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.
Click on a question below to see the answer, or scroll down.
Q1: What should I do if I have bad breath?
Q2: How often should I brush and floss?
Q3: Electric or manual, which brush should I choose?
Q4: Why is it important to use dental floss?
Q5: How often should I have a dental exam and cleaning?
Q6: Are amalgam (silver) fillings safe?
Q7: Composite or amalgam, which filling should I choose?
Q8: How can I tell if I have gingivitis or periodontitis (gum disease)?
Q9: How can cosmetic dentistry help improve the appearance of my smile?
Q10: What are porcelain veneers and how can they improve my smile?
Q11: What can I do about stained or discolored teeth?
Q12: What are my options if I have missing teeth?
Q13: What can be done about old, unattractive, or discolored fillings?
Q14: What does heart disease and other medical conditions have to do with periodontal (gum) disease?
Q15: When are sealants recommended?
Q16: What should I do if a tooth is knocked out?
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.
Keeping a record of what you eat may help identify the cause of bad breath. Also, review your current medications, recent surgeries, or illnesses with your dentist.
In most cases, your dentist can treat the cause of bad breath. If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.
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 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.
Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.
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.
Daily flossing is the best way to clean between the teeth and under the gum line. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
Floss holders are recommended if you have difficulty using conventional floss.
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.
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An electric toothbrush is the better choice. While studies show that with the proper brushing technique and enough time spent in front of the mirror, electric and manual toothbrushes achieve the same results, the reality is that many patients do not achieve the same level of clean. The two main factors in achieving clean teeth are time invested and efficiency.
Let's face it, who wants to spend two full minutes in front of the mirror brushing? It turns out most busy Americans spend far less, just under a minute, brushing their teeth. It is simply too easy to think you brushed long enough when you really did not. Getting an electric toothbrush with a built in timer helps insure that the full two minutes are spent getting things clean.
If an electric tooth brush was a car, it would be a high performance speedster. Meanwhile a manual tooth brush would be a Volkswagen. Electric brush heads move at such a greater rate of speed that they get more done in the same amount of time resulting a better clean. What is the result? A lesser chance of dental decay, a lesser risk for gum disease, and fewer overall visits to your dentist.
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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.
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 (acids) that cause cavities and irritate and inflame the gums. Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar). This will further irritate and inflame the gums and also slowly destroy the bone. This is the beginning of periodontal disease.
Floss holders are recommended if you have difficulty using conventional floss.
Daily flossing will help you keep a healthy, beautiful smile for life!
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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:
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.
The general consensus is that amalgam (silver) fillings are safe. 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.
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The majority of the time composite fillings are a patient's best choice because of their superior esthetics and the ability to conserve as much natural tooth structure as possible. However in some situations of the very young or very old your doctor may recommend the use of dental amalgam.
Concerning children, some may repeatedly fail to properly brush and floss as they should, resulting in a short life span of a composite filling and the need for placement of another. Repeated fillings of an individual tooth over a patient's life will lead to the need of advanced dental care (root canals and crowns) sooner than a tooth filled just once. Dental amalgam tends to be more resistant to bacteria and therefore recurrent decay. It is more forgiving of children who do not properly care for their teeth.
Your doctor will evaluate your child's brushing and flossing with a plaque (bacteria) score and make recommendations as necessary. If a child cannot improve on their at home care, then an amalgam filling may be the better alternative. This is especially so in baby teeth that a child will shed naturally over time.
Concerning the elderly, amalgam fillings are recommended for those who have difficulty in oral hygiene due to a loss of dexterity, suffer from dry mouth, or have very advanced amounts of decay. While an electric toothbrush and dry mouth treatments may help in some situations, sometimes it is not enough. In situations of advanced decay that extends deep below the gum line or underneath crowns, amalgam may be the more appropriate choice in preserving the longevity of the tooth. Your doctor will explain your individual situation and make their recommendations as to the best filling material for treatment of the decay.
Click here for a detailed table outlining the major differences between composite and amalgam fillings.
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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.
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 and properly will ensure that plaque is not left behind to do its damage.
Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
Click here for more information on Periodontal Disease.
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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.
There are many cosmetic dental procedures available to improve your teeth and enhance your smile. Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over. Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry.
Teeth Whitening - Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking. Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present.
Composite (tooth-colored) Fillings - Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings. Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth. This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.
Porcelain Veneers - Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile. They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth. Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.
Porcelain Crowns (caps) - A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size. Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations. They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.
Dental Implants - Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth. Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, and durable solution to removable dental appliances.
Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!
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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.
Veneers may be used to restore or correct the following dental conditions:
Getting veneers usually requires two visits. Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.
With little or no anesthesia, teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers. The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and occasionally a specialized light may be used to harden and set the bond.
Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile.
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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).
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.
It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching. Occasionally, tetracycline and fluorosis 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, a touch-up may be needed every several years to keep your smile looking bright.
Home teeth whitening systems - At-home products usually come in a gel form that is placed in a custom-fitted mouth guard (tray), created from a mold of your teeth. The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep. 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 special 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 to one week.
Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!
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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 try to do everything possible to restore the tooth to its original function. Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.
Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen. Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.
When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth. Also, the tooth above or below the open space will 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, excessive wear on certain teeth, and TMJ (jaw joint) problems. These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.
Removable bridges - This type of bridge 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 tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.
Fixed bridges - This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to a natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.
Dentures - This type of tooth replacement is used when most or 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 - Are a great way to replace one or more missing teeth. They may also be great to support ill-fitting 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 the most aesthetically pleasing tooth replacement option.
If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.
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A: Most of us have fillings in our mouths that date back many years and some may have even been placed during our childhood. These fillings may now be old, dark, and unattractive, making us feel self-conscious when we smile, laugh, and talk. Old fillings are not only unattractive, they may also be defective. When a filling is old, the margins (space between the tooth and filling) may eventually open and allow bacteria and food debris to enter, potentially causing dental decay.
Your dentist can check your fillings and evaluate if they are defective and need replacement. Also, if you simply want to replace fillings that are unattractive, you and your dentist can decide which ones should be replaced first and what replacement options would best suit you. There are many state-of-the-art dental filling materials and procedures available today that are quick, painless, and cost effective for replacing old, unattractive or defective fillings.
Composite (bonding) fillings - These are tooth-colored fillings that can be closely matched to the color of your existing teeth. They are particularly well suited for use in front teeth or visible parts of teeth and are one of the best ways to improve the health and beauty of your smile.
Crowns (Caps) - These types of restoration are used when a tooth is too damaged and cannot be repaired with a filling or other type of restoration. A crown is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens the remaining tooth structure and can be made of gold, porcelain, and other tooth-colored materials.
Inlays/Onlays - These restorations are custom made fillings. They can be made of composite resin, porcelain or gold and are made by a dental laboratory and placed by a dentist. Inlays/onlays are usually best for the posterior chewing surfaces of teeth and are utilized to conservatively repair teeth that have large defective/unattractive fillings or have been damaged by decay or trauma.
Porcelain veneers - Used primarily in the front teeth, veneers are very thin shells of tooth-shaped porcelain that are individually crafted and permanently cemented to the front surface of teeth. They are a great solution for fixing discolored, pitted, shipped, malformed, or slightly crooked teeth. Veneers are also used if you have unwanted spaces. Veneers are very durable, natural looking, and do not stain. This makes veneers a very popular solution for restoring a smile impaired by old, unattractive fillings.
As you can see, there are various options for replacing old, unattractive fillings. These treatments will provide strong, natural, and long-lasting replacement solutions to enhance the health and beauty of your smile.
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Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health. Periodontal disease is one of the most common infections; often more prevalent than the common cold! Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!
Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis. It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth. The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth. When periodontal disease is not treated it can eventually lead to tooth loss!
There are numerous studies that have looked into the correlation between gum disease and major medical conditions. These studies suggest people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections. Research suggests that periodontal bacteria in the blood stream may:
Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.
To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation. Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.
Remember…the mouth body connection! Taking care of your oral health may contribute to your overall medical health!
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A: 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 possibly fit and clean most of these areas. This is where sealants play an important role.
A sealant is a thin plastic 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 it much easier to clean and help keep these areas free of decay.
Sealants are easily applied by your dentist or dental hygienist and the process only takes minutes per tooth. After the chewing surfaces are roughened with an acid solution that helps the sealant adhere to the tooth, the sealant material is “painted” onto the tooth surface, where it hardens and bonds to the teeth. Sometimes a special 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-up.
Combined with good home care, a proper diet, and regular dental check-ups, sealants are very effective in helping prevent tooth decay.
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A: We’re all at risk for having a tooth 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 actually save the tooth. Teeth that are knocked out may be possibly reimplanted if we act quickly, yet calmly, and follow these simple steps:
The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive and possibly last for many years. So be prepared, and remember these simple steps for saving a knocked-out tooth.
Exams, Cleanings & Prevention
Composite & Amalgam Fillings
Full & Partial Dentures
Crowns & Bridges
Periodontal Disease & Treatments
Sealants & Fluoride
Restoration of Implants