My Blog

Posts for: March, 2019

By Paul David Epstein, D.M.D. & Associates, P.C.
March 29, 2019
Category: Dental Procedures
AdvancesinPorcelainVeneersImproveBothStrengthandAppearance

One of the best restorative options for slightly deformed, misaligned or stained teeth is a porcelain veneer. Composed of thin, laminated layers of dental material, the veneer is bonded to the outside of the tooth to transform both its shape and color to blend with other natural teeth.

Veneers are more than a technical process — they’re works of art produced by skilled artisans known as dental lab technicians. They use their skills to shape veneers into forms so life-like they can’t be distinguished from other teeth.

How technicians produce veneers depends on the material used. The mainstay for many years was feldspathic porcelain, a powdered material mixed with water to form a paste, which technicians use to build up layers on top of each other. After curing or “firing” in an oven, the finished veneer can mimic both the color variations and translucency of natural teeth.

Although still in use today, feldspathic porcelain does have limitations. It has a tendency to shrink during firing, and because it’s built up in layers it’s not as strong and shatter-resistant as a single composed piece. To address these weaknesses, a different type of veneer material reinforced with leucite came into use in the 1990s. Adding this mineral to the ceramic base, the core of the veneer could be formed into one piece by pressing the heated material into a mold. But while increasing its strength, early leucite veneers were thicker than traditional porcelain and only worked where extra space allowed for them.

This has led to the newest and most advanced form that uses a stronger type of glass ceramic called lithium disilicate. These easily fabricated veneers can be pressed down to a thickness of three tenths of a millimeter, much thinner than leucite veneers with twice the strength.  And like leucite, lithium disilicate can be milled to increase the accuracy of the fit. It’s also possible to add a layer of feldspathic porcelain to enhance their appearance.

The science — and artistry — of porcelain veneers has come a long way over the last three decades. With more durable, pliable materials, you can have veneers that with proper care could continue to provide you an attractive smile for decades to come.

If you would like more information on dental veneers, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Veneers.”


By Paul David Epstein, D.M.D. & Associates, P.C.
March 19, 2019
Category: Oral Health
LifeIsSometimesaGrindforBrookeShields

Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.

In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.

Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.

What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.

Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.

A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”


By Paul David Epstein, D.M.D. & Associates, P.C.
March 09, 2019
Category: Dental Procedures
Tags: teeth whitening  
4ReasonsyoumaywantYourDentisttoWhitenYourTeeth

With the advent of home whitening kits, you no longer have to go to the dentist to have your teeth whitened. DIY kits are relatively safe and effective, if you follow the directions carefully.

So, you might be thinking: why have a dentist whiten my teeth? Actually, there are good reasons why you might. Here are 4 of them.

We'll make sure your teeth are healthy first. Your teeth may need some attention first, such as treatment for dental disease, before we undertake whitening. We'll also determine why your teeth are stained, which could impact how they're whitened (more about that in a moment).

Our application could take less time and last longer. Bleaching agents in home kits make up less than 10% of volume, much weaker than the applications we use. While it often takes several applications at home to achieve the desired brightness, you may only need one or two sessions with us. Our stronger solution may also extend the “fade time” — when the whitening begins to diminish — than what you may encounter with home whitening.

We can be more precise achieving the right shade. There are different shades of teeth whiteness — what looks good for someone else might not look good for you. We have the training and expertise to achieve a color that's right for you. What's more, we also have techniques and equipment like UV lighting that enables us to color match more precisely than you can with a home kit.

Your DIY kit can't alter some forms of staining. Home kits bleach only the outermost layers of tooth enamel. That won't help, though, if your discoloration originates inside the tooth. This intrinsic staining requires procedures only a dentist can perform to bleach the tooth from the inside out.

Even if you'd still like to use a home kit we'll be happy to advise you on purchasing and application. It's also a good idea to have us check the staining first to see if a home kit will work at all. In the end, we share the same desire as you do: that your teeth are as healthy as they can be and bright as you want them to be.

If you would like more information on tooth whitening options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Whitening Safety Tips.”