FAQ's
#1. Why do I need dental x-rays?
Dental x-rays are extremely helpful in detecting oral diseases of the teeth, surrounding gum and bone. They can reveal small cavities between the teeth that cannot be seen visually. Infections in the bone, abscesses, cysts and other abnormalities can also be detected with x-rays. A complete set of x-rays is recommended every 3-5 years. Cavity-detecting x-rays (bitewing x-rays) generally should be taken every year. If you are concerned about the amount of radiation you are receiving, modern digital x-rays use 90% less radiation than older film-based x-ray machines. The radiation from a complete set of x-rays is extremely small compared to other naturally-occurring sources of radiation.
#2. I have heard about a new way to do fillings without a drill. Can you tell me about it?
Yes, dental science is advancing rapidly, making treatment more comfortable all the time. A new technique for treating cavities and many gum and soft tissue problems uses a dental laser. Often treatment can be done without an injection of anesthetic. A great number of dental problems can be treated with the Waterlase including: denture sores, canker sores and cold sores, mouth ulcers, desensitizing teeth sensitive to cold and air, removing excess or infected gum tissue, releasing tongue-ties, removing growths in the mouth and lips, performing root canal fillings, and removing excess bone where necessary. Post-treatment healing is faster and more comfortable when the Waterlase is used.
#3. A friend of mine has migraine headaches and her dentist told her about this new device to reduce the pain. Please tell me more about this treatment.
The new device is called a NTI-tss (tension suppression system). It is the only dental device to earn approval from the Food and Drug Administration (FDA) for the treatment of migraine headaches (and muscle tension headaches) which are related to clenching and grinding of the teeth and jaws. Research has shown that the NTI is about 80% effective in reducing both the severity and frequency of migraines. Many of my patients report sleeping better than they have in years. This relatively inexpensive device can reduce pain and suffering, reduce lost time from work and the need for medication. It is a benefit of some dental and medical insurance plans. A good source of additional information can be found at: www.nti-tss.com.
#4. My teeth are yellow and “dingy” even after I get my teeth cleaned. Can I safely get them any whiter?
Many treatment options are available. Your dentist will want to examine your teeth and gums to assure good oral health. Once things are healthy, one treatment option is to make custom whitening trays that hold the whitening gel close to your teeth. In most cases, your dentist will recommend whitening during waking hours. Whitening gels are generally very safe and mild, though a few patients do experience sensitivity of the teeth and gums. For this reason, whitening should be done by dental professionals who know how to correct this problem should it occur. Most patients will see dramatic results in anywhere from 3 to eight days. Research and experience show that the results last for years. Some patients prefer to do a “booster” bleach occasionally to keep their smile as bright as possible.
#5. What is a crown?
A crown is a replacement for missing tooth surfaces. If fits over the tooth and makes weak teeth stronger. Teeth get weakened through the years for several reasons. Extensive decay or a large filling generally require a crown to restore the tooth. Broken cusps or severe wear can be corrected by a crown. Crowns are custom-made of a variety of materials and your dentist can explain which techniques and materials are most appropriate in your particular situation.
#6. I have a chipped front tooth. Can this be fixed without a crown? Will it look natural?
Often chipped teeth or worn teeth can be restored to health, function and beauty with a variety of bonding techniques. White plastic “composite” comes in a variety of shades that allow us to match most teeth colors. It can be sculpted and polished to look just like your natural tooth. In certain circumstances, a porcelain veneer or porcelain crown is a better way to restore the severely decayed or broken tooth. Porcelain is stronger and more stain-resistant than composite and will maintain its’ beautiful appearance longer also. Be sure to see a dentist who has experience with this type of procedure and takes time and has pride in this treatment.
#7. I had a really bad toothache and my dentist put me on antibiotics and it doesn’t hurt anymore. He told me I need a root canal. Why should I have this done when my tooth doesn’t hurt anymore?
Your tooth doesn’t hurt anymore because the infection is gone due to the antibiotics you were taking. However, the cause of the infection has not been eliminated and the infection will return in the future. You could even have more bone damage from infection or lose the tooth due to continued decay.
Frequently, this infection spreads to the rest of your body. People with diabetes are more prone to infections and others with compromised immune systems can die from abscessed teeth that aren’t properly treated. Most people simply endure unnecessary swelling, pain and suffering, and expense by delaying the proper treatment. Toothaches always seem to occur at the worst possible times.
#8. I am in my third month of pregnancy. Will I lose teeth because I’m pregnant?
During pregnancy, many hormonal changes occur. The gums become much more sensitive to bacterial plaque, get red and bleed easily. It’s more important to have your teeth cleaned to remove plaque and tartar to avoid bone loss around your teeth and prevent unusual overgrowths of the gum tissue called “pregnancy tumors”.
Unfortunately, many pregnant women don’t feel well, snack more and do not take good enough care of their teeth and gums. Those that do and seek regular dental care before, during and after pregnancy actually notice little or no dental problems.
#9. My mother is elderly and lives in a nursing home. Should she be going to the dentist?
As we age, it becomes more critical that we take even better care of our teeth and gums. Many people are on a variety of medications that can dry the mouth leaving the teeth vulnerable to rapid decay. Many times people snack on starchy or sugary foods out of boredom. These promote tooth decay whereas fresh fruits and vegetables do not. Prescription-strength fluoride rinses and gels can help prevent rapid decay in these situations.
Assuming that your mother can walk or be moved about in a wheelchair, it is important that she continue seeing her dentist for routine checkups and cleanings. It’s generally best to have her teeth cleaned every 3-4 months, especially if she has reduced arm or hand movement or dexterity. Often, in a nursing home setting, the teeth are neglected and severe problems can develop. It’s important for you or a staff member to help her with her dental hygiene. A powered tooth brush can be a very useful instrument in helping elderly people.
#10. What's wrong with drinking soda pop?
There are several medical reasons to reduce the quantity of soda you’re consuming. From a dental standpoint, soda can be very damaging to the teeth because of the acids it contains. Acid dissolves the enamel on the teeth. Bacteria convert sugars and starches into acids that cause tooth decay, but the acid in soda and other foods can cause the enamel to simply melt off the teeth. I see this regularly in my practice.
There is no harm in enjoying an occasional soda with a meal, but avoid sipping on soda pop all day long. The long term exposure of the teeth to the acid causes severe damage that is both time-consuming and expensive to repair.
#11. My 2 ½ year old son’s front teeth have started turning black recently. What’s causing this?
There can be many causes of teeth turning dark or black. The most likely cause is trauma from a fall that damaged the nerve and blood vessels inside the pulp of the tooth. Generally, you’d recall that your child fell, had a swollen or bloody lip or nose.
If you don’t recall anything like this happening, the next most common problem is baby bottle mouth. Many children develop decay of the 4 or 6 front teeth from drinking sugar containing beverages at bedtime. Even milk contains sugar. It’s best to put plain water in your son’s bottle when putting him down for a nap or at night.
Children this age need help with tooth brushing before bedtime. You should place a pea-size amount of fluoride-containing toothpaste on your son’s toothbrush and help him brush his teeth, including the back teeth on the outside and inside. Brushing should take 2-3 minutes by the clock. Most people brush less than one minute.
#12. What options do denture wearers have for cosmetic restoration of missing natural teeth?
Fortunately, you have several options today. First, there is one particular brand of denture, called Geneva 2000™ that uses customized hand-made teeth that contain the many colors of natural teeth. Many denture teeth are mono-chromatic (one color). Geneva 2000™ teeth are poly-chromatic (many colors) so they look more natural. Furthermore, Geneva 2000™ molds are based on the individual person’s facial characteristics and personality and are arranged in a very natural pattern, instead of the teeth being lined up like a picket fence. You can learn more about these specialized dentures at http://www.geneva-dental.com/.
#13. Why do dentures fit poorly as the years go by?
The mouth is in constant change, especially once the natural teeth are removed. Pressure on bone from dentures causes it to shrink, creating gaps between the denture and gums which leads to loosening and slipping. In addition, the denture teeth wear and not always evenly, depending on chewing habits, and the presence of natural teeth or crowns. Generally, the looseness problem can be corrected by relining the denture with new plastic.
Eventually however, there’s too little bone for an adequate foundation for any denture and remaking the denture only helps to a limited degree. Consequently, the 2nd and 3rd sets of dentures generally don’t provide the same chewing ability as the first.
There are several alternatives for denture wearers, and those considering dentures, to protect the bone and make dentures more secure and comfortable, such as saving a couple roots of teeth or placing implants to secure the denture.
If a patient has bad teeth and wants to have dentures, it is advisable to save the canine teeth in both jaws to support and retain the denture. This protects the bone from shrinking and the lower canine teeth can have snap-attachments placed to hold the denture in place.
If a person has no teeth, then implants can be used to stabilize and secure a denture. Dental implants offer a variety of alternatives for replacing missing teeth. Some patients have 2 implants to hold a full denture in place; others have 4-6 implants to support either a removable denture that clips onto the implants or is attached permanently to the implants as replacement teeth.
#14. Recently I went to a new dentist and was told I need scaling and root planing instead of a cleaning. What’s the difference and why does is cost so much?
A standard “cleaning” involves removal of soft bacterial plaque, hard calculus (tartar) and stains from the teeth ABOVE the gumline. This is really only a cosmetic procedure.
If the crevice around your teeth (called the “sulcus”) is deeper than 3 mm (about 1/8”) you can not clean the bacterial plaque from the bottom of the sulcus.This is called a “pocket” and is infected because of the bacteria you can’t remove. Without treatment pockets get progressively worse, destroying bone around the roots of the teeth. Eventually the teeth can fall out.
Root planing or a “deep” cleaning involves carefully removing the bacteria, calculus and bacterial toxins which penetrate the root so these pockets can heal. This procedure is “therapeutic” (not cosmetic) because it treats the disease process. It takes more skill and time and often is completed over 2, 3, or 4 appointments. Once root planing is done you should continue to have periodontal maintenance scaling every 3 months to control the gum disease and prevent bone loss.
#15. Why should I have a missing tooth replaced if it’s in the back and no one can see it?
Teeth function like a Roman arch. Each brick in the arch has pressure from the bricks on both sides. The keystone is the last brick added to an arch to stabilize all the other bricks. Our dental arches are similar in many ways. If a tooth is lost the teeth on either side and the tooth above can shift and drift, including growing longer into the space where the tooth is missing. Shifting creates gaps where more food can be trapped which can lead to tooth decay and gum disease. Also the tooth that grows into the space can only fit in that one place which changes the bite. This can create stress and pain in the teeth and TMJ (jaw joint) and muscles of the jaws which can contribute to muscle-tension headaches and migraines.
16. What options do I have to replace a missing tooth or several missing teeth?
There are 3 ways commonly used to replace missing teeth. The best method depends on which tooth (teeth) is missing, how many teeth are missing, how strong the other teeth are and the health of the gum and bone around the adjacent teeth.
One method that’s been used for many years is to make a “fixed” bridge. The teeth on either side of the space are shaped for crowns and a false tooth (or teeth) is connected in between the anchor crowns. This is “fixed” because it is cemented to the anchor teeth and doesn’t come out.
Another newer technique for replacing missing teeth in a “fixed” manner is to surgically place metal cylinders in the jaw bone. These replace the roots of your natural teeth. After healing, crowns can be attached to these implants, which are secure and strong and function just like your natural teeth.
The oldest, and least secure method, involves using a removable partial denture. A partial denture uses a metal frame to support teeth. The appliance is held in place by clasps which grip the remaining teeth. This prosthesis is removed to clean it and your remaining natural teeth. Unfortunately, partial dentures trap bacterial plaque underneath and against natural teeth which often leads to tooth decay or gum disease of the anchor teeth. Extra home care is required to maintain the natural teeth in a healthy condition.
