FAQs

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. Feel free to read our Cleaning and Prevention page for more.

• 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 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 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 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 alternatives to silver fillings, including composite (tooth-colored), porcelain and gold fillings. We encourage you to discuss these options with your dentist to determine which is the best option for you.

• You should have a checkup and teeth cleaning 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, a dentist usually provides:
  • Medical history review: Knowing the status of any current medical conditions, new medications and illnesses, gives us insight to your overall health as well as your dental health.
  • Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts and bone loss. X-rays also help determine tooth and root positions.
  • Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues and gums for any signs of oral cancer.
  • Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
  • Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
  • Examination of existing restorations: Check current fillings, crowns, etc.
  • Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
  • Removal of plaque: 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 (poisons) that inflame the gums, which is the start of periodontal disease.
  • Teeth polishing: Removes stain and plaque that is not otherwise removed during tooth brushing and scaling.
  • Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
  • Review dietary habits: Your eating habits play a very important role in your dental health.

• Four out of five people have periodontal disease and don’t know it. 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:
  • Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
  • Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
  • Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side effects that reduce saliva, drying out the mouth and making it easier for plaque to adhere to the teeth and gums.
  • Pregnancy, oral contraceptives and puberty – Changes in hormone levels can cause gum tissue to become more sensitive to bacteria toxins.
  • Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
  • Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.

Brushing our teeth removes food particles, plaque and bacteria from all tooth surfaces, except in between the teeth. 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.

• Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink and smoking. Teeth darkened from an 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.
• 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 alternative to removable dental appliances.
• Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients. Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.

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:

• Severely discolored or stained teeth
• Unwanted or uneven spaces
• Worn or chipped teeth
• Slight tooth crowding
• Misshapen teeth
• Teeth that are too small or large

Getting veneers usually requires two visits. For more information, see our procedures page.

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 and 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.

Missing teeth can be caused by a multitude of accidents, injuries, improper care and more. But there are plenty of ways to fix the problem including:

• 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.
• Fixed bridges – This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to natural teeth adjacent to the missing tooth site.
• Dentures – This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch.
• Dental Implants – A great way to replace one or more missing teeth. They may also be great to support ill fitting dentures.

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, including:

• Composite (bonding) Fillings – These are tooth-colored fillings that can be closely matched to the color of your existing teeth.
• 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.
• 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.
• 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.

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 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:

• Contribute to the development of heart disease
• Increase the risk of stroke
• Compromise the health of those that have diabetes or respiratory diseases
• Increase a woman’s risk of having a preterm, low-birth weight baby

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.

We’re all at risk for having a tooth knocked out. 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 re-implanted if we act quickly and follow these simple steps:

• Locate the tooth and handle it only by the crown (chewing part of the tooth), not by the roots.
• Do not scrub or use soap or chemicals to clean the tooth. If it has dirt or debris on it, rinse it gently with your own saliva or whole milk. If that is not possible, rinse it very gently with water.
• Get to a dentist within 30 minutes. The longer you wait, the less chance there is for successful re-implantation.

Ways to transport the tooth are tricky. Try to replace the tooth back in its socket immediately. Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place. Apply a cold compress to the mouth for pain and swelling as needed. If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk. You can also place the tooth under your tongue or between your lower lip and gums. Keep the tooth moist at all times. Do not transport the tooth in a tissue or cloth.

Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit. The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport. You can prevent broken or knocked-out teeth by:

• Wearing a mouthguard when playing sports
• Always wearing your seatbelt
• Avoiding fights
• Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.

Straighter teeth perform chewing, biting and speaking functions more effectively than crooked teeth. In addition, a straight smile boosts confidence, is aesthetically pleasing to look at and can help stave off a wide variety of dental ailments. There are several types of malocclusion, including overbite, underbite, crossbite, and overcrowding. Each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth. Here is a brief overview of some of the main disorders associated with crooked teeth:

• Periodontitis – Periodontitis or gum disease begins with a bacterial infection. The bacterial infection is caused by inadequate oral hygiene. Crooked teeth are hard to clean effectively, which means that debris, plaque and bacteria can build up in hard-to-reach areas. Straight teeth are much easier to clean and are at less risk of contracting gum disease.
• Temporomandibular Disorder (TMJ) – Crooked teeth can lead to improper jaw alignment, which in turn causes a painful condition known as TMJ. Severe headaches, jaw pain, lockjaw and the grinding of teeth characterize this debilitating disorder.
• Tooth Injury – Straight teeth create a strong wall, which means injuries are less likely to occur. Crooked teeth are weaker and often protrude, making them far more vulnerable to external injury.
• Uneven Wear – Crooked teeth cause some of the teeth to work harder than others when biting and chewing. Straight teeth share the workload evenly, meaning less risk of injury and better aesthetics.

Teeth can be straightened using either orthodontic braces or customized aligning trays. Orthodontic braces are usually affixed to the teeth for a set duration. The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete. Fixed braces can be placed on the front side or back side of the teeth and are effective for most types of malocclusion. Aligning trays are fully removable and are used where the malocclusion is less severe, and the teeth need to move a shorter distance. These trays are replaced every few weeks for the duration of the treatment, and have proven to be equally effective for straightening teeth.