Frequently Asked Questions
Q: Why should I go to the dentist regularly? (Crisis treatment vs. preventive treatment)
A: Many people do not see a dentist on a regular basis. They go only when they have a problem. We call this “crisis treatment” as opposed to “preventive treatment.” While these patients may feel they are saving money, it usually ends up costing much more in both dollars and time. The reason for this is that most dental problems do not have any symptoms until they reach the advanced stages of the disease process. A simple example is tooth decay. We often hear, “Nothing hurts…I don’t have any problems.”
But tooth decay does not hurt! Until, that is, it gets close to the nerve of the tooth. By that time, root canal treatment followed by a post, buildup, and crown are often necessary, instead of the filling which could have been placed several years earlier when the cavity was just beginning to form. Your dentist can usually detect a cavity 3-4 years before it develops any symptoms. It is not uncommon to see a patient with a huge cavity and who has never felt a thing! This is why regular checkups are important – so why not schedule yours today?
Q: How often should I have a dental exam and cleaning?
A: You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits. Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and checked for cavities. Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health.
- History review: Knowing the status of any current medical conditions, new medications, and illnesses gives us insight to your overall health and also your dental health.
- Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss, X-rays also help determine tooth and root positions.
- Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
- Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
- Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
- Examination of existing restorations: Check current fillings, crowns, etc.
- Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments.
- Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
- Teeth polishing: Removes stain and plaque that is not otherwise removed during tooth brushing and scaling.
- Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
- Review dietary habits: Your eating habits play a very important role in your dental health.
As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth. We are committed to providing you with the best possible care, and to do so will require regular check-ups and cleanings.
Q: Why does the dentist take X-rays?
A: Many diseases of the teeth and surrounding tissues cannot be seen when your dentist examines your mouth.
An X-ray examination may reveal:
- small areas of decay between the teeth or below existing restorations (fillings)
- infections in the bone
- periodontal (gum) disease
- abscesses or cysts
- developmental abnormalities
- some types of tumors
Finding and treating dental problems at an early stage can save time, money and often unnecessary discomfort. Dental radiographs can detect damage to oral structures not visible during a regular exam. If you have a hidden tumor, radiographs may even help save your life. Your dentist will evaluate your need for radiographs based on the conditions present in your mouth. The schedule for radiographs can vary with age, risk for disease or for evaluation of growth and development. There are many benefits to having dental radiographs taken. Any additional questions or concerns should be discussed with your dentist.
Q: Why is fluoride important to my dental health?
A: Fluoride is a mineral that occurs naturally in many foods and in water. Some natural sources of fluoride are brewed tea, canned fish, cooked kale and spinach, apples, and skim milk. Some city water contains fluoride, so by drinking tap water you will acquire fluoride. If your drinking water does not have fluoride, supplements are available.
The lack of exposure to fluoride places individuals of any age at risk for dental decay. Fluoride is important to dental health because it helps prevent tooth decay by making the enamel outer portion of the tooth more resistant to acid attacks from plaque bacteria in the mouth.
Studies have shown that children who consumed fluoridated water from birth had less dental decay. Fluoride can reverse early decay and help prevent osteoporosis, a disease that causes degenerative bone loss.
Talk to your dentist or dental hygienist about whether you’re getting the daily amount of fluoride you need.
Q: How often should I brush and floss?
A: Brushing and flossing help control the plaque and bacteria that cause dental disease.
Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay. Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.
Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.
• Tooth brushing: Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste. Brush at a 45-degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums. Brush the outer, inner, and biting surfaces of each tooth. Use the tip of the brush head to clean the inside front teeth. Brush your tongue to remove bacteria and freshen your breath.
Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.
• Flossing: Daily flossing is the best way to clean between the teeth and under the gum line. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands. Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion. Curve the floss into a “C” shape around each tooth and under the gum line. Gently move the floss up and down, cleaning the side of each tooth. Floss holders are recommended if you have difficulty using conventional floss.
• Rinsing: It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.
Q: How can I get my kids to brush their teeth?
A: Make it fun! If you are enthusiastic about brushing your teeth, your children will also be enthusiastic. Children want to do the things their parents do. If your children see you brushing your teeth and displaying good dental habits, they will follow.
Checking Plaque Removal – To see if any plaque has been missed, you can use a disclosing (staining) tablet or solution. These products are made of harmless vegetable dyes that stain the plaque a bright color, so that you can see where the plaque is.
Begin to take your children to the dentist at an early age. All children should be seen by their 1st birthday or 6 months after the eruption of the first tooth. Ask your dentist for other creative ways to get children to brush their teeth.
Q: What are cavity-fighting sealants?
A: The American Dental Association points out sealants are an effective weapon in the arsenal against tooth decay. Sealants are a thin coating painted on chewing surfaces of molars and premolars. Dental sealants act as a barrier, protecting the teeth against decay-causing bacteria.
Sealants have proven effective with both adults and children, but are most commonly used with children. Despite the fact that sealants are about half the cost of fillings, only a small percentage of school-aged children have sealants on their permanent teeth.
Ask your dentist whether sealants are a good choice for you or your children of fluoride you need.
Q: I knocked out a tooth, can it be saved?
A: Oral injuries are often painful, and should be treated by a dentist as soon as possible.
- Attempt to find the tooth.
- Rinse, do not scrub, the tooth to remove dirt or debris.
- Place the clean tooth in your mouth between your cheek and gum or under your tongue.
- Do not attempt to replace the tooth into the socket as this could cause further damage.
- Get to the dentist. Successful re-implantation is possible only when treatment is performed promptly.
If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse it in milk.
Q: Are amalgam (silver) fillings safe?
A: Over the years there has been some concern as to the safety of amalgam (silver) fillings. An amalgam is a blend of copper, silver, tin and zinc, bound by elemental mercury. Dentists have used this blended metal to fill teeth for more than 100 years. The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems.
According to the American Dental Association (ADA), up to 76% of dentists use silver containing mercury to fill teeth. The ADA also states that silver fillings are safe and that studies have failed to find any link between silver containing mercury and any medical disorder.
The general consensus is that amalgam (silver) fillings are safe. Along with the ADA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost effective. The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling. The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, and this is out of countless millions of silver fillings over the decades.
Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material when we are exposed at high, unsafe levels. For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them. However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.
There are numerous options to silver fillings, including composite (tooth-colored), porcelain, and gold fillings. We encourage you to discuss these options with your dentist so you can determine which is the best option for you.
Q: What can I do about sensitive teeth?
A: Sensitivity toothpaste, which contains strontium chloride or potassium nitrate are very effective in treating sensitive teeth. After a few weeks of use you may notice a decrease in sensitivity. Highly acidic foods such as oranges, grapefruits and lemons, as well as tea and soda can increase tooth sensitivity, and work against any sensitivity toothpaste. If you do not get relief by brushing gently and using a desensitizing toothpaste, see your dentist. There are special compounds that can be applied in office to the roots of your tooth to reduce—if not eliminate—the sensitivity. High-fluoride containing home care products can also be recommended to help reduce tooth sensitivity.
Q: How can I tell if I have gingivitis or periodontitis (gum disease)?
A: You Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.
Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.
Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.
Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:
- Smoking or chewing tobacco. Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
- Certain tooth or appliance conditions. Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
- Many medications. Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side effects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
- Pregnancy, oral contraceptives, and puberty. Can cause changes in hormone levels,
causing gum tissue to become more sensitive to bacteria toxins.
- Systemic diseases. Diabetes, blood cell disorders, HIV / AIDS, etc.
- Genetics may play a role. Some patients may be predisposed to a more aggressive type of periodontists. Patients with a family history of tooth loss should pay particular attention to their gums.
Signs and Symptoms of Periodontal Disease:
- Red and puffy gums. Gums should never be red or swollen.
- Bleeding gums. Gums should never bleed, even when you brush vigorously or use dental floss.
- Persistent bad breath. Caused by bacteria in the mouth.
- New spacing between teeth. Caused by bone loss.
- Loose teeth. Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
- Pus around the teeth and gums. Sign that there is an infection present.
- Receding gums. Loss of gum around a tooth.
- Tenderness or Discomfort. Plaque, calculus, and bacteria irritate the gums and teeth.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
Q: How can cosmetic dentistry help improve the appearance of my smile?
Cosmetic dentistry has become very popular in the last several years, not only due the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health. This includes dental prevention and having a healthier, whiter, more radiant smile.
There are many cosmetic dental procedures available to improve your teeth and enhance your smile. Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over. Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry.
- Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking. Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present.
- Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings. Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth. This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.
- Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile. They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth. Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.
- Porcelain Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size. Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations. They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.
- Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth. Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, and durable solution to removable dental appliances.
- Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients. Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.
Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!
Q: What can I do about stained or discolored teeth?
A: Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile. Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and is an ideal way to enhance the beauty of your smile. Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the American Dental Association (ADA).
As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade. The color of our teeth also comes from the inside of the tooth, which may become darker over time. Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull. Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline. Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.
It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching. Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains. Since whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins. Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.
Since whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.
Professional whitening: This treatment includes dental office visits combined with use of a custom tray at home. A custom tray is made to fit your mouth and prescription strength bleaching gel is used at home to accomplish the desired tooth color. In office follow up is required to monitor progression.
Some patients may experience tooth sensitivity after having their teeth whitened.
This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.
Whitening can be very effective and can give you a brighter, whiter, more confident smile!
Q: Do whitening toothpastes work?
A: Commercial whitening toothpastes vary greatly in their ability to whiten teeth. They work by removing surface stains from the teeth with the use of mild abrasives. However, unlike professional whitening, some whitening toothpastes do not alter the intrinsic color of the teeth. Toothpastes that are effective in removing stains can also destroy tooth enamel in the process. These toothpastes use harsh abrasives. With repeated use, harsh abrasives begin to damage tooth enamel and can contribute to increased tooth sensitivity. If you would like to try a whitening toothpaste, consult with your dentist first.
Q: Is smokeless tobacco harmful?
A: Smokeless tobacco may be smokeless, but it isn’t harmless.
These are some of the potential hazards:
- Tooth abrasion from grit and sand in tobacco can scratch teeth and wear away the enamel
- The constant irritation caused by chewing tobacco can result in gum recession and other permanent damage to periodontal tissue
- Increased tooth decay can result from sugar that is added to smokeless tobacco
- Tooth discoloration and bad breath are common with long term use
- Nicotine blood levels are similar to those found in cigarettes
- A diminished sense of taste and smell caused by tobacco use can lead to unhealthy eating habits
- Cancer can be caused by all forms of smokeless tobacco
Watch out for some of these danger signs:
- A sore that does not heal
- A lump or white patch
- A prolonged sore throat
- Difficulty in chewing
- Restricted movement of the tongue or jaw
- A feeling of something in the throat
- Pain is rarely an early symptom. All tobacco users need to see their dentist.
Q: Why should I use a mouth guard?
A: A mouth guard can prevent injuries to your face and teeth. Most people benefit from wearing a mouth guard when playing any sport. You should wear one whether you are playing professionally or just on weekends. Do what you can to preserve your smile and your health. The best mouth guards are custom-fitted by your dentist. This is especially important if you wear braces or fixed bridgework.
Commercial, ready-made mouth guards can be purchased at most sporting goods stores. They are relatively inexpensive but they are also less effective. In either case, rinse your mouth guard with water or mouthwash after each use. With proper care, it should last for several months.
Ask your dentist which kind of mouth guard you should use.
Q: I have diabetes. Why is my dentist concerned?
A: Research today suggests a link between gum disease and diabetes. Research has established that people with diabetes are more prone to gum disease. If blood glucose levels are poorly controlled you may be more likely to develop gum disease and could potentially lose teeth. Like all infections, gum disease can be a factor in causing blood sugar levels to rise and make diabetes harder to control. Be sure to see your Dentist regularly for check-ups and follow home care recommendations. If you notice other conditions such as dry mouth or bleeding gums be sure to talk with your dentist, and don’t forget to mention any changes in medications.
Q: I just found out I am pregnant, how can this affect my mouth?
A: About half of women who are pregnant experience a condition called pregnancy gingivitis. This condition can be uncomfortable and cause swelling, bleeding, redness or tenderness in the gum tissue. A more advanced oral health condition called periodontal disease (a serious gum infection that destroys attachment fibers and supporting bone that hold teeth in the mouth) may affect the health of your baby. Studies have shown a relationship between periodontal disease and preterm, low birth-weight babies. In fact, pregnant women with periodontal disease may be seven times more likely to have a baby that’s born too early and too small. The likely culprit is a labor-inducing chemical found in oral bacteria called prostaglandin. Very high levels of prostaglandin are found in women with severe cases of periodontal disease.
Q: Why do I have to take antibiotics before my dental appointment?
A: There are certain conditions that require pre-medication with an antibiotic prior to dental treatment to prevent adverse affects and infection that can be caused by bacteria that enter the blood stream during certain treatment. You will want to consult with your Dentist about this prior to treatment.
Q: I am undergoing chemotherapy and/or radiation for cancer treatment, how can this affect my mouth?
A: Chemotherapy and Radiation can cause a number of problems in the mouth, some of which might include: mouth sores, infections, dry mouth, bleeding of the gums and lining of the mouth and general soreness and pain of the mouth. It can be harder to control these things while undergoing treatment as the immune system is generally compromised as a result of the treatment. There are some special mouth rinses that can be prescribed to help with discomfort during treatment. It is very important to see your Dentist before treatment begins and then to continue with recommended follow-up care. These treatments can cause dry mouth, and recommendations might be made for additional care both in-office and at home.
Q: I have dentures. Is it necessary for me to still see my dentist?
A: Visits to the Dentist include more than just “checking teeth”. While those patients who wear dentures no longer have to worry about dental decay, they may have concerns with ill fitting appliances or mouth sores to name a few. Annual visits to the Dentist (or sooner if soreness is present) is recommended. During these visits an oral cancer screening and head and neck exam will be performed as well as an evaluation of the fit or need for replacement of the existing appliances. Regular visits can help you to avoid more complicated problems down the road even with a denture.