Q: What's the best way to whiten teeth?

A: There are many options available to consumers when it comes to whitening products.  Some must be administered by a licensed dentist, while others can be obtained over-the-counter.  Regardless of the method chosen for teeth whitening, it is essential that you consult with your dentist to determine if whitening is right for you.  In-office procedures such as Zoom® whitening can make teeth noticeably whiter after a single one-hour appointment with your dentist, however this can be very expensive and may require further treatments to achieve the desired results.  Another option your dentist may offer is to use custom-fit take-home whitening trays.  These trays are loaded with special whitening gel and used at home for 1-2 hours each day for 2-4 weeks.  This is the most common and, some feel, the most effective way to whiten teeth.  Some over-the-counter products use "boil and bite" trays in the same manner, but the whitening gels available in stores can be less effective and the ill-fitting trays may cause gum irritation.  One simple and cost-effective over-the-counter whitening product is Crest's White Strips®.  These self-adhesive strips are impregnated with whitening gel and applied to the teeth to achieve the desired effect but may not fit extremely large, small, or crooked teeth.  Remember, there are many options when it comes to teeth whitening.  Ask your dentist which one is right for you.

Q: How do I know if I have gum disease?

A: Gum disease, or periodontal disease, is an infection of the tissues surrounding and supporting the teeth. You may be surprised to know that most people have experienced some form of gum disease during their lives, but many are never aware that the problem exists.  Sometimes there are no outward signs or symptoms.

It is possible to have periodontal disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed. Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or recurring.

Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis.

Some factors increase the risk of developing periodontal disease:

• Tobacco smoking or chewing
• Systemic diseases such as diabetes
• Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
• Bridges that no longer fit properly
• Crooked teeth
• Fillings that have become defective
• Pregnancy or use of oral contraceptives

Several warning signs that can signal a problem:

• Gums that bleed easily
• Red, swollen, tender gums
• Gums that have pulled away from the teeth
• Persistent bad breath or bad taste
• Permanent teeth that are loose or separating
• Any change in the way your teeth fit together when you bite
• Any change in the fit of partial dentures

What Is periodontal (gum) disease?

• Periodontal (gum) disease is an infection of the tissues surrounding and supporting the teeth. It is a major cause of tooth loss in adults. Because periodontal (gum) disease is usually painless, however, you may not know you have it.
• Periodontal (gum) disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.
• In the early stage of periodontal (gum) disease, called gingivitis, the gums can become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.
• In the more advanced stages of periodontal (gum) disease, called periodontitis, the gums and bone that support the teeth can become seriously damaged. The teeth can become loose, fall out or have to be removed by a dentist.

Periodontitis
Unremoved, plaque hardens nto calculus (tartar). As plaque and calculus continue to build up, the gums begin to recede pull away) from the teeth, and pockets form between the teeth and gums

Advanced periodontitis
The gums recede farther, destroying more bone and the periodontal ligament. Teeth -even healthy teeth - may become loose and need to be extracted.