Dental Bonds can close spaces, lengthen teeth, and make your new smile look years younger.

As a dentist practicing in the Encino Sherman Oaks area of Los Angeles for well over 25 years, I have done more than my share of great-looking bonded fillings.  Known simply as Dental Bonds, or Tooth Bonding, its when a plastic type resin that’s also the color of your teeth, is added, or bonded to the enamel of your tooth.  That addition is usually done with a special frequency light which hardens the material to the tooth or teeth in question. Dental bondings can fill in gaps, close unsightly spaces, recontour the tooth to make it look nicer-looking, even make a tooth look longer, be used to bond on porcelain veneers, or lumineers, fill in notches, protect the tooth, and otherwise make one’s smile more youthful-looking. 

In my office in Sherman Oaks and Encino, I have used Dental bonds to also replace mercury-amalgam fillings with tooth-colored ones. This has become especially popular in our office, particularly as patients are nervous about the effects of mercury vaporization in their mouths from these old amalgam fillings, especially during chewing and grinding on them. Vaporization could result in possible damage to one’s immune systems.  In these cases, dental bonded fillings, tooth-colored, and free of all metal, can be placed within the tooth in place of those old dark grey fillings.  Of course, the removal of the mercury-amalgam fillings should be done with utmost care, with the use of a dental dam and other protective techniques!

Regarding bonding techniques, if a LOT of tooth gaps exist, or they are large spaces, and reshaping of the smile is required, dental bonds alone may simply not fit the bill.  This is because they may not be strong enough to withstand the stress of chewing and biting forces, and they can have a tendency to stain over time.  In these cases, the dental bonding adhesives are used to hold porcelain in place instead.

What does this mean? The newer and possibly more sophisticated approach to dental bonding procedures is to apply the bonding adhesive to the back side of a thin piece of porcelain, oftentimes called a veneer, to change the shape and shade of the tooth.  The newer porcelain Lumineers have largely replaced porcelain veneers in this niche, primarily because Lumineers are much thinner, and little to no tooth reduction is required.  In the patient below, I placed several porcelain Lumineers on the front teeth, resulting in a dazzling new smile.  Usually done in two appointments, the Lumineers, although thin, when bonded onto the teeth are so strong that they can last 20 years, usually longer than the more invasive crown procedures.

Trey, before and after with his new smile make-over with Lumineers.

I get people from all over the world expecting gross reduction of tooth structure for a smile makeover, and when I tell them that isn’t the case with porcelain Lumineers, boy are they happy!  In some cases, where a patient has a lot of wear and tear on the teeth surfaces due to either grinding, clenching or bruxing at night, I simply make a ‘Lumi-guard’ which covers the Lumineers when they are sleeping.  The lumiguard is a very thin piece of plastic, much like a nightguard, but simple to put on, and it stays put on the teeth at night.  Most patients don’t even know its there, and the compliance is quite high. Best of all, their new Lumineered smile is protected, and kept healthy!

In summary, tooth bonding or dental bonds come in many different sizes and shapes.  Whether bonding to fill in a small space between a few teeth, or a wholesale reshaping of the teeth, new and simple and especially comfortable materials are available to the consumer.  For more photos of actual ‘before and after’ patients with Lumineers smile makeovers, please click here.  Further information on Lumineers can also be found on the company’s Den Mat site.

Ed Reifman, DDS  818.990.6659   www.encinosmiledr.com

To contact the office…

This cavity detector can tell the difference between simple dark brown stain on your teeth, and a true cavity!

The Diagnodent is a special portable laser that when shined or ‘lasered’ upon the tooth, can detect if a cavity exists or not.  It is a real breakthrough in the diagnosis of cavities or tooth decay.  The laser is totally painless, and when tooth pathology is found, you will hear a small beep, followed by a number that is seen on the laser screen on the machine. 

The  larger the cavity, the slightly louder buzz and higher number reading appearing on the laser monitor (see image on the left).  No more guessing if there is a cavity, or not!  The numbers go from a zero all the way up to 99.  If there is a reading below 15, I usually discount that as a mild, and indeed normal bacterial count within the mouth itself.  However, when the laser decay detecting numbers go higher than 15, than there is real, honest-to-goodness decay within a tooth.

Most readings I find in the office are around the 20-30 mark, and indicate mild to moderate decay.  The treatment is usually to remove the cavity and fill the tooth with a white-colored bonded resin.  If the laser numbers get any higher, the larger the decay, and the closer to having a large filling or even a crown is indicated.

I use this laser routinely. It is even FDA approved for dentists to use, its so exacting.  In fact, my Diagnodent laser cavity detector gets a good work-out when people come in for a 2nd opinion.  They might have been told they have a lot of cavities, but when I shine this special laser on their teeth, wherever there are dark brown areas, in most cases they usually turn out to be deep stain. This stain is usually cavity-free, meaning there is NO need for a filling. In fact, I will find a particularly ‘nasty-looking’ dark brown area on the chewing surface of the tooth.  However, when I shine the laser beam directly o the spot, and the reading is between O and 15, there is usually NO NEED to do any restoration.  Conversely, there may be no dark-looking areas on the tooth surface, but if I get a reading of say, 30, THAT means there is a cavity, and if unattended to, will just get worse.  Worse, meaning root canal therapy.  Let’s try to avoid that.

Another caveat I find on 2nd opinions: When the cavity detector is focused on an OLD bonded filling, you will get an erroneous, very high reading.  Bonded composite fillings interact with the laser pulse to give readings as high as 90-99, and I’ve actually had patients come in saying they were diagnosed with a huge cavity, when in actuality it was a perfectly normal bonded filling that required no attention at all!

The Laser Cavity Detector has not only finessed the diagnosis for decay, or a cavity-free tooth, but made me a better dentist by quantifying the amount of decay found, if any.  Be sure your dentist has this amazing  instrument- its definitely 21st century dentistry at work!

For more information on the Diagnodent, and other lasers that Dr. Reifman uses in his office, Click Here.

Ed Reifman, DDS   818.990.6659

www.encinosmiledr.com

To contact the office…

Mouthguards protect your smile!

Most mouthguards cover the upper teeth only, but for some pretty aggressive sports (boxing for one), covering the upper and lower teeth can be mandatory.

Whatever type of mouthguard you have (and colored designed ones that speak out your own unique personality, are now available at some dental offices – ask for them!) caring for them is easy.  Before and after you wear them, rinse with tap water or even your favorite mouth rinse.  Clean the insides with toothpaste the way you’d clean your own teeth.  When not wearing the guard, keep it in the container that came with the mouthguard full of cool tap water.  This reduces distortion or shrinkage and loss of wearability.

So unless your a video weekend warrior, wearing a mouthguard is important for your kids sports program, and for you.

Ed Reifman, DDS

(818) 990.6659

www.encinosmiledr.com

To contact the office…

Regenerating stem cells - from teeth!

Of all the places in the human body to acquire stem cells, scientists today are finding the right kind to regenerate nerve cells and possibly make paraplegics and quadraplegics walk again- from your own teeth!
That’s right- Inside the dental pulp (the soft stuff inside your pearly whites that contain the nerves, small arteries and veins that help keep your teeth alive) are dental pulp stem cells that look promising to restore cell regeneration to help those with severe spinal cord injuries. The latest research showed that adult mice that received transplanted human dental pulp cells to entirely severed spinal cords showed an almost 100% recovery of their limbs. And human success stories could be right over the short-term horizon!

Edward M. Reifman, DDS
818.990.6659
encinosmiledr.com

To Contact the Office…

”Dr. Reifman’s work exceeded my expectations!” Lynda S. / Los Angeles, CA

This morning I just completed another exciting Lumineers case, and after doing thousands of Lumineers (you know, those gorgeous, contact-lens thin porcelain laminates that fit over the front of your teeth), I still get amazed how when done correctly, they transmit the natural light-translucency of one’s teeth so much better than what crowns do.  Its also amazing how they literally change people’s lives, because you exude confidence by smiling so much more (people can’t help but show off their new, dazzling pearly whites).

Although placed on the front teeth, to change one’s current yellowed tooth shade to a super-duper light one (such as ‘Hollywood White’-  one of the most popular selections in my S. California office), and to also modify the shape of the front teeth (instant orthodontics, anyone?), Lumineers are a dental restorative procedure whose time has indeed come.

Best of all, unlike the older porcelain Veneers, porcelain Lumineers are ideal in that they require no anesthetic, no shots, no temporaries, and in most cases there is little to NO removal of sensitive tooth material! And if you’re a coffee and tea drinker, go ahead and enjoy.  They are pretty much stain resistant.  For baby-boomers, or anyone who needs younger-looking teeth, Lumineers will strengthen older teeth- an added benefit beyond aesthetics. And finally, Lumineers will look good 5, 10, even 20 years from now!

For more information, call 818.990.6659, or go to Lumineers Before and After Gallery

To Contact Us…

TMJ or Teeth Grinding can produce morning headaches, shoulder, neck or jaw pain!

Has your dentist ever said that you have TMJ, or you are grinding or clenching your teeth when asleep, wearing them down?  Whether you call it TMJ, night-grinding, flattening your teeth, clenching or bruxing, the chances are that you are a woman with this malady.  Why? Because TMJ or any of the nightly symptoms affect 8 times more women than men.  Talk about a sexist disease!

Why is that so?  The research still isn’t completely sure, but one of the reasons may be that men’s TMJ cheek musculature is stronger, and less susceptible to the afflictions that TMJ or teeth grinding bring on: morning headaches, shoulder, neck or back aches upon awakening.  Although I have my share of male comrades with TMJ, it never ceases to amaze me of the preponderance of women with it.

Thanks to the dental almighty, that we have the newer front teeth-fitting nightguards that are so much more comfortable than the older guards that fit over all the teeth.  These newer nightguards (such as the ‘NTI’) work by keeping your back teeth from hitting, grinding or clenching during sleep.  The result?  Your cheek muscles have been allowed to rest during the night and are not innervated by constant nightly activity of teeth grinding.

So, male or female, at last we have a great treatment for the majority of TMJ/grinding cases!

For more information, please go to Dr. Ed Reifman’s popular TMJ Teeth Grinding page.

To Contact Us…

The ugly ' Notched Gum' look. Done when using tooth picks to clean one's teeth after a meal!

This may came as a shock to some, but Mother nature never issued an 11th commandment to use toothpicks to clean up food debris in between the teeth and gums. Although theoretically gently using that 20th century, marvelous wooden instrument to remove bothersome bits of food after a wonderful dinner may not appear to be a bad idea, the vast majority of us ‘go for it’… with bad results.

We are all far too aggressive with the toothpick. I see on too many patients what I call ‘notched gums’, where the toothpick has been used after a ‘going out on the town meal’, resulting in permanently, notched-looking gum tissue between the teeth.

Ewww… looks nasty!

Worst of all, some of us get it in our heads that once we feel our teeth are squeaky-clean, why not just chew on this neat, micro piece of wood for a spell!… like chewing gum!

Remember, this is a stick between your pearly whites, and toothpick chewing promotes chipped and cracked teeth. Good for the dentist…, bad for you!

So, try to avoid toothpicks altogether, and floss more later on in the evening instead. And I won’t even get into ice-chewing!

Dr. Ed Reifman, DDS
www.encinosmiledr.com
818.990.6659

Hookah use messes with your lungs, and starts gum disease. It accelerates aging in young people!

In a word, no. Although tons of young people throughout the country think hookah use is ‘very cool’ due to the fact that you are breathing in tobacco ‘cleansed by the water vapor’, nothing could be further from the truth.

There is a heightened risk for respiratory problems, lung cancer, preterm or much lower birth weight, and gum disease. This may sound like the risks associated with cigarette smoking, but I’m still talking about weekend hookah use.

In fact, its worse. You’ve heard of 2nd hand smoke found in the immediate vicinity of smokers. However, around hookah smokers, multiply by four-fold the amount of cancer causing hydrocarbons, and 31 times the carbon monoxide found from a cigarette smoker. Yikes!

And don’t even think of kissing after hookah use, unless you want to transmit or have someone give you gingivitis or periodontal disease.

Have a good weekend!

Ed Reifman, DDS

www.encinosmiledr.com

818.990.6659

Until just a few years ago, Oral Cancer or Mouth Cancer, was considered a disease of ‘old male smokers’. Although I routinely check for oral cancer on all patients during their regular dental exam, I have never found oral cancer among young people. But from almost zero, to now one of three people with oral cancer are found in women between 18 and 30 years of age!

What’s going on here?

Its oral sex that’s the culprit. They are finding that the human papillomavirus (HPV), yes the same one found as a causative factor in cervical cancer, is also being found in the mouths of those involved in oral sex. And women are more at risk. Remember, if found in its late stages, 1 out of 4 people with it will die from oral cancer. It is also the fastest growing carcinoma in the country!

Your dentist should be able to spot it. If you have a red or white patch, or a sore in your mouth that just doesn’t seem to heal, have it checked out. Canker sores last at the most, about 2 weeks, but if you have a sore area that lasts longer than 14 days and doesn’t appear to heal, make a beeline to your dentist. If found early enough, its very, very curable!

Edward M. Reifman - www.encinosmiledr.com – 818.990.6659

A Protein Solution that will halt tooth decay!

Ready for prime time within a couple of years is a protein solution that may be in the form of a mouthwash, or actually painted on your pearly whites. What this will do is a modern day miracle: it will help broken-down or decay-ridden teeth regenerate new tooth structure!
In the laboratory now, but looking extremely optimistic, this unique protein solution will provide a frame that will actually attract calcium and build new tooth enamel. Although tooth colored bonded composite technology is advanced, there is nothing better than having natural tooth structure replaced by, well, natural tooth materials. And if the reports are to be believed, no drilling will be necessary, and no shots nor pain will be evident.  So Gator-aid move aside, and get ready for the anti-cavity, tooth regenerator drink!

Ed Reifman, DDS   www.encinosmiledr.com   818.990.6659