Nathan Mayo, DDS
Nathan Mayo DDS General Dentistry
429 Lake Howell Road
Maitland, FL 32751

(407) 671-4445

8 a.m. - 5 p.m. M-Th
8 a.m. - 1 p.m. F
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Teeth Whitening Methods

10/19/2015

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Should I get my teeth whitened? If so, how?  These are questions many people ask themselves from time to time and, in all honesty, it depends! We understand how important it is to have a smile you can be proud of, and we love seeing those smiles on all of our patients. We do hope to avoid, however, unrealistic expectations that can be picked up through the blindingly white teeth you see in pop-culture media; those mouths can cost upwards of tens of thousands of dollars and it just isn’t realistic to expect your mouth to look like that without being ready to spend some serious cash. One of the best ways to set yourself up for failure is to start with unrealistic expectations. However, we also don’t want you feeling discouraged, because there are ways we can noticeably brighten your smile without costing an arm and a leg. Now that we have managed our expectations a bit, let’s talk about the basics.

There are a number of approaches to fixing tooth discoloration and maintaining a happy, healthy, beautiful smile. Each of these approaches have pros and cons and one may be better in certain situations while another is more appropriate in others.

Keep in mind before starting any whitening program that man-made materials, such as stained white fillings or crowns will not change color and will look worse as the bleaching gets whiter and whiter. However, that can be a good thing because you probably needed to have those old restorations replaced anyway!

Whitening Toothpastes
Effectiveness: Low
Cost: $

If you haven’t already, this is likely going to be the first thing you try: it’s cheap, doesn’t require an office visit, and can be picked up on a whim at the grocery store. What you need to know, however, is that all toothpastes help fight surface stains using mildly abrasive polishing agents. What separates whitening-specific toothpastes with the ADA Seal of Acceptance from regular toothpastes are additional special chemicals or polishing agents. Overall, whitening toothpastes may be worth keeping around if you find they help you, but you shouldn’t be expecting any miraculous changes using these toothpastes. A mix of baking soda and hydrogen peroxide is cheap and works just as well, if you can put up with the taste. Just as an aside, it should be noted that basic oral hygiene, like regular brushing, flossing, and dental cleaning appointments are your first line of defense against unwanted discoloration.

Over-the-Counter Whitening Strips
Effectiveness: Moderate
Cost: $$


Whitening strips are available at your local pharmacy or grocery store and have been gaining in popularity over the years. If you’re looking to brighten your smile a little bit and haven’t found whitening toothpaste to be especially helpful, these strips may be an option to consider. It’s important to follow the individual instructions on the packaging of the brand of strips you get, but, in general, you will be expected to keep the strips in your mouth for up to 45 minutes at a time, sometimes several times per day, for up to a couple weeks. While similar in many ways to the next method I discuss, there are some key differences.

Strips can be messy. When I tested them out, I couldn’t get the darn things to stay where I put them and I found myself constantly messing with them with my tongue. The weaker whitening substance and the shorter duration these treatments use can require higher frequency of use and a longer duration of the whitening regimen. I will say that I did notice a brighter smile after using the strips.

Office-Made Trays and Prescription Whitening Gel
Effectiveness: High
Cost: $$$


Trays are a glorious way to whiten your teeth. Unlike whitening toothpaste or strips, trays take advantage of your dentist’s skill in producing a highly refined custom-fit set of trays in combination with prescription strength whitening gel. Like most instances of “you get what you pay for,” custom trays provided for a more comfortable treatment regimen and a more dramatic result. Don’t let that scare you off, the price may be higher than strips, but not prohibitively so. Typically, during treatment you will be instructed to wear your trays while you sleep at night for about a month.

One noteworthy side effect from use of either strips or trays is the potential for enhanced tooth sensitivity during and immediately following the whitening regimen period. About 50% of people who use trays experience some sensitivity to cold. I found switching to Sensodyne during my whitening regimen provided just what I needed to counteract the sensitivity from the whitening, but results may vary. If you are worried at all about how whitening will affect your tooth sensitivity, consult your dentist!

In-Office Whitening
Effectiveness: High
Cost: $$$$


In-office whitening systems vary by office. Using an in-office whitening treatment, you can expect better results, faster. There may be some followup work to be done at home, but this is minimal. Some in-office whitening treatments are nearly pain free, but some can cause sensitivity and pain.

At this point, you should be discussing the particulars of your needs and treatment options with your dentist. Just make sure to ask good questions and listen carefully. Being an informed patient is important, and dentists cannot read minds, so ask those questions!
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Toothbrush Reviews: How Does Your Choice Stack Up?

10/14/2015

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We find ourselves in a glorious age for great diversity of tools to maintain your oral hygiene. The most important of these is, of course, our toothbrush. The price range for toothbrushes these days is rather large, starting with your basic, no-frills manual toothbrush for a couple bucks going all the way up to the most expensive of electric/sonic toothbrushes which can cost you $200. Today we are going to be looking at the various types of toothbrushes available in today’s market, discussing some pros and cons, and giving Dr. Mayo’s overall recommendations.

One rule that applies to all toothbrushes, cheap or expensive, is that you need soft bristles. The reason for this is fairly simple: your gumline. In fact, soft tissue is going to be a big motivating factor in a lot of the analysis I go through today. You see, there is a constant tradeoff that must be considered when brushing your teeth: you want to clean your gumline without damaging it (which can leading to receding gums). The best way to protect them, from a purely “hardware” standpoint, is to only buy toothbrushes with soft bristles--the more firm the bristles, the greater the likelihood that you will damage your gums and teeth. Receding tissue is associated with a myriad of problems, but that’s for a whole other article.

​For the purposes of this article, I’ll be discussing four main archetypes of toothbrushes: manual, electric, sonic, and ionic. So let’s start with the age old manual toothbrushes and go from there.


Manual Toothbrushes:
Doc’s Ranking: 3rd place

Let’s be honest, there is only so much you can do to a manual toothbrush to aid in its effectiveness. In this realm, technique is king (well, technique is important for all brushes, but especially with manual toothbrushes). You will want to carefully brush all exposed surfaces on each of your teeth with your toothbrush at a 45 degree angle to your gums. Here is a helpful graphic, put together by the American Dental Hygienist Association, which describes proper brushing technique:

ADHA: Proper Brushing Technique (new window)

Don’t get me wrong, a manual toothbrush is all you need (brush-wise, we can’t forget floss, can we?) to keep your teeth healthy and happy. But, you can’t expect to just zone out and move the brush around in your mouth and get the results you’re looking for. With manual toothbrushes, the old adage “garbage in, garbage out” most certainly applies. You want to be sure to cover all exposed surfaces on each of your teeth, and you want to make sure you do that well.

Electric Toothbrushes:
Doc’s Ranking: 1st place (tied)

These are toothbrushes you will commonly see from companies like Oral B. They rely on mechanical movement of the head/bristles in order to aid in the cleaning process. Optimally, you will use proper technique with your electric toothbrush and the clean you get will be much better when compared to a manual toothbrush. However, one common psychological effect of using that shiny new electric toothbrush is that you may focus less on proper technique and rely more on the mechanical function to do the cleaning. Even so, these electric toothbrushes are still likely to provide a better cleaning than a manual toothbrush. It is, again, important to stress that overzealous use of brushes on the gumline can lead to recession.

Sonic Toothbrushes:
Doc’s Ranking: 4th

Sonic toothbrushes have taken the dental world by storm. Widely hailed as the greatest thing in dentistry since the proverbial “sliced bread,” these brushes have been gaining in popularity. This surge in popularity has led to increasing options and a larger range of pricing (generally between $40 and $200), not to mention increased visibility.

Dr. Mayo is not overwhelmed by the performance of sonic toothbrushes.

It is his professional belief that sonic toothbrushes can do more harm than good. Much like a brush with more firm bristles, a sonic toothbrush can be too much for the overzealous brusher’s tissues. Recession of the gumline is not uncommon because overbrushing is easy. Yes, the ultrasonic movement of the bristles can easily rip plaque right off the teeth, and sonic toothbrushes can provide benefits by reducing gum bleeding and reducing mouth odor. These benefits can be overstated and ignore the possibility of causing the gumline to recede.

Ionic Toothbrushes:
Doc’s Ranking: 1st (tied)

Ionic toothbrushes are relatively lesser-known, so if you are aware of these brushes, kudos to you! If you are not aware, worry not, I will tell you all you need to know about them here!

Ionic toothbrushes work much like a manual toothbrush, using no moving parts, no vibration, no bells and whistles to make you feel special. But would you rather have something that makes you feel fancy, or something that works? These toothbrushes work by producing an electric charge on the surface of the teeth that repels plaque--even in those hard to reach areas. While it may sound like some Hollywood hocus pocus, it really does work and leaves your teeth feeling clean and smooth all day long. Being that there are no moving parts like the electric and sonic toothbrushes, technique comes more to the forefront when evaluating the efficacy of the ionic toothbrush. Yes, you may need to focus a little more to make sure you get a good clean (unless you’ve developed the muscle memory that comes with practicing good cleaning), but the ionic action is truly remarkable.

Dr. Mayo recommends Dr. Tung’s Ionic Toothbrush, which can currently be purchased from Amazon.com for about $20. At that price point, even if you’re not sure how you’ll like it, how can you not give it a try? No, we don’t get a kickback or any other compensation for recommending Dr. Tung’s Ionic Toothbrush, we just know it works and, like any recommendation you receive from Dr. Mayo, profit is not a motivating factor, we just want to provide you with the best possible tools to accomplish your oral hygiene goals.

What do you think? Have you tried these brushes and what did you think when you changed from one to another? Leave notes or questions in the comments!
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The Insurance Game

10/8/2015

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As much as we’d like to believe that all medical professionals, to whom we entrust our health and well-being, have our best interest at heart, that is, unfortunately, not always true. Some stories regarding the absolutely absurd conditions surrounding some malpractice lawsuits show that a Doctor can be a no-good swindler just as bad as any fly-by-night snake oil salesman. Inflated prices, unnecessary procedures, sloppy work, and other undesirable behaviors are not as uncommon as we would like.

Dr. Mayo believes in “The Golden Rule.” As an adherent to the principles of this rule, all treatment recommendations and prices given to you are designed to reflect the actual cost of the treatment and the value of the experience Dr. Mayo has to offer you, his valued patient. There is no “nickel and diming” here, which is why we don’t charge for use of nitrous oxide gas (AKA Laughing Gas), like at some other practices. It doesn’t matter what insurance plan you have, a crown from here costs what a crown costs. While others might play “the insurance game,” Dr. Mayo does not.

If a tooth can be successfully filled, we fill it, not crown it. If a crown is truly needed, that’s what it gets. Insurance is not a factor in the decision process.

When you become one of our patients, we treat you the way we think we should be treated because you are a human being.
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Crowns vs. Bonding: The Inside Scoop

9/21/2015

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So there you are, minding your own business eating your lunch when, out of nowhere, you bite down on something HARD. Unfortunately, you bit down so hard that you chipped, cracked, or otherwise broke a tooth or teeth. Anyone who has had something like this happen to them knows that a visit to your dentist could end up resulting in a rather pricey procedure.

Many dentists would order a crown be put in place and be done with it. This, however, can present a number of issues. The first question is whether a crown is needed at all; could composite bonding do the job instead? A good dentist would never want to remove any more of the natural tooth than what is needed in order to fix the problem. Generally speaking, crowns require the tooth to conform to a particular shape in order for the crown to sit properly. This usually means some amount of grinding the tooth away in some places, building it up in some places, or both. This alone is a good enough reason to resort to crowns only in cases where it is absolutely necessary. But that’s just a part of what needs to be considered when determining if a crown is desirable. Another big consideration is, of course, the cost!

Many dentists would just put a crown on our hypothetical chipped tooth, but another important option is the use of composite resin bonding. Bonding has some significant advantages over crowns. It helps preserve the part of the tooth that remains, requires less preparation, provides us with the ability to manipulate color easier than with a crown, reduces the risk of nerve damage, and costs about a third of the price of a crown. There is a bit of artistry required to make sure the bonding looks natural, but Dr. Mayo is nicknamed the Bondo King for a reason!

Many people who are told by their dentist that they need X number of crowns with build up, will be hit with sticker shock when they see that estimate on paper. They may be so shocked that they seek a second opinion. Seeking a second opinion is a great idea when considering any large purchase, especially when it involves your health and oral hygiene (not to mention your wallet). Unfortunately, it is not uncommon for Dr. Mayo to find that a good portion of the recommended work either does not need to be done, or that an alternative treatment could be done without such a high cost and without unnecessary damage to the tooth.

Nothing lasts forever. Whether you get a crown or have bonding done, you will likely need to get the work replaced at some point in your life. Wouldn’t you prefer the savings that composite bonding provides? I know I would!



P.S. For some examples of Dr. Mayo's bonding work, check out our Gallery!
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