Below are some of the most frequently asked questions patients have about dentistry and oral health issues. If you have any other questions, or would like to schedule an appointment, we would love to hear from you.
Frequently Asked Questions
Q: What should I do if I have bad breath?
A: Bad breath (halitosis) can be an unpleasant and embarrassing condition. Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.
There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue. Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.
What may cause bad breath?
- Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
- Certain foods – Garlic, onions, etc. Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
- Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
- Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
- Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
- Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
- Tobacco products – Dry the mouth, causing bad breath.
- Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
- Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
- Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.
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.
Toothbrushing – 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 gumline. 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 gumline. 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: Are amalgam (silver) fillings safe?
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: 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. These include:
- Medical 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 sometime 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 toothbrushing 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: How can I tell if I have gingivitis or periodontitis (gum disease)?
A: 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 affects 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 role – Some patients may be predisposed to a more aggressive type of periodontitis. 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: Why is it important to use dental floss?
A: Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth. Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.
Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
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 (acids) that cause cavities and irritate and inflame the gums. Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar). This will further irritate and inflame the gums and also slowly destroy the bone. This is the beginning of periodontal disease.
How to floss properly:
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 gumline. Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
Daily flossing will help you keep a healthy, beautiful smile for life!
Q: How can cosmetic dentistry help improve the appearance of my smile?
A: If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.
Cosmetic dentistry has become very popular in the last several years, not only due to 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 are porcelain veneers and how can they improve my smile?
A: Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth. They are very durable and will not stain, making them a very popular solution for those seeking to restore or enhance the beauty of their smile.
Veneers may be used to restore or correct the following dental conditions:
- Severely discolored or stained teeth
- Unwanted or uneven spaces
- Worn or chipped teeth
- Slight tooth crowding
- Misshapen teeth
- Teeth that are too small or large
Getting veneers usually requires two visits. Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.
With little or no anesthesia, teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers. The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and occasionally a specialized light may be used to harden and set the bond.
Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile.
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 teeth 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 teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.
The most widely used professional teeth whitening systems:
Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth. The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep. It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening.
In office teeth whitening: This treatment is done in the dental office and you will see results immediately. It may require more than one visit, with each visit lasting 30 to 60 minutes. While your gums are protected, a bleaching solution is applied to the teeth. A special light may be used to enhance the action of the agent while the teeth are whitened.
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.
Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!
Q: I catch myself clenching and grinding. How can I stop this habit?
A: Clenching and grinding also known as Bruxism is a subconscious habit. Stress is a major contributor in developing this habit. Clenching and grinding can cause TMJ related issues such as tooth wear, Stiffness in the jaw, neck and shoulder area and clicking in the jaw joint. Clenching and grinding cannot be stopped, however, wearing a custom formed mouth guard can help protect your jaw joint and teeth. Consistent use of the mouth guard can help relax the muscles around the jaw joint and decrease the stiffness and pain in the jaw, neck and shoulder area.
Q: How do I care for my dentures?
A: Brushing: Do not brush your dentures with normal toothpaste. Toothpastes are designed to be used on teeth, and they often contain materials and chemicals that help whiten and strengthen teeth, but may harm dentures, which are made of a very durable plastic. Even though the plastic is strong, it is not as strong as the enamel of teeth and may be scratched by using toothpaste to clean your dentures. You should use a dish washing liquid and a special denture brush to clean your dentures by hand every day. After rinsing them thoroughly, soak your dentures in water-based cleaning solution overnight.
Repairing broken dentures: The best solution is to return to the prosthodontist who made your dentures and have the cracked denture repaired professionally. It may seem easy to fix, but it is important that the repair is done correctly to prevent problems with chewing and to avoid any sore spots. The prosthodontist also needs to check the denture and adjust it after it is repaired. The denture may be too old and may no longer fit closely to your gums, and you may need a new denture.
Q: Is it possible to have dentures put in the same day as teeth removal?
A: Yes, it is possible to have your teeth removed and dentures put in the same day. These dentures are called immediate dentures and you should talk to your prosthodontist to see if that treatment is the best for you.
Q: As a new denture wearer, the bottom denture seems loose. What should I do?
A: In most cases, the lower denture is much less stable than the upper denture. This is due to the shape of the gums on the lower ridge and movement of the denture caused by the tongue. Ask your prosthodontist about supporting your lower denture with dental implants. Implants can be used to stabilize and retain the lower denture allowing you to chew more efficiently and feel the confidence of knowing that your denture will stay in place.
Q: What is the difference between a crown and a bridge?
A: A crown is utilized to restore an existing tooth back to its natural appearance. Whereas a bridge uses surrounding teeth to help fill the gap of a missing tooth. Bridges and crowns differ from dentures, as they are fixed prosthetics. Should problems arise or additional treatment becomes necessary, a dentist will be the only one able to remove these materials.
Q: How do I care for my bridge?
A: A dental bridge is an appliance used to replace one or more missing teeth , which is cemented into place and can’t be removed. And if it can’t be removed it means you can’t take it out to clean it every night like you can with dentures. So if it’s staying in your mouth 24/7 it needs to be 100% clean and fresh at all times.
A dental bridge depends on the health of the adjacent teeth and gums for support. To care for your bridge, brush and floss normally after each meal.
Super Floss and floss readers are effective tools for keeping the area under your bridge plaque-free.
Superfloss has a stiff end that helps in threading it through tight areas and a fuzzy tufted segment that can remove plaque as you floss. Insert the super floss under the bridge and use it to floss the sides of the teeth and under the bridge.
Q: What is a dental crown?
A: A dental crown, sometimes known as a “cap,” is a special type of restoration that is designed to fit over, protect, and support a damaged tooth. Today’s crowns are typically made of porcelain or ceramic and can be shaded and designed to look virtually identical to a natural tooth. Once a crown has been placed, in fact, it’s highly unlikely that anyone will be able to tell your capped tooth apart from your other teeth. A dental crown, sometimes known as a “cap,” is a special type of restoration that is designed to fit over, protect, and support a damaged tooth. Today’s crowns are typically made of porcelain or ceramic and can be shaded and designed to look virtually identical to a natural tooth. Once a crown has been placed, in fact, it’s highly unlikely that anyone will be able to tell your capped tooth apart from your other teeth.
Q: What are dental implants?
A: Dental implants are a replacement for tooth roots. A single dental implant is a tiny post that is implanted into the space where the supportive root structure once was. When it is here, the post fuses together with the jaw bone to provide stability for the crown, bridge, or denture that can be affixed on top.
Q: What is the process for dental implants?
A: Dental implants are placed in two major phases: initial implantation and final restoration. This entire treatment occurs over the course of 6 to 8 months. First, the implant posts are placed in a surgical procedure and healing begins. Then, the dental implants are exposed once more and a connecting abutment secures the prosthetic teeth to the implants. A recovery period of 4 to 6 months is necessary in between.
Q: What are dental implants made of?
A: Most dental implants are made of titanium, a biocompatible material which promotes the growth of bone tissue (a process called “osseointegration”). Patients with metal allergies or sensitivities may benefit from ceramic or zirconia dental implants.
Q: What are the benefits of dental implants?
A: Dental implants offer a number of advantages for patients who are missing teeth. As a comprehensive replacement, they take care of the tooth’s supportive root as well as the visible crown for the ultimate in stability. Dental implants also promote oral and overall health by preventing the loss of additional teeth and supporting a balanced, nutritious diet. What’s more, when cared for properly, dental implants can last a lifetime.
Q: What is a root canal?
A: Root canal treatment involves a procedure that is used by dentists if a tooth is badly decayed or fractured. The procedure is needed because if the tooth is left untreated, the pain will get worse and the gum disease will spread to other teeth, leading to more decay.
Q: Will I lose my tooth?
A: The answer to this question depends on the severity of your case. If your tooth is not too badly decayed, your dentist will remove the decayed part and leave the remaining part of the tooth in your mouth, then cover it up with dental filling or a dental crown.
If the damage or decay is extensive, your dentist will recommend extracting the tooth and replacing it with an artificial tooth through the use of a dental implant.
Q: Is a root canal painful?
A: There is a misconception that root canals are painful, but the truth is they are not. Thanks to technological advances, root canals are about as painful as getting a dental filling, which is not painful at all.
Q: How long does the procedure take?
A: Root canals typically can be done in one visit to the dentist and usually do not take more than two hours. If your problem is severe, you will likely need at least two visits to the dentist to complete the procedure.
Q: Do I need a root canal if the tooth does not hurt?
A: If your tooth is decayed and you leave it untreated, you will make matters worse because the decay will spread to other teeth. If you wait until you are in a significant amount of pain, your dentist might have to perform a root canal on more than one tooth. This will cost you more money than if you had taken care of it much earlier.
Q: Is it cheaper to have the tooth removed?
A: Extracting the infected tooth is an alternative to undergoing a root canal, but that option should not be on the table unless there is nothing that can be done to salvage the damaged tooth. Extracting the tooth also will not save you any money because you will be charged for the extraction and will also have to pay for the implant to replace the removed tooth, which will be more expensive than the root canal itself.
Having your teeth pulled can lead to the loss of bone density in your jaw, especially if the missing tooth is not replaced soon after it was extracted. The loss of bone density can affect your facial structure and make you appear older than you are.