In his decades long career, pop-music chameleon David Bowie has gone through a dizzying series of transformations. And as he morphed from alien-inspired space oddity to fashion-forward international superstar, his smile benefited from some very dramatic ch-ch-ch-changes. While Bowie hasn't talked much about his dental treatments, a comparison of pictures from the mid 1970s to the mid '90s (not to mention a much-viewed youtube video on the subject) makes it clear: his tooth staining, misalignment and gum recession have been left behind like polyester bellbottoms.

But tooth makeovers aren't just for pop stars! Cosmetic dentistry can benefit anyone who's interested in improving their appearance, at any age. Often, treatment starts with a “smile analysis” — a review of the current aesthetics of your mouth, including the shape, spacing, color and alignment of the teeth, the appearance and general health of the gums, and the way the lips and gums frame the smile.

This analysis can help pinpoint some places where the overall look of your smile may need improvement, and it can also identify some specific treatments to make it better. It's even possible to see a simulation of what you'd look like after the treatments are complete, to help ensure that your goals are realistic and attainable. What are some of the most common cosmetic procedures?

For stained teeth, you can try in-office whitening with concentrated bleaching solutions, or professionally-supervised at-home treatments using plastic trays that are custom-made to fit your teeth. The major difference between the two is the amount of time you need — with in-office treatments, you'll see results right away, while at-home gels may require weeks.

Tooth bonding and restoration with composite resin is a relatively fast and easy way to fix minor to moderate chips, flaws and discoloration. Because the composite material bonds directly to the tooth itself, this method requires only minor tooth preparation, and is often completed in just one office visit.

If your teeth, like Bowie's, need more extensive restoration, dental veneers or crowns may be required. Veneers are super strong, wafer-thin coverings that fit over the front surface of your teeth. Besides giving you that “Hollywood white” smile, they can also lengthen teeth that are too small, correct misalignment and close gaps in your smile. To correct even more extensive problems, crowns (also called caps) can replace the entire visible portion of one or more teeth — or, if teeth are missing, a permanent, long-lasting dental implant can be placed.

Many adults are choosing orthodontics to correct problems of tooth position, alignment or spacing — in fact, some 20% of all orthodontic patients today are grown-ups! It's never too late to start treatment, and with less-noticeable appliances like clear aligners and tooth-colored braces, it's easier than ever to make those ch-ch-ch-changes.

If you would like more information about the options available in cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Orthodontics For The Older Adult” and “Cosmetic Dentistry.”

An icy cold beverage on a hot day or a steaming cup of cocoa on a frigid day are some of the simple pleasures in life. So why do they sometimes seem to turn against you and send sharp, sudden pain shooting through your teeth?

When pain affects your teeth, it's because the nerves within the very center portion, the “pulp,” are reacting to a stimulus such as temperature, pressure changes, or acidic or sugary substances. In healthy teeth, the pulp is protected from stimuli. Above the gum line, a layer of enamel encases and protects the visible portion of tooth (crown). Below, the gums (gingiva) and a thin layer of “cementum” protect the root portion. Neither of these contains nerves. However, directly under the enamel and cementum, surrounding the interior pulp, is the “dentin.” This layer contains nerve fibers that can relay sensations to the nerves in the pulp, which respond as they are designed to — with an unpleasant feeling that tells you something's wrong.

That feeling can range from a momentary pang, to prolonged dull throbbing, to downright excruciating distress. The nature of the pain depends on the type and degree of stimulus. The only way to be certain of what's causing the pain is with a professional dental examination. However, your symptoms can hint at some possible sources.

Fleeting sensitivity triggered by hot and cold foods generally does not indicate a serious problem. It may be due to any of the following:

1. a small area of decay in a tooth,
2. a loose filling,
3. an exposed root surface resulting from gum recession (often due to improper or excessive brushing), or
4. temporary pulp tissue irritation from recent dental work.

To help alleviate root sensitivity, make sure the tooth is free of dental bacterial plaque by brushing gently no more than twice a day. Fluoride-containing toothpaste made for sensitive teeth might help. Fluoride and additives such as potassium nitrate or strontium chloride help relieve sensitivity. Try using the toothpaste like a balm, gently rubbing it into the tooth surface for about 10 minutes. If the sensitivity is related to recent dental work, it should resolve within a few days to a week or two, depending on the extent of the work you had done. A mild over-the-counter pain reliever may help in the meantime.

No matter what the reason, if the sensitivity persists or worsens, please come see us. Together we'll get to the root of the underlying problem and resolve it so you can get back to enjoying the foods and beverages you love, no matter what the temperature!

If you would like more information about tooth sensitivity and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Sensitive Teeth” and “Tooth Pain? Don't Wait!”

Like many who have risen to the top tier in show business, singer Taylor Hicks found that he needed a few things (besides talent, of course) to really succeed: a willingness to seek out opportunities and work hard; a unique and energetic stage presence; and a bright, appealing smile.

“Everyone wants to have a great smile,” Hicks recently told Dear Doctor magazine. “In my business, it’s one of the most important things. A lot of what I do is smiling and having fun, being in front of the camera and taking pictures.”

To help him keep his smile sparkling, Hicks opts for in-office whitening treatments from his dentist. These treatments are a safe, quick and effective way to lighten teeth by 3 to 8 shades in a single one-hour visit. Best of all, you don’t have to be an American Idol winner or a Las Vegas headliner to take advantage of them — in fact, we offer them right here in our own office.

Why choose in-office treatments instead of take-home trays (or over-the-counter products)? While each system can be effective at lightening teeth to some degree, the in-office method offers several distinct advantages. For one, it’s the fastest way to get your teeth as bright as they can be; the same lightening that can be achieved in one office visit could take a week when done at home, using custom-made trays and dentist-supplied bleaching solutions — and several weeks with over-the-counter products! So if your time is limited, in-office treatment is the way to go.

Plus, in-office treatments are performed under our direct supervision. That means we can safely use the most powerful whitening gels, and achieve the maximum control over the result. This can be important when you have crowns or replacement teeth such as implants, which Hicks has. Artificial crowns don’t whiten like natural teeth, so it’s important to get just the right degree of lightening to produce an evenly bright smile.

The bottom line, of course, is the result: a dazzling white smile. “In entertainment, a big, pearly white smile makes a difference,” Hicks said. But you don’t have to be an entertainer to enjoy the benefits of a brilliant smile — we do it for plenty of “regular folks” too.

So if your smile could use a little brightening, why not call us and schedule an appointment for whitening treatment? You can learn more in the Dear Doctor magazine articles “Teeth Whitening” and “Important Teeth Whitening Questions Answered.”

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is an interesting condition because it can be hard to diagnose and often mimics many other conditions. It arises when there are problems inside the temporomandibular joint, and the muscles attached to it, causing pain. When treating TMD, we typically start by relieving the symptoms of pain and discomfort with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. We feel that it is critical to address your pain issues as soon as possible before preceding any further with treatment.

Once we have provided some pain relief and after having completed a thorough history and examination, we can move to the next phase of treatment. This may include the introduction of a bite guard or some form of oral appliance therapy. A bite guard is an unobtrusive yet rigid plastic horseshoe-shaped appliance that fits snuggly over the biting surfaces of the upper teeth. When in place and properly adjusted, this custom-made appliance allows your muscles and therefore jaw joints to relax. And it will prevent you from grinding your teeth, another contributing factor to TMD. We will probably ask you to wear it when sleeping or in times when you are feeling stressed when clenching or grinding habits may be active. We may also suggest that you obtain some relaxation therapy and/or biofeedback from a licensed therapist, as this can prove helpful in treating TMD.

If you have suffered from frequent jaw pain in the past and suspect that you may have TMD, please let us know so that we can address it at your next appointment. Or if you are currently in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.

We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?

Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.

When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?

In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.

So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.

If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”