Pregnancy Related Dental Problems
G U A R A N T E E D S M I L E
Gingivitis and Periodontal Disease
Gingivitis, also generally called gum disease or periodontal disease, describes the events that begin with bacterial growth in your mouth and may end – if not properly treated – with tooth loss due to destruction of the tissue that surrounds your teeth.
What’s the Difference Between Gingivitis and Periodontics?
Gingivitis usually precedes periodontics. However, it is important to know that not all gingivitis progresses to periodontics.
In the early stage of gingivitis, bacteria in plaque build up, causing the gum’s to become inflamed (red and swollen) and often easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.
When gingivitis is left untreated, it can advance to periodontists. In a person with periodontists, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gum’s collect debris and can become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line.
Toxins or poisons – produced by the bacteria in plaque as well as the body’s “good” enzymes involved in fighting infections – start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become looser, and tooth loss occurs. Gum disease, in fact, is the leading cause of tooth loss in adults.
What Causes Periodontal Disease?
Plaque is the primary cause of periodontal disease. However, other factors can contribute to gum disease. These include:
Hormonal changes such as those occurring during pregnancy, puberty, menopause, and monthly menstruation-make gums more sensitive, which makes it easier for gingivitis to develop.
Illnesses may affect the condition of your gum’s. This includes diseases such as cancer or HIV that interfere with the immune system. Because diabetes affects the body’s ability to use blood sugar, patients with this disease are at higher risk of developing infections, including periodontal disease.
Medications can affect oral health because some lessen the flow of saliva, which has a protective effect on teeth and gums. Some drugs, such as the anticoagulant medication Dilantin and the anti-angina drug Procardia and Adalat, can cause abnormal growth of gum tissue.
Bad habits such as smoking make it harder for gum tissue to repair itself.
Poor oral hygiene habits such as not brushing and flossing on a daily basis, make it easier for gingivitis to develop.
Family history of dental disease can be a contributing factor for the development of gingivitis.
What Are the Symptoms of Periodontal Disease?
Periodontal disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. They include:
Gum’s that bleed during and after tooth brushing
Red, swollen, or tender gum’s
Persistent bad breath or bad taste in the mouth
Formation of deep pockets between teeth and gum’s
Loose or shifting teeth
Changes in the way teeth fit together upon biting down, or in the fit of partial dentures.
Even if you don’t notice any symptoms, you may still have some degree of gum disease. In some people, gum disease may affect only certain teeth, such as the molars. Only a dentist or a periodontist can recognize and determine the progression of gum disease
How Does My Dentist Diagnose Periodontal Disease?
During a periodontal exam, your dentist or periodontist typically checks for these things:
Gum bleeding, swelling, firmness, and pockets (the space between the gum and tooth; the larger and deeper the pocket, the more severe the disease)
Teeth movement and sensitivity and proper teeth alignment
Your jawbone to help detect the breakdown of bone surrounding your teeth
How Is Periodontal Disease Treated?
The goals of periodontal treatment are to promote reattachment of healthy gums to teeth; reduce swelling, the depth of pockets, and the risk of infection; and to stop disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues. A full description of the various treatment options is provided in Gum Disease Treatments.
How Can Gingivitis Be Prevented?
Gingivitis can be reversed in nearly all cases when proper plaque control is practiced. Proper plaque control consists of professional cleanings at least twice a year and daily brushing and flossing. Brushing eliminates plaque from the surfaces of the teeth that can be reached; flossing removes food particles and plaque from in between the teeth and under the gum line.
Other health and lifestyle changes that will decrease the risk, severity, and speed of gum disease development include:
Stop smoking. Tobacco use is a significant risk factor for development of periodontitis. Smokers are seven times more likely to get periodontitis than nonsmokers, and smoking can lower the chances of success of some treatments.
Reduce stress. Stress may make it difficult for your body’s immune system to fight off infection.
Maintain a well-balanced diet. Proper nutrition helps your immune system fight infection. Eating foods with antioxidant properties, for example, those containing vitamin E or vitamin C (vitamin E-containing foods include vegetable oils, nuts, green leafy vegetables; vitamin C-containing foods include citrus fruits, broccoli, potatoes) can help your body repair damaged tissue.
Avoid clenching and grinding your teeth. These actions may put excess force on the supporting tissues of the teeth and could increase the rate at which these tissues are destroyed.
Despite following good oral hygiene practices and making other healthy lifestyle choices, the American Academy of Periodontology says that up to 30% of the Americans may be genetically susceptible to gum disease. And those who are genetically predisposed may be up to six times more likely to develop some form of gum disease. If anyone in your family has gum disease, it may mean that you are at greater risk as well. If you are more susceptible to gum disease, your dentist or periodontist may recommend more frequent check-ups, cleanings, and treatments to better manage the condition.
Is Periodontal Disease Linked to Other Health Problems?
According to the CDC, researchers have uncovered potential links between periodontal disease and other serious health conditions. In people with healthy immune systems, the bacteria in the mouth that makes its way into the bloodstream is usually harmless. But under certain circumstances, the CDC says these microorganisms are associated with health problems such as stroke and heart disease. Diabetes is not only a risk factor for periodontal disease, but periodontal disease may make diabetes worse.
What Causes Tooth Sensitivity?
Tooth sensitivity occurs when the underlying layer of your teeth – the dentin – becomes exposed as a result of receding gum tissue (the protective blanket that covers the tooth roots). The roots, which are not covered by hard enamel, contain thousands of tiny tubules leading to the tooth’s never center (the pulp). These dentinal tubules (or channels) allow the stimuli – for example, the hot, cold, or sweet food – to reach the nerve in your tooth, which results in the pain you feel.
There are many factors that may lead to the development of tooth sensitivity, including.
Brushing too hard. Over time, brushing too hard or using a hard-bristled toothbrush can wear down enamel and cause the dentin to be exposed. It can also cause recession of the gums (the gum tissue pulls away from the teeth)
Recession of the gums. As gums move away from a tooth due to conditions such as periodontal disease, the root surface becomes exposed.
Gum disease (gingivitis). Inflamed and sore gum tissue may cause sensitivity due to the loss of supporting ligaments, which exposes the root surface that leads directly to the nerve of the tooth.
Cracked teeth. Chipped or broken teeth may fill with bacteria from plaque and enter the pulp causing Inflammation.
Teeth grinding. grinding or clenching your teeth may wear down the enamel and expose underlying dentin.
Tooth whitening products or toothpaste with baking soda and peroxide. These products are major contributors to teeth sensitivity.
Your age. Tooth sensitivity is highest between the ages of 25 and 30.
Plaque build-up. The presence of plaque on the root surfaces can cause sensitivity.
Mouthwash use. Long-term use of some mouthwashes. Some over-the-counter mouthwashes contain acids that can worsen tooth sensitivity if you have exposed dentin (the middle layer of the tooth). The acids further damage the dentin layer of the tooth. If you have dentin sensitivity, ask your dentist about the use of a neutral fluoride solution.
Acidic foods. Regular consumption of foods with a high acid content, such as citrus fruits, tomatoes, pickles and tea, can cause enamel erosion.
Recent routine dental procedures. Sensitivity can occur following teeth cleaning, root planing, crown placement, and tooth restoration. Sensitivity caused by dental procedures is temporary, usually disappearing in 4 to 6 weeks.
What Can I Do to Reduce Tooth Sensitivity?
Maintain good oral hygiene. Continue to follow proper brushing and flossing techniques to thoroughly clean all parts of your teeth and mouth.
Use a soft bristled toothbrush. This will result in less toothbrush abrasion to the tooth surface and less irritation to your gums. Brush gently and carefully around the gum line so you do not remove more gum tissue.
Use desensitizing toothpaste. There are several brands of toothpaste available for sensitive teeth. With regular use you should notice a decrease in sensitivity. You may need to try several different brands to find the product that works best for you. Another tip. spread a thin layer of the toothpaste on the exposed tooth roots with your finger or a Q-tip before you go to bed. Do not use a tartar control toothpaste; rather, use a fluoridated toothpaste.
Watch what you eat. Frequent consumption of highly acid foods can gradually dissolve tooth enamel and lead to dentin exposure. They may also aggravate the sensitivity and start the pain reaction.
Use fluoridated dental products. Daily use of a fluoridated mouth rinse can decrease sensitivity. Ask your dentist about available products for home use.
Avoid teeth grinding. If you grind or clench your teeth, use a mouth guard at night.
See your dentist at regular intervals. Get professional tooth cleaning, oral hygiene instructions, and fluoride treatments every 6 months.
If you still have discomfort, talk to your dentist. There may be some dental procedures that may help reduce sensitivity, including the use of:
White fillings (bonding) to cover exposed root surfaces
Fluoride varnishes applied to the exposed root surface
Dentin sealers applied to the exposed root surface
Cavities occur as a result of tooth decay. Tooth decay is the destruction of tooth structure. Tooth decay can affect both the enamel (the outer coating of the tooth) and the dentin layer of the tooth.
Tooth decay occurs when foods containing carbohydrates (sugars and starches) such as breads, cereals, milk, soda, fruits, cakes, or candy are left on the teeth. Bacteria that live in the mouth digest these foods, turning them into acids. The bacteria, acid, food debris, and saliva combine to form plaque, which clings to the teeth. The acids in plaque dissolve the enamel surface of the teeth, creating holes in the teeth called cavities, or caries.
Who Gets Cavities?
Many people think cavities only affect children, but changes that occur with aging make cavities an adult problem too. Recession of the gums (a pulling away of gum tissue from the teeth), often associated with an increased incidence of gingivitis (gum disease), can expose tooth roots to plaque. Also, sugary food cravings in pregnant women can make them more vulnerable to developing cavities.
Decay around the edges of fillings is also common in older adults. Because many older adults lacked the benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and can fracture, allowing bacteria to accumulate in the tiny crevices causing tooth decay.
How Do I Know if I Have a Cavity?
Your dentist can discover cavities during your regular dental check-up. The tooth surface feels soft when probed by your dentist with a dental instrument. X-rays can also show cavities before they become visible to the eye.
In advanced stages of tooth decay, you might experience a toothache, especially after consuming sweet, hot, or cold foods or drinks. Other signs of tooth decay are visible pits or holes in the teeth.
How Are Cavities Treated?
Cavities are treated in a number of different ways depending on the extent of tooth decay. If decay is not extensive, the decayed portion of the tooth is removed by drilling and replaced with a filling made of silver alloy, gold, porcelain, or a composite resin. Restorative materials used in fillings are considered safe. Concerns have been raised over the safety of mercury-based, silver amalgams in particular, but the ADA, FDA, and other public health agencies continue to support the safety of this restorative material. Allergies to silver amalgam are rare as are allergies to other restorative materials.
If the decay is extensive and there is limited tooth structure remaining, crowns will be used. If a crown is needed, the decayed or weakened area of the tooth is removed and repaired and a crown is fitted over the remainder of the tooth. Crowns are made from gold, porcelain, or porcelain fused to metal.
If the decay causes the nerve or pulp of the tooth to die, a root canal will be performed. During the procedure, the center of the tooth (including the nerve, blood vessel, and tissue) is removed along with the decayed portions of the tooth. The roots are then filled with a sealing material. If necessary, a crown can be placed over the filled tooth.
Several new treatments are under development. One experimental technique uses fluorescent light to detect the development of cavities long before they can be detected by traditional means, such as x-rays or dental examination. In many cases, if cavities can be detected early, the decay process can be stopped or reversed.
A dental sealant is an acrylic-like material that helps shield out decay-causing bacteria from the chewing surfaces of back teeth. We base our diagnosis and recommendation for dental sealants on the patient’s susceptibility to tooth decay and how the teeth were shaped when they originally formed below the gum. Though there is no specific age at which sealants are indicated, often we will recommend that the best time to apply them is when the six-year molars (the first permanent back teeth) appear.
|Even a single toothbrush bristle cannot reach all the way into the depressions and grooves to extract food particles, bacteria and plaque.||The sealant material flows to the depth of the groove, sealing out decay-causing bacteria.|
How Do Sealants Help Prevent Decay?
Sealant material forms a protective barrier by bonding to tooth surfaces and covering natural depressions and grooves (called pits and fissures) in the teeth. More than 75 percent of dental decay begins in the pit and fissure areas of the back teeth. Combined with proper home care and regular dental visits, sealants are extremely effective in preventing tooth decay.
Are Sealants Suitable For All Teeth?
Sealants are applied only to pit and fissure areas of specific teeth. Unfortunately they cannot be applied to the surfaces in between teeth, where daily flossing is recommended to prevent decay. Though sealants are most often applied to children’s teeth, many adults are now seeking the preventive benefits of pit and fissure sealants as well.
How Are Sealants Applied?
In this painless procedure, a solution is applied to the chewing surface of the tooth to condition the enamel and help it bond more effectively to the sealant material. The tooth is thoroughly washed and dried. Then the sealant material is applied and allowed to harden, sometimes using ultraviolet light. The procedure takes only a few minutes.
How Long Do Sealants Last?
Depending on your chewing pattern, the sealant effect can last many years. Even though sealant material is durable, at subsequent dental appointments we make sure the sealant material is intact. Occasionally, we might need to replace or add a new layer of sealant material to keep the protective barrier strong and effective.
Now That Your Teeth Have Been Sealed.
Chewing on ice cubes, hard candy or very sticky foods should be avoided as much as possible. Here are some tasty, healthful snack alternatives that combined with sealants, fluoride and good home care, can help to reduce your susceptibility to tooth decay:
reduced fat peanut butter
sugar-free, non-fat fruit yogurt
dry, unsweetened cereal
Sealants Versus Fluoride.
Sealants and fluoride are materials designed to preserve and prolong the life of your teeth by preventing dental decay. Sealants are applied topically to certain areas of individual teeth and are a visible sign that the tooth is being protected. Fluoride, on the other hand, may be used effectively from the pre-natal stages through the adolescent period, when children are most prone to cavities. Once absorbed and retained in tooth enamel, fluoride stays on the teeth permanently, though invisibly. Unlike sealants, fluoride is supplied in a variety of forms, including commercially prepared mouth rinses, foams, gels, drinking water and many toothpastes.
Applying sealants and fluoride can be important steps in preventing tooth decay. Here are some other steps you should take to protect your teeth:
Brush and floss regularly.
Follow a balanced diet.
Visit us at least twice a year for routine checkups.
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Many teeth whitening systems are available, including whitening toothpastes, over-the counter gels, strips and trays, and whitening agents obtained from a dentist.
Teeth whitening is ideal for people who have healthy, unrestored teeth (no fillings) and gums. Individuals with yellow tones to their teeth respond best. But this cosmetic procedure is not recommended for everyone.
Find out if teeth whitening is right for you.
All toothpastes help remove surface stains because they have mild abrasives. Some whitening toothpastes contain gentle polishing or chemical agents that provide additional stain removal effectiveness. Whitening toothpastes can help remove surface stains only and do not contain bleach; over-the-counter and professional whitening products contain hydrogen peroxide (a bleaching substance) that helps remove stains on the tooth surface as well as stains deep in the tooth.
Whitening toothpastes can lighten your tooth’s color by about one shade. In contrast, light-activated whitening conducted in your dentist’s office (see below) can make your teeth three to eight shades lighter.
Over-the-Counter Whitening Strips and Gels
Whitening gels are clear, peroxide-based gels applied with a small brush directly to the surface of your teeth. Instructions generally call for twice a day application for 14 days. Initial results are seen in a few days and final results are sustained for about 4 months. The retail cost for this product is about $15 for a 14-day treatment.
Whitening strips are very thin, virtually invisible strips that are coated with a peroxide-based whitening gel. The strips are applied twice daily for 30 minutes for 14 days. Initial results are seen in a few days and final results are sustained for about 4 months. The retail cost for this product ranges from $10 to $55 for a 14-day treatment.
Tray-Based Tooth Whitening Products
Tray based tooth whitening systems, purchased either over-the-counter or from your dentist, involve filling a mouth guard-like tray with a gel whitening solution – which contains a peroxide-bleaching agent – and wearing the tray for a period of time, generally from a couple hours a day to every day during the night for up to 4 weeks and even longer (depending on the degree of staining and desired level of whitening).
Learn more about the differences between over-the-counter tray-based whitening systems and one obtained from the dentist.
In-office bleaching provides the quickest and most effective way to whiten teeth. With in-office bleaching, the whitening product is applied directly to the teeth. These products can be used in combination with heat, a special light, and/or a laser. The light and/or heat accelerate the whitening process. Results are seen in only 1, 30- to 60-minute treatment. But, to achieve dramatic results, several appointments are usually needed. However, with laser-enhanced bleaching, dramatic results can be seen after the first treatment.
In-office bleaching procedures range in cost from $200 to $500 per arch, or $500 to $1,000 for the whole mouth.
How Long Do the Whitening Effects Last?
Whitening is not permanent. People who expose their teeth to foods and beverages that cause staining may see the whiteness start to fade in as little as 1 month. Those who avoid foods and beverages that stain may be able to wait one year or longer before another whitening treatment or touch-up is needed.
The degree of whiteness will vary from individual to individual depending on the condition of the teeth, nature of the stain, the type of bleaching system used and for how long.
Over-the-Counter At-Home Teeth Whitening Vs. Dentist-Supervised Teeth Whitening Products
There are differences between the two, including:
Strength of bleaching agent. Over-the-counter home use products and dentist-supervised at-home products usually contain a lower strength-bleaching agent from 10% carbamide peroxide, which is equivalent to about 3% hydrogen peroxide, up to 22% carbamide peroxide. In-office, professionally applied tooth whitening products contain hydrogen peroxide in concentrations ranging from 15% to 43%.
Mouthpiece trays. With dentist-supervised at-home bleaching products, your dentist will take an impression of your teeth and make a mouthpiece tray that is customized to exactly fit your teeth. This customization allows for maximum contact between the whitening gel, which is applied to the mouthpiece tray, and the teeth. A custom-made tray also minimizing the gel’s contact with gum tissue. Over-the-counter whitening products also contain a mouthpiece tray, but the “one-size-fits-all” approach means that the fit will not be exact. Ill-fitting trays can irritate the gum and soft tissue by allowing more bleaching gel to seep onto these tissues. With in-office procedures, the bleaching agent is applied directly to the teeth.
Additional protective measures. In the office setting, your dentist will apply either a gel to the gum tissue or use a rubber shield (which slides over the teeth) prior to treatment to protect your gums and oral cavity from the effects of the bleaching. Over-the-counter products don’t provide these extra protective measures.
Costs. Over-the-counter bleaching systems are the least expensive option, with costs ranging from $20 to about $150. Depending on where you live and the extent of the procedure, dentist-supervised home bleaching systems range in cost from approximately $150 to $300 per upper or lower set of teeth, or $300 to $600 for the whole mouth
Supervised vs. unsupervised process. Dentist-supervised at-home bleaching and in-office treatments offer additional benefits compared with over-the-counter procedures. First, your dentist can perform an oral examination and consider your complete medical history, which can be helpful in determining how your teeth became discolored and if bleaching is an appropriate course of treatment based on your type and extent of stains and type, number and location of restorations. Your dentist can then better match the type of stain with the best treatment, if appropriate, to lighten those stains. With dentist-supervised bleaching procedures, your dentist will likely want to see you a couple of times to ensure you are following directions, to make sure the customized tray is fitting properly, to inspect your gums for signs of irritation, and to generally check on how the teeth whitening process is proceeding. With over-the-counter bleaching products, you are on your own.
Who Should Not Undergo Teeth Whitening?
Whitening is not recommended or will be less successful in the following circumstances:
Age and pregnancy issues. Bleaching is not recommended in children under the age of 16. This is because the pulp chamber, or nerve of the tooth, is enlarged until this age. Teeth whitening under this condition could irritate the pulp or cause it to become sensitive. Teeth whitening is also not recommended in pregnant or lactating women.
Sensitive teeth and allergies. Individuals with sensitive teeth and gums, receding gums and/or defective restorations should consult with their dentist prior to using a tooth whitening system. Anyone allergic to peroxide (the whitening agent) should not use a bleaching product.
Gum disease, worn enamel, cavities, and exposed roots. Individuals with gum disease or teeth with worn enamel are generally discouraged from undergoing a tooth whitening procedure. Cavities need to be treated before undergoing any whitening procedure. This is because the whitening solutions penetrate into any existing decay and the inner areas of the tooth, which can cause sensitivity. Also, whitening procedures will not work on exposed tooth roots because roots do not have an enamel layer.
Fillings, crowns and other restorations. Tooth-colored fillings and resin composite materials used in dental restorations (crowns, veneers, bonding, bridges) do not whiten. Therefore, using a whitening agent on teeth that contain restorations will results in uneven whitening-in this case, making the teeth without restorations appear lighter than those with restorations. Any whitening procedure should be done prior to the placement of restorations. Individuals with numerous restorations that would result in uneven whitening may be better off considering bonding, veneers or crowns rather than a tooth whitening system. Ask your dentist what strategy is best for you.
Unrealistic expectations. Individuals who expect their teeth to be a new “blinding white” may be disappointed with their results. Smokers need to be aware that their results will be limited unless they refrain from continued smoking, particularly during the bleaching process. A healthy guide as to a reasonable degree of whiteness to achieve with a whitening process that would give a natural appearance to a person’s teeth is a slightly whiter color than the whites of your eyes.
Darkly stained teeth. Yellowish teeth respond well to bleaching, brownish-colored teeth respond less well and grayish-hue or purple-stained teeth may not respond to bleaching at all. Blue-gray staining caused by tetracycline is more difficult to lighten and may require up to 6 months of home treatments or several in-office appointments to successfully lighten. Teeth that have dark stains may be better candidates for another lightening option, such as veneers, bonding, or crowns. Your dentist can discuss the options best suited for you.
Risks Associated With Teeth Whitening
The two side effects that occur most often are a temporary increase in tooth sensitivity and mild irritation of the soft tissues of the mouth, particularly the gums. Tooth sensitivity often occurs during early stages of the bleaching treatment. Tissue irritation most commonly results from an ill-fitting mouthpiece tray rather than the tooth-bleaching agent. Both of these conditions usually are temporary and disappear within 1 to 3 days of stopping or completing treatment.
If you do experience sensitivity, you can reduce or eliminate it by:
Wearing the tray for a shorter period of time (for example, two 30-minute sessions vs. two 60-minute sessions)
Stop whitening your teeth for two to three days to allow your teeth to adjust to the whitening process
Ask your dentist or pharmacist for a high fluoride-containing product, which can help remineralize your teeth. Apply the fluoride product to the tray and wear for 4 minutes prior to and following the whitening agent.
Brush your teeth with a toothpaste made for sensitive teeth. These toothpastes contain potassium nitrate, which helps soothe your teeth’s nerve endings.
Some bleaching products dispensed through dentists’ offices as well as professionally applied (in-office) bleaching products have received the ADA Seal of Acceptance, which indicates that the product has met ADA guidelines for safety and effectiveness. Currently, only dentist-dispensed home-use products containing 10% carbamide peroxide and office-applied products containing 35% hydrogen peroxide have received the ADA Seal of Acceptance. No over-the-counter products have received the Seal of Acceptance. Over-the-counter bleaching products are not endorsed by the ADA because the organization believes that professional consultation is important to ensuring safe and effective use. No whitening products using lasers currently are on the ADA’s list of accepted products. Several whitening toothpastes that are available over-the-counter have received the ADA Seal of Acceptance. For a list of specific toothpastes that have gained the ADA’s Seal of Acceptance, visit: www.ada.org
It should be noted that not all manufacturers seek the ADA’s Seal of Acceptance. This is a voluntary program that requires considerable expense and time on the part of a manufacturer. Just because a product does not have the ADA Seal of Acceptance does not necessarily mean that the product is not safe and effective. You can be assured, however, that products that do carry the seal have meet the ADA’s standards for safety and effectiveness when used as directed.
Teeth whiteners are not drugs and therefore are not regulated by the FDA.
Tips to Consider When Choosing an Over-the-Counter Whitening Kit
Try to select a kit that allows some customization of the mouthpiece. Some kits come with a mouthpiece that can be molded to some degree. These are better than others that come with a standard mouthpiece.
Try to gain the opinion of others who may have already tried the kit you are considering.
If at any time you experience a prolonged change in the color of your gums or an increased tooth sensitivity to hot or cold foods and beverages, stop wearing the mouthpiece and see your dentist immediately.
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Early treatment will restore normal function of your teeth and your sweet smile too. Delay in treatment might result in permanent loss of teeth, infections, under-nutrition, etc.
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