Dental terminology can be confusing. So in order for you to make a well-informed decision about your oral health, we provide answers to the most frequently asked questions. We are always available to answer questions about your dental health, so please do not hesitate to contact us if you still have anything you wish to discuss.
Our friendly staff will always be available to answer questions you have about your teeth before, during and after treatment. Feel free to bring headphones and listen to music or your favorite program while we provide dental treatment if that helps you relax.
We can also use nitrous oxide, or laughing gas, to help you relax during your appointment. You remain responsive and awake during treatment but may feel less anxious, more relaxed and sleepy or you may even forget about parts of the dental treatment. The nitrous oxide leaves your system at the end of treatment, so you may come and go from your appointment unaccompanied and can drive yourself to and from the appointment. Nitrous oxide is not recommended in the following cases: nasal obstruction, pregnancy, pulmonary disease such as COPD or respiratory infections. It is safe to use on children and adults and those with asthma.
Anti-anxiety medications can also be prescribed that can be used alone or in conjunction with the nitrous oxide. These medications, if you have not taken them, may have a stronger sedative effect or a very mild one. In this case, you will be required to bring an escort with you to your appointment who must wait for you during your appointment and also escort you home. You cannot drive a vehicle to and from your appointment.
While nitrous oxide and anti-anxiety medications may help you relax, local anesthetic is still required to numb the teeth.
As always, please let us know what we may do to help you relax and have a positive dental experience. We are here to help.
Crown and cap are two words to describe the same thing. It is a type of dental restoration that fully covers a portion of the tooth or dental implant that lies at or above the gum line. Once placed, it becomes the tooth’s new outer surface. In comparison, a filling just fills in or repairs a portion of the tooth. Crowns are permanently cemented into place, function just like natural teeth and are cared for like natural teeth. They are used to repair and strengthen damaged teeth when a filling may not be strong enough to withstand the chewing forces. They may also be used to change the tooth appearance (including color, shape and even apparent alignment). Crowns, on average, last 25 years and may last a lifetime if properly cared for and with regular check-ups to catch and address problems early. Other treatment alternatives may exist, so be sure to talk to your dentist about your options.
Peroxide-containing bleaching agents such as over-the-counter whitening strips or dentist-dispensed home-use products are safe and do not cause any harm to enamel, existing dental restorations or your health. However, whitening can lead to increased short-term tooth or gum sensitivity. Schedule a visit with us first to treat any cavities, check the health of your gums before whitening and discuss which type of whitening may be best for your situation. Pregnant women and nursing mothers should postpone tooth whitening.
Filling longevity may vary greatly depending on many factors including diet, oral hygiene habits and whether or not you grind/clench your teeth at night. Composite, or white tooth-colored fillings, last on average about 7-10 years and are designed to match your teeth and blend into your smile. They require less drilling and are typically the more conservative, esthetic option. Composites also form a chemical bond with the tooth which may make the tooth stronger. However, they may not always be the best option. Amalgam, or silver fillings, last on average 10-15 years. Some patients dislike the visibility of these restorations. Silver fillings also require greater tooth removal so are generally the less conservative option. Removing more tooth structure to place a filling also makes the tooth weaker—so teeth with silver fillings are more prone to fracturing or cracking over the long-term.
The best restorative material of choice, whether it is a silver or white filling, will be recommended depending on your tooth’s specific situation.
A cavity, or tooth decay, is caused by plaque, the colorless, sticky film of bacteria that constantly forms on teeth. Bacteria produce acids which demineralize, or dissolve, our enamel leading to decay. The reason we brush and floss every day is to remove plaque, because bacteria in plaque reacts with sugar in the foods we eat to produce acids that can attack and weaken tooth enamel–the hard protective covering on our teeth. Eroding enamel leaves the teeth unprotected, allowing for cavities to develop more easily.
Cavities form in 3 areas:
Dental amalgam is a safe and durable material that has been used to restore the teeth of more than 100 million Americans. It contains a mixture of metals such as silver, copper and tin, in addition to mercury, which binds these components into a hard, stable and safe substance.
It has been studied and reviewed extensively and has established a record of safety and effectiveness. The World Health Organization concluded in a statement: “No controlled studies have been published demonstrating systemic adverse effects from amalgam restorations.” A 2003 paper published in the peer-reviewed New England Journal of Medicine 1 states “Patients who have questions about the potential relation between mercury and degenerative diseases can be assured that the available evidence shows no connection.”
In 2006 the Journal of the American Medical Association (JAMA) published the results of two independent clinical trials and concluded that “there were no statistically significant differences in adverse neuropsychological or renal effects observed over the 5-year period in children whose caries are restored using dental amalgam or composite materials” 2, 3; and “children who received dental restorative treatment with amalgam did not, on average, have statistically significant differences in neurobehavioral assessments… when compared with children who received resin composite materials without amalgam. These findings, combined with the trend of higher treatment need later among those receiving composite, suggest that amalgam should remain a viable dental restorative option for children.” 4
X-rays are a valuable part of dental care because they can detect damage to teeth and gums not visible during the visual examination. An x-ray may reveal: cavities just starting between the teeth or below existing fillings, infections in the bone, periodontal (gum) disease, abscesses or cysts, developmental abnormalities and some types of tumors.
Finding and treating dental problems at an early stage can save time, money and often unnecessary discomfort. Your dentist will evaluate your need for x-rays and what types should be taken. Although many people are concerned about the risks to their health from x-rays, the chances of being harmed from dental x-rays are extremely small.
We are sensitive to patients’ concerns about radiation and prescribe x-rays only when they are necessary and to tailor the frequency to your individual needs. We use digital x-rays which use about 80% less radiation than conventional x-rays. We also use a lead apron, which reduces the radiation further. Dental x-rays emit far lower levels of radiation than other medical x-rays. Any additional questions or concerns should be discussed with your dentist.
Fluoride prevents tooth decay by making your tooth enamel more resistant to acid attacks from plaque bacteria in your mouth. When fluoride contacts teeth, it turns some of your enamel into fluorapatite which is more resistant to bacterial acid. Fluoride comes from fluorite, a naturally occurring mineral which is found in the earth’s crust. It naturally occurs in many foods and in water. Fluoride may be obtained from toothpaste, mouth rinses, supplements, well water, city water that has had fluoride added and various food sources. Carefully controlled studies have determined the optimal level of fluoride that should be added to city water to have the maximal effect in reducing decay. Well-water should be tested to make sure that it is safe and does not contain too little or too much fluoride or any other substance.
Some people have concerns about community water fluoridation programs. More than 70 years of scientific research has consistently shown that an optimal level of fluoride in community water is safe and effective in preventing tooth decay by at least 25% in both children and adults. Many cities add substances to the water that help to improve water quality and flavor, but fluoride is added due to its benefit in reducing tooth decay. The Centers for Disease Control and Prevention (CDC) named “community water fluoridation as one of the 10 greatest achievements in public health of the 20th century. This simple, safe and inexpensive public health intervention has contributed to a remarkable decline in tooth decay in the United States.” The American Academy of Pediatrics (AAP), the American Medical Association (AMA), the American Public Health Association (APHA), the U.S. Surgeon General and the World Health Organization (WHO) all endorse community water fluoridation. For more information regarding the history of fluoridation, facts, research and references, please see this document Fluoridation Facts from the American Dental Association (ADA).
Some genetic conditions can result in poor enamel development which may give teeth a translucent appearance as a result. Tobacco, certain foods and drinks such as tea or coffee may actually stain teeth on the surface. Translucency can also be caused by acid erosion. Acids in your favorite foods and drinks and exposure to stomach acid, such as in conditions like gastroesophageal reflux disease (GERD), morning sickness or bulimia, may cause thinning of enamel. Thin enamel may appear gray or translucent or may also cause a tooth to look more yellow as you can see through to the inner layer, or dentin, more easily which is yellowish or brownish in color. Because there are many possible causes, it’s best to see your dentist to find out exactly what’s going on with your teeth.
Congratulations! Let us know your due date when you schedule. It is safe and important to get cleanings and exams. Dental treatment (e.g., fillings, root canals) and x-rays are also safe but are usually delayed until after pregnancy to prevent unnecessary stress—unless there is a dental emergency. If treatment must be scheduled, 2nd trimester or early 3rd trimester is best. Read more here.
This may vary for each individual, but if you’re in good dental health you generally should visit once or twice a year for a checkup and cleaning. If you have gum disease, you may require professional cleanings three to four times per year to stabilize your condition.
People often respond to bleeding gums with giving the gums less attention. Usually, gums that bleed are a symptom of the onset of periodontal disease (gum disease) or gingivitis. But often, people stop brushing as frequently and effectively because it may be painful or it may cause the gums to bleed again. However, when gums are inflamed, brushing could help reduce the inflammation. More importantly, you should see your dentist to have a periodontal screening and recording performed in order to determine the level of disease present and the best treatment course to pursue.
Brush 2-3 minutes per day. Floss once per day. Watch the sugars (artificial and natural) you eat. There is sugar in candy, fruits, juice crackers and chips. Avoid sticky foods that stick to your teeth such as raisins and soft bread and brush your teeth immediately after eating sweet or sticky foods. Swish with water and brush your teeth 30 minutes after eating or drinking anything acidic such as oranges, grapefruits or lemons which weaken tooth enamel. Brushing too soon can damage the enamel in its weakened state. Prolonged exposure to phosphoric acid, which can be found in soft drinks like soda and diet soda, can erode hard tissues from the tooth surface. Acid erosion causes permanent damage to your teeth and makes your teeth more prone to cavities. To prevent acid erosion, limit snacking between meals and be mindful of consumption of soft drinks and sugary snack foods. Use a fluoride-containing toothpaste and mouth rinse to harden enamel and re-harden soft tooth surfaces.
It may not be necessary to remove wisdom teeth if they are correctly positioned in your mouth and do not cause pain or dental problems. Your dentist can determine this after an examination and x-rays.
Wisdom teeth should be removed when they are causing damage to other teeth due to their positioning, develop cysts which can be seen on x-rays, cause chronically inflamed gums, have cavities that are difficult to treat due to their positioning and when their alignment interferes with braces, bridges or other dental work. They can be removed at any age but are best removed when young, between ages 16-24, as healing is faster and roots are not fully formed. Wisdom teeth do not crowd teeth. Teeth drift forward throughout life naturally, whether or not orthodontic treatment has been done or if wisdom teeth are present.
Certain foods, poor oral hygiene, gum disease, dry mouth, tobacco products or a medical disorder such as acid reflux can cause bad breath. Sometimes a sinus infection, postnasal drip or other respiratory tract infections can cause bad breath. Morning breath is due to a decrease in saliva production when you sleep. Since saliva is your mouth’s natural mouthwash, most people experience morning breath. Bacteria found on teeth and on the taste buds of the tongue break down food particles which produces bad odor-causing sulfur compounds.
Brushing or scraping your tongue, using a mouth rinse, receiving a professional dental cleaning, and improving your oral hygiene may all help to alleviate bad breath. Chronic, long-term bad breath can be a sign of a more serious illness. See your dentist for an evaluation.
Electric toothbrushes are better at preventing cavities and gum disease. Compared with manual toothbrushes, electric toothbrushes reduce dental plaque 21 percent more and gingivitis (i.e., inflammation of the gums) 11 percent more after three months of use, studies show. An electric toothbrush may also help if you have arthritis or a dexterity problem that makes thorough brushing difficult.
Does your jaw feel stiff, do you have difficulty opening your mouth wide, do your joints pop or creak, do you have morning headaches or migraines, do your jaw muscles feel tired in the morning, do your teeth feel achy and are they sensitive to cold drinks? If you answered yes to any of these, you may be grinding your teeth at night (a medical condition called bruxism) or you may be clenching your teeth, which can be just as harmful. People with nighttime grinding habits may wear away their tooth enamel ten times faster than those without abusive chewing habits. Eventually, your teeth may become worn down and destroyed. In addition to relieving head, neck, jaw joint and shoulder pains, treating bruxism and clenching is cost effective compared to ignoring the condition and exposing teeth to continued grinding. Without treatment, crowns (caps), bridges, implants and dentures are often needed to repair or replace worn and damaged teeth. Ask your dentist if a night guard can help to provide temporary relief from grinding, bruxing or clenching.
If you’ve ever felt pain in your teeth after drinking or eating hot or cold food and drinks, you’ve had tooth sensitivity. One out of every four adults has had tooth sensitivity, often coming and going over time. It is tooth pain that comes from a wearing away of the tooth’s surface or gums. When gums recede, or pull away from the teeth, they leave the root of the tooth bare. Because these roots are not covered by enamel (the hard outer layer of the tooth), thousands of tiny channels leading to the tooth’s nerve are exposed. When heat, cold or pressure touches these channels, you may feel pain. Ignoring your sensitive teeth can lead to other more serious oral health problems. This is especially true if the pain causes you to brush poorly, which can lead to tooth decay and gum disease. Tooth sensitivity may also be caused by undiagnosed cavities, nighttime grinding or clenching or frequent intake of highly acidic foods and beverages. See your dentist to diagnose the problem and to discuss solutions such as possibly treating cavities, using sensitivity toothpaste or applying professional desensitization products to the tooth surface.
Dental sealants act as a barrier, protecting your teeth against decay-causing bacteria. Sealants are a thin tooth-colored coating which fill in the grooves and crevices on the chewing surfaces of teeth, typically the back teeth—molars and premolars. 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.
If you have had a prosthetic joint replacement, heart valve replaced, have had infective endocarditis or other condition(s) related to prosthetic joints or a heart condition, check with your medical doctor or dentist regarding your need for an antibiotic premedication. Please see our article here for details (link to: articles-antibiotic-prophylaxis-before-dental-treatment).
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 some of which may be short-term or long-term. Dry mouth can dramatically increase your decay rate. It can be harder to control these things while undergoing treatment as the immune system is generally compromised as a result. There are special mouth rinses that can be prescribed to help with discomfort during treatment. Fluoride gels, fluoride trays and fluoride prescription toothpastes may be prescribed to help combat the high cavity risk due to dry mouth.
It is very important to see your dentist before treatment begins and then to continue with recommended follow-up care.
Gum disease is an infection of the tissues that surround and support your teeth and is a major cause of tooth loss in adults. Because gum disease is usually a painless and chronic problem, you may not know you have it. It is caused by plaque, the sticky film of bacteria that is constantly forming on our teeth. If plaque isn’t removed and allowed to grow, it can cause your gums to become inflamed and infected. When this happens, the gums pull away from the teeth and form deeper pockets which cause more plaque to get trapped that cannot be removed with regular brushing. If untreated, gum disease can lead to bone and tooth loss.
Tartar (same as calculus) is a hardened form of plaque. It is caused by minerals that come from our saliva and from plaque in deep pockets.
Warning signs that may signal a problem: gums that bleed easily, red/swollen/tender gums, gums that have pulled away from the teeth, persistent bad breath or taste, permanent teeth that are shifting/loosening/separating, changes in your bite, changes in the fit of appliances such as partial dentures.
Factors that increase the risk of developing gum disease: poor oral hygiene, smoking/chewing tobacco, genetics, crowded teeth that are hard to clean, pregnancy, diabetes
See your dentist for regular checkups to evaluate your dental health including gum health. Diagnosis of gum disease is done by measuring the natural pockets around the teeth and by x-ray examination. Teeth with gum disease will have deeper gum measurements and will exhibit bone loss on the x-rays.
If gum disease is caught early and hasn’t damaged the structures below the gum line, a professional cleaning should do. However, if the pockets between your gums and teeth are too deep so that you cannot clean them with a regular toothbrush and floss, a scaling and root planing, or deep cleaning, may be necessary.
The deep cleaning is usually done in two 90-minute appointments, with half of the mouth being numb at a time so you are comfortable during the cleaning process. Plaque and tartar is removed from above and below the gumline to the bottom of the gum pockets so that the roots are nice and smooth again—this allows the gums to reattach to the tooth which, if successful, will result in smaller healthier pockets that you can clean with a regular toothbrush and floss. We will re-measure the pockets 4-6 weeks after the deep cleaning appointments to see how the gums have healed and to determine how often we need to see you for cleanings to maintain healthier gum pockets. Research shows that, in order to stabilize gum disease and prevent it from getting worse, cleanings every three to four months is usually necessary.
Good dental care and healthy habits at home are essential to help keep gum disease from becoming more serious or recurring. Brush your teeth twice per daily, floss daily, eat a balanced diet, avoid tobacco use and see your dentist regularly.
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. Having a well-baby checkup at this age connects your child to a dental home and helps your dentist get to know your child’s and your family’s specific needs. During the first visit, we will learn your child’s health history, give a complete oral exam to check growth and development, oral hygiene, injuries, cavities or other problems, discuss your child’s risk of developing cavities, clean the teeth and provide tips for daily care, discuss whether your child is getting enough fluoride to prevent cavities, review dietary concerns related to tooth decay, discuss teething, pacifier use, or finger/thumb sucking habits, discuss treatment if needed and answer questions you may have regarding your child’s teeth.
Starting at birth clean your child’s gums with a soft infant toothbrush or cloth and water. Parents should use a tiny smear of fluoride toothpaste to brush baby teeth twice daily as soon as they erupt and a soft, age-appropriate sized toothbrush. Once children are 3 to 6 years old, then the amount should be increased to a pea-size dollop and perform or assist your child’s tooth brushing. Remember that young children do not have the ability to brush their teeth effectively. Children should spit out and not swallow excess toothpaste after brushing. Baby teeth that are touching each other and do not have spaces between them should be flossed. You may find it easier to use floss picks at first rather than regular string floss.
As teeth begin to erupt, some babies may have sore or tender gums. Rubbing your child’s gums with a clean wet gauze or finger may help. A clean, chilled teething ring—don’t dip it in sugar, syrup, honey or other foods—may also ease tender gums. Numbing gels or creams containing benzocaine should not be used to soothe sore gums in babies younger than 2. Stick with other methods of soothing your child’s gums. If your child is still cranky and uncomfortable while teething, consult with your pediatrician regarding over-the-counter pain relievers your child may take.
Avoid nursing children to sleep or putting anything other than water in their bed-time bottle. Also, learn the proper way to brush and floss your child’s teeth. Take your child to a dentist regularly to have his/her teeth and gums checked. The first dental visit should be scheduled by your child’s first birthday.
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 and help adult teeth come in straighter.
See a dentist as soon as possible. Also, rinse the irritated area with warm salt water and place a cold compress on the face if it is swollen. Give your child acetaminophen for pain (always consult with your physician before giving your child new medications), and never give your child aspirin due to the risk of developing Reye’s Syndrome, a rare but serious condition that causes swelling in the liver and brain.
xThumb and pacifier sucking habits will generally only become a problem for dental or skeletal development if it goes past the age of four. 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 may be recommended by your dentist.
A check-up every six months is recommended in order prevent cavities and other dental problems. However, your dentist can tell you when and how often your child should visit based on their personal oral health.
General dentists see adults and children of all ages. Pediatric dentists only treat children and have 2-3 years of additional specialty training following dental school. They are better suited to care for children that might require sedation, those with special health needs or advanced dental problems.
Make sure your child has a balanced diet. Limiting the servings of sugars and starches will also aid in protecting your child’s teeth from decay. Do not allow your child to freely sip on juice, and limit snacks and juice to specific times of the day to decrease the frequency of sugar or acid attack on the teeth. Avoid sticky, chewy foods and candies that stick to the crevices of teeth such as gummy bears, crackers, and soft breads.
Sealants work by filling in the crevices on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years. As sealants fall out over time, they will be evaluated and replaced as needed at future dental visits
Fluoride comes from fluorite, a mineral that is naturally occurring in the earth’s crust which is very effective in protecting teeth from decay. When a child’s teeth are forming, fluoride works by making enamel more resistant to the acid that causes tooth decay. Fluoride also helps repair areas where the acid attacks have already begun. Fluoride may be found in toothpastes, mouth rinses, professional fluoride applied in the dental office, fluoride tablets or fluoridated tap water. Bottled water does not always contain fluoride, so children who regularly drink bottled water or unfluoridated tap water may be missing the benefits of fluoride. Check the water bottle label to see if fluoride has been added. Ask your dentist if you are not sure if your child is receiving the benefits of fluoride.
A bad bite, or malocclusion, may occur when the teeth are too crowded, spaced, crooked or out of line or the jaws don’t meet properly. A bad bite may first be noticed between the ages of 6-12 when the adult or permanent teeth start to come in. Your child’s teeth and bite will be evaluated for orthodontic treatment before the age of 7. If braces or another treatment is needed, your dentist may refer your child to an orthodontist who specializes in bite problems.
Soft plastic mouth guards can be used to protect a child’s teeth, lips, cheeks and gums from sport related injuries. A custom-fitted mouth guard developed by a dentist or a store-bought mouth guard will protect your child from injuries to the teeth, face and even provide protection from severe injuries to the head.
The most important thing to do is to remain calm. Then find the tooth. Hold it by the crown rather than the root. If it is dirty, gently rinse the root with water but do not scrub the tooth or remove any attached bits of tissue. If possible, you may try to gently insert the tooth by holding the tooth in its socket with a clean wash cloth or gauze. If this isn’t possible, or if the child cannot safely hold the tooth in his/her mouth, put the tooth in a container of milk, saline or saliva and take your child immediately to the dentist. The tooth has the best chance of survival if it is put back in place within an hour. Don’t forget to bring the tooth and any tooth pieces you can find.
Finding and treating dental problems at an early stage can save time, money and often unnecessary discomfort. There is very little risk in dental x-rays. Dentists are especially careful to limit the amount of radiation to which children are exposed. Lead aprons and digital x-rays are used to ensure safety and minimize the amount of radiation.
X-rays are a valuable part of dental care because they can detect damage to teeth and gums not visible during the visual examination. An x-ray may reveal: cavities just starting between the teeth or below existing fillings, infections in the bone, abscesses or cysts, developmental abnormalities and some types of tumors.
Parents should take their children to the dentist regularly, beginning with the eruption of the first tooth. Then, the dentist can recommend a specific program of brushing, flossing, and other treatments for parents to supervise and teach to their children. These home treatments, when added to regular dental visits and a balanced diet, will help give your child a lifetime of healthy habits. Be a role model yourself by showing your child your healthy food choices and by practicing good oral hygiene.
Anything that boosts your child’s interest in oral care can be helpful in preventing plaque and cavities. Manual and electric toothbrushes may be equally effective at removing plaque and preventing cavities at this age. However, an electric toothbrush for kids may be the answer for a child who doesn’t like to brush. For children who are reluctant brushers or have difficulty brushing with a manual brush, an electric brush may be easier or more comfortable to use. If you are unsure which brush is best for your child, discuss it with your dentist at your next dental exam.