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.
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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.
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.
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.
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.
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.
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.
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.
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.
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.
Among the most common, irritating and difficult to diagnose problems with head and neck pain are temporal mandibular joint problems, more commonly known as TMJ problems. The joint is located near the ear where the top of the mandible or lower jaw meets the upper jaw at the base of the skull.
Like all other joints in the body, the TMJ is subject to inflammation and other chronic joint problems. Many of these issues may be caused by destructive bite habits like clenching or grinding. These actions cause pressure on the joint that can lead to inflammation and general breakdown of the joint itself. What makes TMJ problems difficult to diagnose and treat properly is the fact that the symptoms vary widely in both location and severity. Symptoms can range from a slight clicking in the jaw with no pain to severe head and neck pain which is not relieved by medication.
Once diagnosed properly treatments include everything from simple placement of a night guard, which prevents pressure on the joint to surgical intervention in more severe cases. A dental health professional is the person most able to diagnose this widely variable and very common issue.
Malocclusion means the teeth are not aligned properly.
Occlusion refers to the alignment of teeth and the way that the upper and lower teeth fit together (bite). Ideally, all upper teeth fit slightly over the lower teeth.The points of the molars fit the grooves of the opposite molar.
The upper teeth keep the cheeks and lips from being bitten and the lower teeth protect the tongue.
Malocclusion is most often hereditary, which means the condition is passed down through families. There may be a difference between the size of the upper and lower jaws or between the jaw and tooth size, resulting in overcrowding of teeth or in abnormal bite patterns.
Variations in size or structure of either jaw may affect its shape, as can birth defects such as cleft lip and palate. Other causes of malocclusion include:
- Childhood habits such as thumb sucking, tongue thrusting, pacifier use beyond age 3, and prolonged use of a bottle.
- Extra teeth, lost teeth, impacted teeth, or abnormally shaped teeth.
- Ill-fitting dental fillings, crowns, appliances, retainers, or braces.
- Misalignment of jaw fractures after a severe injury.
- Tumors of the mouth and jaw.
- There are different categories of malocclusion.
- Class 1 malocclusion is the most common. The bite is normal, but the upper teeth slightly overlap the lower teeth.
- Class 2 malocclusion, called retrognathism or overbite, occurs when the upper jaw and teeth severely overlap the bottom jaw and teeth.
- Class 3 malocclusion, called prognathism or underbite, occurs when the lower jaw protrudes or juts forward, causing the lower jaw and teeth to overlap the upper jaw and teeth.
Symptoms can include:
- Abnormal alignment of teeth
- Abnormal appearance of the face
- Difficulty or discomfort when biting or chewing
- Speech difficulties (that is rare) including lisp
- Mouth breathing (breathing through the mouth without closing the lips)
Most problems with teeth alignment are discovered by a dentist during a routine exam. The dentist may pull your cheek outward and ask you to bite down to check how well your back teeth come together. If there is any problem, the dentist will usually refer you to an orthodontist for diagnosis and treatment. Dental x-rays, head or skull x-rays or facial x-rays may be required. Plaster or plastic molds of the teeth are often needed.
Used by dentists for more than a century, dental amalgam is the most thoroughly researched and tested restorative material among all those in use. It is durable, easy to use, highly resistant to wear and relatively inexpensive in comparison to other materials. For those reasons, it remains a valued treatment option for dentists and their patients.
Dental amalgam is a stable alloy made by combining elemental mercury, silver, tin, copper and possibly other metallic elements. Although dental amalgam continues to be a safe, commonly used restorative material, some concern has been raised because of its mercury content. However, the mercury in amalgam combines with other metals to render it stable and safe for use in filling teeth.
While questions have arisen about the safety of dental amalgam relating to its mercury content, the major U.S. and international scientific and health bodies, including the National Institutes of Health, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material.
Because amalgam fillings can withstand very high chewing loads, they are particularly useful for restoring molars in the back of the mouth where chewing load is greatest. They are also useful in areas where a cavity preparation is difficult to keep dry during the filling replacement, such as in deep fillings below the gum line. Amalgam fillings, like other filling materials, are considered bio compatible—they are well tolerated by patients with only rare occurrences of allergic response.
Disadvantages of amalgam include possible short-term sensitivity to hot or cold after the filling is placed. The silver-colored filling is not as natural looking as one that is tooth-colored, especially when the restoration is near the front of the mouth, and shows when the patient laughs or speaks. And to prepare the tooth, the dentist may need to remove more tooth structure to accommodate an amalgam filling than for other types of fillings.
Composite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth-colored filling. They are sometimes referred to as composites or filled resins. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be “bonded” or held with adhesive in a cavity, often allowing the dentist to make a more conservative repair to the tooth.
The cost is moderate and depends on the size of the filling and the technique used by the dentist to place it in the prepared tooth. It generally takes longer to place a composite filling than what is required for an amalgam filling. Composite fillings require a cavity that can be kept clean and dry during filling, and they are subject to stain and discoloration over time.
Periodontal procedures are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the aesthetics of your gum line.
You may have asked your periodontist about procedures to improve a “gummy” smile because your teeth appear short. Your teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, your periodontist performs crown lengthening.
During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.
Your dentist or periodontist may also recommend crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.
What are the benefits of this procedure?
Whether you have crown lengthening to improve function or aesthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health — your keys to smiling, eating and speaking with comfort and confidence.
Dental Implants are a great advancement in dentistry as they permanently replace missing teeth in a way that no previous dental technique was able to accomplish. Implants are anchors made out of the strongest titanium materials, that are implanted into the bone and then covered with a cap or denture. They are stronger than a natural root and will never require a root canal or filling. An implant will help maintain the health and shape of the bone in the jaw area, and neighboring teeth do not need to be filed down to make room for it.
It is imperative that the dentist performing the implant be experienced and skilled in all the proper techniques of Implant dentistry. When done successfully, an implant will result in a comfortable and natural looking tooth, thereby providing a permanent solution to a missing tooth.
Periodontal procedures are available to stop further dental problems and gum recession, and/or to improve the aesthetics of your gum line.
Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you're not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.
Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment your periodontist can help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.
Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During this procedure, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.
A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve aesthetics of your smile. Whether you have a soft tissue graft to improve function or aesthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health — your keys to smiling, eating and speaking with comfort and confidence.
For decades, fluoride has been held in high regard by the dental community as an important mineral that is absorbed into and strengthens tooth enamel, thereby helping to prevent decay of tooth structures.
In nearly every U.S. community, public drinking supplies are supplemented with sodium fluoride because the practice is acknowledged as safe and effective in fighting cavities.
Some private wells may contain naturally fluoridated water.
Fluoride is a safe compound found throughout nature-from the water we drink and air we breathe, to many kinds of foods.
Fluoride is absorbed into structures, such as bones and teeth, making them stronger and more resistant to fractures and decay. A process in your body called “remineralization” uses fluoride to repair damage caused by decay.
Just drinking public water will provide a certain measure of fluoride protection. But for years, health professionals have endorsed the practice of supplementing our intake with certain dietary products, and topical fluorides in many toothpastes and some kinds of rinses. Certain beverages such as tea and soda may also contain fluoride. Certain kinds of dental varnishes and gels may also be applied directly to teeth to boost fluoride intake.
At each of your dental visits, until the age of 18, your dentist or hygienist will apply a fluoride treatment to your teeth. This concentrated fluoride should remain on your teeth for one minute and should not be rinsed away for at least a half an hour. This fluoride will strengthen the enamel and make your teeth more resistant to decay.
Dental sealants are thin plastic coatings that protect the chewing surfaces of children's back teeth from decay (cavities). Because they have small pits and grooves, these surfaces are rough and uneven. Food and germs can get stuck in the pits and grooves and stay there for a long time because toothbrush bristles cannot brush them away. Sealants fill in the grooves and keep the food out.
Children should get sealants on their permanent molars as soon as they come in and before decay attacks the teeth. Sealants, daily brushing and flossing, drinking fluoridated water, and regular dental check-ups are an important part of your child's oral health and the best defense against tooth decay.
Oral cancer includes cancers of the mouth and the pharynx (the back of the throat). Oral cancer accounts for roughly two percent of all cancers diagnosed annually in the United States. Approximately 35,000 people will be diagnosed with oral cancer each year and about 7,600 will die of the disease. On average, 60 percent of those with the disease will survive more than 5 years. Oral cancer most often occurs in people over the age of 40 and affects more than twice as many men as women.
Tobacco and alcohol use can put you at risk. Most cases of oral cancer are linked to cigarette smoking, heavy alcohol use, or the use of both tobacco and alcohol together. Using tobacco plus alcohol poses a much greater risk than using either substance alone. HPV Infection with the sexually transmitted human papillomavirus (specifically the HPV 16 type) has been linked to a subset of oral cancers. Risk also increases with age, oral cancer most often occurs in people over the age of 40. Cancer of the lip can be caused by sun exposure. A diet low in fruits and vegetables may play a role in oral cancer development.
See a dentist or physician if any of the following symptoms lasts for more than 2 weeks:
- A sore, irritation, lump or thick patch in your mouth, lip, or throat.
- A white or red patch in your mouth.
- A feeling that something is caught in your throat.
- Difficulty chewing or swallowing.
- Difficulty moving your jaw or tongue.
- Numbness in your tongue or other areas of your mouth.
- Swelling of your jaw that causes dentures to fit poorly or become uncomfortable.
- Pain in one ear without hearing loss.
It is important to find oral cancer as early as possible when it can be treated more successfully. An oral cancer examination can detect early signs of cancer. The exam is painless and takes only a few minutes. Your regular dental check-up is an excellent opportunity to have the exam. During the exam, your dentist or dental hygienist will check your face, neck, lips, and entire mouth for signs of cancer.
If you're diagnosed with periodontal disease, your periodontist may recommend periodontal surgery. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:
Pocket Depth Reduction. When supporting tissue and bone is destroyed, “pockets” form around the teeth.
Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth.
Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.