucent quality that looks like natural enamel, and it is very durable. Porcelain veneers are recommended when teeth have significant chips or gaps. They are also especially stain-resistant.

Composite veneers aren’t as expensive, and usually don’t need as much tooth structure removed to bond them to the tooth. They might not last as long as porcelain, and they aren’t quite as resistant to staining.

When you visit our New York, NY office, we can discuss the pros and cons to find the perfect veneers for your needs. Just remember,

  • Once created, veneers can’t change color.

Veneer color should be considered permanent. If your porcelain veneers seem to have dimmed a bit, often a gentle professional polishing will bring them back to their original shine. Composite veneers, as well, can respond to polishing and cleaning. This is the upside of permanent veneer color.

The downside? Veneers can’t be whitened to match your newly whitened tooth enamel. If you decide to whiten your teeth at a later date, your veneers might appear darker than your surrounding teeth. If you want to change veneer color, you will need to replace your veneers. So . . .

Now that you’ve decided to transform your smile with veneers, take a little extra time to talk to your dentist. Find out if whitening makes sense for you for a perfect, uniform match between your other teeth and your veneers.  And then be ready to enjoy your matchless smile!

Dental Filling Options

May 10th, 2023

You’ve made an appointment at our New York, NY office to treat your cavity, the decayed area has been removed, and the site has been cleaned and prepared for a filling. Now it’s decision time. What kind of filling should you choose? Well, that depends. There are durability, aesthetic, and price considerations involved in any of your choices, so let’s look at some options before you decide.

Gold

This is a classic choice for a reason. Gold is very durable and can last longer than fillings made from other materials. Because they are crafted from precious metal, gold fillings are more expensive than other alternatives. They are also most often indirect fillings—that is, they are not immediately placed in a tooth, but are formed based on a mold of your tooth taken on your first visit and set in position on a second visit. A gold filling is also noticeable, which can be a matter of concern or a style statement!

Metal Amalgam

An amalgam is a mixture, and an amalgam filling is usually composed of several metallic elements, including silver, tin, copper, and mercury. This filling is also very durable and is one of the most cost-effective choices. Its silver color does not blend into the tooth, so visibility is a factor. Amalgam fillings are considered a safe option, but, if you wonder about potential metal allergies or the amount and kind of mercury involved, we will be happy to discuss your concerns. One possible drawback to amalgam fillings is that sometimes more tooth structure needs to be removed to accommodate them, so this is also a subject we can discuss.

Composite Resins

These fillings are often selected because they are both durable and almost invisible when the color is matched to your tooth. Made of acrylic resin and powdered glass, a composite filling is what is called a “direct filling”—one that can be completed and bonded to the tooth in one visit. These are often more expensive than amalgam fillings, but might be preferable for cosmetic reasons, especially when a front tooth is involved. They also need less tooth structure removed to accommodate them and can be better bonded to small excavations than some other options. They can be prone to staining over time.

Ceramic

Ceramic fillings have the virtue of being virtually undetectable. They can be color-matched to your teeth for a seamless look, and are more stain-resistant than composite fillings. They are also a more expensive option, and, like gold fillings, can involve a two-phase process with a filling molded to fit the excavation site placed in your tooth on a second visit.

Dr. David Shipper and Dr. Howard Vogel and our team are happy to discuss all of your options before it is time to treat your cavity, since there are a number of factors which might impact your decision. A molar will require a more durable filling than a front tooth, while being less visible when you smile or speak. Insurance plans might pay for only a portion of a filling’s cost if it is more expensive than an amalgam, or will pay for a composite filling only if it is in a visible location. We can help you decide which filling best fits all your needs, providing you with the healthy and beautiful smile you deserve!

Are My Child’s Baby Teeth on Schedule?

May 10th, 2023

Your darling three-month old is crying and fussy—can she be teething already? Or, your happy baby boy has just celebrated his first birthday—with only one tooth in that beautiful, gummy smile. Is this normal? Probably! While baby teeth do typically erupt (come in) in the same order for all babies, and around the same time, there is still a lot of flexibility in the time it takes for a full, healthy smile to develop.

Baby teeth actually form before your baby is born, and those 20 teeth are there under the gums waiting to come out and shine. And even though there are no firm and fast dates for each of these primary teeth to erupt, it’s helpful to have a general overview of typical teething patterns so you know what to look forward to.

Incisors

These little teeth create a charming baby smile, and, if your finger has been in the wrong place at the wrong time, a very sharp one as well! That is because these tiny incisors are made to bite into foods. You might notice this when you introduce solid foods, even if the majority of your child’s “chewing” is done with her back gums. These teeth are the earliest to arrive.

  • Six to ten months old: The lower central incisors (bottom front teeth) are often the first to come in.
  • Eight to 12 months old: The upper incisors (8-12 months) are the next to show.
  • Nine to 13 months old: The upper lateral incisors on each side of the front teeth arrive.
  • Ten to 16 months old: The lower lateral incisors appear.

First Molars

Because these are larger teeth, babies often experience another bout of teething pain at this time. The large flat surface of each molar helps your child to chew and grind food, so he can handle a wider variety of foods and develop his chewing skills.

  • 13 to 19 months old: You can generally expect to see the upper first molars arrive.
  • 14 to 18 months old: The lower first molars appear.

Canines (Cuspids)

Fitting between the first molars and the incisors, the strong, pointed shape of the canine teeth allows your child to grip food and break it apart more easily.

  • 16 to 22 months old: The upper two canines make their way into the space between the incisors and the first molars.
  • 17 to 23 months old: The two lower canines appear.

Second Molars

By the age of three, most children have a full set of baby teeth.

  • 23 to 31 months old: The second pair of bottom molars start erupting—you are in the home stretch!
  • 25 to 33 months old: The upper second molars come in—completing that beautiful set of 20 teeth!

Baby teeth are extremely important, as Dr. David Shipper and Dr. Howard Vogel will tell you when you visit our New York, NY office. They help your child eat and chew, develop face and jaw muscles, assist proper speech formation, and provide space for the adult teeth to come in properly. Now that your child’s smile is complete, keep providing him with the same care and attention you have been giving those little teeth since the arrival of the very first incisor.

It seems that so much of new parenthood is scheduling—when to feed her, when to put her to bed, how many hours between naps. But we soon find out that every baby is not on the same schedule, and the same is true for the arrival of their teeth. We should see your baby when that first tooth comes in, or by his or her first birthday. And if you ever have concerns at any time about your child’s teething schedule or teething delays, always feel free to give us a call.

What Are Dental Sealants?

May 3rd, 2023

You’re constantly playing defense. Your child spends two minutes in the morning and two minutes at night carefully brushing and flossing with a fluoride toothpaste. You make sure sugary and acidic foods are not a major part of your diets. Your child visits our New York, NY office for regular exams and cleanings. Really, how can a cavity get past all that?

But even with the best defensive practices, you don’t have a level playing field—literally. The tops of our molars and premolars don’t have the smooth, easy-to-clean surfaces that our other teeth have. If you look at the chewing surfaces, you will notice deep grooves which toothbrush bristles have a much harder time reaching.  

Plaque and food particles can become trapped in these grooves (known as pits and fissures), providing perfect conditions for a cavity to develop. That is why cavities are so common in newly erupted molars. Dental sealants protect these teeth from cavities by providing a barrier which smooths out the surface of the tooth and prevents food and bacteria from reaching the molar’s crevices.

Most sealants are invisible plastic resin coatings which we apply in our New York, NY office. Usually the procedure is so quick and easy that no dental anesthetic is required. Each tooth will be examined first. If we find any signs of early decay, we will gently treat that area before beginning.

When the tooth is ready, it will be cleaned and dried. An etching solution will be brushed on to the dry surface to roughen the area a bit so that the sealant will hold to the tooth more effectively. A thin coat of the sealant is then painted on and hardened under a curing light. And that’s it!

Once teeth are sealed, they should be cleaned and flossed just as carefully as before. Regular exams and cleanings are still very important, and we can monitor the condition of the sealant and the sealed teeth. Properly applied, sealants can last from three to five years, or even longer.

Who should consider sealants? Sealants are typically recommended when the permanent molars first erupt. Children’s enamel takes a while to become its strongest, and so these just-erupted teeth are more at risk for cavities. Sometimes Dr. David Shipper and Dr. Howard Vogel will recommend sealants for primary (baby) teeth if needed. But even adults can benefit—talk to us if you are interested and we will let you know if sealants might be right for you.

Sealants are a simple, safe, and minimally invasive way to prevent cavities. Studies of sealed molars and premolars show a dramatic reduction in cavities compared to untreated teeth. Sealants are one of the most effective ways to defend your teeth or your children’s teeth from tooth decay. And as we’ve all heard—defense wins championships!

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