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Posts for: June, 2014

By Edward Joseph, D.D.S.
June 18, 2014
Category: Dental Procedures
Tags: root canal   whitening  
Non-VitalBleachingRemovesUnsightlyToothDiscolorationFromWithin

Root canal treatments are an important method for stopping the disease process within an infected tooth and ultimately saving it. However, one of the few side effects could have an aesthetic impact on your smile. Leftover blood pigments or the filling materials themselves can cause a darkening of the tooth — the tooth could eventually stand out in an unsightly way from surrounding teeth.

There is, however, one possible solution: a whitening technique known as internal or non-vital bleaching can lighten a darkened, non-vital tooth. For this procedure, we would insert a bleaching mix (usually sodium perborate mixed with hydrogen peroxide) into the pulp chamber of the darkened tooth for a short period of time. The chemical reaction of the mix whitens the tooth from within.

Our first step is to make sure by x-rays that the root canal filling in the tooth is still intact and still has a good seal. We then create a small opening in the rear of the tooth just above the root canal filling, irrigate it with water to remove any debris, and then add a special cement at the point where the root canal filling begins to seal it from any leakage of the bleaching solution into the root canal filling.

We then insert the bleaching solution into the empty pulp chamber. This is covered with a cotton pellet, which is then sealed in with a temporary filling. We repeat this application over a number of days until we see a noticeable change in the tooth color (normally after one to four visits). At this point, we would remove any residual solution and apply a permanent filling to seal the tooth.

This procedure can be performed instead of more extensive procedures such as veneers and crowns as a cover for the discolored tooth, or as a way to lighten teeth before applying a veneer or crown to help prevent discoloration from showing through. Either way, non-vital bleaching can help remove unsightly discoloration and restore vibrancy to your smile.

If you would like more information on internal or non-vital bleaching, 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 “Whitening Traumatized Teeth.”


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By Edward Joseph, D.D.S.
June 10, 2014
Category: Oral Health
Tags: bad breath  
FindingtheRootCauseofBadBreathistheKeytoSuccessfulTreatment

Halitosis (bad breath) is a major personal and social concern — so much so that Americans spend nearly $3 billion annually on rinses, mints and gum to freshen breath. While helpful in alleviating occasional bad breath caused by oral dryness (brought on by stress, eating certain foods, prescription medications, smoking or consuming alcohol), those with chronic halitosis require a much different treatment approach.

That's because there are a number of possible causes for chronic halitosis, among them: xerostomia (chronic dry mouth), caused by mouth breathing; periodontal (gum) disease; or candidiasis, a yeast infection caused by some antibiotics. It may also arise as a secondary symptom of systemic diseases like liver disease, diabetes or cancer.

The most common cause, though, is bacteria. Many types of oral bacteria can produce terrible odors, most notably volatile sulphur compounds (VSCs) with their “rotten egg” smell. Because of its relative dryness and difficulty in cleaning, the back of the tongue is a wonderful environment for bacteria to multiply and thrive.

If you suffer from chronic halitosis, our primary objective then is to try to uncover its specific cause, which will determine what course of treatment we would recommend. First, what is your experience with halitosis — have others noticed it or just you? Next, we would consider your medical history — have you had any health issues with your ears, nose or throat, or experienced any gastrointestinal disorders or lung problems? What kind of medications do you take, and are your kidneys and liver functioning properly? We would also perform a thorough dental exam for any signs of tooth decay, gum disease or a dry, coated tongue as well as look at your diet and lifestyle choices, like smoking or alcohol use.

Having a better idea of what may be causing your bad breath, we can then tailor a treatment plan that might involve, among other things, treatment for tooth decay, a periodontal cleaning (scaling), instruction on better oral hygiene and tongue cleaning with a scraper or brush, or the removal of third molars where debris may be accumulating in the gum flaps.

Finding the cause of bad breath can take time, but is well worth the effort. The end result is a treatment plan that works.

If you would like more information on understanding and treating chronic halitosis, 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 “Bad Breath: More than just embarrassing.”


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By Edward Joseph, D.D.S.
June 02, 2014
Category: Oral Health
Tags: oral health  
StrictInfectionControlProtectsDentalPatients

It’s rare now to encounter a news story about an infection spreading among a group of dental patients — a rarity thanks to the development of standards and procedures for infection control. As these standards have improved over the last few decades, the prevention of infection stemming from dental treatment has become more effective and easier to perform.

Like other healthcare providers, dentists are held (and hold themselves) to a high legal, moral and ethical standard to stop the spread of infection among their patients, and both governmental authorities and professional organizations mandate safety procedures. The United States Center for Disease Control regularly publishes recommendations for disinfection and sterilization procedures for all healthcare providers and facilities, including dental clinics. Dental and medical licensing bodies in each U.S. state also mandate control procedures and have made continuing education on infection control a condition of re-licensure.

For both medical and dental facilities, blood-borne pathogens represent the greatest risk of infection. These viral infections spread through an infected person’s blood coming in contact with the blood of an uninfected person, via a cut or a needle injection site. One of the most prevalent of these blood-borne diseases is hepatitis. This disease, which can severely impair the function of the liver and could be fatal, is caused by either of two viruses known as HBV and HCV. Any medical facility that encounters blood through needle injection or surgical procedures (including blood transfusion and surgical centers, and dental offices) must have a high degree of concern for controlling the spread of hepatitis and similar viral diseases.

Infection control protocols cover all aspects of potential exposure, including protective wear for workers and patients, proper disposal of contaminated refuse and disinfection of instruments and facilities. These comprehensive procedures not only keep patients safe from viral exposure, they also protect healthcare providers who experience greater exposure and risk for infection than the patients they serve.

Thanks to this strong emphasis on infection control, your dental visits are reliably safe. If you do have concerns, though, about the risk of infection during a dental visit, please let us know — we’ll be happy to discuss all we do to protect you and your family from infection.

If you would like more information on infection control, 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 “Infection Control in the Dental Office.”


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Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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