Straight Talking: Dr Cohan Rajan

By: Dr Cohan Rajan
Created on 21st February 2011

Dr Cohan Rajan is the principal dental surgeon at dental-Spa in central London. Every issue he discusses the latest treatments and procedures and answers your dental questions

My dentist says I have an ‘incorrect bite’. What does this mean?

Incorrect bite is a term that generally means that the way the upper and lower teeth come together has the potential to cause damage to the teeth and jaw joints, usually accompanied by tension in the jaw muscles, neck and upper back.

If left untreated, an incorrect bite can lead to excessive wear of the teeth leaving teeth differently shaped with diamondlike facets. It can also lead to poor jaw joints with clicking and locking out of the jaw. This trauma to the jaw usually leads to pain in the jaw and arthritis.

Alignment of poor bites as an adult is now easily treated, and I prescribe Invisalign for my patients to ensure a good aesthetic during and after treatment as well as to avoid the problems outlined above.

What would you recommend for tetracycline stained teeth that are healthy and straight?

Tetracycline staining occurs because tetracycline, an antibiotic, was given during development of the teeth. The teeth have horizontal bands of discolouration.

Depending on what age the antibiotic was given, these bands of staining can be anywhere on the teeth but most commonly are darker towards the gum line. The colour of the banding can range from a barely visible light yellow to a very dark brown with everything in between.

For all patients wanting treatment I would start with a Deep Bleaching Protocol. This is a combination of home whitening and in-office whitening and I think that Enlighten is the best product for this. In milder cases, I have seen enough improvement so that the discoloured banding and the normal tooth structure all get whitened to the same level. Often, extended home whitening, for six to eight weeks, combined with in-office whitening can deal with the more serious cases, but it is unpredictable.

For the most severe cases, no amount of whitening will work so I would prescribe minimally invasive veneers. These can be made with hardly any removal of tooth tissue and combined with a more opaque resin bonding material can make a discoloured smile into a beautiful one

Masterclass... Deep Bleach Protocol

Deep Bleach Protocol is the only teeth whitening protocol that I prescribe because it predictably whitens teeth. First, perfectly fitting, re-useable trays are fabricated under a patented system to provide an excellent, suction on fit allowing the whitening agent to work best.

I use the Enlighten 15 day home whitening kit that gradually increases the concentration of the whitening gel to penetrate deeper into the tooth and reduce sensitivity.

Next is a photo-activated bleaching treatment. This is different from laser whitening because the whitening gel is used in the trays. Comparatively, a much lower concentration of whitening gel is used making it is very comfortable. Because the teeth are covered by the trays, there is no drying out of the teeth associated with laser whitening.

This is why the results we achieve last for a long time while laser whitening results fade more quickly as the teeth rehydrate.

Before and after Deep Bleach Protocol