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By Cental Valley Dentist
March 16, 2018
Category: Dental Procedures
Tags: teeth whitening  

Do-it-yourself (DIY) whitening kits are a popular option for restoring a healthy shine to stained and dulled teeth. They're relatively safe and generally live up to their packaging claims.

But a home kit might not always be your best option. Here are 4 reasons why DIY whitening might not be right for you.

You're on the early side of your teen years. Tooth whitening at home is quite popular with teenagers. For older teens it doesn't really pose a dental risk as long as you use the product appropriately (more on that in a moment). However, the immature enamel of younger teens' permanent teeth is still developing and can be vulnerable to damage by whitening processes.

You don't follow instructions well. Not to say you have this particular character quirk — but if you do you may run into trouble with DIY whitening. Home kits are safe if you follow their instructions carefully. If you use them to excess as one 13-year old boy was reported to have done, you could severely (and permanently) erode your teeth's protective enamel.

Your teeth are in need of dental work. Tooth whitening can't fix everything that may be contributing to an unattractive smile. It's always better to have issues like dental disease or chipped teeth addressed first before whitening. And, if your tooth discoloration originates from inside your tooth, a whitening kit won't help — they're only designed for staining on the enamel's outside surface. You'll need a special dental procedure to whiten internal (or intrinsic) tooth staining.

You want to control the amount of brightness. Home kits don't have the level of fine-tuning that a clinical procedure can achieve. While the bleaching agent in a professional whitening solution is much stronger than a home kit, your dentist is trained in techniques that can vary the amount of bleaching, from a softer white to dazzling “Hollywood” bright. And clinical whitening usually takes fewer sessions and may last longer than a home kit.

If you're interested in teeth whitening, see your dentist for a dental examination first before purchasing a DIY kit. Even if you decide to do it yourself, your dentist can give you buying advice for whitening kits, as well as how-to tips.

If you would like more information on tooth whitening, 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.”

By Cental Valley Dentist
March 01, 2018
Category: Dental Procedures

Via a recent Instagram post, pop diva Ariana Grande became the latest young celebrity to publicly acknowledge a dental milestone: having her wisdom teeth removed. The singer of hits such as “Break Free” and “Problem” posted an after-surgery picture of herself (wearing her signature cat-eye eyeliner), with a caption addressed to her teeth: “Peace out, final three wisdom teeth. It’s been real.”

With the post, Grande joined several other celebs (including Lily Allen, Paris Hilton and Emile Hirsch) who have shared their dental surgery experience with fans. Will "wisdom teeth removal" become a new trending topic on social media? We aren’t sure — but we can explain a bit about the procedure, and why many younger adults may need it.

Technically called the “third molars,” wisdom teeth usually begin to emerge from the gums between the ages of 17 and 25 — presumably, around the same time that a certain amount of wisdom emerges. Most people have four of these big molars, which are located all the way in the back of the mouth, on the left and right sides of the upper and lower jaws.

But when wisdom teeth begin to appear, there’s often a problem: Many people don’t have enough space in their jaws to accommodate them. When these molars lack sufficient space to fully erupt (emerge), they are said to be “impacted.” Impacted teeth can cause a number of serious problems: These may include pain, an increased potential for bacterial infections, periodontal disease, and even the formation of cysts (pockets of infection below the gum line), which can eventually lead to tooth and bone loss.

In most cases, the best treatment for impacted wisdom teeth is extraction (removal) of the problem teeth. Wisdom tooth extraction is a routine, in-office procedure that is usually performed under local anesthesia or “conscious sedation,” a type of anesthesia where the patient remains conscious (able to breathe normally and respond to stimuli), but is free from any pain or distress. Anti-anxiety medications may also be given, especially for those who are apprehensive about dental procedures.

So if you find you need your wisdom teeth extracted, don’t be afraid to “Break Free” like Ariana Grande did; whether you post the results on social media is entirely up to you. If you would like more information about wisdom tooth extraction, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”


Although usually an orderly process, some permanent teeth don't come in as they should. In fact, they may not come in at all and remain hidden in the gum — a situation called impaction. This creates multiple problems for function, health and, in the case of front canines, appearance.

Canines are the longer and more pointed teeth on each side of the front-most incisors. They help tear and cut food during chewing, a function impaction eliminates. Besides a higher risk for developing abscesses (isolated areas of infection) and cysts, they can also put pressure on neighboring teeth and damage their roots or cause them to erupt abnormally.

Dentists often remove impacted wisdom and other back teeth to lessen these potential problems. Removing canines, though, has additional considerations: besides compromising ideal chewing function, missing canines often create an unattractive smile.

But before considering removal, there's another technique we might be able to use to save the canines and actually draw them down through the gums to their correct position. It's usually part of an overall orthodontic plan to correct a poor bite (malocclusion).

After pinpointing their exact position with x-rays or CT scanning, a surgeon surgically exposes the impacted canines' crowns through the gums. They then bond small brackets to the crowns and attach a small gold chain to each bracket. They fasten the other end of the chains to orthodontic hardware that exerts downward pressure on the impacted teeth. Over several months this pressure can help move the teeth into their normal positions.

Unfortunately, this technique isn't always advisable: one or more of the impacted teeth may be in a difficult position to attempt it. It's usually best in these situations to remove the teeth, usually sooner rather than later for the sake of neighboring teeth.

Fortunately, with today's advanced restorative techniques, we can eventually replace the canines with dental implants, although that's best undertaken after the patient enters adulthood. In the meantime, we can utilize orthodontic means to preserve the open space and provide a temporary restorative solution.

Whatever route taken, these teeth don't have to become a source of problems, especially for your appearance. Whether through orthodontics or restorative dentistry, impacted canines don't have to ruin your smile.

If you would like more information on various orthodontic procedures, 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 “Exposing Impacted Canines.”


In the early Eighties, dentists began noticing symptoms among a few patients that indicated something far more serious. They were, in fact, among the first healthcare providers to recognize what we now know as HIV-AIDS.

Today, about 1.2 million Americans have contracted the Human Immunodeficiency Virus (HIV). It’s a retrovirus, somewhat different than other viruses: it can invade immune system cells and hijack their replication mechanism to reproduce itself. Untreated it eventually destroys these cells to give rise to the more serious, life-threatening disease Acquired Immunodeficiency Syndrome (AIDS).

Thanks to antiretroviral drugs, most HIV positive patients live somewhat normal lives and avoid the more serious Acquired Immunodeficiency Syndrome (AIDS). But while antiretroviral therapy effectively inhibits the action of the virus, it isn’t a cure — the virus is a permanent resident of the body and can still affect health, especially in the mouth.

In this regard, one of the more common conditions associated with HIV is Candidiasis, a fungal infection also known as thrush, which causes cracking of the mouth corners and lesions or white patches on the surface of the tongue or roof of the mouth. HIV patients may also experience limited saliva flow that causes dry mouth (xerostomia) with effects that range from bad breath to a higher risk of tooth decay.

The most serious effect, though, of HIV on oral health is the body’s lower resistance to fight periodontal (gum) disease. HIV patients are especially susceptible to a severe form known as Necrotizing Ulcerative Periodontitis (NUP), a sign as well of immune system deterioration and the beginning of AIDS. This painful condition causes gum ulcerations, extensive bleeding, and the rapid deterioration of gum attachment to teeth.

If you or a family member is HIV positive, you’ll need to pay close attention to oral health. Besides diligent brushing and flossing, you or they should also regularly visit the dentist. These visits not only provide diagnosis and treatment of dental problems, they’re also an important monitoring point for gauging the extent of the HIV infection.

Taking care of dental problems will also ease some of the discomfort associated with HIV. Thanks to proper oral care, you or someone you love can experience a higher quality of life.

If you would like more information on oral and dental health for patients with HIV, please contact us or schedule an appointment for a consultation.

By Cental Valley Dentist
January 15, 2018
Category: Oral Health
Tags: oral hygiene  

Twice a year dental cleanings are an important aspect of optimal oral health. But if you’re not brushing and flossing every day, your dental visits could change from regular maintenance to teeth rescue missions.

These two hygiene tasks don’t take long—a single trip with floss around each tooth and a couple of minutes of brushing at least twice a day—but you’ll need to perform them effectively to get the most out of them. Not to worry, though: with a little practice and helpful advice from us, this small investment in time and effort could save your teeth—and your money.

The first thing to know, though, is the reason behind brushing and flossing: to remove disease-causing bacterial plaque that can build up daily on teeth. Bacteria produce acid, which at elevated levels can erode enamel and lead to decay; and some bacterial strains can cause periodontal (gum) disease. These infections could ultimately lead to gum recession, bone deterioration and tooth loss.

Daily brushing and flossing lowers your risk of this occurring. It’s your preference in what order you do them, but for now let’s start with flossing.

There are a number of techniques—and tools—for effective flossing. If you’re using thread floss, simply cut off about 18 inches and wrap each end around the middle finger from each hand. Use the remaining fingers to create a small amount of floss between the two best fingers for a particular area of the mouth and gently pull the floss in between the tooth gap. Form a “C” shape around one of the tooth sides and rub up and down until you hear a squeak (which you’ll only hear if you use un-waxed floss). Now, repeat the action with the adjacent tooth, then move to the next and each succeeding gap and do the same until you’ve cleaned each side of each tooth.

When brushing, hold your toothbrush gently like a paintbrush or pencil at about a 45-degree angle with just a small amount of toothpaste on the end bristles. All it takes is a gentle scrubbing or wiggling motion and the abrasives and detergents in the toothpaste will do the rest.  Just make sure you fully brush all your teeth and gum surfaces, which should take about two minutes.

Along with regular dental visits and a low-sugar diet to discourage bacterial growth, brushing and flossing will help you avoid disease and enjoy the best oral health possible.

If you would like more information on keeping your teeth and gums clean, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”

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