Your dental questions answered


Q: My teeth are sensitive when I drink something cold or sweet?

A: The most common cause of tooth sensitivity is the existence of a cavity or recession of the gum line, which may be associated with abrasion of the tooth in this area. If the sensitivity involves an area or side of your mouth this could be due to clenching and grinding.


Q:My tooth has been sensitive to temperature for a while and it now aches spontaneously and even woke me up last night?

A: When a cavity (decay) is not treated early on, the decay process extends to involve the nerve of the tooth. This becomes inflammed and in most situations will require rootcanal treatment. Do not place aspirin adjacent to the tooth, as it will cause severe tissue burn. Take pain medication orally and place an ice pack over the area until you get to a dentist.


Q:My jaw feels tight and sore when I wake up in the morning?

A: This is usually due to clenching and grinding your teeth at night. This may be associated with headache and neck stiffness. These are symptoms of what is known as TMJ dysfunction. Treatment may include wearing a nightguard or in some instances adjusting the way your teeth meet. This clenching can also cause generalized non-specific tooth sensitivity.


Q: I knocked out a tooth, what do I do?

A: If your child has knocked a tooth out, rinse the tooth under water (do not use any cleaning agents) to remove any debris and place it back into the tooth socket. Time is critical for success especially the first 20 minutes. If you are not able to replant the tooth place it in a glass of milk and get to the dentist immediately.


Q: My gums bleed sometimes?

A: When gums bleed this means that you have gingivitis (gum inflammation). This is usually associated with the presence of plaque and calculus (tartar) which maybe aggravated by existing dental work. In most instances a professional dental cleaning followed up by effective homecare and flossing will resolve it. If it were associated with defective dentistry, this would need to be replaced. In some instances this gingivitis maybe a warning sign of gum disease. If you are pregnant, hormonal changes make the gums very sensitive to irritation causing swelling and bleeding. Diligent hygiene with regular professional cleanings will help reduce the inflammation.


Q: I chipped a front tooth?

A: If you have the broken fragment the dentist may be able to reattach the broken segment with bonding techniques. Other treatment options include composite bonding and sometimes a veneer or crown (cap) if most of the tooth is missing.


Q: My cap is loose or has fallen off, what do I do?

A: Do not attempt to glue it back. When a cap (crown) becomes loose, it may indicate an underlying problem such as secondary decay (cavity) under the crown.


Q: My teeth are not temperature sensitive but when I bite down on something I get a sharp shock-like pain?

A: This is usually indicative of a crack within the tooth. It is important to see a dentist as untreated the tooth will eventually fracture and if the fracture is too extensive the tooth may require extraction.

Q: What should I look for when choosing a dentist?

A: During your first visit, you should be able to determine if this is the right dentist for you. Consider the following:

* Is the appointment schedule convenient for you?
* Is the office staff friendly and courteous?
* Is the office close to your home or job?
* Does the office appear to be clean, neat and sterile?
* Was a thorough medical and dental history taken and reviewed with you?
* Does the dentist explain your treatment options and listens and responds to your concerns?
Your dentist should be a partner in maintaining your dental health.
* Are emergency after hours visits available and if the dentist is not available are arrangements made to be referred to a dental colleague?
* Are insurance benefits, fees and payment plans reviewed before treatment is scheduled?


Q: What happens if I miss a dental appointment?

A: Ask your dentist about his or her appointment policy. Many dentists ask that you call to cancel at least 24 hours in advance. This will allow time to find someone else for your appointment. Those who don't call to cancel may be charged a missed appointment fee. If you feel ill, but well enough to keep your dental appointment, keep it unless you've got a fever, strep throat, difficulty breathing or are too uncomfortable to sit in the chair. Some dentists also request patients to cancel if they have an active herpes virus (cold sore) around the mouth. If in doubt, ask your dentist if the visit should be rescheduled.


Q: What is the best way for me to prevent cavities in myself and in my children?

A: There are some very simple steps that you can take in the prevention of cavities that can save you much pain and money in the long run. Here are a few of the major ones.

* Brush twice a day with a fluoride toothpaste.
* Floss daily after brushing.
* Eat nutritious and balanced meals and limit snacking. Limit the amount of sugars you and your children eat.
* Check with your dentist about use of supplemental fluoride, which strengthens your teeth, and about use of preventive resin restorations (stronger than sealants) applied to the chewing surfaces of the back teeth to protect them from decay.
* It is important to visit your dentist regularly for professional cleanings and oral examinations.


Q:How often should I change my toothbrush?

A: Most dental professionals recommend that toothbrushes be replaced at least every two-three months. Toothbrushes should also be replaced after you or your family members have had any upper respiratory tract infections such as a cold or the flu. It is also recommended to rinse your toothbrush with an antiseptic before use and keep it covered when not in use.


Q: Do I really need to floss my teeth?

A: Yes, as brushing alone reaches only 3 out of 5 tooth surfaces. These surfaces between the tooth that brushing can't reach are areas where cavities and periodontal disease(gum disease) most frequently get started. Daily flossing is essential for healthy teeth and gums.


Q: Are amalgam (silver) fillings safe?

A: The majority of the dental community feel that amalgam fillings are safe and that the risk associated with the mercury contained in these restorations is minimal. There are trace amounts of mercury, which are bound to other elements of the filling. You probably ingest more mercury from the fish you eat! If you have any concerns about amalgam fillings your dental professional will be happy to discuss alternative restorative options.


Q: Are routine dental x-rays safe & necessary?

A: Radiation in the amounts used to expose dental X-rays, is very small. In fact, the average American actually receives more radiation from sitting in front of the family television for a period of one year than from routine X-rays taken at the dental office. Dental x-rays are taken to diagnose problems that may be occurring in your teeth and supporting bone that are not visible to the naked eye. If the condition is allowed to develop until it is detectable by a visual exam the problem will have progressed significantly and require more extensive treatment than if it was caught in the early stages. Nevertheless, the radiation we receive from all sources is cumulative over our lifetime, so we need to be aware of exposures. Discuss with your dental professional the need and frequency for x-rays and have your original x-rays forwarded if you change dental care providers.


Q: What about teeth bleaching /whitening?

A: Today there are many options for teeth bleaching or whitening. There are over-the-counter whitening toothpastes and whitening products as well as professional whitening systems. These dentist-administered systems can be done in-office by the dentist (power bleaching) or at home using professional products. Whitening toothpastes DO NOT work. The drugstore whitening products have bulky uncomfortable moulds and do not retain the bleach properly causing some bleach to be swallowed. The professional bleach trays made by a dentist are customized from a mould of your teeth, so it fits only your mouth. It comfortably holds the bleaching agent closely against your teeth for maximum results. The most effective results are obtained by having the power bleaching followed by the home system Results differ depending on the type of staining and genetic color of your teeth. Stains that are the result of smoking, colored foods/drinks such as coffee, tea and or age may respond well to bleaching. Staining from antibiotic (tetracycline) use or excess fluoride intake during childhood is less likely to respond to these treatments. Before trying any whitening procedure, discuss your condition with your dentist and together you can decide which treatment will achieve the best results.


Q: Do I need a "cleaning" appointment every six months?

A: All patients are individuals, and have varied needs. The interval of six months for "cleaning & check-up" is a commonly recommended time frame, which may or may not be appropriate for you. If you have concerns about the frequency of your "recall" appointments you should discuss them with your dental professional. Together you can reach a "recall" schedule that is appropriate for your oral condition and that fits your busy schedule.


Q: Are fluoride treatments effective for adults?

A: Yes. Topical application of fluoride increases the level of fluoride in the outermost surface of the tooth, regardless of the age of the tooth. While we tend to think of children as being more prone to cavities, adults still get decay. People are maintaining their natural teeth longer and root decay is a condition that is more likely to occur as we age. The key is multiple applications of fluoride with fluoridated toothpaste, possibly a home fluoride gel, and in-office treatments. Your dental professional will be able to prescribe the best home care and in office treatment options for your dental condition.


Q: When should children have their first dental appointment?

A: Certainly parents should not wait until their children have cavities or a toothache to see the dentist. The first few appointments should be fun and foster a trusting relationship. We have found that there are far fewer difficulties with children who know that the dentist is there to help them - before they need dental work. The goal is to have your child`s first dental experience be a positive one. Generally speaking, when a child has all of their primary teeth in place is a good time to have their first oral exam. The first cleaning and check-up appointment can follow a few months later, depending on the child`s maturity and his readiness to accept the treatment.


Q: What exactly is Gingivitis, and what causes it?

A: Gingivitis is a form of Periodontal Disease (gum disease). Periodontal disease involves inflammation and/or infection that results in destruction of the tissues that support the teeth. This supporting unit comprises the gingiva (gums), the periodontal ligaments (hold the tooth in place), and the tooth sockets (bone).

Gingivitis (inflammation of the gums) is caused by the long-term effects of plaque deposits. Plaque is the sticky material that develops on the exposed portions of the teeth, consisting of material such as bacteria, mucus, and food debris. It is a major cause of dental decay. Unremoved plaque mineralizes into a hard deposit called calculus (tartar) that becomes trapped at the base of the tooth. Plaque and calculus cause mechanical and chemical irritation and inflammation of the gingiva. Bacteria and the toxins produced by the bacteria, cause the gums to become infected, swollen and tender.


Q: What is the best prevention for Gingivitis?

A: Good oral hygiene is the best prevention against gingivitis because it removes the plaque that causes the disorder. The teeth should be brushed at least twice daily and flossed gently at least once per day. For people who are prone to gingivitis, brushing and flossing may be recommended after every meal and at bedtime. Consult the dentist or dental hygienist for instructions on proper brushing and flossing techniques.


Q: How is Gingivitis treated?

A: The goal of treatment is reduction of gingival inflammation. The teeth are cleaned thoroughly by the dentist or dental hygienist. This may involve the use of various instruments or devices to loosen and remove deposits from the teeth. Meticulous oral hygiene is necessary after professional tooth cleaning. The dentist or hygienist will demonstrate brushing and flossing techniques.

Professional teeth cleaning in addition to brushing and flossing may be recommended twice per year or more frequently for severe cases. Antibacterial mouth rinses or other aids may be recommended in addition to frequent brushing and flossing. Repair or replacement of dental work or orthodontic treatment of misaligned teeth may be recommended.


Q: How are Periodontal Disease and Gingivitis related?

A: Periodontal Disease is a dental disorder that results from progression of gingivitis, involving inflammation and infection of the ligaments and bones that support the teeth. This gradually causes the destruction of tooth support and if left untreated will lead to tooth loss.


Q: What should I know about dental treatment during pregnancy?

A: You should advise your physician that you are continuing routine dental care during your pregnancy (regular cleanings). There are a numbers of reasons why dental care is vital during your pregnancy. Tooth development in the embryo begins as early as the fifth or sixth week of intrauterine life often before your pregnancy has been confirmed. Hormonal changes during pregnancy make the gum tissue very sensitive to plaque and irritation commonly causing gingivitis. In addition, your eating habits may change, causing changes in your oral health. Normally it's best to schedule necessary visits during the second trimester of your pregnancy. Morning sickness commonly occurs in the first trimester, and during the last trimester it may be less comfortable for you to sit in one position for any length of time. If you should have a dental "emergency" (such as unexplained pain or facial swelling) during your pregnancy you should contact your dentist immediately. Also remember to inform your dentist about your pregnancy before taking any medications.


Q: What is the normal Eruption sequence of baby teeth?

A: At about 5-8 months, the first 2 baby central incisors erupt on the bottom.

* From 8-10 months, four upper incisors come in.
* At 10-16 months, the first baby molars and the lower lateral incisors and the first baby molars come in.
* At 16-22 months the cuspids ("fangs" or "canines") erupt.
* Finally, when the child is 2-31/2 years old, all 20 baby teeth have usually
* arrived.

(These times are approximate.)


Q: When is it appropriate to pull a baby's teeth?

A: The baby teeth perform 2 functions that help the proper eruption of the permanent teeth. First, the baby tooth hold the spaces available for the permanent tooth by preventing the movement of the adjacent teeth into the space. Second, the roots of the baby teeth help to guide the permanent teeth into place if all goes as planned. Sometimes when the baby teeth are pulled early, the gums heal over the site and the adult tooth has a difficult time breaking through the healed gum tissue. There are three times when it is appropriate to pull a child's teeth.

If they are in the way of other permanent teeth trying to erupt in the wrong place.

If they are interfering with the child's eating (usually because of infection), or If the baby tooth is fused to the bone and inhibiting the permanent tooth eruption.


Q: What are dental Sealants?

A: Cavities most commonly start on the biting surfaces of the back teeth (molars and premolars) due to the existence of developmental grooves. These cavity prone grooves are sometimes too narrow for your toothbrush bristle to reach and clean. A Dental sealant is a tooth colored material that is applied to cover these deeper susceptible grooves to "seal-out" the harmful bacteria and therefore reduce the chance of decay. Sealants are most beneficial at an early age, when the teeth are most susceptible to decay. As decay may start in the deeper section of the groove and go undetected, it is important for the dentist to make sure that there is no hidden decay before placing the sealant. As this may seal the decay under the sealant- dentist.net recommends that the dentist flare the groove first to ensure there is no underlying decay. As sealants are weaker and susceptible to chipping we recommend the use of Preventive Resin Restorations instead. Ask your dentist if sealants are an option for your child. It is recommended that sealants be applied to a child's primary (baby) molars by the age of three or four years. Once the six-year molars (the first permanent back teeth) appear, it is best to apply preventive resin restoration if needed. As a child's most cavity prone years continue until the mid-teens, the premolars should also be sealed as they appear.


Q: Can children get too much fluoride?

A: Yes. If excess fluoride is ingested it can result in a condition known as fluorosis. Fluorosis can cause varying degrees of staining and irregular enamel formation in your child’s permanent teeth. Most municipal water supplies are fluoridated at safe levels (1.0 ppm). If your water source is an independent well, or if you drink only bottled water, you will have to investigate the level of fluoride that the water contains. Another potential source of excess fluoride is fluoridated toothpaste. Children should use a "pea" size dab of fluoridated toothpaste and expectorate as much as possible. Parents should always supervise young brushers.


Q: When is it the right time to seek the services of an orthodontist?

A: Often it will be obvious early that the permanent teeth are not coming in properly. This is usually due to some level of overcrowding. However this does not always mean that braces or removable retainers should be put in at once. In conjunction with the braces specialist [orthodontist] the decision must be made as to whether the adult teeth should be allowed to come in before the braces are placed, or whether the orthodontist should intervene immediately, and possibly place appliances twice - once early, and again after the permanent teeth erupt. One of the main factors to consider in early intervention is whether the child has to move the jaw to the left, right, or forward to make the teeth fit together. This can lead to jaw growth problems and should be treated right away. I otherwise wait for the permanent teeth to come in to put braces on. Of course there are many other factors to weigh and an orthodontist should always be consulted.


Q: Why should I have orthodontics now?

A: There are a number of reasons for deciding to have orthodontic treatment as an adult. Orthodontics can help you enjoy a straighter smile, more even teeth and greater self-confidence in social and business settings. Other benefits include easier brushing and reduced chances of developing periodontal (gum) disease later on.


Q: Why do I need root canal treatment?

A: When a tooth dies on the inside where the nerve is, it becomes an area that is ripe for infection. If left alone, the tooth will become infected and pressure will build up causing a toothache. It is very difficult to treat the inside of a tooth like a regular infection, because blood carrying antibiotics cannot reach inside the tooth to help kill the bacteria. So the dentist opens into the center of the tooth, removes the bacteria and debris (removing the infection), and fills the center with a rubbery substance to seal the dead space.


Q: Does a root canal hurt?

A: Once anesthetized (numbed) or if the nerve is non-vital (dead) the procedure is usually painless and comfortable. But sometimes, if the tooth is a "hot one" (acute abscess) it can be painful when the dentist "drops in" to the tooth chamber. At this stage the anesthetic [like novocaine] can be placed directly in the chamber and the rest of the procedure will be comfortable.


Q: What are dental implants?

A: Dental Implants are made of titanium which is biocompatible. These are surgically placed into the jawbone to anchor permanent replacement teeth. Replacement teeth are then attached to that part of the implant that projects from the gums. Approved and tested dental implant systems are very successful. In fact, some have lasted more that 20 years with a better than 90 percent success rate. Patients who have good oral hygiene habits and regular dental checkups can enjoy implants that last a lifetime.


Q: Why do I need dental implants?

A: Fifty million teeth will be removed this year as a result of infection, gum disease or trauma (accident and injury). When teeth have been removed, several problems occur. The remaining teeth shift, rotate and become crooked, causing a bad bite and making it difficult to chew food properly. Unsightly spaces or large gaps between your teeth may cause embarrassment.

You need to ask yourself these questions:

* Do I feel comfortable when I smile, speak or eat?
* Do my dentures slip or cause sore spots when I chew?
* Do I hide my smile because of unsightly spaces between my teeth or missing teeth?
* Are my teeth loose and need to be stabilized following treatment for advanced gum disease?
* Do I regularly need my dentures relined because of bone resorption?


Q: What are some of the symptoms of TMJ (TMD)?

A: There are many signs and symptoms of TMD syndrome, not all necessarily present in all cases. Here are some of the most common:

* Tenderness of the jaw muscles with limitation in opening
* Pain in or around the ear that often spreads to the face
* Pain or difficulty in chewing, yawning or opening wide
* Headaches, particularly present upon awakening
* Jaws that get stuck or lock
* Earache or pain when no infection is present
* Dizziness
* Clicking or popping or grating sounds when opening or closing the mouth


Q: How is TMJ treated?

A: Dentist.net believes that a conservative treatment approach is best. Because every patient is different, treatment also varies from patient to patient. Treatment may include but not limited to:

* Firstly, eliminate the muscle spasms and pain
* In some situations, correct the way in which the teeth fit together
* Stress relieving conditioning is recommended.


Q: What is an impacted wisdom tooth and what can I do about them?

A: When you approach 17 years of age, your last set of teeth are due to erupt. These teeth are called third molars or wisdom teeth. Often since the jaw is already formed when they erupt, there is not enough room for the wisdom teeth and they become wedged between the back of your lower jawbone and the tooth in front of them. This is called an impaction.

Impactions usually are brought to your attention when they begin hurting because of infection of the surrounding gum and then need to be extracted as an emergency. Most specialists (oral surgeons) recommend that even impacted wisdom teeth that are not causing you problems should be removed when you are young because of potential problems when you are older (the bone is more resistant and the teeth are harder to extract). In cases where braces are put on, most dentists/orthodontists want wisdom teeth extracted so that they don't erupt and ruin the straightened teeth.


Q: What is a crown and/or bridge?

A: Crown and Bridge treatment is a permanent method of replacing missing teeth. A crown is placed on an individual tooth, (somewhat like a thimble over your finger) where there is no longer sufficient tooth structure left to place a filling. A bridge spans a space where one or more teeth have been lost in the dental Arch. The teeth on either end of the span are crowned, and are referred to as Abutments. The false teeth in a bridge that join the abutments are referred to as pontics. Crowns and bridges are most often made from a combination of precious metals(gold), platinum palladium and porcelain, or space age reinforced resins and porcelain with no metal. Both esthetics (appearance) and function are considered when selecting the material most suitable for you.

 

Relaxation Tips

Ten Tips to help ease your dental anxiety (compliments of the ADA)

Regular dental visits are essential for maintaining good oral health. Yet, an estimated 35 million adults experience sufficient anxiety at the thought of an upcoming dental visit that they needlessly worry about, postpone, or avoid seeing their dentist.

If, like most people, you experience some degree of anxiety when it comes time to see your dentist, the following suggestions can help you to relax before and during dental treatment. What's important is to recognize your anxiety, accept it as a common reaction to an uncertain situation, and learn to master it. These recommendations will help you to accept dental visits comfortably and, in turn, boost both your confidence and oral health.

 

One

Start by sharing your feelings with your us.. Let us know that you are fearful, tense, or anxious so that we can tailor their treatment and their pace to your needs. Often, a pain reliever can be given if it's pain you fear. By bringing your fears out into the open, you will gain control of them, relax, and receive more effective, pain-free treatment.

Two

Set aside a stress-free time for your visit with us - a time when you won't be rushed, physically strained, or troubled by other concerns. You may find an early morning appointment less stressful than rushing to see the dentist directly from work.

Three

Keep in mind that when you see your dentist on a regular basis, many dental visits rarely involve more than a professional cleaning, examination, and consultation. You can therefore use this opportunity to get acquainted with the dental staff. Being friendly and sociable helps establish trust and warmth, both of which can do wonders in allaying your fears and in reducing tension. You might also have a close friend or family member (one who has a positive attitude toward dental care) accompany you to your appointment if it makes you feel more at ease.

Four

Try to identify your specific fears and concerns. Some people feel anxiety because they had or heard about a negative dental experience during childhood. Others fear the sound of the drill, the possibility of pain, or their feeling a lack of control during any given procedure. While these fears are very understandable, it is important to recognize that they often are not realistic given the modern, pain-free techniques now used in dentistry. Discuss your feelings with a supportive friend or family member. Pinpointing the cause of your anxiety will help you understand and control it better.

Five

Get a good night's sleep the day before and eat a light breakfast the day of your appointment. To allow unconstrained movement, wear loose, comfortable clothes. Especially avoid wearing constricting necklines, such as tight collars.

Six

Schedule short dental appointments by having different procedures performed on different days, if possible. Also arrange to break from lengthy procedures now and then. (This may not always be possible, however, depending on the procedure.) If you are feeling any discomfort during treatment, you can motion the dentist to stop through a prearranged signal--by raising your hand, blinking sharply, or nodding, for example.

Seven

Use visualization to feel more comfortable and relaxed both before and during a dental visit. For instance, before your visit you might imagine yourself sitting calmly and confidently in the dental chair while the dentist examines your mouth and soothingly talks to you. You can also focus on a relaxing scene from a favorite vacation spot or activity and hold it before your "mind's eye" during treatment.

Eight

During the dental visit, practice distraction and relaxation techniques to take your mind off of treatment and to reduce tension. You might focus, for instance, on such pleasant distractions as soft music or a colorful poster. Or you can practice deep, slow, rhythmic breathing, counting each breath as you go along. Another common relaxation technique involves systematically tightening and then relaxing the major muscle groups in your legs, hands, arms, shoulders and neck.

Nine

Ask the dentist or hygienist to explain each step of the dental examination or procedure. The more you know about the reasons for a certain procedure and what will be done during it, the more confident and relaxed you'll be. Also, knowledge helps you to gain control over an unfamiliar situation and enables you to choose comfortably between the treatment options your dentist might recommend.

Ten

Once the dental visit is over, praise yourself for a job well done! You might also treat yourself to a special reward for overcoming your dental anxiety.
And remember, the dentist-patient relationship is just that--a relationship mutually involving you and your dentist. Overcome the habit of thinking of yourself as the passive recipient of treatment. Your dentist will welcome your taking an active role in your dental care. You'll be glad you did, too, and you'll come away smiling.