Secret in Hollywood smile.

Have you ever wondered why almost every hunk or babe in the TV series Baywatch had such glistening white teeth? Well, of course no one would have paid too much attention to Pamela Anderson’s teeth, but the worst kept secret in Hollywood is, they all had their teeth bleached. That pearly white, “starry” smile used to be called the Hollywood smile. And it used to cost thousands of US$. Not anymore. The Hollywood smile has descended to the realm of mere mortals. Not only is tooth whitening readily available in dental practices all over the developed world, the cost for the procedure, like the US$, had come tumbling down.

The Bleaching Conspiracy?
The moment tooth whitening became a mass market thing, something unfortunate happened. Marketing efforts by various manufacturers of dentrifices churned out an array of relatively cheap whitening gels, pastes and liquids which gave consistently poor results. One TV ad even said that with their product, nobody would ever need to pay their dentist hundreds of dollars for whiter teeth. Hardly any one of those products is still being sold in Singapore. Why were these products ineffective? Because the strength of peroxide (the active ingredient in bleaching gels) in them is too low. Meanwhile, at the dentist’s office, fanciful “laser whitening” procedures were performed. These procedures seemed to work very well, but within days, the teeth started yellowing again. In the end, they only worked marginally better than the OTC products but cost many times more.
Back in the good old days (20 years ago) dentists were taught that only non-vital, root canal treated teeth could be bleached. In those days, we would open up the pulp chambers of non-vital teeth, place hydrogen peroxide into the chamber and then, heat up the potent solution with a hot instrument. The whitening effect came fast and was very effective. Every science student can tell you that heating up hydrogen peroxide will cause it to decompose into oxygen and water. It’s the heat that speeds up the process and release whitening oxygen into the microscopic pores in the inside of the teeth.
Then, vital bleaching hit the market not long after I first started practising. Suppliers started telling us that even vital teeth which have not been root canal treated can be bleached with peroxide gel applied on the outer, non-porous surface of the tooth. It didn’t sound probable, but the “magic light” suspended our disbelief.
Fanciful light equipment like plasma arc lights, LED lamps, lasers etc burned holes through many a dentist’s pocket. It turned out that many dentists have either forgotten their basic sciences or somehow decided to go along with the suppliers’ marketing strategy. Light does not activate peroxide decomposition. Not plasma arc light and definitely not LED light which is cool. It’s heat that does it, so perhaps laser does work, but we can’t use heat on vital teeth or we’ll kill them. As far as bleaching is concerned, a safe, non-heat-generating light is a useless light.
Not only were some of these equipment bulky and expensive to rent, the hype generated by aggressive marketing tactics resulted in unrealistic expectations on the part of both dentists and their trusting patients who have paid about S$900 to S$1200 for mediocre results.
Tooth whitening with carbamide peroxide has been around for almost as long as I’ve been practising dentistry. However, very few dentists had their bleaching products flying off the shelves. I was curious enough to have tried out a wide range of products, encountered almost every kind of tooth discolouration and after countless complaints and praises, I more or less figured out some of the realities of tooth whitening. It’s not magic. It works for the majority of people but the degree of whitening varies from individual to individual. It doesn’t work for just anybody. Maybe that’s why not every lifeguard you see below is smiling. And the expensive, fanciful equipment are a big rip-off.

Frequently Asked Questions

Q. What is cosmetic dentistry? 

A. Cosmetic dentistry is the art and science of altering a person's existing tooth colour, form or alignment to achieve a condition that best matches an aesthetic norm. 

Q. Is cosmetic dentistry a dental specialty? 

A. No. There is no such dental specialty. Nevertheless, there is plenty of scope for the practice of cosmetic dentistry in the various dental specialties like prosthodontics and periodontology. However, cosmetic dentistry is very much an art. How good a cosmetic dentist one is depends a lot on his eye for aesthetics and his ability to improvise or think out of the box. Many tricks of the trade are not taught in dental school.

Ask about Dental Implant

 

hannah  ask :

There are basically two types of implants. Those that are placed on the jaw bone, but under the gums, and those that fit into the jawbone similar to the root of a natural tooth. Each type offers solid, non–mobile support for replacement teeth which act and feel like natural teeth. Since both types are attached to your jawbone they can provide distinct advantages over traditional methods of replacing missing teeth.

• Implants restore proper chewing function and so you can enjoy foods previously too “Difficult” to eat.
• You feel confident that your replacement teeth won’t move or loosen.
• You regain the closest thing to the look, feel and function of your natural teeth.
• Throw away those sticky adhesives.
• Forget about unsightly partial denture clasps which place damaging pressure on remaining natural teeth.
• Eliminate irritated and painful gums.
• Improve your speech by eliminating or reducing the “Fullness” of full or partial dentures.
• Replace missing teeth with the look and feel of natural teeth without having to “Cut down” healthy teeth.
• Dental implants help stop the progressive bone loss and shrinkage of your jawbone by “Mimicking” the    roots of natural teeth.

• Dental implants are clinically proven with a success rate in excess of 90%.

Admin reply :

 

Dentists must be careful that “commercials” like the one above will set patient expectations very high. When things don’t turn out right, the dentist involved will have a lot of questions to answer.
Implants are indeed the ultimate way to replace missing teeth - provided conditions are favourable. Many patients who wish to have their missing teeth restored with implants are not ideal implant candidates.

If you have any required e-mail to us at  poohfa@hotmail.

The young actress decieded to do treatment @ My clinic.

This young actress chipped her front tooth.  Even though there was no nerve exposure, she decided to do root canal treatment followed by an emax crown.

We explained the options to her. Both bonding and veneers will increase the bulk of the tooth and ma...ke it look even more protruding.

By doing root canal, cutting back the tooth and then rebuilding it, we can effectively reposition the tooth and make it look straight.

 

The right central incisor looks short because it is protruding. it is also chipped at the corner.

 

The lateral incisor was a little instanding. As the patient has budget constraints. We did a little bonding to bring out the lateral incisor. Root canal is done on the protruding incisor.

 

Another view. The left central incisor was also bondedso that all 3 teeth will look harmonised when the protruding tooth is crowned.

 

An emax crown has been fitted. Check the alignment.

 

She'll look even better if the 2 adjacent teeth are laminated with Empress veneers. bonding has its limitations.

 

As the finishing for the emax and bonding can be quite different, the patient is advised to have veneers on her other 2 teeth.

 

Cost of Full Ceramic Crowns.

Everyone who has had an angry member of the family thrown a porcelain plate at him will raise an eyebrow when told that his crown is going to be made with porceelain. In the past, porcelain had to be backed with a metal core if the crown is to last more than a couple of years in function. These crowns were known as porcelain fused to metal (PFM) crowns. While they were strong and lasted for many years, PFM crowns posed aesthetic challenges. This is because metal will impart an ugly greyish colour to porcelain. To mask this greyish colour, an opaque layer must be painted on the metal. This is why many PFM crowns look flat. Light does not penetrate it like it does a natural tooth. A black line also appears at the gum margin after a while as wear and tear sets in.

Of course, there were patients who insisted on having metal-free crowns. Full porcelain jacket crowns (PJC) were done, but these crowns never lasted for than a few years as unreinforced porcelain just isn’t strong enough to withstand chewing forces.

Some years back, a new material called Empress came into the market. Like glass, Empress can be made to mimic the translucency of natural teeth. Like glass which can be made bullet proof, Empress can be made stronger than conventional porcelain. The fracture strength is about 200MPa. In spite of the increased strength, many Empress crowns and bridges fractured within a few years.

About 4 years ago, the same manufacturer that gave us Empress brought in a new, improved material called emax. Just as aesthetic as Empress, emax is even stronger, with a strength of 400MPa. With emax around, there is now no reason to make PJCs or PFMs for front teeth.

 

The patient wants to straighten his lateral incisors

The teeth to be rearranged were trimmed down

Completed emax crowns fitted. Teeth look straighter now.

 

Asian Beauty

Some eye candy to sweeten things up a bit.

My way.

Somebody said that it isn’t fair for me to just reject people suffering from information overload. I’ve got to show people how I handle information overload.  The information overload coming from the mailbox is easy to take care off. There is a nice row of recycling bins lying between Tangs and Lucky Plaza. Sometimes, a look at the envelope can help me decide whether it’s better off in the recycling bin.
As for information overload from the internet, that’s even easier to switch off. I sometimes do a “negative search”. What’s that? When a salesperson comes to me with a new product … let’s call it Bestooth. I’ll listen to what the salesman has to say, then I go online and enter “Bestooth sucks”. I’ll see all the negative reviews. Of course, some of these negative reviews are written by idiots who have axes to grind. But not that many idiots have the time to grind them. What if I miss out on an opportunity to try an excellent product? My experience in dental practice tells me that exisiting materials and instruments are quite adequate for almost all procedures that are performed in any regular dental practice like mine. New is not always good. Just take a look at the new nano composites. Expensive and no big deal at all. Give me good old microhybrid any day.
A few years back, I attended a continuing education course where the speaker compared several brands of of adhesives in the lab. The conclusion, a certain brand (the one his company is selling) came up top in all the tests. But what is the significance? I have used the worst performing adhesive (according to his tests) and it has worked well in most cases. I have used his brand of adhesive (proven to be the best) and a few cases didn’t turn out well. So which is the best one of them all? I have no answer. But that does not mean that I don’t know which ahesive to use. They all work well with the proper technique! The trouble is, when a patient asks me which adhesive is best, he/she may be expecting the answer that will show that I know what I’m doing?
We dentists are all bound by the system. We have no choice but to get involved in continuing education. This puts us at great risk of information overload. The way to prevent this overload is simple. Just switch off. It takes a little practice to know when to sign in for points and then just switch off, but it shouldn’t be too difficult.

The patient who has overdone his/her research and listened to 100 opinions too many should understand that it’s more than sufficient to read up on some basics, enough to choose a good dentist. Once a dentist has been chosen, one should probably stop asking others for their opinions. I get rather cross when someone under another dentist’s care wants me to comment on a colleague’s management of the case halfway through the treatment. Interestingly, some patients get rather cross when they get different treatment plans from different dentists. They expect all dentists to handle a case in exactly the same way. The truth of the matter is, there is no single “best” way to treat a patient. By seeking different opinions, these patients are generating their own information overload. Shop by all means, but if you drop, then it’s your own fault.
Life is short and I think we can all do with a little more sleep.