3013 N. West St.
Flagstaff, AZ 86004
282 E River Rd.
Tucson, AZ 85704
12320 North 32nd Street, Suite 1
Phoenix, AZ 85032
Panietz, Karen R D.D.S.
10613 W Olive Ave # 201
Peoria, AZ, 85345-7339
Northwest Endodontics Ltd
7972 W Thunderbird Rd # 103
Peoria, AZ, 85381-4903
Kerr, Mark A D.D.S.
1355 S Higley Rd # 116
Gilbert, AZ, 85296-4789
Hooker, William J D.D.S.
718 N Humphreys St # 102
Flagstaff, AZ, 86001-3046
The appearance of your teeth is heavily impacted by the position of the surrounding gum tissue. In a normal situation, two teeth that are side by side in your mouth have contact with each other. Below this contact, the area is filled in with gum tissue in the shape of a triangle. This triangular-shaped gum tissue is called the papilla. It is not uncommon to have an empty space in the area where the papilla is supposed to be. If this occurs, the result is perceived as a black space.
They are caused by a loss of the gum tissue itself or by the shape and/or position of the teeth. For any black space that is present, the first thing that needs to be done is to diagnose what caused it to occur. Once this is done, the restorative dentistry treatment choice can be made. The best decision will be the most conservative treatment that corrects the black space.
One of the most common causes of loss of gum tissue is due to the gum disease known as periodontitis. This gum disease acts on the supporting bone around the teeth, causing a loss of bone. This loss of bony support causes the papilla to slump and flatten, creating a black space between the teeth. The first step in treating the resulting black space in this situation is to treat the cause. Once the gum disease is under control, the black spaces can then be addressed with restorative dentistry.
To remove the black spaces, the teeth need to have restorations placed that will change the shape of the teeth and fill in this space. The type of restorative dentistry can vary depending on whether or not there are any other problems with the teeth. The simplest and most conservative restoration is composite, a tooth-colored filling material. It can be bonded directly on the tooth in the area of the black space. Since it is placed only in the affected area, the situation where this is used requires that the overall appearance of the tooth is acceptable and does not need to be changed.
If the overall appearance of the tooth needs to be altered, then a different type of restorative dentistry needs to be used. The choice is either a dental veneer or a dental crown. The choice between the two depends on both the appearance and the structural changes that need to be done. Usually, to correct a black space, both teeth on either side need to be restored. In doing this, the symmetry between the teeth will remain the same. If you restored just one tooth, you would end up with one tooth being wider than the other. The advantage of using restorative dentistry to correct black spaces is that it usually results in a shorter treatment time.
Another cause of the black space is due to the position of the teeth themselves. One example is teeth that are tilted towards each other. When this occurs, the area for your gum tissue to fill becomes too large for the amount of tissue you have. This same concept may occur with certain types of tooth shapes. In these instances, the restorative dentistry treatment of choice is to use orthodontics (braces) to align the teeth. The advantage of doing this is that the black space will disappear without having to do any restorations on the teeth.
By Greggory Kinzer, DDS, MSD
If you require a dental crown to be placed, it is a good idea to talk to your cosmetic dentist about how you feel about the color of your existing teeth before beginning the process. If you like the color of your teeth, your cosmetic dentist will then find a color that matches the crowns.
On the other hand, teeth bleaching may be an option for you. If you feel you would like to whiten or lighten your teeth, it is a good idea to communicate this to your cosmetic dentist beforehand. Once the final restorations are made, it will not be possible to change their color without redoing them.
If you desire whiter teeth before the cosmetic crowns are placed, the best way to achieve this is to talk to your cosmetic dentist about at-home teeth bleaching. With this procedure, custom-fitted plastic trays will be made for your teeth and you will be given some small tubes of teeth bleaching material.
Your cosmetic dentist will show you how to place a small amount of teeth bleaching material in the tray and then place the tray in your mouth. If any excess material squirts out of the tray onto your gums, you will want to remove it with your finger or a toothbrush.
The tray is then worn for one to two hours in the evening, depending on the type of teeth bleaching material. The biggest advantage of this method of teeth bleaching as compared with procedures that are done in your cosmetic dentist's office is that you are the one that can control how white you want your teeth to be.
Since you are the one in control, you can stop the teeth bleaching whenever you feel you have achieved the desired color. The typical teeth bleaching time is one and one-half to two weeks, but it may be longer.
You may experience that your teeth become sensitive to cold air or liquids during the teeth bleaching process. This is normal and will subside and finally go away when you stop the teeth bleaching.
There are a couple of things you can do to decrease this sensitivity if it arises during the teeth bleaching process. One is to only bleach every other night. By taking a break after each night of teeth bleaching, your teeth will not be as sensitive.
The other is to have your cosmetic dentist prescribe you a fluoride gel that you can place in your custom teeth bleaching trays every other evening. The fluoride acts to decrease the sensitivity by coating or sealing the tooth surface and it will not affect the color of your teeth. This is the most reliable way to decrease sensitivity while you bleach.
Once you get your teeth to the desired color , your cosmetic dentist will have you wait about three to four weeks before taking a color match of your teeth in order to make the final restoration. During this time, the color of your teeth is stabilizing.
Teeth bleaching is very predictable, but the results will not last forever. Since the restorations were placed when your teeth were at their whitest, you will most likely find that in one and one-half to two years, the restorations may begin to appear lighter than your natural teeth.
This result is to be expected. It is not caused by a change in color of the restorations, but rather by your own teeth getting darker. At this point, all that is required is to, once again, bleach your natural teeth until the color is evened out. Usually, this only requires teeth bleaching a couple of times.
After the color is evened out, you can then expect to have the color stability last for another one and one-half to two years. On the other hand, if no restorations were placed by your cosmetic dentist after your teeth bleaching, you will most likely not notice the teeth changing color because there is no reference to help judge this change.
By Greggory Kinzer, DDS, MSD