In today’s camera-ready, smile-for-your-selfie culture, we’re all in search of even prettier pearly whites, but getting veneers and paying for at-home whiteners doesn’t guarantee a sterling smile in the long run. With help from a few of this year’s top dentists in Northern Virginia, we got to the root of what it really takes—not just to maintain a beautiful smile, but to have a truly healthy mouth.
Teeth Trends
Ask any dentist or specialist and they’ll tell you that the best way to get a mouthful of sparkling teeth is to practice good dental hygiene. That starts with diligent brushing and flossing, sure, but it extends into dentists’ offices with advances in cavity care, treatments for gum recession and more. “It’s amazing how dentistry has embraced so much new technology,” says Dr. Keren Sperling, a periodontist practicing in Vienna. “We have lots of new materials, new methods, and they’re not things that one dentist just woke up and decided to do—they’re supported by research and they’re working.”
To help you stay on top of what’s happening in your mouth, we found some of the most effective in-office techniques enabling dentists to give you stronger, healthier and more
attractive smiles.
Crowning Achievement
If you got a crown in decades past, you either had a mouthful of metal or rows of dull caps without the nuanced sheen of real teeth. Thankfully, the experts keep finding more realistic-looking and longer-lasting materials for crowns and fillings. “The trends toward beauty are getting better and better with porcelain technologies,” says Dr. Peter Cocolis, a general dentist in Springfield. For Cocolis, translucency is crucial to mimicking a realistic tooth. “I could give you a laundry list of things we use—zirconia, Emax, even the filling materials we use have a bit of translucency to them,” he says. Materials like the titanium-based zirconia or ceramic-based Emax allow Cocolis and other dentists to copy the translucency, color and strength of real teeth. “It’s form and function working together,” Cocolis says.
Scan-tastic Results
Digital dentistry is a win for everyone. Over the last 10 years, CT scans have become more popular in dentists’ offices in combination with digital impressions. “We can be greener in our footprint because we’re not using impression materials, which are made of polyvinyls or rubbers,” says Cocolis. “They’re just as accurate, but instead of taking the impression with a bunch of goop, we get something with a lot less guesswork and discomfort for the patient.” It also improves communication between your general dentist and specialists like periodontists—insuring that tooth implants are tailor-made and built-to-last. “It’s my eyes and ears—it’s everything,” says Sperling, who relies heavily on the 3D capabilities of CT scans for her periodontal work. “The general dentist can make a print mark for exactly where he wants the crown, and it helps us work hand in hand.”
Get in the Groove
Cavities often form in the space between two teeth—hence your poor dentist’s persistent (sometimes futile) pleas for you to floss every day. However, cavities also form in your teeth’s grooves (the valleys that run through the middle of your teeth), and those cavities can be more difficult to prevent. “Your toothbrush bristle has a thickness to it and it doesn’t make it all the way into the groove, so there are bacteria that live in those grooves,” says Cocolis. To better detect cavities in grooves, many dentists use DIAGNOdent, a laser tool that reveals minute cavities by measuring how light reflects off the tooth’s surface. “If we’re going to find something, we try to find something as small as possible,” says Cocolis, who protects his patients’ grooves with in-office fluoride treatments and resin-based sealants for children’s teeth.
The Way to a Whiter Smile
We all want glowingly white teeth, but is it enough to put on a whitening strip at home? The answer is a bit of a mouthful. It depends on your teeth—do they have deep, intrinsic
stains, or are the stains only surface-deep? It also depends on you—are you willing to spend 30 minutes with a tray inside your mouth, or do you want something simpler that you can buy at the drugstore? The first step is to talk to your dentist about your options, but in the meantime, here’s a quick recap of a few effective whitening methods.
From Your Dentist
Whitening products come in several categories, including: bleaching products with peroxide, which work on both deep and surface stains, and non-bleaching products such as whitening toothpastes. When you go to the dentist’s office for whitening, more often it’s for a bleaching treatment. One such option is GLO, a paint-on product that comes with a mouthpiece and controller to apply light and heat to whiten your teeth. “It’s one of the best bleaching agents we’ve seen in our office for the past 25 years,” says Cocolis.
Unlike Zoom!, another popular in-office treatment, GLO leaves patients with very little sensitivity. “Say you do your bleaching at 4 o’clock, you can have some sensitivity into the next day. It’s these hot-and-cold zingers, like biting into cold ice cream,” Cocolis says of Zoom! Though you can purchase GLO treatments at Sephora, Cocolis recommends GLO Dual Whitening for its potency. Your dentist applies the first treatment in the office, then
you take the tools home to continue whitening. Before going with GLO, remember: As cosmetic treatments, most whitening procedures aren’t covered by dental insurance.
From the Drugstore
These methods can involve bleaching, but many are products that remove surface stains without bleaching called “dentifrices.” One of the most common dentifrices is good, old-fashioned whitening toothpastes. “My favorite right now is Colgate Optic White, but again, finding a toothpaste that you’re not allergic to with a flavor you like is key so you’ll brush consistently,” Cocolis says.
Whitening toothpastes also have polymers in them that make teeth a little slippery, preventing food and bacteria from clinging, thus preventing further staining. Using a whitening toothpaste once a day and rinsing after consuming blueberries, coffee, red wine—basically anything that might stain a white tee, Cocolis says—are two simple ways to lighten and prevent stains. Crest Whitestrips are also effective over-the-counter options, but teenagers who haven’t yet developed deep stains in their teeth see better results, Cocolis says.
Anatomy of a Cavity
How Cavities Form
Bacterial byproducts, including acids, break down the tooth. It starts as a tiny hole in the enamel, which then lets more bacteria inside the tooth. The rot continues from there.
How to Spot Them
Like rotten wood is sometimes squishy, so are teeth affected by cavities. Dentists look for changes in color, feel for soft areas with tools and rely on digital devices and disclosing agents to find cavities.
Preventing Cavities
Dental cleanings every six months and regular flossing and brushing. It matters less whether you choose Colgate or Crest, Waterpiks or waxed floss—find products you like so you’ll brush and floss consistently.
A Dental Primer
Maintaining that pretty smile can take more than just a twice-a-year cleaning. Here, we’ve decoded the different types of dentists who have made ensuring healthy smiles their mission.
General Dentist
They diagnose and treat diseases and disorders in your mouth. Often times, a general dentist will assess your condition before recommending a specialist. You might see a general dentist for a teeth cleaning or filling.
Endodontist
They diagnose and treat conditions affecting your dental pulp (the nerves and blood vessels at the center of your tooth) and periradicular tissues (the tissues around the root of your tooth). You might see an endodontist for a root canal or an additional surgery if a root canal fails.
Oral and Maxillofacial Surgeon
They diagnose and treat injuries and defects of both the hard and soft tissues in the face, jaw and mouth. You might see an oral and maxillofacial surgeon to have your wisdom teeth extracted.
Orthodontist
They diagnose and treat misaligned teeth and abnormalities in either developing or mature orofacial structures—like your jaw. You might see an orthodontist for braces or
treatment for a temporomandibular disorder (TMD).
Pediatric Dentist
They provide oral healthcare for infants and children through adolescence. Professionals agree that a child should have their first visit to the pediatric dentist by one year old or once they cut their first tooth.
Periodontist
They diagnose and treat diseases in tissues that surround your teeth. You might see a periodontist to treat gum disease or gum recession.
Prosthodontist
They diagnose and treat conditions associated with missing or deficient teeth. You might see a prosthodontist for a bridge (a false tooth that fills the gap between two crowned teeth) or for dentures.
Getting to Know Your Gums
When we think of dentistry, we usually think teeth first and foremost. However, for the vital role gums play protecting our teeth and the underlying bone, they should be top-of-mind when we consider our oral health. That’s why periodontist Dr. Keren Sperling compares them to the foundation of a house.
“If the foundation around a house is not good, then the house is not going to stand,” she says. “It’s the same thing with your mouth. If the foundation—the bone, the gums—is not strong enough, then the tooth is not going to be able to hold.”
So, what do we do if we want our gums to hold? Let’s start by understanding the biggest threats.
What is gum disease?
Gum disease can be pretty insidious. It doesn’t usually have strong symptoms, it advances quickly from milder gingivitis to more severe periodontitis, and if left untreated, it can cause you to lose teeth. “The problem with having a gum disease is that there’s no pain,” says Sperling. “Some redness or soreness of the gums, some pus or pain when biting down or none at all.” Gum recession—which you can also get from smoking, brushing too hard or from traumatic gum injuries—is another unfortunate side effect of gum disease. Instead of fitting snugly, your gums come away from your tooth and expose the underlying bone, making the area sensitive to hot and cold and vulnerable to further decay.
How do we get it?
It starts when plaque builds up and spreads below the gum line. Bacteria in the plaque irritate your gums and trigger a chronic inflammatory response that erodes them and the bone beneath your teeth. Poor dental hygiene and a laissez-faire approach to dental cleanings can set the process in motion, and there are other risk factors that contribute too. “There is a huge relationship to gum disease and other diseases in our body. For instance, having an uncontrolled gum disease is very related to having diabetes,” says Sperling. “Treating the gum disease can actually improve the diabetes condition and vice-versa.” Certain medications, pregnancy, smoking and stress can also open you up to gum disease.
How do we prevent it?
Regular dental cleanings and fastidious at-home hygiene can stave off gum disease while also creating opportunities for your dentist to catch the disease in its infancy. The harder part is treating gum disease once it’s spiralled. “Sometimes patients think that a dental cleaning is enough, but the disease keeps on going. Once you have a gum disease, it’s very difficult to get rid of without intervention,” Sperling says. For those cases, Sperling has an arsenal of ever-improving treatments, including gum and bone grafts to regenerate damaged tissues and protect the bone exposed by gum recession. Periodontists used to take these grafts only from the patients themselves, but now there are more options “Whether it’s a cow’s bone or from a cadaver, those materials are resorbable, and eventually it’ll be the patient’s own bone,” says Sperling. “It’s much easier for the patient, the healing is faster and the results are awesome.”