Frequently Asked Questions

Frequency of Dental Checkups--How Often Should I Go?

We pride our office in being prevention oriented.  In the long run, this type of treatment will prove to be the most cost effective, least time consuming, and simplest way of keeping a beautiful and functional smile for a lifetime.  Some people have the idea that you should only see the dentist when something is wrong.  They might view a series of successful checkups as a waste of time because nothing was found to be wrong.  In the long run, this can end up costing you a lot of money, time, and perhaps even unnecessary tooth and bone loss.

Our dental team's goal is to prevent decay, disease, and tooth loss.  We are trained to detect problems before you are even aware that they are present.  We must depend on you to work with us as a team to enable you to achieve optimal dental health.  Individual patient's needs may vary, but checkup appointments at six-month intervals are sufficient for most people.  Ongoing checkups are essential to allow us to evaluate the condition and well being of your mouth. Your checkup appointment will entail an update of dental and medical history; an examination of the mouth, including oral cancer screening; a professional cleaning; a fluoride treatment, if indicated; and a general assessment of hygiene at home.  Ongoing recall appointments are critical in preventing dental disease as well as maintaining already existing conditions, such as periodontal disease.

What Is Your Sterilization Process?

We care about you, and we care about protecting your teeth. To assure your protection, we have always maintained the most rigorous standards of infection control in our practice. We follow guidelines established by the American Dental Association and the Center for Disease Control to guard against the transmission of infectious diseases.

We know that infection control and the spread of infectious disease is a concern for everyone these days.  For these reasons, we have taken every measure to make patient protection one of our top priorities.  We are doing everything within our capabilities to assure the sterility and safety of our working environment. By adhering to the guidelines of both the Center for Disease Control and the National Institute of Health, as well as continually reviewing updates on infection control materials and techniques, we are optimizing our ability to achieve this in our office.  Treatment of our patients is based on the commitment to provide the same standards that we expect and demand for our own families and for ourselves.

Extensive and ongoing continuing education has been the basis for rigorous design of our patient protection system. The utilization of fresh gloves, masks, and protective eyewear is the obvious part of many measures that are taken to ensure your safety. What goes on behind the scenes? What infection control measures do we implement that are not so obvious to you? After each patient's visit, the treatment rooms are thoroughly wiped with a surface disinfectant. Instruments are then processed through an ultrasonic cleaner, which removes surface debris.  Instruments are then sterilized with a large, pressurized steam sterilizer called an autoclave. All of our handpieces (drills) are also thoroughly wiped with the surface disinfectant and then sterilized in a pressured steam oven.  We use disposable products whenever possible to eliminate cross-infection.

It is our intent that by making you aware of the measures we take, your trust and confidence in our team will assure a more comfortable visit. If any of your friends or family members would be interested in learning about our patient protection program, we ask that you share this information with them.  If you have any questions or concerns, please contact our office.  As always, we appreciate the opportunity to discuss this or any other dental matter with you

How Do I Keep A Smile For A Lifetime?

We feel that preventive dental care begins in infancy.  We like to talk to expectant parents about proper care of their baby's teeth so they can avoid problems in the future.  We encourage parents to begin cleaning their infant's teeth at bath time with a moist washcloth.  After several teeth have erupted or when the baby is about one year old, you may begin brushing his/her teeth with a small toothbrush.  Place a very small amount of toothpaste on the brush; an amount less than the size of a pea is more than sufficient.  We recommend you bring your baby in for the first checkup at this age so we can check for any problems that might be developing and advise you on how to best care for your child's teeth and prevent any dental disease.

Begin to wean the baby from the bottle to a sipper cup at about eight months.  The baby should be completely weaned from the bottle by the first birthday.  Some people are reluctant to wean the baby because they think they look cute with bottles.  There is nothing cute about an infant or child with extensive decay, which is known as baby bottle mouth.  Baby bottle mouth is a direct result of not weaning the baby early enough; putting cavity promoting liquids like Kool-Aid, carbonated soft drinks, and fruit juices from concentrate into the bottle; and putting the baby to bed with a bottle, even if it contains milk.  Decay can also occur in breast fed babies who are nursed for an extended period of time.  If you suspect your baby has decay, do not delay in bringing him/her in for an examination.  Often times, complicated treatment can be avoided if the problem is discovered early enough.  If you live in an area without fluoridated water or if your child drinks bottled or purified water, you need to check if fluoride supplements are indicated.

Your second set of teeth is your last, and proper care will insure that you keep them for a lifetime.   A thorough brushing and flossing routine is important for maintaining healthy teeth and gums. Brushing, however, cleans only three of the five surfaces of your teeth.  The amount of time spent brushing is a factor in disease prevention.  Most people, on average, spend thirty seconds brushing, but you need to spend three minutes to do an adequate job of cleaning.  Flossing is important because it cleans the areas a toothbrush can't reach, which are between the teeth and under the gum line.  Flossing is essential in the war against gum disease.  Your teeth need proper nutrition just as your body does. Fresh fruit and vegetables are very important in your diet to maintain healthy teeth and gums. Natural sugars, however, act in the same way on teeth as refined sugars, so be sure to brush, or at least rinse with water if a toothbrush is not handy, after eating even a piece of fruit.  It is best not only for dental reasons but also for health reasons to keep the consumption of carbonated beverages to a minimum.  One or two sodas a week probably won't do a lot of damage to your teeth, but two or three a day will take their toll on your teeth.  If you are going to drink a soda, try to have it at a meal when you can brush and floss right afterward.  This will help to lessen the amount of damage done.  Even diet soda will do harm because it is also contains phosphoric acid, which eats away at the protective enamel coating.  Try to limit between meal snacking, and brush at least twice a day.  Flossing should be done on a daily basis.  It is important to find a dental team that makes you feel comfortable and works well with you to maintain a healthy smile for life. Routine visits to your dentist for a check up and cleaning will help to maintain healthy teeth and gums.

Aw Doc, It's Only a Tooth.  Why Save It?

Premature loss of primary (baby) or permanent teeth can have severe consequences.  When you lose a tooth, you lose some of your ability to chew food properly. This may mean that you either place more stress on other teeth in order to chew all of the food you eat, or you do not chew enough, so the food is not quite ready to be digested. This can lead to digestive difficulty. You might switch to a diet that consists of softer foods that do not have to be chewed as much, and you might have to eliminate certain favorite foods because you cannot chew them thoroughly.  Even worse yet, you may swallow food without chewing, or without chewing well.  This may lead to digestive problems or choking accidents.  For each missing tooth, you lose approximately 10% of your remaining ability to chew food.

Another problem that can occur is that the teeth adjacent to the space left by the missing tooth will eventually shift. If a lower tooth, for example, is extracted, the opponent tooth in the upper jaw will grow longer in a downward direction into the space.  This is called extrusion or supereruption. The teeth on either side of the space left by the missing tooth will move and tilt off their proper vertical axis and drift into this space.  The teeth will literally drift out of the bone, thus losing their support.  This can make you more prone to decay because it is much harder to keep the teeth clean when they are not aligned properly. You will also increase your chances for developing periodontal (gum) disease when missing teeth are not replaced because the adjacent teeth will literally drift right out of the bone.  Root structure that is normally covered by gum and bone may become exposed. This leads to decay and root sensitivity. All this can happen if one tooth is lost.

Other major problems can occur if multiple teeth are lost:

Arch length (the distance from the back of the last tooth on one side of your mouth to the back of the last tooth on the other side of your mouth) may be reduced;

Vertical dimension (the distance from your chin to the tip of your nose) may decrease and make your face shorter.  This is a result of collapsed bite.  Have you ever noticed an older person with large, red creases around the corners of the mouth?  Most people think this is due to old age, but actually it is due to overclosure from tooth loss;

Gum tissue from the upper jaw may touch the teeth or gum tissue of the lower jaw due to downward growth of the maxillary (upper) alveolar bone.

If the space left by an extracted tooth is visible when you talk or smile, the result can be a distressing cosmetic problem.  This can lead to a loss of self-esteem and a feeling that you are getting old. Losing a tooth can have serious consequences because tooth loss can actually cause you to look older.  You may also have problems chewing, and this can lead to digestive problems.    The longer you wait to replace a tooth after an extraction, the harder and potentially more expensive it can become to make the replacement you need. With very few exceptions, it is better to replace missing teeth as soon as possible. Humans have evolved to chew their food with all of their teeth.

What are your options for tooth replacement?  We will be glad to discuss with you what type of replacement would be best suited for you, such as a fixed replacement that could be either an implant, a conventional bridge (crown/cap), a bonded resin bridge, or a combination of implants and bridges. You could also have a removable partial denture made.  For people who have already lost all of their teeth, full dentures are used to replace the missing teeth.  Dentures at best often make chewing difficult; you will chew only one-fifth as well with dentures as you did with your natural teeth.  If you have been a long time denture wearer and have difficulty chewing or are faced with having all of your remaining teeth removed, you may want to consider dental implants.  The advantage of fixed replacements, whether they are implants or bridges, is that they are designed to stay in your mouth at all times.  They offer an easy adjustment, feel more like the original teeth, and are perhaps more esthetic than removable dentures. Their disadvantage is a higher cost. A removable partial denture is held in place by metal clasps that may be visible. It is more bulky and may interfere with your speech for a period of time, but a removable partial generally costs less than a fixed replacement.

The working of your chewing apparatus is a very complex and amazing bit of engineering.   Premature tooth loss causes the breakdown of this function. The best plan is to preserve your dental health so that you can enjoy a lifetime of function and a beautiful smile!

What Is Gum Disease?

Periodontal (gum) disease is the number one cause of tooth loss today. In fact, after the age of thirty-five, three out of every four people have some degree of gum disease.  Periodontal disease causes inflammation and infection of the gums.  The gum tissue harbors the bacteria that cause bone loss.  Ultimately, good teeth may be lost because they don't have adequate bone to anchor them.  Your teeth become loose and eventually fall out or need to be extracted. Anyone at any age is susceptible to gum disease, which is caused by plaque, the sticky film that forms on teeth.  If the plaque is not removed on a daily basis, it will form calculus, which is the breeding ground for the germs that cause periodontal disease.  Recent studies have indicated there is a potential connection between gum disease and cardiovascular disease.

Bleeding gums are the first sign that there may be a periodontal problem.  Puffy, tender, or red gums are also an indication of infection. Bleeding gums, however, are not always present, even in severe cases of gum disease. Often times in the most advanced stages of gum disease, there is little or no bleeding at all of the gums.  Patients may become aware of looseness of their teeth or of constant bad tastes in their mouths.  If you have any of these symptoms, please consult with our office as soon as possible.

Routine and regular dental visits are the best way to catch gum disease in its early stages before too much damage has been caused. Gum disease will go away neither by itself nor with improved home care. The only way to remove calculus 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 maintain regular recall appointments.  For many patients with periodontal disease, we will recommend recall visits for a professional cleaning every two to three months.

Cosmetic Dentistry--What Is It?

Your smile is an important part of who you are and the image you project to others.  When you look good, you feel good.   Cosmetic dentistry changes, improves, or enhances the appearance of your teeth, which can be a very important aspect of the initial impression you make.  People form judgments on you based upon the way you look. Your appearance is not only the way you dress but also the appearance of your teeth when you smile.  When you talk to others, they focus on your face, eyes, and teeth. They will form opinions about you based upon what they see. If you have an attractive and natural looking mouth, teeth, and smile, people will be aware of it. If you have obvious cavities, unsightly fillings, crooked or misshapen teeth, bleeding, swollen gums, or bad breath, people will notice that also. Their impression of you will be affected by what they see.  The judgment based on your appearance may not be accurate, but it will affect how people think of you and how you perceive yourself.  Ultimately, cosmetic dentistry can have both psychological and health benefits.

Many procedures that are performed for the purpose of improving function will also improve appearance.  The term cosmetic dentistry is somewhat misleading because some procedures that fall under this term are not strictly performed for cosmetic purposes.  For example, a fixed bridge may be used to correct a bite, restore function, and replace a missing tooth rather than repair stained or chipped teeth.  Your smile is an important part of your well being.

The following are just a few of the dental procedures available today that can improve the way your teeth look when you talk or smile:

  • Whitening teeth to a lighter color through bleaching;
  • Reshaping your teeth to remove rough, uneven edges;
  • Closing gaps or spaces between teeth;
  • Bonding of teeth with porcelain or resin veneers to change the alignment or shape;
  • Bonding of teeth to repair chips or cracks;
  • Whitening the color of teeth by replacing discolored fillings;
  • Correcting the alignment of teeth by orthodontic treatment (braces);
  • Correcting jaws that did not form correctly by orthognathic surgery;
  • Performing gum surgery to reshape uneven or overgrown gum tissue;
  • Restoring teeth to return them to their natural length;
  • Replacing unsightly old porcelain to metal crowns with all porcelain crowns;
  • Restoring areas abraded by the tooth brush with tooth colored fillings;
  • Using dental implants or bridges to replace missing teeth.

Bleaching--How Is Everyone Getting Such White Teeth?

Many people are now very aware of teeth and are quick to notice beautiful smiles.  We are surrounded by everyone in the media with very esthetic, white teeth.  One of the ways people are getting these brilliant smiles is by bleaching.  Chocolate, blueberry, wine, coffee, tea, and cola stains can be taken up into the surface enamel.  Bleaching serves to remove these stains.

For the whitest smile you can get, contact our office today, or visit our Special Services section on bleaching for more information (link to bleaching section)

What Are Dental Implants?

Implants are man made root forms that are placed into the jaw to replace missing teeth.  They can be used to replace a single missing tooth, provide an abutment (anchor or retainer) to replace several missing teeth, or serve as a retainer to provide added retention to a removable dental appliance, such as a full denture.

For more information, visit our Special Services section on Dental Implants.

Should I Be Concerned About Grinding My Teeth?  (TMJ Treatment and Myofascial Pain)

The temporomandibular joint is located where the lower jaw meets the skull.  It is the joint that allows you to open and close your mouth.  If you notice clicking, popping, or pain in this joint when you chew, you may suffer from temporomandibular joint disorder, commonly called TMJ.  Symptoms of TMJ may include headaches; muscle tensions or tenderness in the head, face, neck, or back; dizziness; and buzzing or ringing in the ears.  The causes of TMJ may be multifactorial.  TMJ problems may be due to a bad bite (otherwise know as malocclusion); poor posture; sleep positions; injury to the head, neck, or face; arthritis; and aging.  Grinding of your teeth can be very harmful not only to your teeth but also to your temporomandibular joint.  People who are under an unusual amount of pressure may deal with their tension and stress by clenching or grinding their teeth not only during the daytime but also at night when they are asleep.

TMJ treatment is determined by a careful, complete examination of the joints and muscles of the head and neck.  Analysis of your teeth and their alignment is also instrumental to determine your TMJ treatment.  Often times we may suggest relaxation exercises to reduce tension, a special diet, and physical therapy.  In some cases, we may make an appliance to help relax your jaw muscles and aid in restoring normal joint functions. If you believe that you suffer from a TMJ disorder, please give our office a call, and we will evaluate you.

Myofascial pain is pain or discomfort in the head and neck region in a person who otherwise has healthy temporomandibular joints.  The symptoms may be very similar to those of TMJ in that the person may clench, grind, experience muscle tension or tenderness, or have headaches.  If you think you have myofascial pain or a TMJ disorder, please give our office a call, and we will evaluate you for treatment.

How Do I Prevent Tooth Decay? What Are Sealants?

If you want to prevent tooth decay, there are measures you can take.  The most important factors are diet and oral hygiene.  Diet not only directly affects the health of your mouth, but it also contributes to your overall health and sense of well being.  If you can eliminate or greatly reduce sugars from the diet, there will be a direct impact on your decay rate because sugar is a food source for the bacteria in cavities.

Plaque and sugar interact with one another to form an acid, which breaks down the enamel of the teeth and results in a cavity. Proper removal of plaque will also greatly reduce the risk of getting cavities. Thorough brushing and flossing will remove not only sugar but also plaque, which continuously forms on the surfaces of the teeth.  Flossing is essential to good home care because it is the only way you can adequately clean between the teeth and remove the plaque that causes gum disease.  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 promote tooth decay. Avoid snacks like raisins, which are sticky and contain sugar, as well as drinks that contain a lot of sugar.  Fruit juices can be a surprising source of hidden sugar.  Try to make sure the juice you buy is not from concentrate, for concentrate has added sugar.

Dental sealants are an excellent way of protecting the biting surfaces of teeth that have never had a filling and have no decay. Sealants are a clear or white material.  They are applied onto the biting surfaces of the teeth to cover up normal crevices where 90% of decay begins.  Sealants will not prevent decay from starting between the teeth or on the sides, so it is still necessary to brush and floss to be decay free.

What Is A Dry Socket?

After the removal of a tooth, the first step in the healing process is the formation of a blood clot.  If this clot remains normal, it acts as a framework into which the healing elements grow.  A dry socket is a condition in which the blood clot has disintegrated or has been lost.  This causes a foul odor and severe pain that is not relieved by pain medication. It can occur anytime from three to ten days following the removal of a tooth. If you are still taking pain medication three days after the removal of a tooth, you probably have a dry socket and need to call our office.  The most common part of the mouth in which this condition occurs is the lower wisdom tooth area, although it can occur elsewhere.

How and why a dry socket occurs is not really known, although smoking and certain medications, such as oral contraceptives, increase the chances for developing a dry socket. It is much easier to prevent a dry socket than to treat one.  Therefore, it is recommended that there be no rinsing, spitting, or drinking through a straw for one day after oral surgery. In addition, there should be no smoking one day before and three days after surgery.

Treatment of a dry socket consists of a series of dressings that have a soothing medicine on them.  The first two dressings are changed daily.  Then dressings need to be changed every two to three days.  A longer acting dressing that lasts up to one week may also be placed into the socket.  These treatments are usually necessary for one to two weeks until the socket starts to fill in with healing tissue.

What If I Have Trouble Bleeding?

For a short period of time after the operation, slight bleeding is expected and may persist until the next day.  However, if there is more than just oozing, the following procedure will control it:

  • If necessary, wipe all blood clots out with a gauze pad;
  • Put two folded, moistened gauze squares or two tea bags soaked with cool water directly over the bleeding area; close the jaws; apply firm constant pressure for one hour.
  • Remain quiet in a sitting position;
  • Do not rinse the mouth for twenty-four hours because this could initiate bleeding;
  • If necessary, repeat the above steps until the bleeding is controlled.

After these directions have been followed in detail for two hours, if there is any persistent pain or bleeding, please do not hesitate to call the office.

Tongue Piercing--What's The Big Deal?

Tongue piercing has become more prevalent, and many people have unfortunately undergone the procedure totally unaware of the consequences of placing jewelry into their mouths.  One of the most important concerns about tongue piercing is the risk of infection.  You may get a local infection of the tongue or the underlying glands because the mouth is very difficult to sterilize, and many of the establishments that provide this service do not maintain a sterile working environment. If infection of the tongue is severe enough, it may cause swelling of the tongue to the extent that it can cut off your airway and leave you unable to breathe.  A systemic infection may result and includes the risk of blood poisoning, hepatitis, and AIDS.   The operators in these places are neither licensed nor regulated by law.

Tongue piercing carries several other risks that are unique to this part of the body.  The tongue contains many major blood vessels, and many operators are not aware of the anatomy of this area.  Consequently, piercing of the tongue may cause severe and prolonged bleeding problems.  Metal allergies may result if the jewelry chosen is not of the highest quality.  If the jewelry loosens, it may be swallowed or cause a choking accident.  If you are unfortunate enough to have the piece of jewelry go into your lungs, you may need surgery to retrieve it.  If it goes into your stomach and is not eliminated, it may also need to be retrieved surgically.

If you happen to make it through the piercing without one of the many possible complications of infection, you still need to be concerned with the strong possibility that the jewelry may chip or break enamel, fillings, or crowns.  The simple act of talking or chewing may result in the fracture of a tooth.  This damage may cause the death of the pulp if the trauma is hard enough or continues for a long period of time.  This may then necessitate placement of a crown or even a root canal.  If you think you have a complication from tongue piercing, you need to inform not only the establishment that pierced you but also your physician and dentist, if indicated.  Are your beautiful smile and pretty teeth worth the price of a piece of tongue jewelry?  Past wearers of tongue jewelry have told us definitely not!