Frequently Asked Questions

A: Many of us have smoked during our lives. Some of us have been lucky enough to quit the use of tobacco products but there are others who still

struggle with banning the addiction from their lives. We know how hard it is to quit and desire to offer information and assistance to our patients. Plus, any of our staff will be happy to discuss the risk of smoking with our patients as it applies to dental health. The following link, tobacco and nicotine, will take you to the American Dental Association (ADAOnline) topical index for tobacco and nicotine.

A: Teeth break for several reasons, namely, a traumatic injury due to a hard or foreign object in your food, severe clenching or grinding (Bruxism) and/or the presence of large amalgam (silver) fillings. Amalgam fillings, as they have been done in the past, weaken the remaining tooth. Present amalgam fillings have less of a tendency to contribute to tooth breakage if they are bonded.

A: According to the American Dental Association, they are safe to use. Amalgam fillings do not contain free mercury; therefore according to the ADA, they impart no health risk and need not be removed unnecessarily.

A: Using present day techniques and materials, a properly done tooth colored filling (bonded composite) will wear almost as well as a silver filling. In addition, bonding to the remaining tooth, strengthens the tooth rather than weakening it. Newer composites, which require 2 appointments and are

laboratory processed, are even more wear resistant. Almost all of the fillings that I do now are bonded composites.

A: Absolutely. Where esthetics allow, gold is still one of the best restorative materials. Unfortunately, it is a costly material to use. Where cost is not a factor, it is recommended, especially in the 2nd molar areas. I clench my teeth, especially while I sleep. What can I do and is it harmful? Clenching and grinding (Bruxism) are habits that develop early in life. It is our way of relieving stress. Unfortunately, the habit can take it's toll on our teeth, our muscles and our temporo-mandibular joint (TMJ). Bruxism is common in a great majority of the population. Symptoms range from broken teeth to temporo-mandibular dysfunction (TMD). A change in life-style may or may not help. An oral appliance, worn at night, may help to relieve symptoms. Each patient must be evaluated individually.

A: After almost 10 years of prescribing home bleaching, numerous clinical studies have shown home bleaching to be safe, as long as the bleaching is done under the care of a dentist. We make a bleaching tray (called a stent) to exactly fit your teeth. It does not cover the gum tissue at all. The bleaching gel is 10% carbamide peroxide, which can be irritating to the gums. It can also cause temporary tooth sensitivity if not used correctly. Since the bleach is in the form of a gel, there is little chance of swallowing the bleach. Store bought bleaching systems have you make the stent by heating a block of tray material and then having you bite into it. There is nothing to prevent the bleach from sitting on your gum tissue. The bleach used in store bought systems is more fluid and can be easily swallowed.

A: You can diligently floss and brush your teeth and still lose a tooth to gum disease or an accident. If this happens, the tooth or teeth should be replaced in order to restore your smile, regain your chewing and prevent other teeth from shifting to an undesirable or less functional position. There are three main types of artificial teeth and each one is designed for a particular situation. They are dental implants, removable dentures and fixed bridges. A DENTAL IMPLANT is made by surgically placing one or more small metal posts beneath the gum into the jawbone. In a few months, when they are attached to the surrounding bone, they are exposed and have the artificial tooth or teeth attached to them. A REMOVABLE OR PARTIAL DENTURE replaces all or some of the lost teeth in the arch with one appliance. The denture is held in place by clasping some of the remaining teeth - or by suction where none of the natural teeth are left. A FIXED BRIDGE is a replacement that is cemented to the adjacent teeth and cannot be removed.

A: How well you brush your teeth is more important than how often you brush. Remember it's the spots you miss where the problems start. Here are five tips to improve your brushing: Take the time to carefully and gently clean each tooth, ideally twice a day. The average person brushes for less than 35 seconds. A good brushing takes at least two to three minutes.

QUICK TIP: Keep brushing for as long as a song. Be gentle, particularly when cleaning where the gums meet the teeth. Hold the brush at a 45-degree angle to the gum line, and gently work the bristles back and forth using short strokes. Don't forget to brush your tongue, too. Use a soft toothbrush, which is less likely to damage your teeth and gums. Choose a size and shape that enables you to easily reach every tooth. Be sure to change your toothbrush frequently. Every three months is recommended - more often if you've been ill. QUICK TIP: New season - New toothbrush. Remember to floss too since no amount of careful brushing can clean between your teeth!

A: A crown or cap is a cover that fits over a properly prepared tooth that has been damaged by decay or accident, or is badly stained or shaped. A crown can be made of acrylic, metal, porcelain, porcelain and metal, or resined metal. All-porcelain crowns look more like your natural teeth, and therefore are usually used for front teeth, while porcelain with metal underlay has more strength and is good for crowns in the back of the mouth. Sometimes all-metal crowns are used for back teeth because of the metal's strength.

HERE'S HOW IT'S DONE: In order to prepare your tooth for a crown, you require a local anaesthetic. Then the tooth is filed down so the cap can fit over it. An impression of your teeth and gums is made and a temporary cap is fitted over the tooth until the permanent crown is made. On your next visit, the dentist will remove the temporary cap and cement the crown onto the tooth. The crown will closely match your natural teeth and give you back your smile.

A: Here are three things you need to ensure good dental nutrition: A HEALTHY DIET Strong teeth need a variety of foods from each of the basic

food groups including whole grain breads and cereals, fruits and vegetables, lean meats or alternatives, and dairy products. ESSENTIAL VITAMINS AND MINERALS In particular, calcium and phosphorus, and vitamin D are needed for strong teeth and bones, as well as vitamins A and C for healthy gums. Eating a varied and healthy diet will provide the essential vitamins and minerals needed for your teeth and gums to stay healthy and strong.

SMART SNACKING While everybody knows that eating sweets is bad for your teeth, what you may not know is that the amount of sweet food you eat is not as important as the length of time your teeth are exposed to sweets. This means that you should avoid eating sticky sweets like toffee or hard candies like mints, because they stay in your mouth longer. It also means that eating sweet snacks between meals is much worse than with a meal, because at mealtime the increased flow of saliva helps protect your teeth by washing sugars away. Choose something without sugar like nuts and seeds, peanut butter, cheese, plain yogurt, or popcorn for your between meal snacks and save your sweets for mealtimes.

A: Let's face it - many people are still not flossing. This is a big problem if you want to keep your teeth and gums healthy for life. Flossing at least once a day cleans between the teeth and under the gum line where your toothbrush can't reach and where most cavities and gum disease start. If you're not flossing, you're missing 35% of every tooth. If you haven't flossed recently, it'll take a while before flossing becomes an automatic part of your daily routine.

QUICK TIP: Floss every night before you brush, for maximum benefit. But soon your teeth won't feel clean without it. Don't worry if at first flossing causes slight bleeding, but if the bleeding continues for more than ten days, contact your dentist. Here's how to floss: Carefully ease the floss between the teeth, right down to the gum line. Gently wipe plaque from both sides of adjacent teeth. The goal is to arc the floss in a "C" shape following the contours of each tooth.

QUICK TIP: Beginners should start with waxed shred-resistant floss because it slides between the teeth more easily.

A: If you give your teeth the "brush off", you may suffer in the future from gum disease and painful tooth loss. By following a few simple steps you will be ensured to keep your teeth for a lifetime. Here's how: Floss daily to remove bacteria and reduce tooth decay. Brush twice a day, holding the brush at a 45-degree angle, and brushing for at least two minutes. Change your toothbrush every three months (Quick tip: New season - New toothbrush). Avoid eating sticky foods. Choose sugar-free snacks, fruits and vegetables whenever possible. Don't chew foods like ice or hard candies, which can damage tooth enamel. Never use your teeth as a tool to open bags, nuts, and bottle caps or to cut thread. If you play sports, always use mouth protection to prevent injury. Taking care of your teeth and gums is easier than you think when you form good dental habits.

A: Periodontal disease is the leading cause of tooth loss in adults. Why? Because it occurs at an age when cavities are usually a thing of the past, and the initial symptoms often go unnoticed.

HERE'S WHAT TO WATCH FOR: Gums that bleed when brushing; red, swollen or tender gums or persistent bad breath. Periodontal or gum disease is a bacterial infection of the gums, ligaments and bone that support the teeth and anchor them in the jaw. The bacteria, which act mainly on certain carbohydrates in our diets, are normal inhabitants of the mouth, living in a thin film called plaque. If plaque is not removed, it may eventually harden into tartar, a hard mineral shell that irritates and erodes healthy gum tissue. This early stage of gum disease is called gingivitis. If left untreated, pockets begin to form between the teeth and gum tissues and may erode the tissue, which attaches the tooth to the jaw. This stage is called periodontitis. Gum disease can be treated at all stages, but more importantly, it can be prevented.

HERE'S HOW: Brush twice a day, floss daily, eat a balanced diet, and visit your dentist regularly - ideally every six months - for a preventive checkup and professional cleaning which is essential in the prevention of gum disease.

A: Not always. Nursing caries in baby's first teeth occurs when babies habitually fall asleep sucking on a bottle. The sugar in whatever they're drinking (cow's milk, juice, formula or sugary drinks) turns to acid, dissolving tooth enamel. Breast-fed babies are also susceptible if they constantly fall asleep with breast milk on their teeth. Early signs of nursing caries include white spots/tooth discoloration. If the process continues, rampant decay and discomfort to the child results. Children need their baby teeth to chew and to learn to speak properly. Fortunately, you can protect your baby from nursing caries. Don't let your baby go to bed with a bottle unless it contains plain water. Never let your child use a bottle as a daytime pacifier because all-day sucking is as bad as nighttime nipping. Clean baby's mouth and teeth after meals and breastfeeding. Finally, if you suspect your child has nursing caries, contact your dentist immediately.

A: Today, with modern dentistry, root canal treatment has become a common form of treatment for diseased (abscessed) teeth. Your regular dentist or root canal specialist (Endodontist) can provide this treatment.

HERE'S NOW IT'S DONE: In healthy teeth, the interior of the tooth is filled with tissue (pulp). Once the tooth is injured, cracked, or decayed, it is necessary to open the tooth and clean out the infected tissue in the center. This space is then filled and the opening sealed. During the procedure the area around the tooth is frozen. Sometimes difficulties may be encountered during or after root canal treatment. This may require the use of medication or involve further treatment. A crown or cap may be necessary to protect the tooth, once the root canal treatment has been completed. Teeth that have had root canal treatment can stay as healthy and last as long as other teeth. In most instances, you won't be able to feel or see a difference.

A: While cavity prevention starts with a healthy diet, brushing twice a day, daily flossing and regular dental checkups, sealants can offer additional protection against tooth decay. Sealants are thin, plastic coatings painted on the chewing surfaces of the back teeth (premolars and molars). This clear, plastic coating bonds into the depressions and grooves (pits and fissures) of the chewing surface effectively sealing out the decay-causing bacteria, and reducing the risk of cavities and tooth decay.

HERE'S NOW IT'S DONE: The application of sealants is easy, painless, and takes only a few minutes to complete. First, the tooth is thoroughly cleaned and then etched with a solution to help the sealant adhere to the tooth. The sealant is then 'painted' onto the pits and fissures, where it bonds directly or is hardened with a high-intensity light. Sealants usually last several years before a reapplication is required. Your dentist will monitor your sealants during your regular checkup. Although children and teenagers will benefit most because they have the highest incidence of pit and fissure decay, adults with difficult to clean molars or wisdom teeth may benefit, as well. Ask your dentist if sealants can help with your preventive care.

A: Temporomandibular joints (TMJ), that is your jaw joints and muscles, are used to open and close your mouth when talking, chewing, singing and

swallowing. Temporomandibular disorders (TMDS) are a group of conditions which can affect the jaw joint or muscle causing facial, tooth and ear aches as well as "clicking" in the jaw, "tension headaches" and even neck, shoulder or back pain. You may experience pain (ranging from minimal to severely debilitating) especially when chewing and opening your mouth wide or, your jaw may lock or be prevented from opening fully. TMDs can be caused by injuries to the face and jaw regions, whiplash, poor posture, bite problems, badly fitted dentures, grinding teeth, and clenching your jaw resulting in damage to the joints or misalignment. Systemic diseases, which effect the joints of the body (like rheumatoid arthritis, lupus, etc.), can also affect your jaw joint, causing degeneration. Ask your dentist about examining your TMJ, if you are experiencing any of these

symptoms. Special tests, including x-rays or MRI scans of the joints, are sometimes carried out. Most patients benefit from simple forms of

treatment, including physical therapy, dental bite guards, and anti-inflammatory medication. Patients with persisting, severe pain may require surgery and may be referred to an oral and maxillofacial surgeon for consultation. See your dentist for more information.

HERE'S NOW IT'S DONE: The application of sealants is easy, painless, and takes only a few minutes to complete. First, the tooth is thoroughly cleaned and then etched with a solution to help the sealant adhere to the tooth. The sealant is then 'painted' onto the pits and fissures, where it bonds directly or is hardened with a high-intensity light. Sealants usually last several years before a reapplication is required. Your dentist will monitor your sealants during your regular checkup. Although children and teenagers will benefit most because they have the highest incidence of pit and fissure decay, adults with difficult to clean molars or wisdom teeth may benefit, as well. Ask your dentist if sealants can help with your preventive care.

A: Are you self-conscious to smile because your teeth are chipped, discolored, or poorly spaced? Cheer up, your dentist may be able to apply a porcelain laminate veneer to your teeth and give them a whole new appearance. Veneers are strong, thin pieces of porcelain that are bonded to the teeth, making them stronger. They are used to repair chipped, decayed or stained teeth and for closing gaps between teeth. With a bit of contouring, veneers can also rectify crowded or overlapping teeth. If your teeth have discolored with age, a veneer may improve their appearance. Veneers can also be used for cosmetic reasons instead of crowns, which are more often used for badly damaged or decayed teeth.

HERE'S NOW IT'S DONE: Typically, the front and edges of the tooth are selectively removed and the veneer replaces the removed surface. Veneer

preparations frequently require the use of local anaesthetic and, depending on color and shade, may take two or more appointments for completion of the procedure. Ask your dentist if veneers can help improve your smile.

A: Wisdom teeth don't make you smart, but they can create problems. These third molars are the last teeth to erupt and usually appear between the ages of 17 and 21, but can begin causing problems as early as age 13. Sometimes the teeth don't always have enough space at the back of the lower and upper jaw and develop at an angle causing the tooth to jam and become impacted. When this happens, a cyst can form in the tissue surrounding the tooth causing deterioration of the jawbone or the tooth in front. Sometimes the wisdom teeth only partially erupt and become prone to recurrent infection and decay. This condition can lead to swelling, pain and difficulty opening the jaw. The development of wisdom teeth can be painful and is often associated with sore throats, headaches and gum infections. By checking the development of your wisdom teeth during regular checkups and dental x-rays, your dentist can determine whether your wisdom teeth have enough space to erupt through the gum or if they should be removed.

HERE'S NOW IT'S DONE: Typically, the front and edges of the tooth are selectively removed and the veneer replaces the removed surface. Veneer

preparations frequently require the use of local anaesthetic and, depending on color and shade, may take two or more appointments for completion of the procedure. Ask your dentist if veneers can help improve your smile.