Q: Why should I go to the dentist regularly?
(Emergency 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 can I prevent cavities?
A: You can certainly minimize the number of cavities you get. Always spend two to three minutes brushing your teeth. It takes that long to get rid of the bacteria which destroy tooth enamel. Do not brush too hard. It takes very little pressure to remove bacteria and plaque. Floss at least once a day. It is the only way to get bacteria from between your teeth.
Watch the sugar you eat. There is sugar in candy, fruits, crackers and chips. These are the foods that the bacteria in your mouth like best. Be mindful of foods like raisins and peanut butter that stick to your teeth. They can provide a constant supply for the bacteria eating into your teeth. Try to minimize the times during the day when sweet items are eaten and clean your teeth afterwards.
If you cannot brush after a meal, rinse your mouth with water—which can help to remove food from your teeth. Chewing sugarless gum after a meal can also help. Chewing stimulates the flow of saliva which acts as a natural plaque-fighting substance.
Do not forget your regular dental visits. Good dental habits will go a long way toward a no-cavity visit.
Q: Do I really need x-rays?
A: Dental x-rays are taken routinely by your dentist. There are many diseases and dental defects, which can not be seen by the naked eye, especially where teeth are concerned. These may include such things as decay under old fillings, teeth trapped below the gums, cavities between the teeth, bone loss as a result of gum disease and changes in either jaw bone structure which can be affected by many systemic diseases.
If you are a new patient, your dentist may recommend x-rays to check the current status of your mouth and to check for hidden problems. Upon your first visit to the dentist he will usually take those x-rays that will be necessary to comprehensively assess your oral health. A full series of x-rays usually consists of 14 – 18 films. A Panoramic x-ray film showing a much greater areas of your jaw bones may be needed as well in order for your dentist to comfortably and competently examine you. Every six months or so your dentist may take a small series of x-rays consisting of four to six films. A six-month period is a long time in the life of a cavity and it is for this reason that a visit to the dentist every six months is so important. X-rays are generally safe when only taken as needed to keep the exposure to a minimum.
Q: What are dental sealants, who should get them, and how long do they last?
A: Sealants are a thin, plastic coating that is painted on the chewing surfaces of adult teeth, usually the back teeth (premolars and molars) to prevent tooth decay. The painted on liquid sealant quickly bonds into the depressions and groves of the teeth, forming a protective shield over the enamel of each tooth.
Typically, children should get sealants on their permanent molars and premolars as soon as these teeth come in. In this way, the dental sealants can protect the teeth through the cavity-prone years of ages 6 to 14. However, adults without decay or fillings in their molars can also benefit from sealants.
Sealants can protect the teeth from decay for many years, but they need to be checked for chipping or wear at regular dental check-ups.
Q: Are amalgam (silver) fillings harmful to my health?
A: Over the past several years, concerns have been raised about silver-colored fillings, otherwise called amalgams. Because amalgams contain the toxic substance mercury, some people think that they are responsible for causing a number of diseases, including autism,Alzheimer’s disease, and multiple sclerosis.
The American Dental Association (ADA), the FDA, and numerous public health agencies say amalgams are safe, and that any link between mercury-based fillings and disease is unfounded. The cause of autism, Alzheimer’s disease, and multiple sclerosis remains unknown. Additionally, there is no solid, scientific evidence to back up the claim that if a person has amalgam fillings removed, he or she will be cured of these or any other diseases.
We take the health of our patients extremely serious and even though there is no CURRENT or DIRECT link between amalgam fillings and health concerns, we have decided that the risk of future findings is not one which we feel comfortable taking. With alternative restorative materials that equal in strength and are much more esthetic, we are happy for our office to be AMALGAM FREE.
Q: What is fluoride and why is it important to 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: 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: I'm pregnant, my gums are more sensitive and bleed more easily. Why? What happens if I have a dental problem when I am pregnant?
A: Changing hormone levels during pregnancy can cause normal, healthy gums to become red, irritated and swollen. This irritation, known as “Pregnancy Gingivitis” is the body’s exaggerated response to plaque and calculus.
It is very important during this time to stay current with your regular dental cleanings and exams to ensure that dental infections don’t get missed and lead to greater problems down the road. Although dentists will typically postpone major treatment until after the baby is born, emergencies do come up and need to be addressed. Because many of your baby’s organs are being formed in the first trimester, this work is ideally taken care of during the second trimester to minimize any potential risk.
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 and an overall increased susceptibility to cavities. 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, toothpastes, and fluoride trays 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: What can I do if I have a dry mouth?
A: The basic problem in dry mouth, or xerostomia, is a lack of saliva. This can be caused by diseases of the salivary gland, medications that decrease salivary flow as a side effect or as a natural result of aging. This decrease in saliva can lead to a number of severe dental problems such as gum disease, tooth decay and mouth infections.
The best way to combat this problem is to use sugar free candy or gum and to drink plenty of water. Do not use sugared candy or soda, as they can lead to rapid dental decay in patients with dry mouths. Several over the counter products are also available that can help with some dry mouth symptoms. If you’re concerned that you may have xerostomia, contact your dentist or physician to determine its cause and see what might work best in your situation.
Q: I’ve recently been diagnosed with diabetes. Are there any dental problems that are associated with this disease?
A: Infections and other problems such as receding gums and periodontal disease are common afflictions among diabetics. Diabetes impairs the body’s ability to fight off infections, decreases blood flow and circulation to gum tissue, and in many cases elevates the sugar levels within the oral cavity. These factors tend to promote gum disease and tooth decay.
Good oral hygiene, proper brushing, regular flossing, and healthy glucose levels will go a long way in preventing diabetic-related dental problems.
Q: Why don't my dentures seem to fit anymore?
A: If you’ve had your dentures for more than 3-5 years it’s possible that they actually don’t fit anymore.
You are probably aware that the bone of the mouth holds and supports the teeth. But the teeth of our mouth also support the bone. When the teeth are removed the bone looses the support once provided by the teeth and enters into a lifetime of constant shape change and atrophy (shrinkage). As a result, dentures that were made to fit your mouth several years ago don’t fit now People often try to compensate for this by using more and more denture adhesive until the desired fit is achieved. Unfortunately, this can cause faster loss of bone and an even worse fit.
We have some options available to treat these problems. In these cases, we may recommend we either reline your existing dentures for a better fit, make a new set of dentures, or utilize dental implants to maintain bone and stabilize the denture.
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.
Q: What is CEREC?
A: CEREC is a system which allows our office to offer same-day crowns, as well as same-day inlays / onlays. We replace the impression and lab-fabrication steps when providing a crown. Instead of sending an impression to a dental laboratory and waiting a few weeks for the crown to be made, we capture precise measurement data by scanning it with a special camera. Then we mill and cement the crown in, all during the same appointment.
Q: How long does a CEREC appointment take?
A: Instead of the usual two one-hour appointments that a crown procedure took, we book a single appointment for two-hours. Normally, it takes a little less than the full scheduled time. After the dentist is finished shaping the tooth, patients can relax in the dental chair, reading a book, listening to music, or watching one of the many TV shows that we offer.
Q: What are some of the benefits of having a CEREC crown?
A: Getting a crown is now a single visit – not two. Two appointments usually means two work days interrupted. Or two babysitting arrangements to make.
Also, receiving a crown is now a single anesthetic injection – not two. Normally the area receiving a crown was numbed to shape the tooth down, and then later numbed again to remove the temporary and deliver the crown. Now with Cerec, there are no more temporary crowns. Even well made temporary crowns were sometimes uncomfortable or cracked / fell out.
The design is completely controlled by the dentist, instead of a dental lab technician. While lab technicians do terrific jobs fabricating crowns, the dentist who just finished preparing the tooth a few minutes ago has more intimate knowledge of your mouth and areas surrounding the prepared tooth. They are also more familiar with the “margin” (the perimeter line or area separating the shaped area on the tooth structure.)
Q: Are the fees higher for CEREC crowns (compared to lab-fabricated crowns)?
A: No. Our office has opted to keep the fees the same as a conventional lab-fabricated crown. Our patients truly appreciate the convenience, comfort and beauty of our CEREC crowns.
Q: Do you use Cerec for all crowns?
A: We use Cerec for most crowns. However, computer systems still cannot replace the artistry required for all cosmetic crowns and veneers. Therefore, we still have our cosmetic dental laboratory fabricate some of our veneers and crowns for anterior (front) teeth.
Q: Can I watch the crown being milled?
A: Absolutely. Once the milling process start, patients may request to be taken to the milling station to watch their crown being milled. Milling normally takes 14 minutes.
Q: Will CEREC crowns last as long as lab-fabricated crowns?
A: Definitely. The blocks from which Cerec crowns are milled are made with by the same materials company that provides IPS e.max materials to dental labs. Also, by using the oven in the last step of the milling process, the IPS e.max is “sintered” or fired just as in the lab, to give it the same crystallized strength as lab-fabricated IPS e.max crowns. Of course, as with any restoration, it also depends on how well the patient maintains the crown.
Q: What are inlays / onlays?
A: Inlays and onlays are similar to fillings on the occlusal (chewing) surface. They are similar in that they replace just the cavity areas instead of the entire tooth, as with crowns. Inlays are restorations between the cusps of a tooth, while onlays include a cusp of the tooth. Inalys / onlays have traditionally been fabricated at dental laboratories out of porcelain or ceramic materials. These materials are much stronger than resin which fillings are made from, and therefore inlays / onlays can last much longer than fillings.
Q: I am afraid of going to the dentist ... What can I do?
A: Fear of the dentist is quite common and many people are as fearful and concerned as you may be. However, because fear of the dentist is so common, we are also well aware of this and are properly trained to work with you in helping you to overcome these fears. Just let us know about your concerns and questions and you will find that we are eager to work with you to make your visits pleasant. Asking us questions about your mouth and proposed treatment will help us to remove your fear of the unknown and give you an opportunity to become involved in your dental health.
We also have tools that can help to reduce your anxiety even more. Nitrous oxide, laughing gas, helps many people and is available for most dental appointments. For the extremely anxious patients, medicine can be taken in pill form that will keep even the most fearful patients at ease, and even make them forget that they were even at the dentist. Just like being asleep for the appointment. . . Most importantly, remember that your dental team is eager to work with you, not just on you, in order to achieve a mutual goal – maintaining the health of your smile.
Q: What is gum disease?
A: Gum disease or periodontal disease or gingivitis as it is also called is the number one cause of tooth loss today. The reason you lose teeth from gum disease is because this disease attacks the gums as well as the bone, which are the foundation in which your teeth rest. As the bone literally dissolves away from around your teeth, your teeth become loose and eventually fall out. Anyone at any age is susceptible to gum disease. Gum disease is caused by plaque. If the plague is not removed on a daily basis it will form calculus, which is the breeding ground for the germs which cause periodontal disease.
Bleeding gums are the first sign that there may be a problem with the gums. Puffy, tender red gums are also a sign that there is an infection present. Bleeding gums however are not always present even in severe cases of gum disease. Routine and regular visits to your dentist are the best way of catching gum disease in its early stages before too much damage has been caused. Gum disease will not go away by itself or with improved home care. The only way of removing plaque deep under the gums is with professional cleanings. Once you have had a gum problem you will always be susceptible to recurring problems, so be sure to see your dentist on a regular basis – every two to three months, unless he or she recommends otherwise.
Q: How does a tooth decay?
A: A substance known as plaque causes tooth decay. Plaque is a clear bacteria laden film, which develops on the teeth. The bacteria in plaque interact with the starches and sugars we eat and form an acid, which breaks down or de-mineralizes our teeth. As this process is going, on our saliva along with properties it has, acts to help re-mineralize teeth. When the demineralization process is faster than that of remineralization a cavity occurs.
There are several things that can be done to slow down or totally prevent this breakdown process which leads to cavities. One of the most important contributors to decay are sugars, and eliminating or drastically reducing your intake of them will help greatly in preventing tooth decay. Proper brushing and flossing, and removal of the plaque will also help in preventing breakdown. Home fluoride rinses help aid in the remineralization process. Of course routine visits to your dentist are of importance not only in the early detection of cavities but professional cleanings and fluoride treatments are very important in maintaining a healthy, happy mouth.
There are several things that you can do to help prevent tooth decay. The most important of course is the diet. What you eat plays a very important role in the overall well being of your mouth and the rest of your body. Since sugars are directly related to the breakdown process, which causes decay, eliminating sugar from the diet will have a direct impact on cavities.
Plaque and sugar interact with one another to form an acid, which breaks down the enamel of the teeth, resulting in a cavity. Proper removal of plaque will also greatly reduce the risk of getting cavities. Thorough brushing and flossing will not only remove sugar from the mouth but also the plaque, which has formed on the surfaces of the teeth since the last brushing. Certain foods will help to keep the mouth in a healthy state. These foods include whole grains, fresh fruits and vegetables, and any low sugar foods that won’t aid in tooth decay.
Q: When will my child get his first tooth?
A: The period when early hard teeth are growing is a major event in the life of an infant, and it can be difficult. The eruption of teeth causes inflammation, which leads to congestion, drooling, and discomfort.
While the average time for the appearance of the first teeth is between five and seven months of age, there is a wide range before and after this that can still be considered “normal.” The teeth might come in as early as one month of age, or they may erupt when the child is one-and-a-half years old. Generally the lower front teeth come in first, and girls’ teeth typically erupt earlier than boys.
Q: My child’s baby teeth have cavities. Why should they be filled if they’re just going to fall out in a few years?
A: If baby teeth become diseased or decayed it can lead to pain and infection. It can also be difficult for children to eat a well-balanced meal with a mouth full of cavities. Untreated cavities also increase the amount of decay causing bacteria in the mouth. As permanent teeth erupt, they are at increased risk for developing cavities because of the higher bacteria count.
Baby teeth also hold space in the mouth for the erupting permanent teeth. If the baby teeth become decayed or are taken out too early, the permanent teeth often become crowded and will likely need braces to straighten in the future.
Q: My dentist says I have a cavity and that I need a filling. But why doesn’t my tooth hurt?
A: Most dental problems don’t have any symptoms until they reach more advanced stages, so don’t wait for things to hurt! It is best to get a thorough dental exam, and diagnose and treat problems early. Waiting often makes problems more difficult and more expensive to fix.
Q: What is a root canal?
A: Root canal therapy is intended to be a tooth saving procedure that removes the pulp, or living tissue from inside a tooth. Each tooth typically has from 1 to 3 roots and each root has 1 or 2 tunnels or canals that stretch the length of the root. In a healthy tooth, these canals are filled with tissue (consisting of the nerves and blood vessels) that keeps the tooth alive and provide sensations like hot and cold. Sometimes the tissue can become damaged or diseased due to decay, fracture or trauma. This in turn can cause a toothache or there may be no pain at all.
During root canal treatment a hole is created in the top of the tooth to locate the canals. The dentist cleans and disinfects these canals and seals them with a special filler material. Root canal therapy is highly successful and with todays technology can be painless.
Q: I had a toothache and my dentist told me I need a root canal. He put me on antibiotics and it stopped hurting. Do I still need the root canal?
A .Yes. Even though your tooth feels better since your dentist prescribed antibiotics, the underlying disease process did not change. Patients sometimes believe that antibiotics will “cure” a dental infection in the same way they can cure a medical infection such as strep throat. However, this is not the case. Once the inside (pulp) of a tooth becomes diseased, a root canal (or extraction) is necessary even if you are not experiencing pain or swelling.
Q: When should I take my child to the dentist for the first check-up?
A: In order to prevent dental problems, your child should see a dentist when the first tooth appears, or no later than his/her first birthday.
Q: Are baby teeth really that important to my child?
A: Primary, or “baby,” teeth are important for many reasons. Not only do they help children speak clearly and chew naturally, they also aid in forming a path that permanent teeth can follow when they are ready to erupt.
Q: What should I do if my child has a toothache?
A: First, rinse the irritated area with warm salt water and place a cold compress on the face if it is swollen. Give the child acetaminophen for any pain, rather than placing aspirin on the teeth or gums. Finally, see a dentist as soon as possible.
Q: Are thumbsucking and pacifier habits harmful for a child's teeth?
A: Thumb and pacifier sucking habits will generally only become a problem if they go on for a very long period of time. Most children stop these habits on their own, but if they are still sucking their thumbs or fingers past the age of three, a mouth appliance maybe recommended by your dentist.
Q: How often does my child need to see the dentist?
A: A check-up every six months is recommended in order prevent cavities and other dental problems. However, your pediatric dentist can tell you when and how often your child should visit based on their personal oral health.
Q: How do I make my child's diet safe for his teeth?
A: Make sure your child has a balanced diet, including one serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat fish and eggs. Limiting the servings of sugars and starches will also aid in protecting your child’s teeth from decay. You can also ask your dentist to help you select foods that protect your children’s teeth.
Q: What should I do if my child falls and knocks out a permanent tooth?
A: The most important thing to do is to remain calm. Then find the tooth. Hold it by the crown rather than the root and try to reinsert it in the socket. If that is not possible, put the tooth in a glass of milk and take your child and the glass immediately to the dentist.