Michael Iott Dental Blog

The promise of whiter, straighter teeth appeals to almost everyone, except perhaps those who already are blessed with them. Lumineers have been extensively advertised as one solution. Lumineers are porcelain veneers, made in the same way as other porcelain veneers. But the manufacturer of Lumineers claims their product is unique in that they are extremely thin, about as thin as a contact lens, and can be bonded to your teeth with no ‘prep’ work, meaning no drilling and so forth usually associated with the placement of standard porcelain veneers. Sounds good, right? Well, that depends on what’s wrong with your natural teeth. If your teeth flair in towards your tongue and need to be built outwards, Lumineers might be the ideal solution. But for those with other issues, you may end up with teeth that feel and look unnatural. For many cosmetic dentists, the issue lies in the fact that the surface of the tooth is unprepared. They feel the prep work is essential to a natural result. With standard veneers, your cosmetic dentist can remove as little as half a millimeter from your natural tooth and replace it with the thin porcelain for a natural, non-bulky result. Aesthetically, this result cannot be achieved with the no-prep solution of Lumineers. Prep work also assists with the bonding of the veneer to the natural tooth surface, roughing up the tooth so that the veneer adheres more completely. Of course, if your cosmetic dentist chose to, he or she could complete the same prep work for Lumineeers as they would perform for standard veneers, but that would add to the cost. Skipping this step could mean trouble down the road.

According to experts like Dr. Michael Iott, Lumineers are best suited to individuals whose teeth are tipped back or stick out a bit, because those teeth can be built up to look more even. Because of the no-prep aspect of Lumineers, the product tends to make the teeth bulkier or larger, and even a half a millimeter can feel very odd in your mouth. Additionally, a little bit of an edge might be created along the gum line where the veneer sticks out from the natural tooth, and this could lead to cleaning problems and, eventually, decay.

Many cosmetic dentists, including Dr. Michael Iott, use a veneer lab to create contact lens-thin porcelain veneers that are more aesthetically pleasing. These cosmetic dentists believe the prep work is worth the extra time and money to provide bright, white results that will last for many years with no problems.

Consult with your cosmetic dentist, or contact Dr. Iott’s office today to schedule a consultation to determine if Lumineers or standard porcelain veneers are an option for you.

If your dentist has diagnosed you with TMJ, you might be wondering what you can do at home to relieve your symptoms. Dr. Michael Iott, New York City cosmetic dentist serving Manhattan, NYC and Queens, offers the following suggestions:

Increase blood flow to the area. You can do this with moist heat or ice, but once you experiment to see which works best, stay with it and don’t go back and forth between the two. Apply the heat or ice to the sides of your jaw to assist the flow of blood to this area.

Try stretching your mouth by opening and closing it very gently. No jerky or sudden movements that might further injure the joint. However, also be careful to limit large jaw movements. For example, if you’re going to yawn, hold your fist under your chin to keep from yawning so widely you overstress and further irritate the jaw muscle.

Massaging the joint and the jaw works for some, by bringing more blood to the area to assist with healing.

Purchase a moldable mouth guard from a sporting goods store and use that to hold your teeth in place and support your jaw until you see your dentist.

Limit yourself to soft foods and give your jaw a break from working. Avoid bagels, pretzels, hard candy, or any foods that require intense chewing.

Take one aspirin and call me in the morning. One aspirin followed several minutes later by a self massage using a hot washcloth has worked wonders for some sufferers.

Sit up straight. Watch your posture to be sure you’re not subconsciously stretching your jaw out of place. As you sit and stand, check to see that your cheekbones line up with your clavicle and you ears are naturally in line with your shoulders.

Send your pillow south. Stop using a pillow for a while and try this: Roll up a towel to fit under your neck (it should be about as thick as your wrist). Roll up a second towel to slide in under the small of your back, and put your pillow under your knees. This is a very relaxing position that will allow your jaw to rest.

Stop grinding your teeth. You may not be aware you’re doing this, especially in your sleep. Your dentist can fit you for an appliance you can wear at night that will relieve teeth grinding, called ‘bruxism.”

The common signs of TMJ, (headaches, toothaches, muscle aches of the shoulder, neck and back, and a popping or clicking noise in your jaw when you open or close your mouth) will go away when your condition is corrected. However, see your dentist immediately if you can’t open your mouth, are not able to brush your teeth, or are experiencing sharp headaches, which could indicate your TMJ is getting worse.

BriteSmile is a popular teeth whitening system that uses BriteSmile Procedural Gel to give you the whiter, brighter teeth you’ve been wishing for. The gel is a 15% hydrogen peroxide-based bleaching compound. An "accelerator" is also used before the gel is applied for the second and third times to enhance the effectiveness of the whitening system. The BriteSmile system also uses a gas plasma or light-emitting diode (LED) bleaching light, manufactured by BriteSmile, Inc. specifically for use with their in-office bleaching system. The light illuminates all of the patient's teeth as they are being bleached and activates a ‘photo-initiator’ that enhances the system’s whitening effect, using gentle heat to help with the whitening process.

A Brite Smile teeth-whitening session takes about 60 minutes to complete. You receive two individual bleaching treatments of about 20 minutes. Also included are pre- and post- treatment preparations that round out the hour treatment session.

To determine if the BriteSmile system is right for you, consult with a cosmetic dentist who can evaluate your individual circumstances and expectations. Overall, however, the BriteSmile teeth whitening system provides excellent results for those who are seeking a dazzling white smile.

An alternative to BriteSmile is LumaArch, which delivers whitened teeth that are 2-to-4 shades lighter in about 30 minutes. First, a hydrogen peroxide gel is applied to the teeth. The gel is activated by a special light source directed onto the teeth, and the products combine to remove stains from the surfaces of your teeth.

Compared with BriteSmile’s 15% hydrogen peroxide-based teeth whitener, LumaArch’s whitening system contains 35% hydrogen peroxide. Of course, during both the BriteSmile and LumaArch procedures, treatment precautions are taken to protect your gums and soft tissues from being damaged by the acidic gels.

Compared to two applications of whitening and 60 minutes of time with BriteSmile LumaArch offers three application of whitener, with each application lasting 8 minutes.A xenon-halogen bleaching light illuminates the teeth and activates the bleach to remove stains.

Both BriteSmile and LumaArch produce excellent results. However, for some individuals, tooth sensitivty after the procedure may be an issue, and ocassionally gum irritation may occur.

If you have fillings, veneers, bonding, or crowns, these may not whiten at all or many not match the color of your real teeth when the procedure is completed. Discuss your concerns about this with your cosmetic dentist.

Additionally, if you are pregnant or breastfeeding, avoid whitening procedures that include bleaching.

BriteSmile and LumaArch are highly effective, far more so than home whitening products. But for those who wish to maintain their results at home, tray based teeth whitening product can be used to keep those pearly whites dazzling.

What are dental implants?

Dental implants are small titanium posts inserted into the upper and lower jaws to restore missing teeth. Dental implants are quickly gaining popularity as a great alternative to some forms of dentures.

According to the American Academy of Implant Prosthodontics, implants can:
· reduce movement of dentures, bridges, and/or crowns that have some inherent movement or are beginning to fit improperly due to changes in the bone
· assist with proper chewing
· support and stabilize for removable dentures or fixed bridge work
· feel more like natural teeth- something dentures can never do
· improve speech and appearance, leading to greater self confidence

Are You a Candidate for Dental Implants?

Here are some of the recommended requirements:
· you must be healthy (ability to heal is affected by certain diseases, and this may affect the successful outcome of your implant)
· a thorough and proper diagnosis must be completed before the implant is placed
· implant(s) must be properly treated by both patient and dentist to avoid complications
· heavy smoking and drinking affects the successful outcome of implants, so consider stopping beforehand

Are there different types of dental implants?

There are several types of dental implants, including:

artificial bone substitute
· a synthetic bone substitute that fits on top of the bone and helps rebuild shrinking ridges.
· Provide sturdy support for dentures.
· Made of the same type of mineral found in natural bone, so it bonds to existing jaw bone.

endosteal implants
· inserted into the jaw bone and acts as a substitute for the tooth's root

subperiosteal implants
· a specially-designed implant that fits directly on the existing bone
· an option for those who can not wear conventional dentures


The insertion of your dental implants can be done by a dentist specially training in implantology, or you may choose to receive your dental implants in a hospital setting with an oral surgeon.

Are there any health risks?

According to the American Academy of Implant Prosthodontists:

“Implants are made of biologically compatible materials which have undergone extensive testing over a period of several years. Since these materials are largely metals, such as titanium, and have never been living tissue, there is no likelihood of causing an antigen-antibody response which could cause rejection similar to that which sometimes occurs with heart and kidney transplants.”