Vivian Medina, DDS

Dr. Vivian Medina is a graduate of Creighton University. After working as an associate for several years, she opened a private practice in 1993.

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3630 Madaca Ln.,
Tampa, FL 33618
(813) 264-0286
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By Vivian Medina, DDS
February 15, 2019
Category: Dental Procedures
Tags: teeth whitening  
3QuestionsYouShouldAskbeforeUndergoingTeethWhitening

There are a number of teeth whitening options to put the brightness back into your smile — from professional dentist office applications to over-the-counter products for home use. But before you decide on an option, you should first consider whether whitening is right for you and to what extent.

Here are 3 questions to ask yourself — and us — before undergoing a whitening treatment.

Do I have any dental problems that make whitening problematic? The underlying cause of the staining may stem from decay, root canal problems or other dental issues; in these cases the underlying cause needs to be treated first, because whitening would only mask the actual problem. You also may not want to whiten your teeth for aesthetic reasons: people with certain features like short teeth or gummy smiles may find these features become more prominent after teeth whitening. It might be more advisable in these cases to consider other cosmetic options first.

How much whitening do I really need to improve my smile? One of the biggest myths about teeth whitening is the brighter the shade the more attractive the smile. A truly attractive tooth color, however, is more nuanced, and every person’s ideal color is different. The most attractive and natural color is one that matches the whites of your eyes.

What effect will whitening have on existing dental work I already have? In most cases, none — and that could be a problem. Composite resins or ceramic dental material have their color “baked in” and bleaching chemicals used in whitening have no effect on them. The concern then is whether whitening nearby natural teeth may produce a color mismatch between them and the dental restorations, resulting in an unattractive appearance.

Before you decide on teeth whitening, visit us first for a complete exam and consultation. We’ll discuss whether whitening is a good option for you, or whether there are other issues we should address first. We can also advise you on products and techniques, and how to get the most from your whitening experience.

If you would like more information on teeth whitening, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Important Teeth Whitening Questions…Answered!

FindoutWhatKindofToothStainingyouHaveBeforeSeekingaSolution

Stained teeth can be embarrassing — so much so you may even hesitate to smile. Before you seek out a whitening solution, though, there are a few things you need to know about tooth staining.

Tooth staining is more complex than you might think. There are actually two types: extrinsic, staining from foods and other substances of the outer surface of the enamel; and intrinsic, discoloration deep within a tooth that affects their outward appearance. The latter staining has a number of causes, including the type of dental materials used to fill a tooth, a history of trauma or the use of the antibiotic tetracycline during early tooth development.

There are some noticeable differences between the two types, although an examination is usually necessary to determine which you have. Extrinsic staining tends to be brown, black, or gray, or occasionally green, orange or yellow. Intrinsic staining can be red, pink or, if caused by tetracycline and fluoresced under ultraviolet light, yellow. If only one tooth is discolored it’s most likely intrinsic due to decay in the tooth pulp.

What can be done also depends on which type. Extrinsic staining can be modified through whitening, with either an office application or a home kit (there are differences, so you should consult with us before you decide). It may also be essential to modify your diet by restricting foods and beverages (coffee, wine or tea) known to cause staining and by eliminating tobacco use. You should also practice daily hygiene, including brushing with a toothpaste designed to diminish staining, and regular office cleaning and polishing.

Intrinsic staining can’t be addressed by these methods. Instead, you may need to undergo a procedure where we enter the interior of the tooth and insert a bleaching agent. If this isn’t an option, you can also choose a cosmetic restoration such as a porcelain veneer or crown that will cover the tooth to better match the color of your other teeth.

Dealing with stained teeth begins with a visit to our office to determine what type of discoloration you have and to learn your options. But regardless of what type you have, there is a way to a brighter smile.

If you would like more information on the causes and treatments of tooth staining, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Staining.”

By Vivian Medina, DDS
January 26, 2019
Category: Dental Procedures
SingerDuaLipaSeestheWisdominPostponingTourDates

When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.

“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”

The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”

A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.

It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.

So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Vivian Medina, DDS
January 16, 2019
Category: Oral Health
Tags: jaw pain  
ChronicJawPainCouldbeRelatedtoOtherInflammatoryConditions

If you're suffering from jaw pain or impaired function, it may not be the only source of chronic pain in your body. Of the millions of adults with temporomandibular joint disorders (TMD), many have also been diagnosed — among other conditions — with fibromyalgia, rheumatoid arthritis or sleep problems.

TMD is actually a group of painful disorders that affect the jaw joints, muscles and surrounding tissues. Besides pain, other symptoms include popping, clicking or grating sounds during jaw movement and a restricted range of motion for the lower jaw. Although we can't yet pinpoint a definite cause, TMD is closely associated with stress, grinding and clenching habits or injury.

It's not yet clear about the possible connections between TMD and other systemic conditions. But roughly two-thirds of those diagnosed with TMD also report three or more related health conditions. Debilitating pain and joint impairment seem to be the common thread among them all. The similarities warrant further research in hopes of new treatment options for each of them.

As for TMD, current treatment options break down into two basic categories: a traditional, conservative approach and a more interventional one. Of the first category, at least 90% of individuals find relief from treatments like thermal therapy (like alternating hot and cold compresses to the jaw), physical therapy, medication or mouth guards to reduce teeth clenching.

The alternative approach, surgery, seeks to correct problems with the jaw joints and supporting muscles. The results, however, have been mixed: in one recent survey a little more than a third of TMD patients who underwent surgery saw any improvement; what's more alarming, just under half believed their condition worsened after surgery.

With that in mind, most dentists recommend the first approach initially for TMD. Only if those therapies don't provide satisfactory relief or the case is extreme, would we then consider surgery. It's also advisable for you to seek a second opinion if you're presented with a surgical option.

Hopefully, further research into the connections between TMD and other inflammatory diseases may yield future therapies. The results could help you enjoy a more pain-free life as well as a healthy mouth.

If you would like more information on TMD, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Chronic Jaw Pain and Associated Conditions.”

By Vivian Medina, DDS
January 06, 2019
Category: Dental Procedures
Tags: porcelain veneers  
ANewVeneerwithMinimalorNoToothAlteration

Dental veneers, thin layers of porcelain bonded to chipped, stained or slightly crooked teeth, are an effective and affordable way to transform your smile. Their color, translucence and shape blend so well with the rest of your teeth that it's often difficult to tell them apart.

But traditional veneers have one drawback: although they're less than a millimeter in width, they can still appear bulky on unprepared teeth. To help them look more natural, we often have to remove some of the enamel layer from the tooth surface. Enamel doesn't grow back, so this alteration is permanent and the prepared teeth will require a restoration from then on.

But you may be able to avoid this—or at least keep the alteration to a minimum—with no-prep or minimal-prep veneers, two new exciting choices in cosmetic dentistry. About the width of a contact lens, we can bond these much thinner veneers to teeth with virtually no preparation at all or, in the case of a minimal-prep veneer, needing only an abrasive tool to reshape and remove only a tiny bit of the enamel.

These ultra thin veneers are best for teeth with healthy enamel, and can be placed in as few as two appointments. And besides being less invasive, the procedure is reversible—we can remove them and you can return to your original look without any follow-up restoration. One caveat, though: because of the strong bonding process used, it's not always easy to remove them.

Although their thinness makes it possible to avoid or minimize alterations, there are some dental situations like oversized teeth that may still require extensive tooth preparation. With some poor bites (malocclusions) orthodontic treatment to straighten the teeth may also be needed first.

All in all, though, no-prep or minimal-prep veneers could help you avoid the permanent tooth alteration that usually accompanies their thicker cousins. What's more, you'll have the beautiful, transformed smile that veneers can achieve.

If you would like more information on minimal or no-prep veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “No-Prep Porcelain Veneers.”





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