Dr. Heher…in His Own Words

Thoughts and Opinions for Your Consideration…

I've practiced dentistry for over 30+ years. In that time, I've continued my extensive education, trained with some of the top dentists in world, and amassed a wealth of knowledge and experience. I've treated countless patients and have seen dental trends come and go. Along the way, I've developed some likes, dislikes, and personal opinions. I think knowledge is power, and if I share some of my knowledge with you, I think you benefit. Included in this section are some of the newsletters that I've sent out to active patients, along with some of my thoughts on various dental procedures, both pro and con.

Advantages of Using a Rubber Dam

Rubber dam is a sheet of rubber placed over the mouth with small holes punched in the dam to allow the teeth being worked upon to protrude through the holes. Similar to a surgeon's drape, it isolates the teeth, preventing anything from falling into the back of your mouth and providing dry conditions, so necessary with modern dental materials. The use of the dam dates back over 100 years and its use is taught and advocated by every dental school and many dental materials manufacturers worldwide. However, for various reasons, very few dentists utilize rubber dam after graduation. Granted, one can obtain similar results without using a rubber dam, but the predictability of results cannot be assured without a dam. The longevity of restorations, even though they may look the same initially, is often compromised. It just provides a consistently superior restoration when used.

Zoom! Teeth Whitening

Both Zoom and BriteSmile tooth whitening systems are heavily promoted by their manufacturers, who receive a percentage of the fees charged every time their lights and proprietary bleaching solutions are used. They do work, but independent research shows that identical results can be obtain at usually a lower cost by home-use bleaching trays. If you have a wedding to go to this weekend, then these bleaching lights are probably the way to go, but if you plan ahead, in my opinion, trays will give you the same results, probably at a lower cost, in just a few days more by wearing the trays while you sleep. Like roots growing out from bleached hair, the bleached teeth will darken over time unless the dentist provides bleaching trays; if one has bleaching trays, the teeth can be easily re-lighten with a touch up of the bleaching solutions. Without the trays, you'll have to undergo another visit to the dentist to re-bleach the teeth. While both treatments (bleaching lights and trays) can cause tooth sensitivity, there is usually less sensitivity with the bleaching trays. Further, the bleaching lights tend to bleach the outside of your teeth, whereas with the bleaching trays, both inside and outside of the teeth will lighten. (Envision a light bulb with the back half of the bulb darker than the front half, or a porcelain dinner plate, with the underside darker, and I think you'll get the concept of bleaching both the inside and outside of the teeth.) An additional cost factor with any bleaching system is that they will not bleach any existing restorations, and your restorations may appear much darker after bleaching, necessitating their replacement with a lighter colored material.

No-Prep Veneers

This is a heavily promoted product by a company under the brand name, Lumineers™. There are indications when they are useful such as on people with very small genetically malformed teeth and people with front teeth positioned tongueward. Standard veneers require some tooth removal to prevent an over-contoured appearance to the end result. No prep veneers will overlay the teeth, making them look bulkier and I have yet to understand how the margin of the no-prep veneer will not promote gum problems at the gum line. They obviously are easy to do (read: NO-PREP) and thus profitable, but in my opinion, to mimic a tooth, some tooth structure must be removed.