Bleaching Proved Safe on Enamel

Q:   I am interested in bleaching my teeth. Are there any ill effects that permanently alter my enamel?

A:  The April Journal of the American Dental Association (JADA) contained a study done at a very well respected Italian University’s biomaterial and biomedicine department. They tested real teeth exposed to high-concentration of 38% hydrogen peroxide, commonly used for in-office whitening treatment.

The results showed no roughness alterations of the enamel surface under the scanning electron microscope, even with prolonged and repeated applications.

Several light activated methods are commonly used: Zoom, Rembrandt, Sapphire Whitening, and Brite Smile. Avoid flea market and trade show booth whitening "tents."

Atrial Fibrillation

Q:  I have a heart problem called atrial fibrillation and am worried about starting my dental treatment which includes extractions, implants and bridge work. Should I be worried?...LBJ in Pasadena

A:  Atrial fibrillation (AF) is a cardiac rhythm disturbance arising from disorganized electrical activity in the chambers of the heart. Very often patients are treated with the drug Coumadin to prevent the formation of clots and the possibility of a stroke and beta blockers such as Atenolol to control the heart rate.

Several precautions should be considered: Your hygienist should avoid using ultrasonic scalers during teeth cleanings, but instead use hand scalers. Some local anesthetics containing drugs that constrict blood vessels (vasoconstrictors) need to be used in ways that prevent direct injection into blood vessels. Certain antibiotics, pain medications and anti-anxiety agents prescribed during dental treatment can decrease the effectiveness of the drugs used to treat AF.

You may have all the above needed dental procedures as long as your dentist keeps a few points in mind, starting with a chat with your physician.