FAQ’s

Q: How often should I brush and floss?

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 produce acid from certain food particles that then 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 using a small, circular motion, ensuring that you 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.

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?

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): These are essential for detection of decay.  X-rays also help determine tooth and root positions, as well as the health of the bone.

Oral cancer screening: Check the oral tissues for 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.

Examination of existing restorations: Check current fillings, crowns, etc.

Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line, and can only be removed with 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 (gum 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. We can help you make informed, healthy choices.

As you can see, a good dental exam and cleaning involves 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 often should I have a dental exam and cleaning?

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): These are essential for detection of decay.  X-rays also help determine tooth and root positions, as well as the health of the bone.

Oral cancer screening: Check the oral tissues for 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.

Examination of existing restorations: Check current fillings, crowns, etc.

Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line, and can only be removed with 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 (gum 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. We can help you make informed, healthy choices.

As you can see, a good dental exam and cleaning involves 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)?

Many 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 will ensure that plaque is not left behind.

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 or crowns 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, and oral contraceptives are examples of medications that may have side affects that reduce saliva, making the mouth dry.  Dry mouth can contribute to many oral health problems.

Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacterial toxins.

Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.

Genetics – 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 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: What can I do about stained or discolored teeth?

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).

Most teeth become darker during the natural aging process. Smoking, drinking coffee, tea, and wine may also contribute to tooth discolorationl.

It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching.  Some 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, touch-ups may be required periodically.

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 mouth tray, created from a mold of your teeth.  The trays are worn for varying amounts of time depending on the strength of the gel.  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 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 or weeks.

Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile.

Q: What are my options if I have missing teeth?

With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth.  When something does go wrong with a tooth, we do everything possible to restore the tooth to its original function.  Removing a tooth is the last option.

When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy (or shrink), and may cause the teeth on either side to shift or tip into the open space of the lost tooth. The tooth above or below the open space may also start to move towards the open space because there is no opposing tooth to bite on.  These movements may create problems such as decay, gum disease and excessive wear on certain teeth. These problems and movements do not result immediately, but may eventually appear.

Options for replacement of missing teeth:

Removable partials - This is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable partials are usually the most economical option for replacing missing teeth, and they are appropriate for many patients in order to restore function and to create a more beautiful smile.

Fixed bridges - This type of restoration is generally made of porcelain or metal and is anchored (cemented) permanently to natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable).

Dentures - This type of tooth replacement is used when all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.

Implants - Implants are a wonderful way to replace one or more missing teeth. They may also be highly effective at improving the fit and retention of dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are an aesthetically pleasing tooth replacement option.

If you are missing teeth and would like more information about replacement, ask us what options are available to you. We will decide together what will work best in your particular case.

Q: When are sealants recommended?

Although thorough brushing and flossing remove most food particles and bacteria from easy to reach tooth surfaces, they do not reach the deep grooves on chewing surfaces of teeth. More than 75 percent of dental decay begins in these deep grooves (called pits and fissures). Toothbrush bristles are too large to clean most of these areas. This is where sealants play an important role.

A sealant is a thin coating that covers and protects the chewing surfaces of molars, premolars, and any deep grooves or pits on teeth. Sealant material forms a protective, smooth barrier covering natural depressions and grooves in the teeth, making them much easier to clean.

Who may need sealants?

Children and teenagers - As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-18.

Infants - Baby teeth are occasionally sealed if the teeth have deep grooves and the child is cavity prone.

Adults - Tooth surfaces without decay that have deep grooves or depressions that are difficult to clean.

Sealants are easily applied by your dentist or dental hygienist and the process only takes minutes per tooth. After the chewing surfaces are prepared with a solution that helps the sealant adhere to the tooth, the sealant material is “painted” onto the tooth surface. The sealant material hardens and bonds to the teeth. Sometimes a light will be used to help the sealant material harden.

After sealant treatment, it’s important to avoid chewing on ice cubes, hard candy, popcorn kernels, or any hard or sticky foods. Your sealants will be checked for wear and chipping at your regular dental check-ups.

Combined with good home care, a proper diet, and regular dental check-ups, sealants are very effective in helping prevent tooth decay.

Q: What should I do if a tooth is knocked out?

More than 5 million teeth are knocked out every year!  If we know how to handle this emergency situation, we may be able to save the tooth.

Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.

DO NOT scrub or use soap or chemicals to clean the tooth.  If it has dirt or debris on it, rinse it gently with your own saliva or milk.  If that is not possible, rinse it very gently with water.

Get to a dentist within 30 minutes.  The longer you wait, the less chance there is for successful reimplantation.

Ways to transport the tooth

Try to replace the tooth back in its socket immediately.  Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place.  Apply a cold compress to the mouth for pain and swelling as needed.

If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or milk.  You can also place the tooth under your tongue or between your lower lip and gums.  Keep the tooth moist at all times.  Do not transport the tooth in a tissue or cloth.

Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit.  The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive.  So be prepared, and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

Wearing a mouthguard when playing sports

Always wearing your seatbelt

Avoiding fights

Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.

Q: Why straighten teeth?

Straighter teeth perform chewing, biting and speaking functions more effectively than crooked teeth.  In addition, a straight smile boosts confidence, is aesthetically pleasing to look at, and can help avoid some dental problems.

There are several types of malocclusion including overbite, underbite, crossbite, and overcrowding.  Each of these alignment problems may negatively impact the function and appearance of the teeth.

Here is a brief overview of some of the main disorders associated with crooked teeth:

Periodontitis – Periodontitis or gum disease begins with a bacterial infection.  The bacterial infection is often caused by inadequate oral hygiene.  Crooked teeth are harder to clean. Straight teeth are easier to clean and are at less risk of contracting gum disease.

Temporomandibular Disorder (TMD) - Severe crooked teeth can lead to improper jaw alignment.  Severe headaches, jaw pain, lockjaw and grinding characterize TMD.

Tooth injury – Straight teeth create a strong wall, which means injuries are less likely to occur.  Protruding teeth are more vulnerable to injury.

Uneven wear – Crooked teeth cause some of the teeth to work harder than others when biting and chewing.  Straight teeth share the workload evenly, meaning less risk of injury and less overall risk for wear.

Teeth can be straightened using either orthodontic braces or customized aligning trays.  Orthodontic braces are usually affixed to the teeth for a set duration.  The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete.  Fixed braces are effective for most types of malocclusion.

Aligning trays are fully removable and are used where the malocclusion is less severe, and the teeth need to move a shorter distance.  These trays are replaced every few weeks for the duration of the treatment, and have proven to be effective for straightening teeth.

If you have questions about orthodontics and straightening teeth, please ask for a referral to an orthodontist.