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Dentistry is in transition and so are life styles. What a sudden move away from drill and fill! We are into implants, laser technology and whitening for life marketing spins. If ever there was a case for poetic justice, this certainly is it. Aristotle himself a man for change, argued the case for poetry over history because it demonstrates what must or should occur rather than what the pundits forecast. The man dubbed the father of modern dentistry in the 17 th century Pierre Fauchard would be as uncomfortable in to-day’s dental operatory as a pilot from World War II in the cockpit of the Airbus 380. Dentists still have to work around the foreboding needle phobia. However, the change of the future looks encouraging with the first FDA approved needle free anesthesia product for scaling and root planing. This is the story of Frank and his wife Flavia. They were the perfect couple. Flavia was a bit trendier and into the change from the traditional soccer mom, but by no means could one describe her as “the vanilla flavor of the day”. She had the smarts, and a solid head for business, probably groomed by her father who, like many Italians emigrated from Italy to find their fortune in the Western world, the land of opportunity. Frank and Flavia were comfortably set. They were off to a good start after their wedding, with the help of her dad and family, pretty well owned their first home sooner than most of their friends. Flavia had been pressuring Frank to get some cosmetic work done on his teeth. The daily espresso coffees and his mother's blueberry pies were beginning to seriously test the strength of a solid Roman Catholic marriage. Flavia's desire to pop an impromptu kiss on Frank was starting to wane because of his discolored teeth. She wondered how can “I persuade him to change? To go for a dental check-up”? Her goal for Frank was to have his teeth cosmetically changed to show off the fashionable celebrity white-teeth-smile and nothing was going to stop her desire for hope and change. The whitening of teeth has become a billion-dollar business and celebrities have had no small part in raising the bar for the perfect smile. Another cosmetic fashion statement which is showing its colors is the art of tattooing one’s body parts. I mentioned this purposely, because a visit to the tattooing studio is far more popular that a visit to the dentist, although, ironically there is a common factor, namely pain. Why is this? Why is it that people will pay huge sums of after-tax dollars to have a tattoo sculptured in sensitive parts of the anatomy and yet be hesitant to visit the dentist? Maybe vanity is more powerful than oral health! Or maybe the School of Body Art has out-marketed the college of dentistry? How often have you seen a young woman/man flashing a tattoo, but in need of obvious orthodontic or other dental work? We have to rely on anecdotal reports in the absence of a truly scientific study. Back to my friends Frank and Flavia. Researchers have come to the rescue with a product that brings effective needle-free anesthesia for patients during scaling and/or root planing procedures. Oraqix® fits the perfect scenario for a patient who is needle phobic. This product is the first FDA approved system for the above indications. There are some very desirable properties to Oraqix®; apart from a rapid onset of action, the return to sensitivity is within twenty minutes, thereby making it the perfect product for example, a lunchtime appointment. Sensation is restored before leaving the dental office. Uncontrollable chewing of the lip is a common after-effect of residual anesthetics. Oraqix® allows the patient to return to normal activity without the embarrassing drooling. Hopefully this addition to dental armamentarium will allay the fear of the dreaded needle. Fear of finding other latent problems incurring a cost is an irrational decision. Why should one have two standards for maintaining perfect health? Oral health is no less important that physical health. The diagnosis of oral cancer is by far more often seen by the dentist than by medical doctors. If for no other reason it makes good sense to keep the oral cavity healthy and free of possible terminal diseases. Four out of five Americans claim a desire for whiter teeth. Never before have so many options been available. Nu-pro® White gold® is a dentist prescribed take-home system that has been designed to address the patient's tooth whitening requirements and offers two formulations with dramatic results in one to two weeks. Who are the best candidates for do-it-yourself whiteners? Before you spend a dime on whitening your smile, your dentist will explain what is best for you and the reason why. Teeth should be healthy without cavities or recession of the gums thereby exposing sensitive root structure. If whitening agents come in contact with an open area on a tooth with a clear path to the nerve center of your tooth, you won't care what color your teeth are because they will have to peel you off the ceiling. You need to have a proper evaluation by your dentist. A talk to your dentist will determine if you do have tooth discoloration and what is the cause. There are two major ways teeth become discolored. Teeth naturally discolor as we age, and we all have lighter or darker teeth, just as we have different complexions. Everyday habits and food consumption penetrate the tooth's enamel to cause extrinsic and intrinsic stains: There are as many reasons for tooth discoloration as there are solutions. Over-the-counter whitening doesn't work if the discoloration comes from an injury to a tooth, for example. Also, if you have teeth that have tooth-colored fillings or crowns that are dark or discolored, again, over-the-counter whiteners do not whiten porcelain or tooth colored filling materials. Stains can be caused by foods such as coffee, tea, red wine, and nicotine. Rule of thumb, if it stains your carpet, it can stain your teeth. What kind of results can we expect from an over-the-counter product? Today Over-the-counter whitening products work differently and better than ever before because the technology has changed so dramatically. Will your teeth look as different as if you had full mouth veneers? No. But if you have a pretty smile, that you want whiter and brighter, the newest over-the-counter options are very effective. Here's a look at some of the latest options. Most people hate the messy trays you stick in your mouth. What are the alternatives? Crest White strips, night effects (liquid strip gel). Crest White strips continue to be the OTC gold standard in whitening -- and a beauty secret for millions of Americans, (mostly women). When you look in dressing cabinets, you see them right next to the lipsticks. Whiter teeth give women confidence and make them look younger and prettier. A great new whitening product is hitting store shelves now. It's called Night Effects and it's very exciting because it works while you sleep. The first generation products made to whiten teeth while we sleep included a tray and stuff oozing out of it. I dare you to sleep with that unit in your mouth and not destroy your bed linen. Bearing in mind that these are all Over-the-counter products. Dental prescribed take-home products are still the most effective. So what has been improved for the OTC shopper? Night Effects is great for a couple of reasons: First, it's good for people whom for whatever reason, cannot whiten during the day. Second, the coating sticks to your teeth. You've heard me say that for a product to work, the whitening agent has to stay in contact with the teeth. The problem with some of the other over-the-counter products is that they tend to quickly wash away when they come in contact with saliva, food or drink. Night Effects appears to be the first paint-on product to address this problem. The patent process they use is as follows. Immediately after applying the gel, the product forms a liquid strip coating that stays on your teeth overnight. The liquid strip slowly releases the whitening ingredient into your teeth to remove stains and loosen stain-causing build-up. In the morning, you simply brush the liquid strip coating and stains away. Researchers have overcome the overnight challenge by developing a silicon-based gel applied with a brush. Secondly, it is not water soluble like other paint-on products. Because of this new technology, the whitening gel stays on your teeth for hours while you sleep. Over-the-counter whitening serves a selected market, however for the clinically accepted procedures, it is best to have your dentist involved. Comments to author. localanesthetics@yahoo.ca M.Sc. PharmD. CCPE
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