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FAQs

COSMETIC  CARE

Unfortunately, dental bondings, composite resin fillings (tooth-colored ones), and old crowns cannot be bleached. Fillings that have discolored indicate either leaking or have secondary decay, so it is best to replace them. A better choice may be to replace them with porcelain laminate/veneers for longer-lasting results. Remember; only replace these fillings after bleaching to match your teeth' new, improved color. "How long does bleaching or laser teeth whitening last?" It depends on your diet, the original color of your teeth, and your habits like smoking, drinking red wine, etc. Also, darker teeth will need more than one whitening session to achieve the desired result. What's most important is what you do for maintenance. Professional office visits are not enough. It would be best to incorporate an effective maintenance regimen at home, such as whitening toothpaste designed explicitly to non-abrasively remove surface stains like coffee, tea, tobacco, and red wine and remove plaque and bacteria. Also, use the touch-up kit your dentist gave to keep bleached teeth at their whitest.
First of all, the cause of the dark tooth must be determined. It could be due to an earlier trauma to the tooth or previous root canal treatment. In such a case, external teeth whitening treatments may not help. Your dentist may try internal bleaching, which may take several sessions. If not, consider dental bonding, porcelain veneers, or capping the tooth to mask the darkness.
Teeth may be sensitive during the week following the in-office bleaching. This can be dramatically reduced by using Sensodyne toothpaste to brush your teeth the week before and the week following the bleaching process. Also, your dentist may recommend fluoride treatment following the bleaching process.
Dental bonding is a plastic tooth-colored (composite) resin material molded onto your teeth and hardened with a blue light. It is usually done in one visit. The disadvantages of dental bonding are:

  • They stain over time, may chip, and need to be replaced more often.
  • Porcelain veneers are thin layers of stacked porcelain fabricated in the lab and bonded to teeth.
  • It usually takes two visits. Slight tooth reduction and some anesthesia are required.
  • Porcelain veneers are stronger than dental bondings and less prone to staining.
There are several ways to correct it. Your Dentist may advise Dental Bondings, Veneers, or Orthodontics. Again, seek the advice of your dental health professional to choose the procedure that’s best for you.
In the past, Silver or amalgam fillings were extensively used. They are not tooth colored, stain teeth over time, and healthier tooth structures may have to be removed to retain them since they do not bond to your teeth. Also, since they are an alloy of silver with mercury, there is a risk of mercury poisoning. Depending on the extent of decay and amount of tooth structure lost, your dentist may advise composite (tooth-colored fillings) or porcelain inlays or onlays. Since tooth-colored fillings bond to your teeth, there is no need to remove healthy tooth structures.
With the advent of laser dentistry, this can be done very quickly and painlessly. Tissue sculpting (gingivectomy) is adjunct to any required cosmetic work to achieve a beautiful, healthy smile.

RESTORATIVE  CARE

Tooth decay is the disease known as caries or cavities — a highly Preventable disease caused by many factors.
The answer is… everyone who has a mouth. We all host bacteria in our mouths, making everyone a potential target for cavities. Risk factors that put a person at a higher risk for tooth decay include:
  • Persons with diets high in sweets, carbohydrates, and sugars
  • Persons who live in communities with limited or no fluoridated water supplies
  • Children and senior citizens
Losing a tooth can be the beginning of many more lost teeth. Saving the Tooth maintains space, keeps other teeth from shifting, and eliminates the need and cost of a bridge or implant. Although seemingly expensive, it is pretty cost-effective.
Dental Implants are made of titanium and placed directly into your jawbone surgically. Once they integrate with your bone, a crown, bridge, or denture is placed over the implants.

GUM CARE (PERIODONTALCARE)

Plaque is a colorless, sticky film of bacteria that constantly forms on teeth. If left undisturbed, it hardens to form tartar. The bacteria in the plaque produce byproducts that can irritate the gums and make them bleed, but it can also lead to periodontal disease. A daily regimen of proper brushing, flossing, and rinsing (plus regular dental visits), will help you keep your teeth healthy.
Healthy tissue doesn’t bleed. This is most likely a sign of early gingivitis. If you experience bleeding gums, see your dental health professional review proper brushing and flossing techniques. Schedule a soft tissue evaluation with your dentist, including x-rays and prophylaxis cleaning. Gum bleeding must be taken seriously because it will lead to periodontal disease if left untreated.
People accumulate plaque at different rates. Although most insurance plan coverage is for a twice a year schedule, it’s sensible to get your teeth professionally cleaned as often as your dental health professional advises you, even if it’s every three months.
At least once a day. There’s an adage among dentists: “Floss only the teeth you want to keep.” If you don’t want to lose your teeth, floss every day. Otherwise, you’ll be 75% more susceptible to periodontal disease that has been documented to have serious health consequences, e.g., a higher likelihood of heart disease, diabetes, pneumonia, and infections. About 45% of American adults have some form of gingivitis, and most adults over 60 have already lost their teeth. Don’t be one of them. Floss at least once a day.
Bad breath occurs when sulfur compounds are produced in the body and released into the air. The most common source of this sulfur is anaerobic (without oxygen) bacteria that live in the grooves or fibers at the back of the tongue. These bacteria produce sulfur that gives off an unpleasant smell. This frequently occurs when the mouth is dry, creating an ideal environment for anaerobic bacteria to thrive. Sulfur compounds are also produced when certain types of food are consumed. The compounds make their way into the bloodstream and then to the lungs, where they are excreted into the air we exhale.
Many factors cause bad breath. Usually, saliva helps wash away the natural buildup of bacteria in the mouth and on the tongue. When saliva sits on the back of the tongue, bacteria digest it, and it shows up as a white film on the tongue. This is a major source of bad breath. Postnasal drip also causes bad breath, a condition where the back of the tongue and throat accumulate high amounts of protein, and bacteria thrive on it. Foods high in protein or acidity, such as fish, milk, cheese, or coffee, also cause bad breath. Dieting or fasting, both of which involve a low intake of calories, causes bad breath by reducing the saliva in the mouth. Contrary to popular belief, stomach problems do not cause bad breath.
Periodontal disease is detected by bleeding gums, loose teeth, receding gums, or pain when chewing. More persistent problems with unpleasant breath can indicate diabetes, liver dysfunction, pulmonary disease, and respiratory disease. Periodontal pockets, the spaces that form between the teeth and gums, are another source of bad breath. These pockets, which occur in the latter stage of periodontal disease, create spaces for bacteria to grow and give off a chronic unpleasant odor. It may require dental work to remove these pockets of bacteria. Please refer to the Periodontal Disease section of our Patient Education Library for more information on this condition.
Proper oral hygiene eliminates many cases of bad breath. Daily brushing and flossing remove the plaque and bacteria that often cause bad breath. While brushing, take special care to thoroughly brush the back of the tongue where bacteria usually collect. Mints and mouthwashes can hide bad breath but do not eliminate this condition. Avoid foods with powerful odors and drink lots of water to ensure that the mouth is cleansed and full of oxygen (an environment where bacteria do not thrive). For information on current treatments, contact a dentist in your area regarding current products on the market that can eliminate bad breath.

ORTHODONTICS/ BRACES

Orthodontics is a dental specialty that focuses on developing, preventing, and correcting irregularities of the teeth, bite, and jaws. A patient may consult an orthodontist after receiving a referral from their general dentist — recommending orthodontic treatment to improve the patient’s physical “orofacial” appearance. However, the American Dental Association recommends that every child receive an orthodontic evaluation by seven.
Malocclusion or “bad bite” may be classified as an orthodontic problem. The following issues may be helped or minimized with proper orthodontic treatment: misaligned, crooked, or crowed teeth, missing teeth, extra teeth, an overbite, an open bite, and misaligned or incorrect jaw position.
Moving and correcting the alignment of the teeth follows the same biological and physical process, no matter what age. However, an adult mouth must overcome already positioned facial bones and jaw structure. Thus, overcoming most malocclusions may require more than one type of orthodontic treatment for adults. In most cases, the ideal age for braces, and other orthodontic treatments, are between 10 and 14 years of age, although persons of any age can benefit from treatment.
Braces also called fixed orthodontic appliances, generally come in three varieties:

  1. Brackets, metal or plastic, clear or tooth-colored bonded to teeth.
  2. Lingual-type brackets that attach to the back of teeth are hidden from view.
  3. Bands that cover most teeth with metal bands wrap around the teeth.
All three types use wires to move the teeth to the desired position.
Invisalign is a proven technology designed to give you a smile you’ve always wanted, without the pain and anxiety associated with metal braces. Invisalign uses a series of clear, removable aligners to move your teeth gradually. You wear a set of aligners for about two weeks, removing them only to eat, drink, brush and floss. As you replace each set of aligners with the next in the series, your teeth will gradually move until they reach the position your doctor has prescribed for you. The average treatment time is about a year. Contact your Orthodontist to find out if Invisalign is an option for you.
The following recommendations will help eliminate or reduce any oral health problems while your teeth are in braces: Brush your teeth carefully after every meal with fluoride toothpaste and a soft-bristled toothbrush, as food becomes easily lodged in the braces. Floss daily between the teeth and the braces. Maintain every six months cleanings by an oral health professional. Limit your sugar and starch intake, as debris left behind from these types of foods may turn into damaging acids, which, in addition to promoting plaque formation, may also be harmful to teeth and gums. Avoid hard and sticky snacks that may be difficult to remove from the orthodontic equipment in your mouth. This includes foods such as popcorn, hard or chews candy, caramel, and nuts.

ORAL SURGERY

Also called third molars, wisdom teeth usually make their first appearance in young adults between 15 to 25. Because most mouths are too small for these four additional molars, an extraction procedure, sometimes immediately after they surface, is often necessary.
The following symptoms may indicate that the wisdom teeth have erupted and surfaced and should be removed before they become impacted — meaning, the teeth have surfaced and have no room in the mouth to grow. However, each individual may experience symptoms differently. Symptoms may include pain infection in the mouth, facial swelling, swelling of the gum line in the back of the mouth. Most oral health specialists will recommend immediate removal of the wisdom teeth, as early removal will help to eliminate problems, such as an impacted tooth that destroys the second molar.
  • Bacteria and plaque build-up
  • Cysts development (a fluid-filled sac)
  • Tumor development
  • Infection
  • Jaw and gum disease

Wisdom tooth extraction involves:

    • Removing the gum tissue that presides over the tooth.
    • Gently detaching the connective tissue between the tooth and the bone.
    • Removing the tooth.
    • Suturing the opening in the gum line.
Dry Socket is the most common complication of extraction. (removing a tooth) Most commonly associated with wisdom teeth extractions & lower molar extraction. Dry Socket is one in which the patient is having pain due to the loss of the blood clot from the socket following extraction, thus exposing the bone to air, food, and fluids. Patient experiences excruciating pain along with an offensive odor. This often occurs two or more days after an extraction and can last about 5-6 days. This condition occurs most commonly –
  1. In individuals who smoke before their recommended time. Smoking: decreases healing, decrease blood supply to the protective blood clot, brings toxic products to the area, injuries the gum tissue, and the negative pressure of sucking removes the blood clot from the surgery site.
  2. If you do not care for your extraction site as instructed by staff.
  3. Not following your home care instructions.
  4. Sucking action from smoking, sneezing, coughing, spitting, or sucking within the first 24 hours.
  5. Women taking oral contraceptives are more susceptible.

DENTAL EMERGENCIES

According to the American Dental Association, the difference between saving and losing a knocked out tooth, is the thirty minutes following the incident. To save the tooth, follow these steps:

  • Rinse the tooth in tap water.
  • Avoid scrubbing the tooth.
  • Insert the tooth into the empty socket quickly.
  • If you are uncomfortable inserting the tooth, put the tooth in milk or water Get to the dentist immediately.
Although teeth are the strongest substance in the whole body, they may chip or break due to various reasons. Some of the most common reasons are biting into something hard accidentally, tooth with a large filling, root canal treated tooth that is not capped and tooth undermined due to decay. What to expect Depending on the extent of fracture your tooth may be sensitive to temperature and pressure changes. Rinse your mouth gently with lukewarm water. Take a pain reliever if needed. See your dentist as soon as possible so he can determine the course of treatment. How is it treated? Fractures may involve only the superficial outer part of the tooth (enamel). In such a case your dentist may lightly polish the area to smooth the rough surfaces or place a filling and observe the tooth for further changes. If the fracture involves the enamel and the inner sensitive dentin your dentist may have to place a crown due to the extent of involvement. This will protect the tooth and prevent further damage. Sometimes fractures may involve the enamel, dentin and the nerve tissue inside the tooth. This will necessitate a root canal treatment and a crown. If the crack extends beyond the gum line it may require a crown lengthening procedure, which involves removal of bone to grasp enough healthy structure for the crown. However, if the crack extends to the root the tooth cannot be saved and will have to be removed.

Canker sores are shallow, painful sores in your mouth. They are usually red or may sometimes have a white coating over them. You may get them on the inside of your lips, the insides of your cheeks, the base of your gums or under your tongue. Canker sores are different from fever blisters, which usually are on the outside of your lips or the corners of your mouth.

Anyone can get canker sores, but women people in their teens and 20s get them more often. Canker sores may run in families, but they aren’t contagious. Causes of canker sores are unknown but they may be triggered by stress, poor nutrition, food allergies, spicy foods and menstrual periods.

Treatment
Canker sores usually go away without treatment. However, for pain relief your dentist may recommend medicines such as Anbesol, Oragel, Orabase and Zilactin-B, which may prevent your canker sores from becoming irritated by eating, drinking or brushing your teeth. These medicines can be applied directing on the sore with your finger tip or a Q-tip. Gently dry the sore with a swab before applying. Do not eat or drink anything for 30 minutes after applying.

Prevention
Unfortunately, causes of canker sore formation are unknown. However, using toothpaste that does not contain SLS (sodium lauryl sulphate), avoiding hard, crunchy or spicy foods and chewing gum may help reduce mouth irritation. Brushing your teeth after meals, using a soft toothbrush and flossing every day will also keep your mouth free of food that might cause a canker sore. If you get canker sores often, or if they’re very painful, talk to your dentist.

Operculitis is an inflammation of the gum tissue found over partially erupted teeth. The most frequent site is the mandibular third molar region. The heavy flap of gingival tissues covering portions of the tooth crown of the tooth makes an ideal pocket for debris accumulation and bacterial incubation. In the acute phase, pain and swelling in the area are prominent features. Symptoms of a sore throat and difficulty in swallowing may be present. A partial contraction of muscles of mastication, causing difficulty in opening the mouth (trismus), may also be experienced. Abscess formation in the area may occur, leading to marked systemic symptoms of general malaise and fever.

Treatment involves careful cleaning below the flap and saline irrigation. It may also require antibiotic therapy if the condition warrants. Your dentist may decide to incise the gingival flap to make the area self cleansable. If in the third molar area it may require the extraction of the tooth.

MISCELLANEOUS BRUXISM – (Paranormal tooth grinding)

Bruxism is the term that refers to an incessant grinding and clenching of the teeth, unintentionally, and at inappropriate times. Bruxers (persons with bruxism) are often unaware that they have developed this habit, and often do not know that treatment is available until damage to the mouth and teeth have been done. Damage caused by bruxism often includes the following symptoms. However, each individual may experience symptoms differently. Symptoms may include:

  • Abraded teeth
  • Facial pain
  • Oversensitive teeth
  • Tense facial and jaw muscles
  • Headaches
  • Dislocation of the jaw
  • Damage to the tooth enamel, exposing the inside of the tooth (dentin)
  • A popping or clicking in the TemporoMandibular Joint (TMJ)
  • Tongue indentations
  • Damage to the inside of the cheek

The symptoms of bruxism may resemble other conditions or medical problems. Consult a dentist or your physician for a diagnosis.

Although this habit is unintentional, oral health specialists often point to excessive stress and certain personality types as typical causes of bruxism. Bruxism often affects persons with nervous tension such as anger, pain, or frustration, and/or persons with aggressive, hurried, or overly-competitive tendencies.

Treatment for bruxism:

Treatment may involve:
Behavior modification
Night Guard
– A specially-fitted plastic mouth appliance may be worn at night to absorb the force of biting. This appliance may help to prevent future damage to the teeth.
Biofeedback
-Biofeedback involves an electronic instrument that measures the amount of muscle activity of the mouth and jaw — indicating to the patient when too much muscle activity is taking place so that the behavior can be changed. This is especially helpful for daytime bruxers.

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