__Contactless check-in__

We’ll collect your credit card and [insurance](/insurance) info online for a faster, safer visit, with nothing changing hands. We’ll also tell you exactly what you’ll owe, so there aren’t any surprises.

![FirtTendVisit BrushBag](//images.ctfassets.net/otz9p93fkvjx/4VUer0CP1m9v8TVvCz6zup/b30a5db09ab572a936b50d0bbc53d6c6/FirtTendVisit_BrushBag.png)

__Brush Bag__

When you arrive, we’ll give you a beautiful Brush Bag with oral health products designed by our dentists and hygienists. They’re a smarter way to tend to your mouth between visits.

__The Brushery__

After you’re checked in, we’ll show you into our famous Brushery—a swishy, swirly room just for freshening up. No more awkwardly brushing in the bathroom at work before your visit. 

__Our average wait time is 3 minutes__

We make a superhuman effort to start every visit on time. If you do have to wait, you probably won’t even have time to finish the song in your headphones.

![FirtTendVisit Suites](//images.ctfassets.net/otz9p93fkvjx/6PfXm4FlVckcZzOID3GoLU/cfd23acf296e7437f2e5f8310da81d66/FirtTendVisit_Suites.png)

__A suite prepared just for you__

Next, we’ll show you to your suite, prepped and sanitized just for you. It has personal space to hang your coat, leave your bag, and charge your phone. If you chose a show to watch when you booked, it will be queued up on a ceiling-mounted TV over your chair. If you didn’t choose one, you can do so when you sit down.

__Imaging that’s quick, comfortable, and safe__

Our state-of-the-art Planmeca Promax 3D imaging machine moves around your jaw instead of poking the roof of your mouth or making you gag. This machine turns x-rays into a comfortable, 30-second process. Because the machine is less invasive, it’s less at risk of spreading germs. It also uses 80% less radiation.

__Screening for gum disease and periodontal disease__

After you’ve wrapped up your imaging, you’ll return to your suite. Your hygienist will screen you for gingivitis and periodontitis. If you have one of these diseases, you may not be able to get a normal cleaning. Instead, we’ll recommend non-surgical gum treatment or non-surgical periodontal treatment, which remove harmful bacteria under the gum line and help restore your mouth to health.

![FirtTendVisit Hygienist](//images.ctfassets.net/otz9p93fkvjx/1JMSBbw6H0PyboOyFKlec1/a73ae414f041c851c2df801fc475ff79/FirtTendVisit_Hygienist.png)

__A thorough, gentle cleaning__

If your mouth is free of gum disease and periodontitis, your hygienist will give you a thorough cleaning, using a topical numbing gel so you won’t feel a thing. The tools we use are quieter, gentler, and less intrusive, so you can focus on the TV show you’re watching overhead.

__A beautifying polish__

When your cleaning is finished, your hygienist will give you a polish to remove any cosmetic staining on your teeth. You’ll get to choose between mint polishing paste or a fun flavor like vanilla while you keep watching TV.

![FirtTendVisit Dentist](//images.ctfassets.net/otz9p93fkvjx/2lnw3cabQdVdmsK7AYMqwp/322b92278ae9541a331403d11186cf19/FirtTendVisit_Dentist.png)

__An expert oral exam__

When your polish is finished, your dentist will come into your suite and answer every question you have. Then they’ll examine your mouth and talk to you about your oral health with zero judgment. As part of your exam, you’ll get a complimentary oral cancer screening. Since the mouth can be a front-line indicator of many diseases, dentists can identify early symptoms before they become more serious.

__Only the care you need__

We practice evidence-based dentistry and only offer the care you need, so you can decide whether to proceed with any treatment recommendations confident that your interests and your dentists are truly aligned.

The tools we use are quieter, gentler, and less intrusive, so you can focus on the TV show you’re watching overhead.

![FirtTendVisit InStudio](//images.ctfassets.net/otz9p93fkvjx/21F4zTJtvv9TzN7kki2o9t/f5aefd6489586e65c31c0d320e56aacd/FirtTendVisit_InStudio.png)

__Contactless checkout__

That’s it. Your exam is finished. If you owe anything for your visit, we’ll charge the card we have on file, so nothing needs to change hands. We’ll see you next time!

We make going to the dentist an experience you actually look forward to.


Dental done differently

When you book a dental exam with Tend, here’s what to expect.

Tend Waiting Room and Welcome Bar

Your First Tend Dental Visit | Tend

Your First Tend Visit

The Gargler | Digital Oral Health Magazine - Tend

I’ve worn braces for nearly half my life–14 years on and off, to be exact. That’s a fact that often shocks people (dentists included!). After countless trial and error, I’ve finally come out the other side overjoyed with results from Tend’s Breezy Braces. Before I dive into everything you need to know about them, I want to share more about my overall smile journey because when I say I’ve tried everything, I mean it. Breezy Braces have been my best experience with orthodontics, period.

I was seven years old when my baby teeth all fell out, and my permanent teeth settled in. My two front teeth grew inward (like two covers of a book closing halfway) and I had a significant underbite. I started wearing traditional braces at eight years old, with a Hawley wire retainer in the bottom row that eventually was replaced with braces at 10 years old.

After one braces-free year at 13 years old, my teeth totally relapsed, and I was back to two rows of braces from the age of 14 until 20! It’s hard to find pictures of myself smiling with my teeth those years. Even if I felt enough joy to warrant a giant smile, I often glued my lips together and mustered a close-mouthed smirk, self-conscious about my mouth of metal.

![kristina-braces-journey-2](//images.ctfassets.net/otz9p93fkvjx/1nZwZfQiTQgtheNJJ2g4PB/052b857c2272246bcc8a57f69904a26a/kristina-braces-journey-2.png)

I desperately wanted to feel and look grown up in college, especially as I started building my career studying journalism and interning at magazines. I worked in newsrooms for big-name publications with assignments like fashion week reporting and red carpet interviews where I’d be face-to-face with A-list celebrities. I was thrust into an image-driven industry. Appearances were paramount. While I’d eventually learn that my skills were far more important than my looks, as a young aspiring editor I couldn’t help but worry I wouldn’t be taken seriously if I still looked like a kid. I felt like a real life Ugly Betty! After all, America Ferrera’s iconic character had a full mouth of braces (same), grew up in Queens in an immigrant household (same), and wanted to be a magazine editor (SAME!).

While my braces didn’t stop me from making all my career aspirations come to fruition, I have to admit I was elated to finally have them removed in 2012. My smile was far from perfect, with my stubborn front teeth still crooked and the bottom row crowded, but I was okay with settling if it meant being braces-free.

![kristina-braces-journey-3](//images.ctfassets.net/otz9p93fkvjx/2OqPw4Bn6vdABnv8t3hdh/399ffaa1284b1757f09dadc9081388d0/kristina-braces-journey-3.png)

By 2017, I was working full-time as a beauty editor at a digital publication, testing anything and everything the beauty world had to offer. I reported on oral health, so I was always first to know about exciting innovations. At the time, companies offering clear aligners (the process all done from the comfort of your home) were trending, and I jumped at the opportunity to tweak my smile again. I wore them for a year. I still had more to go, but one necessary tooth extraction later, my retainers no longer fit and my teeth shifted, once again.

This brings us to 2021, when I decided to give orthodontics one last shot with Breezy Braces. Working now as a full-time content creator, and also now a bride-to-be, appearing close-up in photos and videos was top of mind. I teamed up with Tend to document my whole Breezy Braces journey. Here are some big takeaways after wearing them for a year:

![kristina-before-after-breezy-braces](//images.ctfassets.net/otz9p93fkvjx/1qDdEF49jFOpXiDkWoXLd8/a53bf5d736585b4456136ce5870fae56/kristina-before-after-breezy-braces.png)

__Breezy Braces are the only totally invisible option for teeth straightening.__
They were attached behind my top and bottom rows of teeth, so when I spoke, ate, and smiled, no one could see them. They weren’t even visible in videos I’d shoot! This was the main reason why I decided to go with Breezy Braces–even though options like clear aligners are not as obstructive as traditional braces, you still have a sheet of plastic in front of your teeth that’s obvious (especially when we’re talking about a 4K camera capturing content).

__They are low-maintenance.__
I knew that I’d be unreliable if I had Invisalign, which requires compliance to keep them in 22 hours a day. They also have to be removed during eating and drinking. Having used clear aligners before, I knew I’d personally find it annoying to constantly pop them in and out. Breezy Braces, on the other hand, are bonded to your teeth so once they’re in, they’re working at all times to shift your teeth and you’re not responsible for them. As I progressed, I would come into Tend’s studios to get my wires replaced and those appointments with my orthodontist, Dr. Reem, were only necessary once every 6-8 weeks.

__There’s definitely an adjustment period for talking and eating.__ 
The first thing I’d tell anyone interested in Breezy Braces to know, is that you will have a lisp. Your tongue needs to adjust to having braces behind your teeth and it takes some time. It varies person to person, but my lisp faded after two weeks and was fully gone after one month of wearing the braces. 

You might experience soreness on your tongue and gums like I did – the Tend team provided dental wax to cover parts of the wire while my mouth got used to them. By the end of my treatment, I was so comfortable with them I barely noticed they were there. As for eating, you just have to avoid really hard nuts, gum, or anything that could pop off a bracket. I ate soft food for the first couple of days, and just ate regularly after that. Make sure to floss and use a Waterpik to maintain peak hygiene because food will inevitably get stuck! I walked around with GUM soft picks in my purse. 

__Retainers are complimentary.__
Once your treatment is complete, you’ll get clear retainers. I was instructed to wear them at night and also opted to have permanent retainers installed behind my teeth for extra security. I’ve loved the combination of both to ensure my teeth remain straight over time! 

__The process is smooth.__
I think what I appreciated most about Breezy Braces is that the entire Tend team made my experience enjoyable from start to finish. The studios are clean, come with entertainment (watching Netflix while getting my wires put in made appointments fly by), and a calming space to be in. My orthodontist Dr. Reem was incredibly friendly, accommodating for my crazy schedule involving tons of travel, and always willing to answer my million questions. Plus, there’s an app where you can track your progress so you can really see results as they happen.

![kristina-breezy-braces-after](//images.ctfassets.net/otz9p93fkvjx/fOw7edPSyYG0juGMftSxb/2df03cf7584724b0922df302c651d6aa/kristina-breezy-braces-after.JPG)

Overall, I wish Breezy Braces existed sooner because it would’ve been my first choice if I had known about it before! I topped off my experience with Tend’s whitening treatment and I couldn’t be happier with the final results: My smile is totally aligned, the crowding in my bottom row of teeth is resolved, and I am no longer insecure about flashing a big smile. If you’re on the fence about Breezy Braces, definitely book a free consultation to see if it’ll work for you.


Book a free consult with one of our top-rated dentists to learn more about Tend’s Breezy Braces ® 

Ready to take the first step to a straighter smile? 

After 14 years of trial and error with traditional braces, [Kristina Rodulfo](https://www.instagram.com/kristinarodulfo/?hl=en), content creator and former Beauty Director of Women's Health, finally has the smile she’s always wanted.

kristina-before-after-breezy-braces

Kristina Rodulfo is a journalist, magazine editor, and beauty expert. Learn more about her journey with Breezy Braces at Tend.

My Breezy Braces Journey - Kristina Rodulfo

kristina-breezy-braces-after

My Breezy Braces Journey

Unfortunately, without proper care, braces are vulnerable to plaque buildup and cavities. The good news is it only takes a few extra steps to keep your teeth clean with braces.  

Here’s exactly what you’ll need to clean like a professional—and exactly how to do it.

### What you will need:

__Soft toothbrush__

Whether you opt for an electric or manual toothbrush, choose a [soft-bristled toothbrush](https://www.hellotend.com/shop/products/soothsonic) to protect your gums and mouth.

Your new braces can lead to tartar build up at your gum line, so it’s especially important to brush well (in circular motions) in that area. Soft bristles will protect your gums from being irritated when you brush. They’ll also maneuver easily around your hardware without damaging it.

__Anti-sensitivity fluoride toothpaste__

Choosing a [fluoride-based toothpaste](https://www.hellotend.com/shop/products/anticavity-toothpaste) will ensure the most thorough clean. Anti-sensitivity varieties will also help with any discomfort you may be feeling, especially in your first few weeks with braces.

__Oral Irrigator…__

An oral irrigator (also known as a water flosser or Waterpik) is an alternative to standard floss that uses a high-powered stream of water to remove plaque and debris from between your teeth. Because flossing around braces can be tricky, many people prefer to use an oral irrigator, which can be maneuvered more easily around brackets and wires.

__… or Floss Feeder__

If you opt to stick with regular dental floss, a floss feeder (also known as a floss threader) is a must. This handy tool is made of thin plastic with a loop at the end. After putting your floss through the loop, you can easily thread the feeder under the wires of your braces to position the floss.

__Interdental Toothbrush or Proxabrush__

An interdental toothbrush (also known as a proxabrush) is a small, straight, bristled tool specially designed to reach areas that toothbrushes can miss. Its unique shape makes it especially good at cleaning under braces wires.

__Rubber tipped gum massager__

A rubber-tipped gum massager—which looks like a metal rod with a pointed rubber tip at the end—can help stimulate the gums and break up and remove plaque at the gumline. Since this area is often harder to reach with braces, the gum massager can be a useful addition.

__Tongue cleaner__       

[Tongue cleaners](https://www.hellotend.com/shop/products/the-tidy-tongue) come in a few basic designs, but they all serve the same function—removing bacteria from your tongue. Tongue bacteria can easily spread to your new braces, so it’s a good idea to get rid of it with a tongue cleaner. (Bonus: it also helps prevent bad breath!)

## How to clean your teeth with braces

Now that you’ve got the right tools, here’s how to keep that new smile clean.

### 1. Remember to brush after every meal

You’ve probably heard this one before, but now that you have braces, it’s more important than ever. Food particles and debris can (and will!) get caught in your braces during meals. Brushing immediately afterwards is the best way to ensure your braces stay clean and your teeth stay protected.

Bonus tip: if you wear clear aligners ([like Invisalign](https://www.hellotend.com/invisalign)), you need to brush after every meal, too! Always reinsert your aligners into a clean mouth.  

### 2. Go easy on the toothpaste

Believe it or not, less is more when it comes to toothpaste and braces. The foam created by toothpaste can make it hard to see any debris stuck in your braces. A pea-sized amount is just right.

### 3. Don’t brush too hard

Your braces are strong and sturdy—so are your teeth! Even so, be careful not to use too much pressure while you brush. While it’s unlikely that brushing too hard will damage your braces, it can nonetheless lead to problems like recessed gums, tooth sensitivity, and even loose teeth.

### 4. Spend 30” brushing each “quarter” of your mouth for a total of 2 minutes

To start, divide your mouth into four “quarters,” or “quadrants”: top right, top left, bottom right, and bottom left. Each quadrant starts at the center tooth and extends to the back molar.

Then, spend about 30 seconds carefully brushing each quadrant. Many electric toothbrushes have built-in timers you can use; if not, feel free to use your own timer.

Holding your toothbrush at a 45 degree angle, gently maneuver it to brush along the gumline, both sides of the brackets, and the ends of your teeth. Then clean the chewing surfaces and the opposite sides. When your 30 seconds are up, move on to the next quadrant.

### 5. Pay special attention to the area between the brackets and your gums

Braces can lead to tartar build up around your gum line, primarily because it’s difficult to clean the area between the brackets and the gums. Keep your toothbrush at a 45 degree angle and focus on gently brushing in this area at the start of your 30 seconds in each “quadrant.”  

### 6. Use a proxabrush to clean those hard-to-reach places

After your two minutes are up, gently insert your proxabrush underneath your braces wires and in any tight crevices between teeth to dislodge any remaining debris. (No need to use toothpaste on your proxabrush.)
![Man flossing his teeth](//images.ctfassets.net/otz9p93fkvjx/37pNT8IJvv3xw2R8SeRJxd/703e049fa982d08401b3ddc69077eab5/Tend_BreezyBraces_PInk_Mac_Flossing_4358_crop_1.png)
### 7. Don’t forget to floss!

Regular flossing is just as essential as brushing, especially when you have braces. Although it can be tricky to floss with braces, a floss threader can help you maneuver around the wires and make it easier to incorporate into your daily oral hygiene routine.

Carefully thread the floss under the main wire, then pull it through. Wrap the ends around your fingers and slide the floss between your teeth. Take your time moving it towards the gumline, and stop before you feel any pain. You can use any floss you’d like, although waxed floss is often easier to slide in tight spaces.  

To remove, grab one end of the floss and pull the strand out.

### 8. Use an antiseptic mouthwash at bedtime

An antiseptic fluoride mouthwash is a great last step after flossing and brushing. Swish for about a minute to help clear out any remaining debris.

## Tips for cleaning clear aligners

If you have clear aligners, you’ll also need to take the steps to keep them clean.

Most toothpastes are too abrasive for aligners; instead, rinse them at night and scrub them with a toothbrush and a mild liquid soap. You can also soak them in a denture solution, or a specialty cleaning solution like Invisalign’s cleaning crystals.  

After soaking or cleaning, let your aligners air dry on the counter for 15-30 minutes, then return them to their protective case.

Always remember to brush your teeth after eating if you wear clear aligners, before reinserting them. Not doing so can trap bacteria under your aligners, which can damage them and lead to plaque and cavities.

## Other helpful dental tools

__Rubber tipped gum massager__

A rubber-tipped gum massager can be a good addition to your oral care routine if you wear braces. To use, simply hold the rubber tip under warm running water to loosen it up, then run it gently along your gum line. This will help dislodge any leftover plaque or debris near your gums. Be sure to rinse your mouth afterwards.

__Tongue cleaner__

Tongue cleaners come in a few different designs, but most are used the same way.

You’ll start by sticking your tongue out as far as is comfortable. Then, gently scrape the tongue cleaner along your tongue from back to front. Rinse the cleaner, and repeat if you’d like. Be sure to concentrate on the back of your tongue, where bacteria builds up most easily. (But only go as far back as is comfortable!) Rinse your mouth out afterwards.

## FAQ:

### Can you get your teeth cleaned while wearing braces?

You can and should get your teeth cleaned by a hygienist while wearing braces! Getting regular cleanings is one of the most important ways to keep your teeth in top shape while you’re wearing braces.

### How do you clean under braces?

Use a soft-bristled toothbrush at a 45 degree angle to gently clean the tops and bottoms of your brackets and under your wires. For particularly tricky spots, gently insert a proxabrush to dislodge any stuck food or debris.

### How often should you brush your teeth if you wear braces?        

If you wear braces, you should [brush morning and evening](https://www.google.com/url?q=https://www.hellotend.com/thegargler/is-brushing-at-night-more-important-than-in-the-morning), plus after every meal. This small commitment to oral care will go a long way to keeping your mouth healthy. You’ve already invested so much in your new smile—now’s the time to protect that investment.

Your new braces represent an important investment in yourself, and one of the best ways to honor that commitment is by maintaining good oral hygiene. 

Cleaning teeth with braces

Good oral care can be a challenge when you wear braces - fortunately it only takes a few extra steps.  Learn exactly what you’ll need to clean like a pro!

Cleaning Your Teeth With Braces | Tend

Keeping Your Teeth Clean When You Wear Braces

## How long do I have to wear my clear aligners? 
Most clear aligners should be worn 20 to 22 hours a day. Remember: clear aligners only work when you’re wearing them. The most important way to support your treatment is wearing your aligners consistently.  

## When should I take out my clear aligners? 
You should always take your aligners out to eat and brush your teeth. If you’re drinking something sugary, or something that could stain (ahem, red wine), be sure to take your aligner trays out first, and rinse your mouth with water before putting them back in. 

## How do I remove my clear aligners? 
Your aligner trays are designed to fit snugly but be easily removable. It’s easiest to remove each tray from the back of the mouth first. Use a fingertip on your back molar to slowly pull the tray away from the tooth. Repeat this on the other side before completely removing the tray. 

![Cleaning clear aligners](//images.ctfassets.net/otz9p93fkvjx/3jpOHw4eaTZClkTzX9YyMW/ae96484a92014646ce8c37b2dcde3dbd/AlignersMaintenence_Body1.jpg)
## How do I clean my clear aligners? 
Thanks to their medical-grade polymer material, it’s easy to keep your aligner trays clean. Be sure to rinse them with cool water every time you remove them, and for best results, brush them lightly once a day with a toothbrush and cool water. Do not use toothpaste. All toothpaste is slightly abrasive, which can make your aligners less transparent. You can use a mild soap if you’d like. Don’t use hot water, as that can warp the material.

## How long will my clear aligner treatment take? 
The length of your clear aligner treatment will vary depending on your treatment needs. However, the average treatment time for in-office aligners (like Invisalign®) is 12-18 months. Your treatment will not take longer than 24 months. 

## Why do my clear aligners feel loose? 
Your clear aligners are designed to fit snugly. They should feel tightest when you first get them. After the first 3-4 days, they should loosen up a bit. If your aligners feel very loose, however, give your dentist a call. 

## What if my clear aligners hurt? 
Your clear aligners may take a few days to get used to. After getting your first set of trays, you may experience mild discomfort or sensitivity. You may notice that your bite feels different; you may even experience a slight lisp when you speak. The important thing to remember is that all of these symptoms will resolve—fast. By the end of your first week or two, you should be back to normal. If not, contact your dentist.

## How do I keep my teeth straight after treatment? 
After your treatment, you will receive a retainer to maintain your straight smile. And (no surprise here!) it’s important to wear it consistently. Even after orthodontic treatment, your teeth are always moving slightly, which is totally natural. To keep your dream smile, wear your retainer. 


We offer a full range of preventative, restorative, orthodontic and cosmetic dental services. Book an appointment online to come see us. 

Come see us to find out more about our dental care tips

You did it: you made a lifelong investment in your smile and are now sporting brand new clear aligners. Congrats! The next step? Wear ’em—then get ready for impressive results. 

Questions about the process? Below, we’ve compiled answers to some of the most common clear aligner questions we see. Read on for our top tips on how to get the most out of your treatment. 


Clear aligners

You did it: you made a lifelong investment in your smile and are now sporting brand new clear aligners. Congrats! The next step? Wear ’em—then get ready for impressive results. 


How to Care for Your Clear Aligners | Tend

All About Your New Clear Aligners

## Lingual Braces vs Clear Aligners: Which is Better? 
The choice between lingual braces and clear aligners is personal, and depends on your priorities and preferences. Here’s an overview of both options to help you decide which is right for you. 
### 	What are lingual braces?
Lingual braces attach to the back of your teeth, by your tongue (hence the name: “lingual” means “related to the tongue”). At Tend, our specially-developed, hassle-free lingual braces are called Breezy Braces ®. 
### 		How lingual braces work
Lingual braces work similarly to traditional metal braces, except they attach to the back of your teeth, making them completely invisible. 
Tend’s Breezy Braces ® have another special feature. Unlike traditional braces, which rely on painful wire tightening to adjust your teeth, Breezy Braces are made with a shape memory wire which slowly straightens itself, aligning your teeth as it moves.  
### 		Advantages of lingual braces
__Truly invisible:__ If you’re looking for the most discreet option out there, lingual braces are it. Because the brackets attach to the back of your teeth, they’re impossible to see from the front. 
__Hassle-free:__ No need to worry about removing lingual braces to eat or drink: once they’ve been attached, you can pretty much forget about them. 
__Effective:__ Lingual braces align your teeth as effectively as traditional metal braces. While there are some conditions that clear aligners cannot treat (severe misalignment or overbites, for example), lingual braces work for virtually every mouth. 
### 		Disadvantages of lingual braces
__Comfort:__ Any orthodontic product has an initial adjustment period. For the first few weeks after getting your lingual braces, you may notice some discomfort; you may also have to get used to speaking with your lingual braces. Fortunately, this is temporary—soon you’ll forget that your lingual braces are even there. 
__Oral care:__ Because of their position on the back of your teeth, it can be challenging to effectively brush around your lingual braces. You’ll also want to avoid foods that are especially hard or sticky, as these can damage the wires and brackets. 
__Cost & availability:__ Not all orthodontists offer lingual braces. They’re also trickier to attach, which can make them more costly than other orthodontic products. 
The good news? Thanks to our special pricing and flexible payment options, Tend’s Breezy Braces are more affordable than you’d think. 

### 	What are clear aligners (Invisalign ®)?
Clear aligners are transparent plastic trays, custom-made to fit snugly over your teeth. These removable trays slowly adjust your smile over time. 

There’s many different brands of clear aligners—At Tend, we offer Invisalign ®, the industry leader for over twenty five years. 
### 		How clear aligners work
Invisalign ® treatment consists of a series of clear, medical-grade plastic trays designed to fit over your teeth. You’ll wear each pair of trays for approximately two weeks before switching to the next one. Each pair is designed to adjust your teeth closer to your final smile goal. 
### 		Advantages of clear aligners
__Completely removable:__ Many patients love the ability to remove their clear aligners for a photo or special occasion. And since you’ll take them out before eating or drinking, there are no food restrictions with clear aligners. 
__Speed and comfort:__ All orthodontic products involve an adjustment period, but many patients find the adjustment to clear aligners is faster than other options. There may also be fewer speech disruptions. And although clear aligners move your teeth more gently than metal braces, they tend to take the same amount of time overall. 
__Cost:__ Clear aligners cost about the same as traditional metal braces, and are less expensive than lingual braces. (Plus, thanks to flexible payment options at Tend, they may be even more affordable than you’d think!) 
### 		Disadvantages of clear aligners
__Responsibility:__ Unlike lingual braces or traditional braces, you’ll take your clear aligners out throughout the day—to eat, drink, and brush your teeth, for example. Since they must be worn 22 hours a day in order to work effectively, it’s critical that you’re diligent about wearing them consistently. If not, you may not get the results you want. 
__Visibility:__ Although clear aligners are fully transparent, they may still be noticeable to someone close by. Fortunately, they can be removed for photos, job interviews, or other special occasions. 
__Not for every mouth:__ Although clear aligners can treat up to 90% of alignment issues, there are certain things they can’t treat—severe overcrowding or severe bite issues, for example. An orthodontist can tell you if you’re a good candidate for clear aligners. 
## 	How do lingual braces compare to clear aligners?
Although lingual braces and clear aligners produce the same results—a straighter, more beautiful smile—they achieve those results in different ways. Here are some of the main differences. 
### 		Appearance - which is less visible?
Both clear aligners and lingual braces are great options for those looking for a discreet way to straighten their teeth. That said, clear aligners may be noticeable to someone nearby, while lingual braces are invisible even at close range. 
### 		Which moves your teeth more effectively?
Both options can produce effective results, but since clear aligners are dependent on patient responsibility (you have to wear them 22 hours a day), they are considered slightly less effective. If you’re concerned about your ability to wear clear aligners consistently, lingual braces may be a better choice for you. 
### 		Do clear aligners work faster than lingual braces?
For most alignment issues, clear aligners and lingual braces take about the same amount of time to straighten teeth. 
### Pricing and availability
Because lingual braces can be more difficult to attach, not all orthodontists offer them. They may also be more expensive than traditional braces or clear aligners. 
By contrast, clear aligners are more widely available, and generally more affordable than lingual braces. A dentist-led option like Invisalign ® will ensure you get the results you want. 
### Does insurance cover clear aligners?
Yes, some insurances offer coverage for clear aligners like Invisalign ®, or other orthodontic options like lingual braces! (Not sure if yours does? Tend’s insurance experts can check your coverage options.) 
### 		How does the patient experience compare?
Lingual braces like Tend’s Breezy Braces ® offer a hands-off experience. Besides coming in for your visits and brushing well around your braces, there’s nothing to do except enjoy your straighter smile. 
After your orthodontist attaches them, it may take a few weeks to get used to the feel of lingual braces. You’ll also have to avoid especially hard or sticky foods for as long as your lingual braces are attached. 
On the other hand, Invisalign ® aligners need to be worn consistently in order to work effectively. Your treatment may be delayed if you don’t wear your aligner trays for 22 hours a day. You’ll have to be diligent about taking them out and replacing them after eating, drinking, and brushing. 
Because you take them out to eat, there’s no food restrictions with Invisalign aligners. You may also experience less initial discomfort than you would with metal braces. 
### 	So which should you choose: lingual braces or clear aligners?
Every mouth is different. The choice between lingual braces and clear aligners is a personal one, which depends on several factors. 
### 		Who should choose Invisalign®?
If you have mild to moderate alignment issues and want a completely removable option that lets you eat whatever you’d like, Invisalign ® might be a good fit for you. If you feel confident in your ability to consistently wear your clear aligners, consider Invisalign ®. 
### 		Who should choose lingual braces?
If you have mild to severe alignment issues and want a totally hands-off, totally invisible orthodontic experience, lingual braces might be a good fit for you. If you don’t mind avoiding very hard and sticky foods and are prepared for an initial adjustment period, consider Breezy Braces ®. 


Ready to get started? Book a free consult and meet your smile straightening team. 

Smile straightening for every lifestyle

Thanks to modern innovations, straightening your teeth has never been easier, faster, or more discreet. Two of the most popular options? Lingual braces (which go behind your teeth) and clear aligners (like Invisalign ®). While both deliver impressive results, they offer different patient experiences. So how do you know which is right for you? 

Pair of people with aligners

The choice between lingual braces and clear aligners is personal, and depends on your priorities and preferences. Here’s an overview of both options to help you decide which is right for you. 


Lingual Braces or Clear Aligners: Which Is Right for You? 

Simply put (and we’ll get get more in-depth soon), a dental crown is a permanent tooth-shaped cap placed over a damaged or weak tooth to protect and restore it.

While a filling may be able to fix minor decay or damage, more serious oral health issues are best solved with a crown. If your dentist recommends one, that’s something to take seriously.

See, your teeth can’t heal themselves. If you have a cavity, it won’t get better on its own. And the longer you go without treating it, the more painful it will become. (And the more expensive and complicated to fix.)

Fortunately, crowns can halt the damage caused by cavities and restore your mouth to a place of health. (Plus, they’re often covered by dental insurance!)

![Crown Infographic](//images.ctfassets.net/otz9p93fkvjx/giTBj3i30i8RZ3CxS4zcS/fd7109ebbb6cc08d56d04273a37379c8/Crowns_Body2.jpg)
## Dental Crowns: everything you need to know
Curious about crowns? We got you covered. 

__What is a dental crown?__
A dental crown is a cap placed over a damaged or decayed tooth. It restores the tooth’s function, strength, and appearance—so you can get back to chewing and smiling normally. Permanent crowns are custom-built to fit perfectly in your mouth and last for a very long time. 

__Why would I need a dental crown?__
“If your teeth are damaged, injured, or simply worn down over time, a crown could be an excellent treatment option to restore the look and function of your smile,” explains [Dr. Chris Salierno Tend's Chief Dental Officer. ](https://www.hellotend.com/clinical-providers/dr-chris-salierno "Dr. Chris Salierno") 

“Cavities are an incredibly common dental problem. They’re nothing to feel bad about, but they do need to be taken care of quickly, before they do more damage. Sometimes, a dental filling may not be enough to correct the damage left by a cavity—in that case, we’ll use a dental crown.”

In addition to covering damaged teeth, cracked teeth or broken teeth, crowns can be a good option for missing teeth. In that case, your dentist might suggest placing a crown on top of a [dental implant](https://www.hellotend.com/thegargler/why-dental-implants-are-surprisingly-comfortable).

__Why do I need a dental crown instead of a filling?__
If your dentist tells you you have a cavity, you may feel a bit guilty about it. Don’t. Even the best brushers might find themselves with a cavity at some point. If that’s you, don’t feel bad. 

That said, you can’t brush away a cavity; it requires treatment from a dentist. [If you’ve got a cavity, you’ve got to fill it](https://www.hellotend.com/thegargler/do-i-really-need-a-filling). That means using tooth-colored composite resin to fill the hole in your tooth and prevent further decay. 

At your appointment, your dentist will assess whether a composite filling alone is enough to treat your cavity. If the decay is more severe or if the damage is extensive, a filling won’t be enough, and a crown is necessary to make sure things don’t progress.

__How long do crowns last?__
Most dental crowns will last at least 15 years, but proper care and maintenance will greatly extend their lifespan. A well-cared for crown can last up to 30 years.

![Dr Chris Salierno Quote Dental Crowns](//images.ctfassets.net/otz9p93fkvjx/3vFVyjYz6ULbVrSIViB6VY/90e81f1fd6be42b639b1d000eb24ff92/Crowns_Body_Quote1.jpg)

__What happens if I don’t get a dental crown?__ 
The simple answer: things will only get worse. “If your dentist has recommended a dental crown for a tooth damaged by a cavity, it’s important to get the crown placed as soon as possible,” says Dr. Chris Salierno. “It’s one of the most trusted procedures in dentistry to treat the decay, stop it from spreading, and protect your healthy tooth. On the other hand, the more the decay spreads, the more pain you’ll feel. It’ll also get more expensive and difficult to fix.”

## Getting a dental crown: what to expect
__What is the process of getting a dental crown?__
Because crowns are designed to perfectly fit your mouth and mimic your damaged tooth, the procedure will, in most cases, require two appointments.

At the first appointment, your dentist will take measurements for your new permanent crown. They’ll also remove any damage or decay on the affected tooth, so it’s ready to be crowned. Finally, they’ll place a temporary crown same-day to protect your existing tooth structure and keep your bite looking and feeling normal until your permanent crown is ready.

Your crown will be custom made for you. When it’s ready, usually a few weeks later, you’ll come back for a second appointment to have the temporary crown removed and the permanent crown placed.

__Is it painful getting a crown?__
“We’ll numb your mouth completely before we begin the process,” explains [Dr. Chris Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno "Dr. Chris Salierno"), “so crowns don’t hurt at all. Your tooth may feel a bit sensitive for a day or two after, but that will fade.”

__What to expect when you get a crown at Tend:__
“We designed the experience of getting a crown at Tend to be as easy and straightforward as can be,” explains [Dr. Chris Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno "Dr. Chris Salierno"). 

__At your first appointment:__ 

Your dentist will start by numbing your tooth and surrounding area with local anesthetic.

Then, they’ll take digital impressions of the tooth to get precise measurements for your new crown. They may also take x-rays of your teeth.

If your tooth has any remaining decay, they’ll remove it. Then they’ll use a special tool to shape the remaining healthy tooth so its new crown will fit perfectly. 

Finally, your dentist will prepare and place a temporary dental crown with temporary cement to keep your mouth looking and working normally until your permanent dental crown is ready.

After your first visit, they’ll send all your measurements to a special dental lab, which will prepare your custom crown.

A week or so later, you’ll come back to the dentist’s office for a second visit. 

__At your second appointment:__ 

Your dentist will again numb your tooth and the surrounding area.

Next, they’ll remove the temporary crown.

They’ll make sure the permanent crown fits perfectly.

They’ll attach the permanent crown with dental cement and wait a few minutes for it to set.

Finally, they’ll check your bite to make sure your mouth is ready to go!

__What happens after you get a crown?__
You may feel some soreness or mild discomfort in the first few days after getting your dental crown. That’s normal and will fade. You can treat it with over-the-counter pain medications in the meantime.

If the pain relievers don’t feel like enough or the pain doesn’t fade—especially if you feel pain when biting—contact your dentist. They can adjust the crown to make things more comfortable.

Crowns don’t require any special care, but it’s important to keep up your good at-home oral hygiene routine to protect the tooth underneath the crown from decay and gum disease. That means brushing, flossing, and getting regular dental checkups and cleanings.

Your new crown is strong enough to withstand biting and chewing, but it’s not indestructible. Try to avoid using the crown to chew very hard foods like nuts or ice, or very sticky foods like candy. And don’t use your teeth to open packages or chew your fingernails (please!). If your crown chips or breaks, call your dentist right away. 

__How much do dental crowns cost?__ 
Most in- and out-of-network insurances offer coverage for dental crowns.

If you’re scheduling your dental crown at Tend, the studio team will let you know any cost you may be responsible for, as well as how much will be covered by insurance. (Pro tip: you can also check the cost of your dental treatment plan by using the Tend App.) 

## Types of dental crowns: permanent and temporary
In discussing your dental crown procedure, your dentist may have mentioned “temporary” and “permanent” crowns. Here’s the difference. 

__What is a temporary crown?__ 
Temporary crowns are designed to be worn for 2-3 weeks while a permanent crown is custom-made for your mouth.

At your first dental crown appointment, the dentist will prepare your damaged tooth for its permanent crown—often by shaping it.

It’s important that your tooth is protected, and doesn’t move, after it’s prepared. That’s where a temporary crown comes in. Although you’ll only wear it for a short amount of time, it’ll protect your newly-prepared tooth (and keep your mouth looking and feeling good) until your permanent crown is ready.

If your temporary crown falls off, or is is damaged, contact your dentist right away. They will get you in for a dental appointment right away to reattach or replace it.

__What is a permanent crown?__ 
A permanent crown is designed to be worn for decades. These types of crowns are carefully produced in a dentistry laboratory based on precise measurements of your mouth. Permanent crowns perfectly mimic the shape and color of your natural teeth.

Because permanent crowns take a week or so to make, you’ll wear a temporary crown in the meantime. When the permanent crown is ready, you’ll return to the dental office for a quick procedure to securely attach it. 

## FAQ
__What are the advantages of getting a crown?__
Dental crowns are a relatively straightforward way of restoring the appearance and function of teeth that have been damaged due to injury or decay. They can also relieve pain and discomfort from damaged teeth. Because they are custom-made to your mouth, porcelain crowns generally look, feel, and fit like your natural teeth. 

__What are the disadvantages of getting a crown?__
If your tooth has an issue that’s serious enough for a crown, there isn’t a downside. Dental crowns are a necessary restorative treatment that’s essential to keeping your mouth healthy. Though they’re more costly than a filling, they’re also meant to treat more advanced decay and damage. 

__Is a dental crown necessary after a root canal treatment?__
If you’ve had a root canal—a dental procedure where diseased or damaged pulp in the center of your tooth is removed—your dentist may also have recommended a dental crown.

While dental crowns are not always required after root canals, in most cases, they’re the best course of action. 

Most likely, your tooth has been weakened from the original tooth decay. Root canal therapy will stop the damage from getting worse, but your tooth still needs reinforcements. For example, If the tooth that had the root canal procedure was a molar, premolar, or grinding tooth in the back of the mouth, expect it to require a crown to protect it from further damage. On the other hand, front teeth may not require crowns from a strengthening standpoint, but you may still opt for one for cosmetic reasons.

Ultimately, a crown will protect your tooth and restore its original strength. It can also minimize any sensitivity and give your tooth a normal, natural appearance.



Our expert teams at Tend will restore your smile ASAP


Do you think you need a dental crown? 

If your dentist recommends you get a crown, you’ve probably got questions. First and foremost, what exactly is a crown? And is it really necessary? 

Dentist putting on a crown

If your dentist recommends you get a crown, you’ve probably got questions. First, what exactly is a crown? And is it really necessary? Learn more.

Dental Crowns: All You Need to Know About Getting a Crown for a Tooth

Dentist putting in crown square

What happens if you don’t get a crown? 

You’ve just finished up your routine cleaning at the dentist, when you learn you have a cavity. Not exactly the news you wanted to hear, we know. The dentist says you need a filling—but is that really necessary? 

Absolutely. Just because tooth cavities, or dental caries, are an incredibly common dental issue (over 90% of adults have one), doesn’t mean they aren’t a serious one. What exactly is a cavity? It’s an area where a tooth has started to decay.

The problem—teeth can’t heal themselves. If you have a cavity, it won’t get better. In fact, it will only get worse, more painful, more expensive, and more complicated to fix. So even if it’s not painful, a cavity is always serious. 

Fortunately, the solution is simple, and usually covered by insurance. A filling is a small (and nowadays painless) treatment that will keep you smiling and your mouth healthy. 

### Tooth fillings: everything you need to know
Want to know more about fillings? We can fill you in. Fillings are a treatment for cavities, so let’s start at the beginning. 
![Fillings Infographic](//images.ctfassets.net/otz9p93fkvjx/gi3Z4SeI7Tt2TaKKKDNl6/0e8778e4af2804dbef0c9808cb0f8770/Fillings_Body2.jpg)

__What is a dental filling?__

“A dental filling is a simple, safe treatment used to restore a tooth that has been damaged due to a cavity,” says Tend Chief Dental Officer [Dr. Chris Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno "Dr. Chris Salierno"). “We use a special material to fill the hole left by a cavity and return your tooth to its original condition.” 

Which type of filling your dentist uses will depend on several factors, like your own preference, insurance coverage, and where in the mouth the filling is being placed—molars may need a stronger filling material than other teeth, for example. Although amalgam fillings and gold fillings have been used for hundreds of years, modern dentistry has increasingly leaned towards composite fillings—often a combination of quartz or glass bonded to a resin base. It’s what we primarily use at Tend. These restorations are durable and tooth-colored for a natural look. 

__What is a cavity?__
A cavity is an area on a tooth that has started to decay because of a buildup of plaque and bacteria. This decay causes a hole to form in the surface of the tooth. This damage is, unfortunately, permanent—even if the tooth doesn’t hurt yet. Sometimes you can spot cavities with the naked eye—you may even see visible holes—but the best way is to have a dental exam (which is included with every cleaning you get at Tend).

There’s a myth we’d like to bust about cavities. Just because you have one doesn’t mean you’re doing anything wrong. It’s a lot more complicated than simply avoiding sugary foods—some mouths are just more cavity prone than others and there are a lot of factors to consider. Brushing with a [fluoride toothpaste](https://www.hellotend.com/thegargler/fluoride-is-it-legit) and flossing regularly is the best way to prevent cavities, but good oral hygiene alone is not a guarantee against them. So if you have a cavity, don’t feel bad. (And we won’t try to make you.) Let’s fill it, and get you back to health. 

“Unfortunately, cavities represent permanent damage,” explains, [Dr. Chris Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno "Dr. Chris Salierno"). “You can’t brush away cavities. The good news is, fillings and [dental crowns](https://www.hellotend.com/thegargler/what-happens-if-you-dont-get-a-crown) are a simple and effective way to treat them.” 

__Is a dental filling always required to treat a cavity?__
In a word: yes. Cavities won’t get better on their own—in fact, left untreated, they’ll get worse. 

Eventually, the hole in your tooth will get bigger, growing past your tooth enamel (the hard, outer layer of your tooth), to the softer dentin underneath. From there, it can quickly reach the sensitive pulp and nerves at the root of your tooth, where it will form a painful abscess. By that point, a filling might not be enough treatment to save your tooth or prevent a serious infection. Instead, your dentist may need to try more invasive treatments like a root canal—or even a tooth extraction. 
![Dr Chris Fillings Quote](//images.ctfassets.net/otz9p93fkvjx/1Y97dOuX6OKwk1Xs35EZNX/d68f0435e5d39c84ea7182e084193063/Fillings_Body_Quote1.jpg)

__How long can you leave a cavity untreated?__
“If your dentist tells you you need a filling and you’re not in any pain, that’s a very good thing,” says [Dr. Chris Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno "Dr. Chris Salierno") “It means your cavity is minor enough that the fix is simple. It’s very important to treat a cavity as soon as it’s discovered. The longer you go without addressing it, the more painful, expensive, and involved the fix will be.”

In fact, one of the reasons Tend studios recommend twice yearly visits is so your dentist can make sure no cavities are left untreated for too long. The early stages, when you still have a small cavity, represent the best times to treat it. Typically, this is before you have much tooth sensitivity and before your dental health is severely affected. 

__How long do fillings last?__
Most fillings are designed to last well over a decade, although it depends on the material used. Grinding or clenching your teeth can also shorten the lifespan of a filling. If you notice pain or sensitivity around your filling, contact your dentist to see if your filling needs to be replaced. They may do x-rays to check for any further decay under the filling. 

Your dentist will also monitor your fillings at your regular dental check ups. 

### Cavity fillings: what to expect
If your dentist tells you you need a filling, you may feel a little nervous or unsure: will it hurt? Is it expensive? How long will it take? 

__Top reasons to get a filling__
Fillings are a safe, effective way to treat cavities. Left untreated, cavities can cause severe pain and toothaches. They pose a real risk to your oral health and, ultimately, your overall health. Getting fillings promptly keeps your mouth in top shape. 

Besides treating cavities, there may be other reasons to get a filling: 
- To correct any non-cavity holes in your teeth—and keep bacteria from building up in those holes 
- To repair a fractured tooth
- To repair a chipped tooth
- To correct discoloration on teeth

__Is it painful getting a filling?__
“Fillings don’t hurt at all,” explains [Dr. Chris Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno "Dr. Chris Salierno") “We’ll apply a local anesthetic before beginning the treatment, so you won’t feel a thing. The pain of an untreated cavity is much, much more severe than anything you’ll feel getting a filling.” 

After the anesthetic wears off, you may feel some minor soreness, but that should fade quickly. 

## What to expect when you get a filling at Tend
“Getting fillings at Tend is a fast, easy process,” says [Dr. Chris Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno "Dr. Chris Salierno") “Most patients are surprised by how straightforward and painless their experience is. A minor filling only takes about 20 to 30 minutes to perform.” (If you have multiple fillings to do or deeper cavities, expect your appointment to take a bit longer.) Here’s how the process generally works.

First, your dentist will coat your mouth with a bit of numbing gel, then apply a local anesthetic. (You may feel a bit of a sting for that part, but that’s it!) 

Once you’re totally numb (and zoning out to your favorite streaming show), your dentist will remove the decay. Then, your dentist will fill the hole with the filling material. They’ll use a special light to set or harden the filling as they go. Finally, your dentist will polish the tooth, leaving it good as new! 

__Does insurance cover the cost of fillings?__
Yes, most in- and out-of-network insurances do cover the cost of fillings. 

If you’re scheduling your filling at Tend, the studio team will let you know any cost you may be responsible for, as well as how much will be covered by insurance. (Pro tip: you can also check the cost of your treatment plan by using the Tend App!) 

## Cavities FAQ

__How are cavities filled?__
Filling cavities is a very common aspect of routine dental care. First, a dentist will dry the area of the mouth that needs the filling, then numb it.

A special drill is used to fully remove the tooth decay, then the hole in the damaged tooth is cleaned before being filled with the filling material. They’ll use a special light to set and harden the filling. Finally, the dentist checks that your bite is even, and polishes the tooth. (And because all of this is done with a local anesthetic, it doesn’t hurt.)

__How can I get rid of a cavity without a filling?__
There is no way to get rid of a cavity without a filling.

In the case of more severe tooth decay, a dentist may use a dental crown—instead of a filling—in order to correct the damage. 

__Why is my tooth sensitive after getting a cavity filling?__
It’s normal to experience some sensitivity after getting a filling as your mouth adjusts. Maintain good dental hygiene—regular brushing, flossing, and rinsing with fluoride mouthwash—and this should fade within a few days. If the tooth pain gets more severe, or if you feel sharp pain, contact your dentist. 

You may also notice pain with your bite after getting a filling. If it doesn’t subside, contact your dentist. They can smooth down the filling to line up better with your other healthy teeth, which should eliminate any discomfort. 

__Can you get a cavity filled while pregnant?__
The [American College of Obstetricians and Gynecologists](https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/08/oral-health-care-during-pregnancy-and-through-the-lifespan "Oral Health Care During Pregnancy and Through the Lifespan") and [the American Dental Association](https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/pregnancy "Dental Pregnancy") agree that cavities can (and should!) be treated safely at any point during pregnancy. 


Speak with our expert team during your next Tend dental exam. 

Do you think you need a filling? 

Want to know more about fillings? We can fill you in. Fillings are a treatment for cavities, so let’s start at the beginning. 

Dental fillings in a dentist office

The dentist says you need a filling—but is it really necessary? We’ll fill you in on everything you need to know about dental fillings.


Tooth Fillings & Cavities: Do You Really Need A Filling?

Do I really need a filling? 

“The gum disease known as gingivitis.” This phrase has been a staple of mouthwash ads going back decades. But what does gingivitis actually mean? And do I really need to care?

Let’s answer the second question first: Yes, you do need to care. We all do. Gingivitis is a mild and reversible form of gum disease, but if it’s ignored in its early stages, it can turn into a severe, irreversible form called [periodontitis](https://www.hellotend.com/thegargler/periodontitis-the-most-common-dental-disease-youve-never-heard-of) that can result in tooth loss and require surgical intervention.

__What’s gingivitis?__

Plaque buildup doesn’t just happen on your teeth. It also happens under your gums. This can make your gums sensitive and inflamed. That’s gingivitis: gum inflammation that can cause discomfort, bleeding gums, receding gums, bad breath, tooth decay, and other symptoms.

Technically, all of us have some gingivitis. And mostly, we’re able to manage it at home with good oral hygiene: think diligent brushing, flossing, and rinsing. But some of us have gingivitis that’s more advanced. And that form of moderate to severe gingivitis requires dental treatments that go beyond a typical cleaning.

![SRP ArticleGing Gingivitis](//images.ctfassets.net/otz9p93fkvjx/3TSeUu1xjNz6DllElQGqW3/45fab78dd3b8682ffd4acb9bf5c8f0e5/SRP_ArticleGing_Gingivitis.png)

__How is gingivitis treated?__

If you have gingivitis that’s advanced enough, a typical dental cleaning won’t be helpful, because it doesn’t go far enough below the gum line. It can actually be harmful by allowing bacteria to remain trapped where brushing and flossing can’t reach.

That’s where “non-surgical gum treatment” comes in. During this treatment, your dental hygienist removes plaque and tartar underneath your gums, in areas that can’t be accessed during a typical cleaning.

Will non-surgical gum treatment reverse gingivitis? Yes! Most people can expect this treatment to fully restore their gum health and eliminate all signs of gingivitis. After that, a thorough at-home oral health routine will keep your teeth and gum tissue healthy. That means flossing daily, brushing with a soft-bristled toothbrush and [fluoride-based](https://www.hellotend.com/thegargler/fluoride-is-it-legit) toothpaste, and regular dental checkups—at least twice a year. (Some individuals with health issues that make them more prone to gingivitis may even need more frequent professional cleanings to maintain healthy gums.) 

![SRP ArticleGing Treatment](//images.ctfassets.net/otz9p93fkvjx/3VdsJEbXTFUiUGTVXnn5VP/af389e7de68befceb252def8926e9e4c/SRP_ArticleGing_Treatment.png)

__What happens if I don’t treat gingivitis?__

If left untreated, gingivitis can continue to advance until it becomes periodontal disease. That represents a significantly more dangerous stage of gum disease that affects the structures supporting your teeth—as opposed to just your gums. Periodontal disease is a serious threat to your oral and overall health. It can result in loose teeth, bone loss, or tooth loss and require surgery to treat.  

Whereas gingivitis can be cured thanks to non-surgical gum treatment and diligent at-home care, periodontitis can’t be cured. It can only be controlled. That’s why it’s very important to treat gingivitis as soon as it’s diagnosed and to continue to keep it in check.  

![SRP ArticleGing Progression](//images.ctfassets.net/otz9p93fkvjx/2e4tCJkUmJvu9KUCCo0on9/8013740f10f24878ca66a8434292c7f3/SRP_ArticleGing_Progression.png)

__How long does non-surgical gum treatment take, and what does it cost?__

Because non-surgical gum treatment is more thorough than a typical cleaning, it requires more time to complete. As a result, we may need you to schedule another one to two visits. Similarly, because this treatment is more complex than a typical cleaning, it may not be fully covered by your insurance, and you may have a higher out-of-pocket cost. 

We get that it’s not a great feeling to find out that you have to spend more time and money on a medical issue. (And, like any disease, gingivitis is a medical issue.) But ignoring gingivitis will end up creating more complex problems in the future that are far more time-consuming and expensive to deal with. We want to help you avoid that.

__READ MORE:__ [My Dentist Said I Can't Get A Normal Cleaning. Why?](https://www.hellotend.com/thegargler/my-dentist-said-cant-i-get-a-normal-cleaning-why)

__How can I be sure I need this?__

If you’re new to Tend and your prior dentist never diagnosed you with gingivitis, we know this can be a lot to process. Maybe you aren’t familiar with the warning signs and symptoms of gingivitis and aren’t sure the deep cleaning from non-surgical gum treatment is necessary. We want to assure you of two things.

First, Tend practices evidence-based dentistry that’s rooted in the latest clinical research. As a medical field, we now know more than we used to about gingivitis and how to treat it, and Tend always adheres to the American Dental Association’s standards.

Second, our dentists don’t make a commission on procedures. They only offer the dental care you need. You can decide to proceed with any oral care treatment recommendations confident that your interests and your dentists are aligned.

Take advantage of your dentist’s diagnosis to halt your disease before it advances—and restore your mouth to health.

Tread gingerly with gingivitis—reverse it right away

You’ve probably heard of gum disease, or gingivitis (thanks, mouthwash ads), and you know it’s bad. But you might not know exactly what it means—and what can happen if it’s ignored.

SRP Article1 Hero A

Gingivitis - What You Need To Know | Tend

SRP Article1 SquareHero A

Tread Gingerly with Gingivitis

You’ve probably heard of gingivitis—or gum disease—from a million mouthwash ads. But you may not have heard of periodontitis. 

Think of the two as a progression. If bacteria builds up under the gum line, your gums will become sensitive and inflamed. Some of the most common signs of gingivitis are bad breath and bleeding gums when you brush. That’s called [gingivitis](https://www.hellotend.com/thegargler/tread-gingerly-with-gingivitis), and it represents the early stages of gum disease. 

If gingivitis isn’t treated, your gum tissue can start to pull away from the structures that support it, and you may suffer bone loss. Ultimately your teeth may loosen or fall out. That’s called periodontitis. 

![SRP ArticlePerio Progression](//images.ctfassets.net/otz9p93fkvjx/OtA7N32sPMVcFRtG45TaE/a47ff326b7f865b54dda38f8072e6f01/SRP_ArticlePerio_Progression.png)

__Periodontitis is a serious disease__

Even though [it affects almost half of American adults over 30](https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html), periodontitis isn’t something that should be taken lightly. It’s a major threat to your oral health that can cause significant discomfort. Advanced periodontitis—periodontitis that has progressed to its latest stages—can require invasive, costly surgical interventions like bone and soft tissue grafts. 

Periodontitis can’t be cured, but it can be controlled through a combination of diligent at-home care and non-surgical periodontal treatment, a procedure we offer at our studios. 

__What is non-surgical periodontal treatment?__

If you have periodontitis, a typical dental cleaning won’t be helpful, because it doesn’t go far enough below the gum line. It can actually be harmful by allowing bacteria buildup to remain trapped where brushing and flossing can’t reach.

That’s where non-surgical gum treatment comes in. It’s a targeted deep cleaning that removes plaque and tartar underneath your gums in areas that can’t be accessed during a typical cleaning.

After your treatment is complete, you’ll manage your periodontitis at home with good oral hygiene practices, including brushing and flossing daily. 

![SRP ArticlePeio Treatment](//images.ctfassets.net/otz9p93fkvjx/3Xg6rp0LZZ9CuRduUbHWL8/56dd64316b10dc77af998053024a6202/SRP_ArticlePeio_Treatment.png)

__Isn’t periodontitis a disease of older people?__

People who have heard about periodontitis often think it’s a disease that only older people get. But that’s a misconception. It’s true that the prevalence of periodontal disease increases with age: 70.1% of adults 65 years and older have periodontal disease, per the Centers for Disease Control and Prevention (CDC). But almost half of American adults over 30—47.2%—have periodontitis, showing that it’s very much a disease of the young as well.

__How long does non-surgical periodontal treatment take, and what does it cost?__

Because non-surgical periodontal treatment is more thorough than a typical cleaning, it requires more time to complete. To be sure we have enough time, your treatment plan may require another one to two visits. Similarly, because this treatment is more complex than a typical cleaning, it may not be fully covered by your insurance, and you may have a higher out-of-pocket cost.

We get that it’s not a great feeling to find out that you have to spend more time and money on a medical issue. (And, like any disease, periodontitis is a medical issue.) But ignoring periodontitis will end up creating more complex problems in the future that are far more time-consuming and expensive to deal with. We want to help you avoid that.

__READ MORE:__ [My Dentist Said I Can't Get A Normal Cleaning. Why?](https://www.hellotend.com/thegargler/my-dentist-said-cant-i-get-a-normal-cleaning-why)

__How can I be sure I need this?__

If you’re new to Tend and your prior dentist never diagnosed you with periodontitis at any of your checkups, we know this can be a lot to process. We want to assure you of two things.

First, Tend practices evidence-based dentistry that’s rooted in the latest clinical research. We have an ethical duty to treat the medical issues we see, and we always adhere to the American Dental Association’s standards.

Second, our dentists don’t make a commission on procedures. They only present treatment options you need. You can decide to proceed with any treatment recommendations confident that your interests and your dentists’ are aligned.


Periodontitis is a serious disease—and needs to be treated

Periodontitis affects over 47% of adults over 30 in the United States, and it can lead to tooth loss. Yet few people know what it is or how to treat it.[ Our team can help.](https://www.hellotend.com/booking/markets?service=CLNCHK "Book a visit")

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Periodontitis affects over 47% of adults over 30 in the United States, and it can lead to tooth loss. Yet few people know what it is or how to treat it.

Periodontitis: The Most Common Dental Disease You’ve Never Heard Of

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You probably just did a double take. You came to Tend expecting to get a normal cleaning, and instead you were told you have gingivitis or periodontitis, and that you have to schedule another visit to have non-surgical gum treatment or non-surgical periodontal treatment.

You may be thinking: Wait, what? Having my teeth cleaned is the whole reason I’m here! Why won’t Tend do it? What are these other treatments? And if I need one, why can’t it happen now?

We get it. If you’re being diagnosed with gingivitis or periodontitis for the first time, this is a confusing (and probably annoying) moment. But we just want what’s best for your mouth—and you. Failing to deal with either of these diseases now can result in painful, complicated, and expensive issues down the line.

__Let’s back up. What are gingivitis and periodontitis?__

Plaque doesn’t just build up on your teeth. It also builds up under your gums. This can make your gums sensitive and inflamed. It can also cause gingivitis, a mild, easily treatable form of gum disease. 

If left untreated, gingivitis can become periodontitis. That’s an irreversible disease of the structures supporting your teeth that can result in tooth loss.

![SRP Article1 Progression](//images.ctfassets.net/otz9p93fkvjx/3a3osQBYMH9t36GGBsgOvJ/df5b2bcd31c2f8db5500f96194c94d91/SRP_Article1_Progression.png)

__What are non-surgical gum treatment and non-surgical periodontal treatment?__

If you have gingivitis or periodontitis, a typical cleaning won’t be helpful. It can actually be harmful by allowing bacteria to remain trapped below your gums. 

That’s where non-surgical gum treatment and non-surgical periodontal treatment (also known as scaling and root planing) come in. These treatments clean underneath your gum line, in areas where a toothbrush can’t reach and that can’t be accessed during a typical cleaning. 

Because these treatments are more thorough, they require more time. That’s why we ask you to come back in.

![SRP Article1 TreatmentTypes](//images.ctfassets.net/otz9p93fkvjx/64qKVxHi9vL9SDR5Gk0hQk/7cf7083f9a4d15af8d738a11583ebeac/SRP_Article1_TreatmentTypes.png)

__How can I be sure I need this?__

If you’re new to Tend and your prior dentist never diagnosed you with gingivitis or periodontitis, we know this can be a lot to process. We want to assure you of two things.

First, Tend practices evidence-based dentistry that’s rooted in the latest clinical research. As a medical field, we now know more than we used to about both of these diseases and how to treat them, and Tend always adheres to the American Dental Association’s standards.

Second, our dentists don’t make a commission on procedures. They only offer the care you need. You can decide to proceed with any treatment recommendations confident that your interests and your dentists are aligned.

Do non-surgical gum treatment and non-surgical periodontal treatment hurt?

No. Before your treatment begins, we’ll give you an anesthetic, so you won’t feel a thing, though you may be sore for about 24 hours afterward. 

While these treatments do go deeper than a typical cleaning, they’re essential to avoiding more invasive treatments in the future, which could involve surgery.

__What’s the process?__

Both non-surgical gum treatment and non-surgical periodontal treatment typically require two visits, and each visit takes about an hour. Every three to four months, we’ll ask you to come back in to make sure your disease is in check. 

Do these additional visits require more of your time and, likely, more expense? Yes. But ignoring gingivitis or periodontitis will end up creating more complex problems in the future that are far more time-consuming and more expensive to deal with. We want to help you avoid that.

__Are gingivitis and periodontitis curable?__

Gingivitis can be cured thanks to non-surgical gum treatment. Periodontitis, like diabetes and high blood pressure, isn’t curable. However, it is controllable through non-surgical periodontal treatment. Keeping both diseases in check continues at home with diligent brushing, flossing, and rinsing.

![SRP Article1 TreatmentResults](//images.ctfassets.net/otz9p93fkvjx/3E4F9lqcVvbcPKi2GaohcN/3fcbe17dfb100bca97927f493848c44a/SRP_Article1_TreatmentResults.png)

__Is having gingivitis or periodontitis my fault?__

No. There’s no reason to feel bad about your diagnosis. While at-home care is a factor in both diseases, they’re just that—diseases. You shouldn’t blame yourself for having diabetes or high blood pressure, and you shouldn’t blame yourself for having gingivitis or periodontitis. 

But as with diabetes and high blood pressure, you should be proactive about managing  these diseases, especially at the onset.


It’s important to keep gingivitis and periodontitis in check

If you have gingivitis or periodontitis, a normal cleaning won’t be helpful. It can actually be harmful by allowing bacteria to remain trapped below your gums.

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My Dentist Said I Can’t Get a Normal Cleaning. Why?

At Tend, we’re seeing first hand the harmful effects of Covid-related stress on our patients’ teeth. The numbers are grim: these days, our dentists are treating three times as many patients for stress-related oral health issues than they were pre-pandemic. 

### Stress grinding your teeth is very much a thing

One major way we manifest stress is by grinding our teeth, a condition known as bruxism. And while a bit of teeth grinding might not seem like a big deal, it’s actually a major one. Left unchecked, bruxism can destroy enamel—the hard, pearly stuff on the outside of your teeth—and wear teeth down to stumps, or cause emergency issues like broken, fractured, or chipped teeth. “It’s absolutely not something to ignore,” says [Dr. Chris Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno), Tend’s Chief Dental Officer.

### More stress (thanks, Covid) = more teeth grinding

While some cases of bruxism are caused by genetics—“Some people grind because that’s the way they’re hardwired,” says [Dr. Marc Schlenoff](https://www.hellotend.com/clinical-providers/dr-marc-schlenoff), Tend’s Head of Clinical Development—many grinders do so in response to stress. These days, we’re all under more stress than ever, so it’s not surprising that in [a recent survey of dentists by the ADA](https://www.ada.org/publications/ada-news/2021/march/hpi-poll-dentists-see-increased-prevalence-of-stress-related-oral-health-conditions "HPI poll: Dentists see increased prevalence of stress-related oral health conditions"), more than 70% of respondents reported seeing an increase in patients experiencing teeth grinding. 

At Tend studios, the numbers are equally staggering. Our dentists are treating three times as many patients for bruxism as before the pandemic. Perhaps most concerningly, Tend’s dentists are seeing a 281% year over year increase in emergency visits, and a 254% year over year increase in repairs for broken or cracked teeth from causes like grinding.

### Grinding produces a huge amount of force

Broken teeth just due to grinding? Yup. “Grinding can generate up to 1,100 pounds per square inch of pressure on your teeth,” says [Dr. Schlenoff](https://www.hellotend.com/clinical-providers/dr-marc-schlenoff). To put that in perspective, that’s 3-6 times the pressure you use to eat. 

![Tooth Anatomy Infographic](//images.ctfassets.net/otz9p93fkvjx/1S31Ku8WXs8z3F6rx9KB8V/de434b2514666126d1804702867c4323/CovidStress_Body_ToothAnatomy.png)

### Teeth Grinding wears away at enamel, then at dentin

Now for some dental anatomy: a tooth has layers that grinding destroys bit by bit. The first layer is the enamel, which coats the outside of the tooth and is “the hardest substance in the body,” according to [Dr. Schlenoff](https://www.hellotend.com/clinical-providers/dr-marc-schlenoff). Once you grind through this, you’re in trouble. Underneath the enamel is “dentin,” a yellowish substance that’s 11 times weaker than enamel. As a result, it will erode 11 times more quickly.

### Grinding affects multiple teeth at a time

Grinding doesn’t just happen to one tooth: it occurs in a sliding motion that wears down many of your teeth simultaneously in a fairly symmetrical way. So when you’re grinding, you’re not just harming a single tooth—whole sections of your mouth are at risk. 

### There’s a point of no return when it comes to tooth damage

Because the tooth gets softer the deeper you go, over time the damage grinding causes begins to accelerate. At a certain point, the damage is beyond repair and your teeth will require crowns. [Dr. Schlenoff](https://www.hellotend.com/clinical-providers/dr-marc-schlenoff) recalls, “I’ve had cases where I had to do crowns on every tooth in the mouth to rebuild them to their original height because people have worn them down so dramatically.”

### Repairing teeth grinding damage can be incredibly expensive

A single crown can cost up to $2500, depending on where you live. If your case is really extreme and you need crowns on every single tooth like [Dr. Schlenoff's](https://www.hellotend.com/clinical-providers/dr-marc-schlenoff) patient, that could result in a whopping cost of $80,000.

### Prevention > Repair

If you’re a grinder, it’s critical to stop before that $80,000 worth of damage occurs. “Preventing damage is always easier than repairing it,” says [Dr. Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno). “Even if you already have some signs of wear, the sooner you can curb your grinding, the better.”  

### Mindfulness for the win
The problem is, grinding is a sneaky vice: most people are unaware when they’re actively doing it. So how can you stop something when you don’t even notice it happening? 

One simple solution is mindfulness. Make a point to check in with yourself throughout the day, especially at moments you feel particularly stressed. If you realize that you’re grinding your teeth, drop your jaw and let it hang for a few moments before resetting to a looser, more relaxed position. 

### Cut the chewing 

Ice, gum, pen caps… for many of us, chewing these is as normal and natural as breathing. But if you’re a grinder, these repetitive motions can keep your jaw clenched. A clenched jaw leads to—you guessed it—more grinding. Try cutting out all chewing besides food to ensure your mouth stays relaxed throughout the day. 

### Less stress = less grinding

If you’re grinding because you’re stressed, there are some stress-reducing techniques that could help (seriously!). If you’re not already exercising, start there. Adding a few sweat sessions to your weekly routine can reduce stress overall, and you might just find that it causes the grinding to ease up. 

More of a spa person? (Us too.) Opt for a hot bath at the end of the day. For extra credit, try massaging your jaw while in the tub. Because so much grinding happens at night, the more tension you can release before bed, the better. Warm compresses or heating pads applied to your jaw can also help. 

![Mouthguards prevent damage from Covid Stress](//images.ctfassets.net/otz9p93fkvjx/5hRQgi2RpVSY20OGTkNjV/11cea7150555827c36c64897f79a457b/CovidStress_Body_Mouthguards.jpg)

### Mouth guards are the gold standard

If you’re still struggling with teeth grinding, it’s OK. (Remember, some of us are just genetically predisposed to it!) There’s a simple intervention that could make a world of a difference. “One of the most effective ways to combat nighttime bruxism is a night guard,” says [Dr. Salierno](https://www.hellotend.com/clinical-providers/dr-chris-salierno). “It may look like a simple piece of plastic, but it's actually a sophisticated appliance custom-molded to your mouth and designed to be worn while you sleep.” 

Since the pandemic began, Tend dentists have seen a 341% year over year increase in demand for night guards, and for good reason. A night guard typically costs less than a thousand dollars. We charge $599 if you don't have dental insurance, and if you do, it could cost significantly less than that. Compared to the cost of even a single crown, it’s a far more economical solution. 

### Take that, pandemic 

For the past two years, the pandemic has wreaked havoc on our day-to-day lives, so it’s not surprising to find that it’s hitting our stress levels and our oral health hard, too. Still, if stress grinding is your problem, a few tweaks could make a huge difference. And while not everything we’re struggling through can be solved by night guards and hot baths, we’ll take our wins where we can get them. (Because, let’s face it, these days you’ve got other things to worry about.) 


Book a dental exam at your nearest Tend studio, and one of our top-rated dentists will examine your teeth for signs of wear.


Think you’re grinding?

These days, it’s nearly impossible to find an area of our lives that hasn’t been affected by Covid-19. Here’s one more to add to the (very long) list: oral health. 

Woman is holding her jaw in pain, her eyes are closed. 

Affects of Covid Stress 

As the fastest-growing dental services provider in New York, we’re seeing first hand the harmful effects of Covid-related stress on our patients’ teeth. The numbers are grim: these days, our NYC dentists are treating three times as many patients for stress-related oral health issues than they were pre-pandemic. 

Covid Stress Is Ruining Teeth: Here’s What to Do About It

Covid stress effects

Stop us if you’ve heard this before: a dental hygienist starts at a new dental practice and gets thrown right in. No onboarding. No training. They’re expected to learn new systems—even new skills—on the fly. It’s stressful, and it’s isolating. 

That is not what happens at Tend. We do dental differently for our patients, and we do dental differently for our clinicians. For dental hygienists, that means a whole new way of being brought onto the team. We want you to feel supported and prepared from day one. 

![dentalhygienistimaging](//images.contentful.com/otz9p93fkvjx/1e2KxqidF738chgyMo0h4B/7a823d46ad0cd75ff74e9976207e46a9/dentalhygienistimaging.jpg)

__Orientation: The First Week for Dental Hygienists__

In your first week at Tend, we immerse you in the company, and we introduce you [to the team](https://www.hellotend.com/careers) you’ll be collaborating with. You’ll be part of sessions on our brand, culture, and values. You’ll shadow people in different roles—from a dental hygienist, to a dental assistant, to a welcome bar associate—just so you know how everything works. You’ll get trained on all of our technology. You’ll be part of mock appointments (even dress rehearsals). At the end of all of that, you’ll be singing in your scrubs.

![tendhygienistquote](//images.contentful.com/otz9p93fkvjx/419oSq0c5w8N7Fy44PW77D/c8f246e255a6f5fc3c796ae8a280e4fa/tendhygienistquote.png)

__Introducing: Lead Dental Hygienists__

“Lead Hygienist” is a new, elevated role we created to support our team. In addition to cleanings and screenings, our Lead Dental Hygienists also help onboard, coach, and train other dental hygienists. Their goal is to help ensure that you’re set up for success—and that our members have the best possible experience. Over time, we promote dental hygienists to be Lead Dental Hygienists. It just takes a commitment to leadership, responsibility, and being a great teammate.

![dentalhygienistchart](//images.contentful.com/otz9p93fkvjx/4mSzPD4WIluuTLEhFLfWDM/4e5abb8a22c3e0503ee6ae80532171bf/dentalhygienistchart.png)

__A Collaborative Culture at our Dental Studios__

When you’re part of the Tend team, you’re really that—part of the team. You’ll be relied on by the other clinicians who work with you, and you’ll rely on them in turn. It’s the perfect balance of independence and support, trust and feedback. Everyone at Tend is always continuing to learn from each other. We need them to, to keep transforming dental’s future.

![leaddentalhygienistquote](//images.contentful.com/otz9p93fkvjx/PZnZ2f4n0UH7Y5eV0QQAp/60779446e5cf628b15bea62e2940e7d1/leaddentalhygienistquote.png)

__TendU: Our Dental Learning Platform__

We support our dental hygienists well beyond orientation and coaching. We also have an in-house learning platform called TendU. It offers world-class continuing education courses—from how to manage gum sensitivity to how to talk about proper at-home care—so you’ll always have a way to sharpen your skills and build new ones.


We're opening new dental studios near you, and we’re looking for top-notch dental hygienists to join our highly skilled and rapidly growing team.


Apply to be a dental hygienist at Tend

*At Tend, dental hygienists feel supported and prepared to do their jobs—and it's thanks to our unique training program.*

dentalhygienistconsult

Tend's Dental Hygienist Training Program | Tend 

Our Dental Hygienist Training Program

Maybe you went to your dentist with discomfort. Maybe you were referred to an oral surgeon. Or maybe you went to a routine dental exam without any symptoms and the implant recommendation came as a complete surprise. 

__And now you’re looking for a second opinion.__ 

This is extremely common. And we recommend it. An implant can be an amazing way to restore a missing, damaged, or broken tooth. But it’s a serious commitment. And a significant investment. So it’s crucial to: 

  A. Be absolutely sure you need one. This means ruling out less complex and costly alternatives, like a bridge, a root canal, or a removable appliance like a partial denture.

  B. Put your mouth in the best possible hands. This means having a doctor you love, whose guidance you trust 100%.

__Second opinions at Tend are the most objective.__

Tend is New York City's top-rated dental studio, with 11 locations across Manhattan and Brooklyn. When you get a second opinion with us, the recommendation you receive will be completely impartial. This is because we prioritize outcomes over quotas and practice evidence-based care. We only recommend the care you actually need.

If you don’t need an implant, they’ll tell you. If you do, they’ll tell you exactly why, walking you through the results of your imaging in detail. Then they’ll offer to book you a follow-up consult with one of our outstanding oral surgeons, who would place the implant if you decide to get it at Tend.

Either way, your dentist’s interests will be aligned with yours. That’s not true at other practices, where dentists make a commission on procedures, incentivizing them to be clinically aggressive.

![Joel Ayon Oral Surgeon](//images.ctfassets.net/otz9p93fkvjx/52ouVMDPdc1Cs6KP3AysgH/f81df664690307b80512cf0a3027caa9/Joel_Ayon_Oral-Surgeon_01.jpg)

__Tend has world-class doctors you’ll love.__

Not all dentists have extensive experience with implants. Our team does. When you [book a second opinion consult with us](https://www.hellotend.com/booking/studios?service=IMPCON), you’ll meet with an experienced general dentist at your local studio. These clinicians have been specially trained to evaluate clinical needs, and they work directly with our Head of Clinical Development, Dr. Marc Schlenoff, a former Program Director at Columbia University’s College of Dental Medicine. They’re also the top-rated dentists in NYC, with hundreds of reviews from patients who’ve had an amazing experience.

__Tend has beautiful, conveniently located studios.__

When you get a second opinion consult at Tend, here’s what you’ll experience. You’ll [book online](https://www.hellotend.com/booking/studios?service=IMPCON), fast, at a studio location that’s convenient for you, right by public transportation. When you arrive, you’ll enter a beautiful, soothing space and be greeted at the Welcome Bar. You’ll be seen right away (our average wait time is 3 minutes). Your care team will take images of your mouth and conduct a thorough exam. Then your dentist will patiently, clearly explain what they see and talk you through your options. No rushing, no jargon. We’re here to help.

Book a free 30-minute consult with one of the top-rated dentists at Tend.

Ready to get a second opinion on an implant?

So. You’ve been told you need a dental implant.

Tend dentist giving a second opinion consult to an implant patient

Implant Consult

Should I Get a Second Opinion for Dental Implants? | Tend

Tend dentist giving a second opinion implant consult to an implant patient

How to Know for Sure if You Need a Dental Implant

There’s a lot of chatter around fluoride and its place in toothpaste and our public water: do we need it to strengthen teeth? Is it actually safe to use? The simple answer: though it isn’t the only way to strengthen teeth, fluoride is a safe and effective way to do just that. And there’s [over 70 years of research](https://www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation) to back it up.

__Fluoride prevents cavities__

Before we go deeper, let’s establish what fluoride is. Fluoride is a mineral that naturally occurs in our teeth, helping to strengthen the enamel that protects them from decay. Fluoride is incorporated into the mineral matrix that comprises the actual enamel, making it a key component in the preservation of your teeth.

You may be surprised to learn that at least [74.4% of the U.S. population has fluoride in their public water](https://www.cdc.gov/fluoridation/statistics/index.htm). Why? A study in the 1930’s [examined the correlation between tooth decay and water with naturally-occurring fluoride](https://www.cdc.gov/fluoridation/basics/index.htm). It found that communities with more fluoride had stronger teeth and therefore had less susceptibility to tooth decay. Because of these findings, cities around the United States started to put fluoride in public water in 1945. And the results have been astounding: [fluoride in water has prevented at least 25% of cavities in children and adults](https://www.ada.org/en/public-programs/advocating-for-the-public/fluoride-and-fluoridation).

If you’re interested to see if your public water has fluoride, the CDC website provides a resource for people living in [participating states](https://nccd.cdc.gov/doh_mwf/Default/Default.aspx). If you’re in the 25.6% of places that don’t have it in their water, it may be more important to make sure fluoride is incorporated in your dental care routine.   

__Fluoride works in two ways__

The first is through ingesting it as a baby or child, as your teeth are forming. This is where having it in water becomes a factor: people born in NYC, for instance, initially have very strong teeth compared to people in areas with no fluoride in the water at all. In areas with water that doesn’t have fluoride, children can take vitamins with fluoride as a way to incorporate it into developing teeth, building the foundation to have strong teeth as an adult. (If your water has fluoride, this isn’t necessary.)

Fluoride also works topically, once the tooth is fully formed. Fluoride toothpastes and mouthwashes work by filling in the pores that exist in your teeth’s enamel with fluoride, thereby strengthening it against acidic or sweet foods, which can damage your teeth. A highly concentrated fluoride toothpaste can also be useful to lessen the sensitivity of teeth as we age. 

It is important to note, however, that while it can be important to use fluoride as an adult, the most crucial time for fluoride is the first 5 to 6 years of your life. After that, assuming you have good dental hygiene, using fluoride is more about maintenance.

__There is no evidence that suggests fluoride causes autism or cancer__

Now that we’ve established what fluoride is and what it does, let’s talk about the elephant in the room: the claims that fluoride can lead to autism, a lowered IQ, and a myriad of other conditions like cancer. 

There is [very little credible research](https://www.cancer.org/cancer/cancer-causes/water-fluoridation-and-cancer-risk.html) to support these claims. While an excess of anything can have harmful ramifications, at the recommended dosages, the worst that can happen with fluoride is that your teeth may develop white spots (or a few brown spots)—for example, if you take fluoride supplements as a child and also drink fluoridated water. As fluoride has become more prevalent in things like toothpaste and mouthwash, the U.S. has lowered the amount of fluoride put in water to ensure people are not getting harmful amounts. 

__The verdict: fluoride is legit__

Fluoride in our water is one of the most helpful public health initiatives ever undertaken in the United States. [The CDC named it one of the top ten public health achievements of the 20th century](https://www.cdc.gov/fluoridation/basics/index.htm). Fluoride is a practical, safe, and effective way for us to strengthen our teeth from childhood into adulthood. 

That said, there are other, fluoride-free ways to remineralize teeth for routine maintenance. One involves a mineral called hydroxyapatite. This mineral is what most of our tooth enamel is made of. Adding it to toothpaste has been shown to protect teeth in a way that’s comparable to fluoride. So if you still have concerns about fluoride, for any reason, look for a toothpaste with hydroxyapatite. 

Smile strong.

In our “Is It Legit?” series, we weigh in on trendy topics in oral wellness, flossing fiction from fact so that you know what to trust your mouth with.


The Gargler - Fluoride

The Truth about Flouride Oral Care Products - Are They Legit? | Tend

Fluoride: Is It Legit?

When a patient finds out they grind their teeth, they are usually met with a recommendation for an expensive mouthguard from their dentist and sent on their way. But why do we grind our teeth in the first place? Has stress related to Covid caused more grinding? And is grinding really such a big deal? Tend’s Head of Clinical Development, [Dr. Marc Schlenoff](https://www.hellotend.com/about), has these answers and more. (Spoiler: yes, grinding is, in fact, a *very big deal*.)

__Grinding can be caused by stress, but it’s also genetic__

While a lot of us grind due to stress, “some people who are seemingly under no stress grind because that’s just the way they’re hardwired,” says Dr. Schlenoff. 

__For stress-grinders, Covid is a factor__

Many if not at all of us have been under heightened stress since the start of the pandemic. And this would [logically lead](https://www.nytimes.com/2020/09/08/well/live/dentists-tooth-teeth-cracks-fractures-coronavirus-stress-grinding.html) to an increase in “the intensity and severity” of grinding, says Dr. Schlenoff. 

__Grinding produces a huge amount of force__

“Grinding can generate up to 1,100 pounds per square inch of pressure on your teeth.” To put that in perspective, that’s [3-6 times](https://www.chicagotribune.com/lifestyles/health/sns-health-teeth-stress-story.html) the pressure you use to eat.

__Evidence of grinding is easy to spot__

When people grind, the cusps of their teeth gradually become flatter, and shinier, then shorter. “I always show my patients a picture of the wear to show them exactly what’s happening,” says Dr. Schlenoff.

__Grinders typically grind for an hour or so per night__

“We grind and clench and then we stop and then we do it again...all night long,” says Dr. Schlenoff, adding up to about 60 minutes total.

__You’re more likely to grind if you snore__

Some snorers assume they couldn’t possibly grind their teeth while snoring, but sadly they’re wrong. In reality, “grinding is just momentary, and there’s almost a 100% correlation between snoring and grinding.”

__Grinding wears away at enamel, then at dentin__

Now for some dental anatomy: a tooth has layers that grinding destroys bit by bit. The first layer is the enamel, which coats the outside of the tooth and is “the hardest substance in the body.” Once you grind through this, you’re in trouble. Underneath the enamel is “dentin,” a yellowish substance that’s 11 times weaker than enamel. As a result, it will erode 11 times more quickly.

__Grinding affects multiple teeth at a time__

Grinding doesn’t just happen to one tooth: it occurs in a sliding motion that wears down many of your teeth simultaneously in a fairly symmetrical way. 

__There’s a point of no return when it comes to tooth damage__

Because the tooth gets softer the deeper you go, over time the damage grinding causes begins to accelerate. At a certain point, the damage is beyond repair and your teeth will require crowns. Dr. Schlenoff recalls, “I’ve had cases where I had to do crowns on every tooth in the mouth to rebuild them to their original height because people have worn them down so dramatically.”

__Repairing this damage can be incredibly expensive__

A single crown can cost up to $2500, depending on where you live. If your case is really extreme and you need crowns on every single tooth like Dr. Schlenoff’s patient, that could result in a whopping cost of $80,000. 

__There’s a way, way cheaper alternative__

Since there’s no way to consciously stop grinding (especially in our dreams and during a pandemic), our best mode of defense is a night guard. That’s a simple piece of plastic custom-molded to your mouth that you wear just when you sleep. A night guard typically costs less than a thousand dollars. We charge $599 if you don't have dental insurance, and if you do, it could cost significantly less than that. 

That translates to at least $79,401 that you could spend on say, two cars, some bougie vacations, and hundreds of takeout dinners instead. Because as much as we love the dentist, we’re pretty sure that having great wheels, sitting on a beach, and eating delicious food beats sitting in a dental chair. 

Here’s to strong enamel and grind-free teeth!

Book a dental exam at your nearest Tend studio, and one of our top-rated dentists will examine your teeth for signs of wear. 

Think you're grinding?

[8% of adults](http://sleepdisorders.sleepfoundation.org/chapter-7-sleep-related-movement-disorders/sleep-related-bruxism/p/) grind their teeth, but most have no idea about the long-term consequences.


Animation of teeth

Is Stress Ruining Your Teeth? | Tend

Is Covid Stress Ruining Your Teeth?

We love dogs, and we’d pretty much do anything for them. Case in point: we pick up their *poop*. And while we wouldn’t change a single thing about the play time, walks, nuzzles, or sloppy kisses, there *might* be a change or two we’d make in other areas. (See: the “picking up their poop” point, above.) Because, while a good pup snuggle is pretty much the cure for whatever ails us, being on the receiving end of a panty, slobbery huff of rancid dog breath? Not our preferred pastime.

__It’s time to pay attention to our furry friends’ oral health__

“Dogs are also prone to periodontal disease,” explains Dr. Marc Schlenoff, Tend’s Head of Clinical Development. “And yes, that can mean bad breath.” Since dogs shouldn’t ever eat sugar, they tend not to suffer from tooth decay, but plaque and gum disease can be a serious problem. In fact, periodontal disease is the most common clinical condition in dogs. Which means the number one thing you can do to keep your pup’s pearly whites healthy is brush their teeth. Every day. No, really. “You have to,” explains Dr. Schlenoff. Not only will this help freshen their breath, it will also prevent more serious problems—like bleeding gums and tooth loss.

![2021 2 Gargler BreathBiscuit Body2](//images.ctfassets.net/otz9p93fkvjx/5GvzmOtUJpek6DLFuMSciX/d5a761a9c3235c7d535ef0bda4b12b10/2021_2_Gargler_BreathBiscuit_Body2.jpg)

__Tend is here for all the mouths in the family__

While brushing your dog’s teeth is important, there are easier ways to support their oral health. Our new Breath Biscuits by Bocce’s Bakery in NYC are an all-natural, delicious dog treat to keep your canine’s canines healthy and their breath great-smelling. 

These wheat-free biscuits are made from just three good-for-your-dog ingredients: 
- Oat flour is a good source of vitamin B (for a healthy coat), linoleic acid (for strong skin), and fiber (to support digestion)
- Apples are a good source of vitamin C (which may reduce inflammation and cognitive aging in dogs)
- And mint is a long-time favorite to help mask halitosis

![2021 2 Gargler BreathBiscuit Body1](//images.ctfassets.net/otz9p93fkvjx/2vmncJ3sfrTyOD0yZWuNWz/2e177216197079de631bf9cdc71b87ff/2021_2_Gargler_BreathBiscuit_Body1.jpg)

__A dentist-approved dog treat__

In addition to these treats’ health-boosting ingredients, the mere act of chomping down on them or other crunchy snacks can help keep your pup’s teeth clean and in good working order. So pass one to your pup, then pucker up for a long round of minty-fresh dog kisses. Your pup—and your nose—will thank you.

Let’s face it (literally): puppy breath isn’t always cute. 

2021 2 Gargler BreathBiscuits Header v2

Stop Doggy Breath - Oral Health Tips & Recipes for Your Dog | Tend

A Kiss Assist for You and Your Dog

In our experience, there are two kinds of dental patients: 1. those who are afraid of discomfort and want to avoid it at all costs; 2. those who want a bit of soreness or tooth sensitivity to “prove” that they had a thorough cleaning.

If one of these sounds like you, we want to talk to you about what level of comfort it’s realistic to expect during a dental exam (TL;DR, more than you think, but not total bliss), and whether discomfort and thoroughness really do go together (actually, no!).

__If you feel discomfort after your dental cleaning, and that’s worrying...__ 

We do everything possible to make your dental exam comfortable, from bringing your anxiety level down with a soothing space and distracting TV shows, to numbing sensitive gums with a topical anesthetic, to using gentler, state-of-the-art tools (more below). But there’s no way to 100% guarantee that you won’t feel a thing.

Of course, feeling some soreness is no reason to be worried about your oral health. While gum disease, [gingivitis](https://www.hellotend.com/thegargler/tread-gingerly-with-gingivitis), and [periodontitis](https://www.hellotend.com/thegargler/periodontitis-the-most-common-dental-disease-youve-never-heard-of) can lead to increased discomfort during dental procedures, one of the most common reasons people experience sensitivity at their dental checkups has nothing to do with poor oral hygiene; in fact, it’s quite the opposite. The reason? Over-brushing at home.

“A lot of our patients have very healthy teeth,” says Dr. Schlenoff, Tend’s Head of Clinical Development, “but may be very aggressive when brushing.” Overly-vigorous brushing at the gumline can lead to thinner gum tissue and “a tiny bit of gum recession.” This can leave some tooth exposed that’s not protected by enamel. And without that protective layer, your tooth will naturally be more sensitive during or after exams. 

The good news? This type of discomfort “is always transient and completely normal,” says Dr. Schlenoff. If you’re feeling any twinges, just raise your hand and let your dental hygienist know.

In the meantime, a few tweaks to your at-home dental care routine can help prevent further recession and minimize sensitivity. Switching to a soft-bristled toothbrush will help protect your gums, while using a [fluoride-based](https://www.hellotend.com/thegargler/fluoride-is-it-legit), desensitizing toothpaste should help with discomfort. And of course, regular flossing and rinsing with an antiseptic mouthwash will keep your teeth healthy between cleanings.

![2021 2 Gargler Soreness Header](//images.ctfassets.net/otz9p93fkvjx/67KV30YiriiOLjyvFiJuWq/3465f2bb23fdd0da12fa8ee370d608a2/2021_2_Gargler_Soreness_Header.jpg)

__If you’re not sore after your dental cleaning, and that seems weird…__

If you’ve been to other dentists, you may have internalized the idea that exams = pain. You may have even convinced yourself that pain is the only way to know you’ve had a deep cleaning. But it turns out that when you take the latest teeth cleaning technology and put it in the hands of skilled staff whose top priority is your comfort, it makes for a much more soothing experience. 

“We use ultrasonic scalers,” explains Dr. Schlenoff, referring to the instruments Tend hygienists use during the cleaning process to remove plaque and tartar from teeth. “Ultrasonic” means the scaler uses soundwaves to blast buildup off your teeth. And since ultrasonic scalers vibrate faster than traditional scalers, they’re more precise and less painful. 

This means that you’ll likely be more comfortable during your cleanings than you were at your last dentist’s office. And that your teeth will also be just as clean, if not cleaner. So if you think you’re supposed to feel sore afterward, you may be sorely disappointed. (Sorry, we had to!)

Whichever type of patient you are—afraid of discomfort, expecting it and even kind of wanting it—we’re here for you. Book a checkup at your nearest Tend studio, and we’ll make your cleaning as soothing as it is thorough.

A dental exam that’s so much more than routine

Let’s back up. How much soreness are you expecting?

2021 Gargler Soreness Header v3

Is Soreness After A Dental Exam Normal? | Tend

How Much Soreness Is Normal from a Dental Exam?

You may have heard that gum is bad for your teeth. You may have also heard that it’s good for them.

So…which is it? Does gum chewing lead to cavities and decay, or to whiter smiles and fresh breath? (Because really, can a product sold in the candy aisle actually help keep your teeth clean?)

To get the 411 on chewing gum, we sat down with Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

__Choose the right chew__

It’s time to set the record straight: chewing gum can be good...if you pick the right kind.

According to Dr. Schlenoff, chewing gum “is actually not bad for you at all—as long as it’s sugar-free.” 

__Sugar and your teeth: not so sweet__

What’s the problem with sugary gum? In your mouth, sugar gets broken down by bacteria. These so-called “bad bacteria” produce a few gnarly byproducts in the process, including dental plaque and acid. The acid can disrupt your mouth’s delicate pH balance, leading to enamel erosion and cavities, while the plaque can build up and harden, leading to tooth decay.  

__Sugar-free ways to sweeten the deal__

Fortunately for gum-lovers, there are sugar-free chewing gum alternatives. Some popular sugar substitutes in gum include sugar alcohols (such as sorbitol, mannitol, and xylitol), aspartame, and stevia extract.

Not only do these artificial sweeteners avoid the problems caused by sugar, some may actually offer benefits for your mouth. For example, in addition to sweetening like sugar, gum made with sorbitol “has actually been shown to reduce tooth decay,” per Dr. Schlenoff.

__Mouthwateringly good for you__

[The act of chewing gum naturally increases saliva flow](https://www.dentalhealth.org/sugar-free-chewing-gum), and “saliva flow is always a good thing,” says Dr. Schlenoff. Increased saliva flow helps to neutralize and wash away any food particles and lingering acids that are produced when you eat—which helps maintain your mouth’s pH balance and preserve your tooth enamel. [One study found](https://doi.org/10.14219/jada.archive.2008.0347) that people who chewed sugar-free gum for about 20 minutes after eating a meal actually had a lower incidence of cavities.(Another bonus? Increased flow of saliva can help control [bad breath](https://www.hellotend.com/thegargler/dont-just-mask-your-mask-breath)!) 

__Watch out for TMD__ 

One important note: although sugar-free gum has a sparkling reputation, all that chewing can pose a potential risk. [TMD/TMJ](https://www.mayoclinic.org/diseases-conditions/tmj/symptoms-causes/syc-20350941) (or temporomandibular joint disorder) can cause jaw pain or muscle pain as well as difficulty chewing. “Some people are more naturally disposed to TMD,” says Dr. Schlenoff, “but there’s an easy solution if that happens: stop the chewing.” 

__The bottom line__

Still unsure of how your gum stacks up? When in doubt, pick a pack with the [American Dental Association](https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics) (ADA)’s Seal of Approval: reserved for sugarless gums that aren’t going to harm—and may even help!—your oral health.

And of course, remember that no amount of chewing gum is a substitute for a good basic dental care routine: for the healthiest teeth, stick to twice-yearly oral hygiene checkups, plus daily flossing and twice-daily tooth brushing with a [fluoride-based toothpaste](https://www.hellotend.com/thegargler/fluoride-is-it-legit)!

__READ MORE:__
- [Weed: How Bad Is It?](https://www.hellotend.com/thegargler/weed-how-bad-is-it)
- [Seltzer: How Bad Is It?](https://www.hellotend.com/thegargler/seltzer-how-bad-is-it)


Be frank with your dentist. Not comfortable talking to your dentist about this kind of thing? Maybe it’s time for a new dentist. 

Worried about your own habits?

In our “How Bad Is It?” series, we answer your cringing questions about whether something you’ve done, or do everyday, is bad for your oral health (or completely harmless).

The Gargler - Chewing Gum

How Bad Is Chewing Gum for Your Teeth? | Tend

Chewing Gum: How Bad Is It?

If you have damaged teeth or tooth loss, you know how disruptive that can be to your oral health. Biting down into your favorite foods can become a source of anxiety. So can how you look when you’re smiling. 

Still, getting a complex restorative procedure may be intimidating in its own way. You may be afraid of oral surgery, post-operative pain, the idea of drilling, even just the word “implant.” And as a result, you may not explore your options fully.

If you’re in that category—if, say, you think dentures or a dental bridge are your only options for missing teeth—we want you to know something: [dental implants](https://www.mouthhealthy.org/en/az-topics/i/implants) are one of the most effective, durable, and beautiful options for tooth replacement. And getting them is a lot more comfortable than you might think. 

__How the dental implant procedure works__

“Implants tend to be much less uncomfortable than the perception,” explains Dr. Schlenoff, Tend’s Head of Clinical Development. 

Your treatment plan will depend on your specific situation, but in general, dental implant surgery involves [replacing a tooth’s root](https://www.perio.org/consumer/single-tooth-implant) with a small metal post—the “implant.” After the implant and the underlying jawbone come together, a dentist tops the post with an abutment, or connector, to which they attach a ceramic crown. A crown is a gorgeous, long-lasting artificial tooth that looks and performs just like a natural tooth. 

Although the process sounds intimidating, dentists have been performing and perfecting this procedure for [more than 30 years](https://www.aaid-implant.org/dental-implants/what-are-dental-implants/). And they’ve become really good at making it comfortable. Plus, studies suggest that [dental implants have up to a 99% success rate](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212375/), meaning if your dentist or oral surgeon has determined you’re a good candidate for an implant, you can feel confident that it’ll be successful.

__READ MORE:__ [How to Know for Sure if You Need a Dental Implant](https://www.hellotend.com/thegargler/how-to-know-for-sure-if-you-need-a-dental-implant)

__No nerves = no pain__ 

“In the bone where we’re attaching the implant,” says Dr. Schlenoff, “there really are no nerve endings. So, amazingly, that part of the procedure does not hurt.” Plus, depending on your situation, your dentist will use a combination of local anesthesia, sedation, or general anesthesia to ensure the entire surgical procedure is pain-free. 

There is some temporary discomfort post-surgery, he says. But that comes from “the manipulation of the gum tissue” around the implant—not the implant itself. This pain is generally mild and can be managed with over-the-counter pain medications. Salt water rinses (starting the day after the procedure) can also help ease discomfort. 

This means that, overall, “most people are very pleasantly surprised,” he says. In fact, many describe the level of pain as being less than that of a tooth extraction. “I’ve dealt with hundreds of implant patients, and most people are just fine the day after. Certainly by 48 hours later they’re back to their normal activities.” 

__A (worthwhile) wait__

Dr. Schlenoff does note that, once an implant post has been attached at the implant site, [it can take a few months](https://www.mayoclinic.org/tests-procedures/dental-implant-surgery/about/pac-20384622) for it to fully fuse with the bone (a process known as osseointegration). This wait is important, because your new tooth shouldn’t be placed until the implant—technically, your new artificial tooth root—is strong enough to support it. (A temporary restoration can be placed in the meantime.) 

But the wait is worth it. Once the permanent crown is in, it looks and behaves exactly like a normal tooth—making chewing and smiling anxiety-free. Just like a natural tooth, you’ll need to [protect it from gum disease](https://www.hellotend.com/thegargler/tread-gingerly-with-gingivitis) with diligent at-home dental care—including brushing and flossing daily. Regular checkups will also keep your implant and crown performing their best. And the best part of all? With the right oral hygiene routine, you can expect your dental implant to last a lifetime. 

__Tend’s elite team__

If you need an implant, it’s critical to work with a skilled dentistry team—like the one Dr. Schlenoff leads at Tend. Each of our dentists is trained to make placing an implant as comfortable as possible. And to craft beautiful dental crowns that will be part of your smile for decades.

Since there aren’t any nerve endings where the implant sits, most people come away from the procedure “pleasantly surprised.”

The Gargler - Implants

Getting Dental Implants? It's Surprisingly Painless | Tend

Why Dental Implants Are Surprisingly Comfortable

As wearing masks becomes part of our new normal, so does the unwelcome aroma of “mask breath.” That’s your own bad breath trapped inside your mask.

“Masks are designed to keep things in,” says Dr. Schlenoff, Tend’s Head of Clinical Development. “They have layers and layers of fibers. So if your breath is bad, your mask will contain it.”

And if you wear a mask over and over, and it isn’t washable, it could start to take on that odor for good. 

It’s a small price to pay for being safe. But it can still be “pretty gross,” says Dr. Schlenoff. We used to worry about other people smelling our bad breath. Now we’re our own victims.

There’s a solution for this. And it’s not mints, gums, sprays, strips, or any other breath fresheners. Those just “mask” the problem. You need to treat it at the source to actually get rid of it.

“Bad breath can come up through the gastrointestinal tract,” says Dr. Schlenoff. “It can come down through the nose. But most of the time it comes from your mouth. And it’s usually just a hygiene issue. The bacteria in your mouth smell because they weren’t cleaned out.” 

The majority of those bacteria live on your tongue.

“It’s an ideal hiding place,” says Dr. Schlenoff. “Bacteria love it. It’s moist. It’s protected. It has an uneven surface. It’s almost the perfect environment for bacteria.”

Some people brush their tongues like they brush their teeth. “But it’s very difficult to brush your tongue properly,” says Dr. Schlenoff. “Toothbrush bristles are made of flexible nylon, and they give a lot. So they’re going to miss things.”

It’s better to use a tool designed specifically for tongues. That’s why we created the Tidy Tongue, a tongue cleaner with a rigid wiper that slides gunk off like a little zamboni.

You can test this for yourself. First, brush your tongue with a toothbrush and see how it looks. Then use the Tidy Tongue and see how much more icky white stuff comes off. That white stuff is plaque, the same bacteria you brush off your teeth. But on your tongue, there’s way more of it. 

Dr. Schlenoff uses his Tidy Tongue at night. But you can use yours in the morning, or even twice per day. Whatever feels right for your routine. Tongue cleaning only takes a few seconds.

And once you start, you’ll be able to mask up and exhale freely.

When left to its own devices, your tongue becomes a home for bad-breath-causing plaque. Enter the Tidy Tongue, a stainless-steel tongue cleaner designed by our dentists.

Introducing the Tidy Tongue

Clean your tongue to treat bad breath at the source.

Tidy Tongue Gargler

Mask Breath? Try a Tongue Cleaner! | Tend

Don’t Just Mask Your Mask Breath

Straight smile seekers, *we have good news for you*. There’s a revolutionary new orthodontic technology, available exclusively from Tend. It’s called [Breezy Braces®](https://www.hellotend.com/breezy-braces), and it uses a NASA-developed material to invisibly straighten your teeth with zero maintenance. 

Before we get into the details, let’s talk about your situation.

__You want to straighten your teeth.__

Maybe you had braces as a kid, then stopped wearing your retainer. Or you never had braces and thought you wouldn’t need them. But...your teeth have begun to drift. 

At first, you could ignore it. It even looked kind of cool and rugged. But now, not so much. You’re getting embarrassed, and you’re worried about where this is headed. Your teeth may also be getting harder to clean and yellowing (or worse) if they’re overlapping and crowded.

__But you don’t love your options.__

Other orthodontic treatments look terrible, aren’t sanitary, have to be removed every time you snack, get lost, get eaten by dogs, and aren’t actually invisible. In fact, they can be highly visible, resulting in doubletakes from friends and coworkers as they try to figure out why your smile looks...different. 

__That’s where Breezy Braces® come in.__

[Breezy Braces®](https://www.hellotend.com/breezy-braces), powered by Inbrace, give you everything you want—a beautiful, confident smile and fewer dental issues down the line—without any of the embarrassment or hassle.

__Breezy Braces® are actually invisible.__  

Breezy Braces® are truly 100% hidden. As in, the only way someone will know you’re wearing them is if you tip your head back and show them what’s behind your teeth. This allows you to smile freely throughout your treatment.

__They’re totally hands-off.__

Breezy Braces® require next to no maintenance. You can eat and drink (and kiss) whenever you want. And you won’t have to touch your teeth with your fingers.

__They’re more comfortable.__ 

Other orthodontic treatments hurt periodically as they’re tightened or swapped out. Breezy Braces® are different. They move your teeth gently and continuously throughout your treatment, so there aren’t any peaks of discomfort. 

__They’re easier to clean.__ 

Breezy Braces® are designed to be super hygienic. Their rising and falling shape allows you to brush and floss like you normally would. (Or, if you don’t floss, there won’t be anything in the way of you starting. Sorry!)

__They’re rocket science.__

Breezy Braces® are made possible by an incredible technological advance. They’re crafted from a material called shape memory wire that was originally developed for spaceships and satellites. Shape memory wire is flexible, but always returns to its original shape. 

With Breezy Braces®, a thin piece of shape memory wire is “programmed” specifically for your smile, then placed behind your teeth. It slowly and gently moves your teeth until it achieves its final shape.

__They’re affordable.__

In NYC, orthodontic treatments start around $1,850 and go up to about $7,000. 

Breezy Braces® cost $5,000—right in the middle. They cost more than the cheapest straightening option. But in our opinion, that’s a small price to pay for a far better experience.

__And they’re placed by an orthodontist.__

Unlike other orthodontic treatments, Breezy Braces® aren’t put in at home, with no clinical oversight. They aren’t even placed by a normal dentist. They’re placed by an orthodontist. That’s a dentist with special training in the art and science of moving teeth. This ensures that they’ll actually work, and that if any adjustments need to be made, an expert is on call to help—all for the same price.

__Here’s how it works.__

You start by talking with an orthodontic specialist (for free) about your smile and whether Breezy Braces® are right for you. Next, you’ll visit a Tend studio for 3D imaging. If you decide to move forward, your orthodontist will craft your Breezy Braces® specifically for you. Then you’ll come back to have them placed. Every 6-8 weeks, you’ll return for a quick check-in to make sure everything is going according to plan.

__You’ll have a whole new smile in as little as six months.__ 

And by the time your Breezy Braces® come off, you may not even remember you had them.

Interested in learning more? Book a free consult and spend 15 minutes chatting about your smile and whether Breezy Braces® are right for you.

Book a free consult

Breezy Braces Gargler


Introducing Breezy Braces®
A new care-free, can’t-see straightening technology that goes behind your teeth, exclusively at Tend. 

Breezy Braces: Tooth Straightenng Revolutionized | Tend

Straightening Just Got Revolutionized

If you’ve heard of [veneers](https://www.hellotend.com/veneers), you probably know that they’re a way of [gorgeously remaking](https://www.cosmopolitan.com/style-beauty/beauty/a13051650/what-are-veneers/) spaced, uneven, worn down, chipped, or stained teeth. But you probably didn’t know that they’re also a way of transforming the shape of your face, making it more symmetrical, accentuated, and youthful, like a face lift.

Let’s take a step back.

__What are veneers again?__

Veneers are super thin layers of porcelain that a dentist with special training applies to your teeth. They’re works of high-tech artistry, blending 3D imaging with a dentist’s aesthetic eye to create a beautiful, [natural-looking](https://www.nytimes.com/2010/10/21/fashion/21SKIN.html) smile. And they’re incredibly durable: when well cared for, they can last for decades.

__How many do I get?__

Dentists usually recommend getting veneers in multiples of two, for the most symmetrical effect. For cost reasons, you don’t want to get more veneers than you need to achieve the look you want. That said, you don’t want to get too few, or only part of your smile will look new. 

This can be a difficult calculation for patients. That’s why, at Tend, we offer per-smile pricing. No matter how many veneers you need, your price will be exactly the same. So there’s no reason to hold back on your smile makeover.

__What’s the process?__

At Tend, the process begins with me. If you’re interested in veneers, we’ll do a free, 30-minute virtual consult to talk about your smile and whether veneers are right for you. 

If they are, and you want to move forward, I’ll match you with a Tend dentist who I’ve personally trained. You’ll come in for 3D imaging, and your dentist will show you a digital preview of your new smile. This visit takes about 50 minutes. 

Sometimes, the best way to make your smile sing is to supplement veneers with crowns, implants, and other types of restorative work. If your dentist recommends that, you won’t pay anything more.

The next step is temporary veneers. In about 70 minutes, your dentist will remove a thin layer of surface enamel from your teeth, and you’ll leave with a temporary version of your new smile. This lets you test it out with friends and family members. 

When you’re ready, we’ll mill your permanent veneers. Our lab uses state-of-the-art technology, and we hand glaze the porcelain for exquisite natural detail. 

In your last visit, also about 70 minutes, your dentist will apply your permanent veneers. And you’ll start smiling.

__And veneers also change the shape of my face?__

Veneers do more than remake your teeth. They actually transform the shape of your face. As you age, your mouth loses elasticity and muscle tone, making your face less symmetrical. Veneers make you look younger by supporting your mouth’s musculature and accentuating your cheekbones. 

The effect is similar to what you’d get from a face lift. But unlike a face lift, veneers don’t involve surgery. And thanks to temporary veneers, you can actually see what you’re getting before it becomes permanent.

Interested in exploring whether veneers are right for you? Let’s talk!

Spend 30 minutes talking to Dr. Schlenoff about your smile and whether veneers are right for you. Virtual veneers consults are completely free.

Book a virtual veneers consult with Dr. Schlenoff

Veneers Gargler 2

How Veneers Transform the Shape of Your Face | Tend

How Veneers Transform the Shape of Your Face

We all know that cigarette smoking is awful for oral (and overall) health—thank you, decades of PSAs from the [American Dental Association](https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/tobacco-use-and-cessation) and [CDC](https://smokefree.gov/quit-smoking/why-you-should-quit). But what if what you’re smoking doesn’t contain tobacco? As the availability (and legality) of marijuana increases nationwide, it’s natural to wonder if cannabis use is as harmful for your mouth as smoking cigarettes.

To find out, we sat down with resident expert Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

__Smoking weed has been linked to gum issues__

“There have been studies that show that marijuana can be a causative factor in periodontal disease,” says Dr. Schlenoff. Meaning, we’re less worried about the effect smoking marijuana has on your teeth, and more worried about the effect it can have on your gums. [According to a 2017 study from Columbia University published in The Journal of Periodontology](https://www.dental.columbia.edu/news/recreational-cannabis-used-often-increases-gum-disease-risk), “frequent recreational use of cannabis—including marijuana, hashish, and hash oil—increases the risk of gum disease.” 

“You can tell a smoker by the way their gums look,” explains Dr. Schlenoff, “They’re sort of a grayish color because there’s not a lot of blood in there.” Researchers have long understood that the combination of nicotine—which constricts blood vessels—and heat in cigarettes [can restrict blood flow to the gum tissue](https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html), which leaves it vulnerable to infection or [gingivitis](https://www.hellotend.com/thegargler/tread-gingerly-with-gingivitis). And it seems the Columbia study has found the same link with marijuana, a nicotine-free substance. 

Another one of the side effects of marijuana use that can affect your dental health? Dry mouth. The tetrahydrocannabinol (THC) in marijuana interacts with your body’s cannabinoid receptors, impeding the production of saliva and causing “cottonmouth,” a condition known medically as xerostomia.

Xerostomia can be uncomfortable; more critically, it can have serious oral health effects. Without saliva to help wash away bacteria buildup, you’re at an increased risk for tooth decay and, you guessed it: gum disease. (So what increases saliva flow? Believe it or not, chewing gum. Popping a piece of sugar free gum after you smoke weed can help reduce your risk for xerostomia.)

__Vaping may be just as bad (or worse)__

When it comes to the newest trends on the market, the research is less clear cut, since there hasn’t been enough time to conduct studies focusing on long-term effects. “We just don’t have that kind of data yet,” explains Dr. Schlenoff. 

That said, [you may have seen headlines](https://www.foxnews.com/health/vaping-harming-teeth-study) warning about the effects of vaping on your teeth and gums. It’s not hard to imagine why: exposing your gums to heat restricts blood flow. Plus, most [e-cigarette liquid typically does contain nicotine](https://smokefree.gov/quit-smoking/ecigs-menthol-dip/ecigs), which is a known oral health offender. The bottom line: when it comes to vaping, signs point to it being risky for your oral health—and, of course, your overall health, as vaping has been increasingly linked to [severe and even fatal respiratory problems](https://www.fda.gov/news-events/public-health-focus/lung-illnesses-associated-use-vaping-products). 

__CBD results have been more positive__

CBD, on the other hand, may be a different story. There is some preliminary research that suggests cannabidiol (the chemical name of CBD) [may prevent bone loss](https://www.ada.org/en/member-center/oral-health-topics/cannabis), which would help keep your teeth stable and sturdy. However, it’s very preliminary: so far, it hasn’t even [been tested](https://www.ncbi.nlm.nih.gov/pubmed/25517414) [on humans](https://www.ncbi.nlm.nih.gov/pubmed/19070683). And importantly, all studies involved CBD that was injected or consumed as edibles, not smoked. The bottom line: we can’t (yet) count on CBD as a way to prevent oral health issues.

__All things in moderation__

So is the occasional cannabis user or vaper doomed, then? Can marijuana users have good oral hygiene? When it comes to incidence of gum disease for smoking, at least, Dr. Schlenoff says that “it’s very clear that your risk is proportional to how much you smoke.”

The more you smoke, the higher the risk. The same is likely true of vaping. (For weed and CBD gummies, there’s currently too little research to know.) In the meantime, whether you smoke or not, one of the best ways to ensure excellent oral health is with excellent dental care. That means daily brushing and flossing, plus twice-yearly dental checkups.

__READ MORE: __
- [Chewing Gum: How Bad Is It?](https://www.hellotend.com/thegargler/chewing-gum-how-bad-is-it)
- [Seltzer: How Bad Is It?](https://www.hellotend.com/thegargler/seltzer-how-bad-is-it)

Be frank with your dentist. Not comfortable talking to your dentist about this kind of thing? Maybe it’s time for a new dentist. This shouldn’t be an awkward conversation.

In our “How Bad Is It?” series, we answer your cringing questions about whether something you’ve done, or do everyday, is bad for your oral health (or completely harmless).


Animated image of mouth with smoke ring

How Bad Is Weed for Your Teeth? | Tend

Weed: How Bad Is It?

“If you do it right,” says Dr. Marc Schlenoff, Tend’s Head of Clinical Development, “there’s no reason to brush more than once per day.”

“Doing it right” means brushing so thoroughly that if you were to use a disclosing tablet that reveals plaque on your teeth, you wouldn’t find any. Plaque builds up every 24 hours, so in theory one perfect brush per day should do it. (If plaque is left unbrushed for more than 24 hours, it will layer, harden, and damage your enamel.) 

But here’s the catch: “doing it right” is really, really hard (even for a dentist). It requires a level of thoroughness most of us aren't used to. 

That’s why—even though you could brush once per day—“you shouldn’t,” according to Dr. Schlenoff. Brushing a second time helps remove “any plaque you missed” during round one. And unless you’re a superhuman brusher, you need that. 

So stick with it!

If you want a judgment-free, educational dental experience, you've found the right place. Book a visit with one of our amazing dentists and hygienists at your nearest studio.

We answer the questions you're afraid to ask

You’ve probably been hearing all your life that you need to brush twice per day. But—prepare to have your mind blown—you don’t necessarily have to.


Do I Really Need to Brush Twice Per Day?

Do You Really Need To Brush Twice A Day? | Tend

I’m just going to get to it: I’m breaking up with you. That fuzzy feeling you give me just isn’t doing it anymore.

I know this may come as a shock to you, but I’ve felt this way for a while and was just too scared to act on it. The truth is, I’ve finally found someone who will be there for me, who’s a lot nicer than I ever could’ve imagined, and most importantly, makes my teeth strong instead of weak: my new Tend dentist.

I’ll always remember our good times: eating candy at the movies, all the times I forgot to floss or brush and you stood by me, growing in the night. Because you thrive in the bacteria of an unbrushed mouth, it couldn't be helped. I’ll always cherish how hard we laughed about how gross my breath smelled that one morning. Or how your friends Tartar and Cavities kept overstaying their welcome. 

But that’s the thing though, right? Our relationship was never just us. If it was just you and the other millions of friendly bacteria in my mouth, it would be one thing. But I’m slowly accepting that you and your buds are a package deal. And I deserve better than that. 

I know you’ll come back to me. That’s only natural. But I feel compelled to warn you: my new Tend dentist will always be there to support me in getting rid of you again.

Maybe one day we can get to a point where we’re friends, where we can give each other heartfelt hello’s as I scrape you off my teeth at night. But for now, I’m going to make a clean break. I hope you understand.

Don’t cry because it’s over. Smile because of all the candy we ate.


Our amazing clinical team can help. They're really good at writing breakup letters to plaque like this one.

Ready for a breakup?

In some ways this is the hardest letter I’ve had to write. And in some ways it’s the easiest.

Dear Plaque

If you keep up with the latest wellness trends—especially on social media—you’ve probably heard about charcoal. In the last few years, it seems to have lent its pitch-black hue to just about everything: skincare, ice cream, lattes—and oral wellness products. We’ve seen charcoal show up in toothpaste. But what’s it actually doing there? Should charcoal actually be a part of your at-home dental care routine? 

We checked in with Dr. Marc Schlenoff, Head of Clinical Development at Tend, to get to the bottom of the charcoal trend.

__The claim: activated charcoal helps you “detox”__ 

Activated charcoal powder, the flavorless ingredient at the heart of the movement, is essentially a form of carbon that’s been treated to make its surface more porous. It’s made by oxidizing wood, coconut shells, or other natural substances under extreme heat. Theoretically, the holes on the surface of the charcoal particles help them pick up and clear away other substances. 

It’s why you so often hear the word “detox” in connection with charcoal. Because it’s so absorbent, the idea is that ingesting it or washing your face with it will help draw out chemicals and impurities, leaving behind a flushed body or clearer skin. In dental products, the black powder supposedly promises whiter teeth and an end to bad breath.  

__The reality: when it comes to your teeth, there’s no proof__

“I went through the research,” explains Dr. Schlenoff, “and I couldn’t find one single solitary study that advocated for charcoal among independent, unbiased analyses.” 

He’s not alone in that finding: according to a [2017 review from the Journal of the American Dental Association](https://doi.org/10.1016/j.adaj.2017.05.001), there’s “insufficient clinical and laboratory data” to substantiate any safety or efficacy claims about activated charcoal toothpaste. 

__Charcoal could be really bad for your chompers__

Charcoal is abrasive, and there’s concern among dentists that, over time, exposing your teeth to it could wear away your enamel. “No matter how finely you grind up the particles it’s still abrasive,” adds Dr. Schlenoff.

[A study presented at the 2015 Academy of General Dentistry Annual Meeting](https://www.epostersonline.com/agd2015/node/72) found that activated charcoal was more abrasive than traditional whitening toothpastes (and suggested it may not be that effective at teeth whitening). 

Plus, since charcoal-based dental products are still relatively new, it’s not yet known what effect charcoal might have on fillings, veneers, crowns, or other tooth restorations. 

__Excess abrasion can actually lead to yellower teeth__

[The American Dental Association](https://www.mouthhealthy.org/en/az-topics/w/natural-teeth-whitening) cautions that using overly abrasive materials on your teeth can actually make them look less white and more yellow. That’s because you’re not necessarily only removing surface stains—you can also start to abrade your tooth enamel. And if you totally wear away your enamel, you’ll expose the layer below: dentin, a softer, less protected substance that (you guessed it) is yellow in color.

What’s more, many brands of charcoal toothpaste don’t contain fluoride, an important  ingredient for dental health. Fluoride helps to keep your tooth enamel strong and protect against cavities and tooth decay. 

__Been brushing with charcoal? Don’t panic__ 

A single tube of charcoal toothpaste is unlikely to be a huge threat to your oral health. That’s because when it comes to abrasion, “it’s cumulative,” assures Dr. Schlenoff. The longer—and harder—you brush, rinse, or floss with charcoal, the greater the risk. 

__And if you’re using charcoal mouthwash, consider safer alternatives__ 

“It’s not worth the risk at all,” says Dr. Schlenoff. When it comes to fresher breath or a whiter smile, “there are [much safer ways](https://soothsonic.hellotend.com/?utm_source=shop_home&_gl=1*16x14q6*_gcl_aw*R0NMLjE2MDM0MjMzOTUuQ2owS0NRancyOFQ4QlJEYkFSSXNBRU9NQmN5eFNQUko1NmJKUVVLRkNIeWV1R3hFbnBfVXZkeHhhRlhGWTBKR29BaVdPYTdNc0xHektvc2FBcE1XRUFMd193Y0I.&_ga=2.71390803.175980659.1603423396-594925918.1600095315&_gac=1.229445998.1603423396.Cj0KCQjw28T8BRDbARIsAEOMBcyxSPRJ56bJQUKFCHyeuGxEnp_UvdxxaFXFY0JGoAiWOa7MsLGzKosaApMWEALw_wcB) to achieve that result.”

In our “Is It Legit?” series, we weigh in on trendy topics in oral wellness, flossing fiction from fact so you know what to trust your mouth with.

Charcoal on toothbrush

The Truth about Charcoal Tooth Care Products - Are They Legit? | Tend

Charcoal: Is It Legit?

It’s hard to crack open your third (or fourth, or fifth…) can of the day and not feel a little worried that seltzer drinking could be damaging your teeth. What’s actually in seltzer? And does it matter for your oral health?

To find out just how bad—or not—a sparkling water bent can be, we sat down with Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

__Seltzer drinking isn’t something to lose sleep over__

Compared to drinking soda and other not-so-great-for-you sugary drinks like fruit juice, drinking sparkling water “isn’t really something to worry about,” says Dr. Schlenoff.

__Unless your seltzer contains citric acid__

When it comes to your dental care, the danger of many canned and bottled drinks (even the sugar-free ones), is mostly centered on a single ingredient: citric acid. Citric acid is naturally found in citrus fruits, and an artificial version is commonly used as a preservative and flavor-enhancer in some of America’s favorite bevvies.

__Citric acid erodes tooth enamel__ 

By lowering the pH of your mouth, citric acid can [erode your enamel](https://www.ada.org/en/member-center/oral-health-topics/erosive-tooth-wear). Combine that with another popular ingredient—sugar—as many soft drinks do, and, according to Dr. Schlenoff, you’ve got the “perfect conditions for tooth decay and tooth erosion.”

__Seltzer water is more acidic than plain water__

“Part of the seltzer-making process involves mixing water with carbon dioxide, which turns into carbonic acid,” explains Dr. Schlenoff. (That’s the “carbon” in “carbonated beverages”—what creates the “fizz” in fizzy water or club soda. “So there’s a little bit of acidity that’s brought into the mix.” The acidic environment that’s created is one reason seltzer and other acidic drinks taste so good. 

__But only slightly__

Still, the acidity “isn’t dramatic,” says Dr. Schlenoff, though he cautions that seltzer companies don’t share the exact pH levels of their products with the public, so it’s [hard to know what the long-term effects of drinking them will be](https://cspinet.org/tip/your-seltzer-habit-harming-your-teeth).

__To play it safe, swish with regular water__

“All it takes is a swish of water to rebalance the pH of your mouth,” says Dr. Schlenoff. This small behavior can have a big payoff for your dental health. 

So after you get your carbonated water fix, swish with tap water for a few seconds to bring your mouth’s pH level back to normal. But before you do anything else, check your favorite brand’s ingredient list, paying attention to sweeteners and flavor enhancers. If you see citric acid or sugar, pour yourself some still water instead. 

__READ MORE:__
- [Weed: How Bad Is It?](https://www.hellotend.com/thegargler/weed-how-bad-is-it)
- [Chewing Gum: How Bad Is It?](https://www.hellotend.com/thegargler/chewing-gum-how-bad-is-it)


That’s why we call ourselves a dental wellness company. We help you form healthy habits with personalized nutritional tips, product recommendations, and more.

We believe dentists shouldn’t just solve problems. They should prevent them.

*In our “How Bad Is It?” series, we answer your cringing questions about whether something you’ve done, or do everyday, is bad for your oral health (or completely harmless).*

Seltzer Horizontal

How Bad Is Seltzer for Your Teeth? | Tend

Seltzer: How Bad Is It?

We’re often simply told we do it, recommended an expensive mouthguard, and sent on our way with little to no more information. But *why* do we grind our teeth in the first place? Do I have to wear my night guard? And is grinding *really* such a big deal? Tend’s Head of Clinical Development, [Dr. Marc Schlenoff](https://www.hellotend.com/about), has these answers and more. (Spoiler: when it comes to your oral health, yes, grinding is, in fact, a *very big deal*.)

__Teeth grinding can be caused by stress, but it’s also genetic__

While a lot of us grind due to stress, “some people who are seemingly under no stress grind because that’s just the way they’re hardwired,” says Dr. Schlenoff.

Smoking, drinking alcohol, and [certain recreational drugs](https://www.hellotend.com/thegargler/weed-how-bad-is-it) are all risk factors that increase the likelihood of bruxism. Bruxism can also be a side effect of certain medications, like antidepressants. 

Another unexpected cause of bruxism? Missing or crooked teeth. It’s also associated with some medical conditions like Parkinson’s disease, gastroesophageal reflux disorder (GERD), and dementia. 

__Grinding produces a huge amount of force__

“Grinding can generate up to 1,100 pounds per square inch of pressure on your teeth.” To put that in perspective, that’s [3-6 times](https://www.chicagotribune.com/lifestyles/health/sns-health-teeth-stress-story.html) the pressure you use to eat. No wonder grinding can lead to loose teeth, tooth pain, sore jaw muscles, jaw pain, and can worsen, or even cause, TMD/TMJ disorders—compromised movement of the temporomandibular joint.

__Evidence of grinding is easy to spot__

When people grind, the cusps of their teeth gradually become flatter, and shinier, then shorter. “I always show my patients a picture of the wear to show them exactly what’s happening,” says Dr. Schlenoff. 

__Grinders typically grind for an hour or so per night__

“We grind and clench and then we stop and then we do it again...all night long,” says Dr. Schlenoff, adding up to about 60 minutes total.

__You’re more likely to grind if you snore__

Some snorers assume they couldn’t possibly grind their teeth while snoring, but sadly they’re wrong. In reality, “grinding is just momentary, and there’s almost a 100% correlation between snoring and grinding.” Sleep apnea, a sleep disorder that causes pauses in breathing, is also linked to sleep bruxism. 

__Grinding wears away at tooth enamel, then at dentin__

Now for some dental anatomy: a tooth has layers that grinding destroys bit by bit. The first layer is the enamel, which coats the outside of the tooth and is “the hardest substance in the body.” One of the first signs your enamel is going? Tooth sensitivity. 

Once you grind through your enamel, you’re in trouble. Underneath the enamel is “dentin,” a yellowish substance that’s 11 times weaker than enamel. As a result, it will erode 11 times more quickly.

__Grinding affects multiple teeth at a time__

Grinding doesn’t just happen to one tooth: it occurs in a sliding motion that wears down many of your teeth simultaneously in a fairly symmetrical way. (And if you’ve got [fillings](https://www.hellotend.com/thegargler/do-i-really-need-a-filling), grinding can wear away at those, too.) 

__There’s a point of no return when it comes to tooth damage__

Because the tooth gets softer the deeper you go, over time the damage grinding causes begins to accelerate. At a certain point, the damage is beyond repair and your teeth will require [crowns](https://www.hellotend.com/thegargler/what-happens-if-you-dont-get-a-crown). Dr. Schlenoff recalls, “I’ve had cases where I had to do crowns on every tooth in the mouth to rebuild them to their original height because people have worn them down so dramatically.”

__Repairing this damage can be incredibly expensive__

A single crown can cost up to $2500, depending on where you live. If your case is really extreme and you need crowns on every single tooth like Dr. Schlenoff’s patient, that could result in a whopping cost of $80,000. 

__There’s a way, way cheaper alternative__

If you’re grinding due to stress or anxiety, your healthcare provider might recommend stress management techniques like mindfulness. For the vast majority of sufferers, though, that might not be enough—especially if your bruxism is genetic or occurs overnight, like most people’s. 

Since there’s no way to consciously stop grinding (especially in our dreams), the best mode of defense is a night guard, or a simple piece of plastic custom-molded to your mouth that you wear just when you sleep. A night guard typically costs less than a thousand dollars. We charge $599 if you don't have dental insurance, and if you do, it could cost significantly less than that. That’s a savings of $79,401 or more if things were to really go awry.

Here’s to strong enamel, and grind-free teeth!

[8% of adults](http://sleepdisorders.sleepfoundation.org/chapter-7-sleep-related-movement-disorders/sleep-related-bruxism/p/) grind their teeth—a condition known as bruxism—but most have no idea about the long-term consequences.


Reasons to Stop Grinding Your Teeth (and How to Do It)

80,000 Reasons to Stop Grinding Your Teeth

When you’re looking for a dentist, you’re probably aiming to check a few different boxes: you want your dentist to be close to where you live or work, you want them to have good reviews, and you want them to take your dental insurance (if you have coverage). 

On this last point, you’re probably looking specifically for someone who’s “in network” with your insurer. “Out of network” feels like something to avoid: we associate it with more expensive care, specifically big surprise bills that show up in the mail months later.

And these associations are often justified. If a dentist is “in network,” it means they’ve negotiated set rates with your insurer. So you’ll just owe your normal deductible and coinsurance. If a dentist is “out of network,” they may bill you for more than your insurance will pay. Thus the surprise bills.

However,  if Tend is out of network with your insurer (we can’t speak for the other guys), it can actually be a good thing. 

For 80% of our out-of-network members, dental exams are *fully covered*. By dental exams, we mean your twice-per-year cleanings, with x-rays, an oral exam, and a polish. We also include a free oral cancer screening ($60 value), so you get more thorough care than you might elsewhere, without paying anything extra.

Summed up, if you’re coming in for an exam, there’s only a 1 in 5 chance that being out of network will be any different than being in network. And if you’re in that 20%, we’ll make sure you know ahead of time and allow you to cancel, no questions asked.

If you have more questions about being out of network, give us a call at (212) 686-3686. We’ll talk you through it. 

See exactly what you’ll owe for your exam with our real-time insurance checker.


See if your dental exam is covered

With Tend, being out of network can actually be a good thing.

OutOfNetwork Horizontal

Tend Makes Procedures Affordable for Out Of Network Patients

Why Being Out of Network Can Be a Good Thing

“If you had to choose, __brushing at night is more important__,” says Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

At night, you’re brushing away “the accumulation of sugary and acidic things we all eat and drink throughout the day.” Not brushing that away can lead to plaque and tartar buildup, which can cause tooth decay and [gum disease](https://www.hellotend.com/thegargler/tread-gingerly-with-gingivitis). 

Plus, the fluoride that lingers in your mouth after brushing will help maintain saliva production overnight, protecting your tooth enamel from the corrosive effects of any remaining acid. (Just one more reason we—and the American Dental Association—[recommend using fluoride toothpaste](https://www.hellotend.com/thegargler/fluoride-is-it-legit)!) 

Similarly, night is also the best time of day to floss, to ensure no food particles or food debris stay stuck between your teeth overnight. 

In the morning—unless you’re a midnight snacker (which, fair)—your teeth are still pretty clean, since they haven’t really been used. Brushing in the morning is an important part of a good dental care routine, but it’s mostly about clearing away bad breath and getting rid of any plaque you missed the night before. 

(Bonus tip: if you opt for breakfast foods and drinks that are particularly acidic—think, citrus or orange juice, tomatoes, coffee, etc—avoid brushing for at least 30 minutes afterwards. The bristles in your toothbrush can actually spread the acid from these foods over your teeth, weakening your tooth enamel.) 

Still, all that said, __Dr. Schlenoff definitely does not recommend skipping your morning brush__. Long-term it will affect your oral health, and short-term people may “stand a little further away from you.” (Let’s be real: fresh breath > morning breath.) But let’s say you’re a parent negotiating with a particularly brushing-averse kid: if you have to give up something at the bargaining table (just once), now you know what to do.

No matter when you brush, our dentists will make you feel completely and utterly care for.

No judgment ever

It’s standard practice to brush your teeth twice a day. But are the two brushing moments equally important? The answer, it turns out, is no. 