Dentistry Videos

Hello! My name is Dr. Peter Rinaldi and I’m a dentist here in Washington DC at the Washington Center for Dentistry. For the past 25 years, I spent a lot of my clinical chair time enhancing smiles. A lot of this has been done by altering tooth shape, color, and position. A lot of times, this is done with veneers. However, recently, there’s been a new cosmetic challenge in cosmetic dentistry that has nothing to do with teeth. It has to do with gums – Gum Pigmentation. Clinically, this is known as gingival hyperpigmentation. Many people ask: What causes gum pigmentation? The normal color of the gum tissue is pink. Gum pigmentation is caused by melanin and melanin is a natural substance in our body that we find in freckles, sun spots, age spots. It’s what makes us tan in the summertime. Unfortunately, some people have an overproduction of melanin in their gums. Discoloration may also be caused by long term use of certain medications. Now, gum pigmentation medically is not of any consequence. However, aesthetically, this could be a real challenge for some people. It makes them not want to smile at all. However, luckily, there are some things that we can do that can change that for these people and make them very happy.

Gum pigmentation is caused by melanin and melanin is a natural substance in our body that we find in freckles, sun spots, age spots. It’s what makes us tan in the summertime. Unfortunately, some people have an overproduction of melanin in their gums. Fortunately, there is something that can be done today. Its called gingival depigmentation or gum bleaching, and that’s just a fancy word for removal of those brown or black spots. Now, there are a lot of methods of gum bleaching that have been developed to do this. However, the preferred method in this office is to use a laser. Now, there’s a lot of different kinds of lasers, but we use a water lase. Now, a water lase is a laser that utilizes water, air, and laser energy to gently peel away the layers of the dark pigmentation. We love this method here in this office because there is zero discomfort during the procedure and minimal after. Now, there is some redness, raw redness right after the gum bleaching procedure. But, within four days to a week, that heals up and the results are just beautiful pink gums. Afterwards, little discomfort, Advil, Mortin, or Tylenol is all that’s needed and most people find out that its quite an easy procedure.

Gum pigmentation is caused by melanin and melanin is a natural substance in our body that we find in freckles, sun spots, age spots. It’s what makes us tan in the summertime. Unfortunately, some people have an overproduction of melanin in their gums. There are a lot of methods of gum bleaching, however, the preferred method in this office is to use a laser. Now, there’s a lot of different kinds of lasers, but we use a water lase. Now, a water lase is a laser that utilizes water, air, and laser energy to gently peel away the layers of the dark pigmentation. We love this method here in this office because there is zero discomfort during the procedure and minimal after. One of the main questions that patients ask is: How much gum bleaching should I do? Well, just like smile design, it depends on how far the smile goes from corner to corner of the mouth when a patient has full closure. It also is dependent upon lip mobility which means how high the lip rises when people smile and everybody is different. Some people have a low lip line, some people have a high lip line that is also a factor when we consider how much of the black or the brown to remove. Now, this gum bleaching procedure takes approximately 45 to 60 minutes for one arch. Most people opt to do just the upper arch. As I said before, there is some raw redness for the first four days to a week. However, that disappears quite rapidly and beautiful pink gums appear. Most patients only need Advil or Motrin or Tylenol for the first 24 to 48 hours and they feel great afterwards

Gum pigmentation is caused by melanin and melanin is a natural substance in our body that we find in freckles, sun spots, age spots. It’s what makes us tan in the summertime. Unfortunately, some people have an overproduction of melanin in their gums. There are a lot of methods of gum bleaching, however, the preferred method in this office is to use a laser. Now, there’s a lot of different kinds of lasers, but we use a water lase. Now, a water lase is a laser that utilizes water, air, and laser energy to gently peel away the layers of the dark pigmentation. We love this method here in this office because there is zero discomfort during the procedure and minimal after. Another question that patients ask is: “How long does gum bleaching last?” Well, let’s remember that this is caused by melanin and melanin occurs naturally in our body. So, the black or brown pigmentation is really always occurring in our body. With the laser, we’re just removing – layer by layer – the dark pigments that we see. Therefore, we all produce melanin at a different time schedule. Recurrence will be different for everybody. We’re expecting though about one and a half to three years though. Retreatment is fine. It doesn’t hurt to go back in again to do the procedure. However, exciting things are happening on the horizon because they are trying to develop methods to actually inhibit melanin formation in our body which would then stop it from coming back forever.

I’d like to answer a question that I’m frequently asked by patients: Why am I grinding teeth? Well, the obvious answer is because of stress and anxiety. A lot of times, patients will take out their stresses on their teeth and it’ll lead to wearing and chipping and fracturing. A less understood reason for grinding and clenching is because of the relationship between your top and bottom teeth and jaw and how they meet. Malocclusion or crooked teeth or worn teeth will not meet properly and your jaw will sometimes try to find a balanced position leading to grinding. The third – probably the most misunderstood – reason is related to an obstructed sleep airway. Some patients’ airway will collapse at night time and grinding will actually help to posture or keep that airway open at night time. If you recognize some of the teeth grinding / bruxism symptoms, make sure that you see your dentist. At Washington Center for Dentistry, we give our patients outstanding results and excellent care. Learn more about mouth guards which can prevent snoring, teeth grinding and sleep apnea. These devices protect the structure and appearance of your teeth. We can also help correct the damage of teeth grinding such as worn or mobile teeth.

If you are a tooth grinder, there are solutions out there to help you stop teeth grinding. First off, we want to try to help suggest controlling anxiety or possibly a sleep test to see if it’s linked to an airway obstruction at night time. Some people can have an obstructed sleep airway and we want to make sure that we can help them with that. For the typical tooth grinder, we can make a guard – as most people call it. It’s really a muscle deprogramming appliance. It’s a piece of resin plastic that is very comfortably fabricated for your teeth. It’s custom-made in a way so that you can wear it. The most important thing is that you’re compliant because tooth grinding doesn’t just go away. So, we make this appliance out of this resin material. We place it in your mouth and, at night time, it prevents you from putting all those deep forces on your teeth. So, that’s how you take care of tooth grinding. If you suspect that you are experiencing tooth grinding or hear somebody that’s doing it, make sure that they see their dentist. At Washington Center for Dentistry, we give our patients outstanding results and excellent care. Learn more about mouth guards which can prevent teeth grinding and protect the structure and appearance of your teeth. We can also help correct the damage of teeth grinding such as worn or mobile teeth.

I’d like to talk to you about mouth guards. There are several different kinds of mouth guards that you can use, mostly for night guards and clenching and grinding, but there’s also some for an obstructed sleep airway. Some people have an issue with snoring or sleep apnea and there are comfortable appliances that can be custom-fabricated for your teeth to treat tooth grinding, snoring, and sleep apnea. A dentist can create custom mouth guards to protect teeth during sleep. If stress is the cause you need to find a way to relax. Meditation, counseling and exercise can all help reduce stress and anxiety. If you feel as though you have any of these concerns, see your dentist and I hope that this has been helpful.

Today I’d like to answer the question about, “Is a root canal painful?”Actually, it’s not. Many times, patients in our chair will actually fall asleep. With modern technology and proper novocaine, a root canal can be a painless procedure that, sometimes, patients will feel immediate relief on.

Let’s talk a little bit about what causes teeth to become a little yellow or a little dull over time. One reason is external factors. External factors are things such as your diet. Are you a person who loves to eat berries? Or do you eat a lot of dark, heavy foods? Or do you – like me – like red wine? Do you drink a lot of tea, a lot of coffee? All of these things can sort of stain the teeth over time. Then, there are internal factors such as aging. Over time, unfortunately, as you get older, the enamel may turn a little bit more dull-looking. Also, it can be from medications. A lot of different medications out there change the way the enamel develops over time.

Let’s talk a little bit about how long Invisalign takes. I hear this question often and, for most people, it’s from six months to a year. The treatment starts by taking molds of your teeth, sending them off to a laboratory, and then receiving your trays. In our office, we actually take digital scans of your teeth so we can get started the same day you come into the office.Also, we’ve used a new technology called AcceleDent. With AcceleDent, you can just take an extra twenty minutes a day to use this technology and that cuts your treatment down in half. So, half of the time you would have had to wear Invisalign, you’ll be finished a lot faster by using AcceleDent.You know, one of the things people always want to know is “How long do I have to wear Invisalign?” You have to wear it for about 22 hours a day. You only take them out to eat. Compliance with this really helps your overall end treatment. So, I think Invisalign is a wonderful way to straighten your teeth. You don’t have to worry about wearing brackets and food getting stuck in your teeth. This is what a lot of adults do and end up having really good results.

One of the questions I get a lot is “Does whitening your teeth damage your teeth?” and the answer to that is simply, “No, whitening your teeth does not damage your teeth.”You know, enamel is one of the strongest substances in the body and it can really withstand a lot of different things and whitening has absolutely no effect on the enamel. Now, whitening can definitely make your teeth a little bit more sensitive. This is usually a temporary thing for most people and it’s something that can be treated with gels or varnishes that can be put on the teeth to kind of help you get through the sensitive part of it.You know, I have patients ask me if they should not whiten their teeth because they get sensitive. The answer to that is also no. If what you want is whiter teeth, there’s definitely ways to treat the sensitivity that comes along with it.