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1)
Teeth & Fillings
Q.
My teeth are all filled. Can I still get decay?
Q.
My teeth don’t hurt; why do I need a check up?
Q.
My tooth is sensitive to cold drinks. What could that be?
Q.
My tooth is sensitive to hot food and drinks. What could
that be?
Q.
When I bite down
on hard foods, it hurts. What is that?
Q.
My teeth have chips in the front. What causes that?
Q.
My teeth are sensitive along the gum line to cold. What can I do?
Q.
I keep getting cavities. What can I do?
Q.
I don’t like ugly black fillings. What are my options?
Q.
If you cap a tooth, can it ever decay again?
Q.
If I lost a tooth, do I need to replace it?
Q.
I get food, particularly meat or stringy foods, stuck in between my
teeth. Why is that?
Q.
I have fillings in my teeth but they don’t match the color of my
teeth.
Q.
Do you have to cap a
tooth that had a root canal?
Q.
I hate to be numb for fillings. Is there another way?
Q.
Are there different types of Novocain?
Q.
Novocain makes my heart pound when I get it. Are there other types
of Novocain?
Q.
My teeth are generally sensitive. What can I do?
Q.
Can I get white fillings instead of dark metal ones?
Q.
Is mercury safe in teeth?
Q.
Why don’t you use silver mercury fillings?
Q.
I want my mercury fillings taken out. Can that be done?
Q.
I heard gold is best for teeth, but I want a natural look. What are
my choices?
Q.
Is there such a thing as a permanent filling?
Q.
I’ve always had weak teeth. What can I do to make them stronger?
Q.
Weak teeth run in my family. How can I help my kids avoid cavities?
Q.
How can I get decay when my teeth are already filled?
Q.
What is the best way to check for decay?
Q.
Are x-rays safe?
Q.
Why do you need dental x-rays?
Q.
I have broken several teeth and had a cap made. Why do teeth break?
Q.
If you have decay, will an x-ray find it?
Q.
I brush my teeth 5 to 6 times a day. Do I still need to floss?
Q.
Fluoride is mainly for kids. Does it help adults?
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Q.
My teeth are all filled. Can I still get decay?
A.
Yes, you can. A tooth that is filled is actually weaker than a tooth
that has not been filled because the seam between a filling and a
tooth is not as good as a solid undecayed tooth. In addition, the
unfilled tooth area can also decay, just as it did before.
Q.
My teeth don’t hurt; why do I need a check up?
A. Pain is a good
indicator that there is a problem, but it is also a late indicator.
All dental problems start small and don’t hurt. That is the time to
fix them, before they hurt. When a tooth hurts, it may already be
abscessed and require a root canal. Don’t wait for pain.
Q.
My tooth is sensitive to cold drinks. What could that be?
A. Sensitivity to cold
means that the nerve of the tooth is inflamed. If the sensitivity goes
right away after the cold food or beverage is swallowed, the
inflammation is usually reversible by fixing the cause, such as a deep
cavity, grinding your teeth or gum recession. If the cold sensitivity
lingers, the tooth may need a root canal.
Q.
My tooth is sensitive to hot food and drinks. What could
that be?
A. Sensitivity to hot is usually more serious. That often means
that the tooth inflammation is more advanced and may not be reversible
unless root canal is done.
Q.
When I bite down on hard foods, it hurts. What is that?
A. Biting down on hard
foods means that there is inflammation at the top of the root, just
like walking with a stone in your shoe would cause your foot to hurt.
If it is due to biting too hard on the tooth, such as would be the
case with a new filling that is too high, or tooth clenching or
grinding, fixing the bite will help. If it is due to an infection in
the tooth, a root canal is probably needed.
Q.
My teeth have chips in the front. What causes that?
A. Chips in teeth are
caused by mechanical trauma such as a blow to the tooth or, more
commonly, tooth grinding. You can see if the chipping is due to tooth
grinding by putting your top and bottom teeth together edge to edge,
and seeing if the chips or worn spots on the top and bottom teeth line
up.
Q.
My teeth are sensitive along the gum line to cold. What can I do?
A. Usually these
sensitive areas are caused by tooth clenching or grinding. The
solution is to try to desensitize them by using a
prescription-strength fluoride product, such as Prevident, if over the
counter products like Sensodyne don’t help. Also, you need to
determine the cause, such as tooth clenching or grinding or gum
recession, and correct that to prevent the problem from getting worse.
Q.
I keep getting cavities. What can I do?
A. You don’t have to
keep getting cavities. You have to stop what is causing them. Cavities
are due to either eating too much sugar relative to the strength of
your teeth and not flossing, or due to old fillings leaking and
letting decay under them. You need to discover the problem and then
cut down your sugar, start flossing and fix leaking old fillings.
Using a prescription strength fluoride is helpful too.
Q.
I don’t like ugly black fillings. What are my options?
A. Today, you do not
need to have old fashioned metal fillings in your mouth. Bonded
fillings, inlays and crowns are all natural tooth color and can be
used to replace old fillings to give you a younger, natural look.
Q.
If you cap a tooth, can it ever decay again?
A. A tooth with a cap
is much less likely to decay than one with a big silver filling that
is more prone to cracking and leaking. However, a cap is not a
permanent solution to prevent decay. You still have to brush and floss
and avoid sugar foods because where the cap ends the tooth can still
decay.
Q.
If I lost a tooth, do I need to replace it?
A. Except for wisdom
teeth, teeth that are lost should generally be replaced because when a
tooth is lost, several things happen. The other teeth may start to
shift, causing food traps which can lead to more decay or gum disease.
In addition, it can throw the bite off leading to bite problems. The
last problem is difficulty with chewing, leading to poor digestion and
eating processed foods which aren’t as healthy as harder to chew
fresh fruits and vegetable and high fiber breads and cereals.
Q.
I get food, particularly meat or stringy foods, stuck in between my
teeth. Why is that?
A. Food traps between
your teeth may be due to cavities between the teeth, fillings that are
breaking or your teeth may be shifting if you have lost and not
replaced missing teeth. It is important to fix these problems because
the trapped food can cause gum disease in addition to being annoying.
Q.
I have fillings in my teeth but they don’t match the color of my
teeth.
A. If you have fillings that do not match the color of your teeth, you
can have them replaced with new bonded fillings. Over time,
tooth-colored fillings, especially the older ones, can discolor, or
the color of your teeth may have darkened due to food or beverage
stains. Modern bonded fillings hold their color for much longer than
older materials. .
Q.
Do you have to cap a tooth that had a root canal?
A. Usually a tooth has
root canal due to severe decay. In that case, a cap is needed to fix
the tooth properly so it does not continue to decay or break. Ask your
dentist about your specific situation.
Q.
I hate to be numb for fillings. Is there another way?
A. No one likes the
numb feeling, but most people prefer numbness to pain. If the cavity
is small, you may be able to do it without Novocain. Also, air
abrasion, which does not use a drill, can sometimes be used for
smaller cavities without Novocain.
Q.
Are there different types of Novocain?
A. As a matter of
fact, Novocain is actually not used any more at all. There are several
different types of local anesthetics used by dentists. Some are longer
and some are shorter lasting.
Q.
Novocain makes my heart pound when I get it. Are there other types of
Novocain?
A. The heart pounding
is an annoying but temporary effect of a chemical in the local
anesthetic that helps it work better. If it is a problem for you,
there are local anesthetics that do not have that chemical. Often
those don’t last as long, so for a longer procedure, the numbness
might not last long enough, requiring re-injection of additional local
anesthesia. Ask Dr. Phelps what would be best for you.
Q.
My teeth are generally sensitive. What can I do?
A. Generalized
sensitivity of teeth is usually due to gum recession caused by gum
disease or tooth grinding due to a bite problem. You need to find the
source of the problem and fix it. If it is only one tooth, then it
could also be due to decay.
Q.
Can I get white fillings instead of dark metal ones?
A. Yes. Many dentists
today do not even use dark silver mercury fillings at all.
Q.
Is mercury safe in teeth?
A. The safety of
mercury fillings is very controversial. The American Dental
Association and many other organizations says it is. Many other people
are concerned that it may not be safe. Several European countries do
not permit its use in children. The instructions supplied by
manufacture of silver mercury fillings in the USA say not to use it in
patients with kidney disease or compromised immune systems. The
Environmental Protection Agency says that when dentists do a silver
mercury filling in a patients tooth, any unused filling material must
be stored in a covered container and disposed of as medical waste.
Dentists are not allowed to store scrap filling material in an open
container. This leads us to believe that there may be a problem, so we
do not use silver mercury fillings at all. For additional information,
visit http://www.iaomt.org.
Q.
Why don’t you use silver mercury fillings?
A.
We do not use silver mercury fillings for several reasons. First, they
tend to corrode and leak, permitting further decay. Second, they have
a tendency to expand over time like ice cubes and can cause otherwise
healthy teeth to fracture. Third, they are unattractive and tend to
darken teeth. Fourth, although the ADA says that they are acceptable
for continued use, there is some concern about the safety of mercury
and some people are intolerant to mercury in fillings.
Q.
I want my mercury fillings taken out. Can that be done?
A. Silver mercury
fillings can be removed easily and replaced with tooth colored
materials. The dentist does it all the time if there is decay or if
they are leaking or broken. They can be removed for cosmetic reasons
to lighten dark teeth as well, as if the patient requests it.
Q.
I heard gold is best for teeth, but I want a natural look. What are my
choices?
A. Gold is a very
excellent material but some people object to its appearance, even in
back teeth. Now there are several choices of materials to repair
decayed or broken teeth. Laser bonded composite fillings are used for
small-to-medium-sized cavities. They are natural tooth color. Gold or
porcelain inlays are used for very large cavities. The traditional
gold, while an excellent material in terms of durability and strength,
is generally not selected in areas where it would be visible.
Porcelain, on the other hand is very natural looking. In the case of
even more extreme tooth damage, a porcelain crown can be used.
Q.
Is there such a thing as a permanent filling?
A. There are three
reasons why a restoration in a tooth could fail. First, the material
could break or wear out. Second, the remaining tooth could break or
start to decay. And third, some conditions such as gum disease could
damage the support of a tooth or cause gum recession that would cause
a cosmetic problem with an otherwise successful restoration. Based on
this, considering that people bite, chew and swallow 24 hours a day,
eat cold foods and drinks as low as 35 to 40 degrees (F) to hot
beverages as warm as 150 degrees (F), there is nothing that could be
considered “permanent”. That said, if the material selected is
appropriate for the size of the cavity and the individual brushes and
flosses daily, eats minimal sugar and uses prescription strength
fluoride, most dental repairs will be very long-lasting.
Q.
I’ve always had weak teeth. What can I do to make them stronger?
A. Some people do have
weaker than average teeth. These people can use prescription-strength
fluoride, like Prevident, to make their enamel stronger and more
decay-resistance.
Q.
Weak teeth run in my family. How can I help my kids avoid cavities?
A. To help your kids
avoid decay, make sure they are getting optimal fluoride in water or
by prescription and minimal sugar. In addition, make sure they are
getting dental check-ups twice a year to catch problems while they are
small and practice effective plaque removal at home.
Q.
How can I get decay when my teeth are already filled?
A. Teeth that are
filled can get more decay if the filling chips or cracks open and
starts to leak. That is why the material selected must be strong
enough. In fact, an extensively filled tooth is generally weaker than
an unfilled tooth. In addition, if the person does not practice
effective plaque control and continues to eat too much sugar for their
own system, decay can start in the remaining unfilled tooth structure.
Q.
What is the best way to check for decay?
A. To check for decay,
you need to use a combination of dental x-rays to “look” in
between the teeth where you cannot see. In addition, it is necessary
to use a video enhanced system to magnify the size of the image so
small cracks or chips in the filling that allow decay can be found.
Very large cavities often form under what appears to be acceptable old
fillings. These cavities can easily be missed unless the teeth are
carefully evaluated.
Q.
Are x-rays safe?
A. X-rays, when used
properly, are definitely safe. Over the years, the amount of radiation
has been going down as better systems have been developed. Today, the
average set of dental x-rays provides far less radiation than a day in
the sun. And remember, the dental technician uses a lead apron to
cover your neck, chest and stomach to minimize radiation exposure.
Q.
Why do you need dental x-rays?
A. You need dental
x-rays because there are some areas like in between the teeth or under
the gum line that are just not visible any other way. If the doctor
does not catch decay, infection or bone tumors while they are small,
and waits for the patient to complain of pain or other symptoms,
little cavities can grow to the point where root canal is needed.
Q.
I have broken several teeth and had a cap made. Why do teeth break?
A. Most commonly,
teeth break due to large cavities weakening the remaining tooth
structure. That is why, with large cavities, they usually need to be
fixed with a material that can strengthen the tooth, such as a crown.
The other reason teeth sometimes break is from the pressure of tooth
clenching or grinding, which is far more common than most people
think.
Q.
If you have decay, will an x-ray find it?
A. If you have decay,
an x-ray may not find it depending on where the decay is located on
the tooth and whether there is a metal filling in the tooth that could
block the x-rays. That is why you need to combine dental x-rays and a
careful, video enhanced dental examination.
Q.
I brush my teeth 5 to 6 times a day. Do I still need to floss?
A. From a decay point
of view, two good brushings a day will clean the places a brush can
reach. The problem is that the brush can’t go between the teeth
where most decay forms. No amount of brushing will replace flossing.
They just don’t do the same spots. Just like cleaning the bathroom 6
times a day doesn’t make the kitchen clean. You need to brush and
floss.
Q.
Fluoride is mainly for kids. Does it help adults?
A. Yes, it does.
Adults can get great benefits from fluorides applied to their teeth on
a daily or weekly basis because fluoride hardens the outside of the
tooth. If the outside is harder, decay can’t start.
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2)
Cosmetic Dentistry
Q.
My teeth are yellow. What
are my options?
Q.
If my teeth are crooked, do I have any options besides braces?
Q.
Is tooth whitening safe?
Q.
I have a wedding soon. How can I whiten my
teeth overnight?
Q.
How old do you have to be to whiten your teeth?
Q.
Can you be too old to whiten your teeth?
Q.
I want to improve my smile, but I don’t want fake looking teeth.
What can I do?
Q.
Is it possible to get a preview of how my teeth could look before
doing any cosmetic work?
Q.
I don’t have a lot of money, can I still improve my smile?
Q.
I’d like to cap my teeth but I hate it when it looks dark at the
gum line. Can that be avoided?
Q.
I don’t have much time, how long does it take to do cosmetic
work?
Q.
If I get a cap to whiten my teeth, does that mean I need a root
canal?
Q.
Does bleaching always work?
Q.
Can you bleach old fillings or crowns?
Q.
I want to bleach my teeth, but I have fillings or crowns on my
teeth. If they won’t bleach what do I do?
Q.
Can bleaching weaken my teeth?
Q.
Is bleaching bad for my gums?
Q.
How long do porcelain veneers take to get?
Q.
Do porcelains veneers discolor over time?
Q.
How long do porcelain veneers last?
Q.
Can I eat normally with porcelain veneers?
Q.
What do you do if something happens to a porcelain veneer?
Q.
What is the difference between a porcelain veneer and a crown?
Q.
Can a porcelain veneer close spaces between my teeth?
Q.
Can a porcelain veneer make crooked teeth straight?
Q.
If I’m not sure what I want, can I try bleaching my teeth first
and then do veneers later if I am not happy with the results.
Q.
Can teeth darken after tooth whitening?
Q.
If teeth do darken after whitening, what can I do?
Q.
What can cause teeth to be dark?
Q.
If I smoke or eat and drink foods that tend to stain teeth, does
that mean I can’t whiten my teeth?
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Q.
My teeth are yellow. What are my options?
A.
Yellow teeth can be whitened by bleaching them or by putting porcelain
veneers or crowns on them. If the teeth are not extensively decayed or
filled and generally good looking, except for the yellow color,
bleaching is the easier, most conservative and least expensive option.
Q.
If my teeth are crooked, do I have any options besides braces?
A. In addition to
braces, teeth can be straightened by using porcelain veneers or
crowns. This method is especially useful with adults who want a result
in two weeks, instead of two years. In addition, if the teeth are dark
or have decay or unattractive old fillings, that can all be corrected
at the same time.
Q.
Is tooth whitening safe?
A. Tooth whitening is
absolutely safe and many studies have demonstrated that tooth
whitening does not weaken or damage the teeth.
Q. I have a wedding soon. How can I whiten my teeth overnight?
A. We've had wonderful success stories with our new Zoom!
whitening light. After only and hour and a half of your time
you'll notice several shades lighter.
Click Here to
learn more.
Q.
How old do you have to be to whiten your teeth?
A. The company who
supplies us with the tooth whitening materials we use recommends that
it is safe and effective for children age 12 and up.
Q.
Can you be too old to whiten your teeth?
A. You cannot be too
old to whiten your teeth. Some of our most excited tooth-whitening
patients have been in their seventies and eighties as they found that
tooth whitening quickly and easily takes years off their appearance.
Q.
I want to improve my smile, but I don’t want fake looking teeth.
What can I do?
A. A dentist trained
in proper cosmetic dental procedures does not create the “white
chiclet” tooth look you may have seen. We can discuss the shape,
color and arrangement of your teeth so you get a great “natural”
looking smile.
Q.
Is it possible to get a preview of how my teeth could look before
doing any cosmetic work?
A. Yes, you absolutely
can get a preview before your work is done. Cosmetic Imaging is a
system where we take a picture of your smile and then, in our
computer, change your teeth so you can see how great you would look
with cosmetic dental treatment.
Q.
I don’t have a lot of money, can I still improve my smile?
A. Many cosmetic
procedures, such as tooth whitening and cosmetic contouring, which
reshapes crooked and misaligned teeth, are not very expensive and can
make a big difference in your smile.
Q.
I’d like to cap my teeth but I hate it when it looks dark at the gum
line. Can that be avoided?
A. The dark area at
the gum line with traditional caps is usually due to metal in the
crowns. At our practice, with teeth that show when you smile, we avoid
metal in crowns whenever possible and use all ceramic crowns.
Q.
I don’t have much time, how long does it take to do cosmetic work?
A. Cosmetic dental
procedures can be accomplished in as few as two visits over as little
as a week or two. Of course, every patient's situation is different so
you need to discuss your specific requirements and circumstances with
us prior to starting any cosmetic work.
Q.
If I get a cap to whiten my teeth, does that mean I need a root canal?
A. Getting a cap does
not require that the tooth get a root canal.
Q.
Does bleaching always work?
A. Bleaching is an
inexpensive process that is designed to take the dark pigments out of
the teeth. It will not whiten fillings or crowns on teeth. In
addition, certain types of discolorations tend to respond better to
bleaching than others. Based on our experience bleaching several
thousand people's teeth, we can give patients a reasonably accurate
predication of the results they can expect with tooth bleaching, but
there can be no guarantee of results.
Q.
Can you bleach old fillings or crowns?
A. Bleaching only
affects natural tooth structure, not artificial fillings or crowns.
Q.
I want to bleach my teeth, but I have fillings or crowns on my teeth.
If they won’t bleach what do I do?
A. If you have old
fillings or crowns, don’t be concerned. Bleach your teeth and then,
when you are happy with the results, we can replace old fillings or
crowns to match your new whiter smile.
Q.
Can bleaching weaken my teeth?
A. Bleaching only
takes the dark pigments out of teeth and does not weaken them in any
way.
Q.
Is bleaching bad for my gums?
A. The bleaching
materials we use today were actually developed originally as a
treatment for periodontal disease. Researchers noticed that, while
they had no long term benefits for gum disease, the oxygen released
during the bleaching process did help kill certain types of bacteria
during the actual bleaching sessions.
Q.
How long do porcelain veneers take to get?
A. Porcelain veneers
can be done in as little as one to two weeks.
Q.
Do porcelains veneers discolor over time?
A. Porcelain veneers
are very strong and the glazed surface is generally impervious to
stains. Just like a dinner plate can be washed, porcelain veneers can
be cleaned and professionally polished to keep them looking great.
Q.
How long do porcelain veneers last?
A. Porcelain veneers
last for many years. As long as the patient exercises proper home care
to prevent decay or gum problems, gets regular professional cleanings
at least twice a year and avoids unreasonable force on their teeth,
they can expect many years of service from porcelain veneers. You
cannot abuse them by using your veneered teeth to crack open nuts,
pull pins out of shirts, or as one of our patients said, “use your
teeth like a Swiss Army Knife”. Doing so would likely cause
breakage.
Q.
Can I eat normally with porcelain veneers?
A. You can eat
normally with veneers. Foods like corn, apples, chicken, ribs, fresh
fruits and vegetables, carrots, etc., are all fine. So are sandwiches
and bagels. You cannot use your teeth to break open nuts or eat stale
breads that would require a hacksaw without causing veneers to develop
cracks or actually break. Repeated abuse of veneered teeth will weaken
them and then, one day, something might break while you are eating a
tuna fish sandwich on white bread. This would only happen if the
veneers had been damaged by prior abuse.
Q.
What do you do if something happens to a porcelain veneer?
A. If a veneer chips
or cracks, it can usually be repaired successfully. If it completely
breaks, it may need to be replaced.
Q.
What is the difference between a porcelain veneer and a crown?
A. A classical
porcelain veneer covers just the outside and biting edge of a tooth
and requires a minimal amount of tooth reduction. A crown would go
completely around a tooth and require more then twice the amount of
tooth reduction. That is why we recommend porcelain veneers unless the
tooth is extensively decayed beyond the point where a crown is
necessary. Sometimes, in one patient, we use a combination of
porcelain veneers and crowns to get the best most conservative result.
Q.
Can a porcelain veneer close spaces between my teeth?
A. Porcelain veneers
are an excellent way to close spaces in between teeth in just two
weeks with no braces.
Q.
Can a porcelain veneer make crooked teeth straight?
A. Porcelain veneers
are an excellent way to make crooked teeth straight in just two weeks
with no braces.
Q.
If I’m not sure what I want, can I try bleaching my teeth first and
then do veneers later if I am not happy with the results.
A. You can always
start with bleaching and then use veneers later. In your consultation
with the doctors, they will let you know what results you can expect
from bleaching and then you can decide what you want to do. Some
people may decide to start with bleaching and contouring and then do
veneers in the future.
Q.
Can teeth darken after tooth whitening?
A. It depends on how
they are whitened. The same process that lets us bleach teeth can let
them darken again. Teeth are permeable. That means stains can go in
and out. Generally teeth that have been bleached will darken a little
over time but it would take at least several years for them to return
to their original color. If the teeth are whitened with veneers or
crowns, they will not darken significantly at all.
Q.
If teeth do darken after whitening, what can I do?
A. If they darken more
than you want, you can them again. As long as you save your models and
bleaching trays, you can do a touch up bleaching for a few days at any
time in the future by purchasing an inexpensive touch-up kit of bleach
material.
Q.
What can cause teeth to be dark?
A. Some people simply
start out with darker teeth than other people. Anything that could
stain a white cloth can cause your teeth to darken. The worst
offenders are smoking of any kind, dark beverages like red wine and
cokes, and dark gravies and sauces. Skipping regular cleanings also
lets deposits build up and penetrate into the tooth to darken them.
Q.
If I smoke or eat and drink foods that tend to stain teeth, does that
mean I can’t whiten my teeth?
A. Regardless of your habits, you can have whiter teeth. If your teeth
are dark and your habits tend to stain your teeth, you will get a less
than desirable result from the tooth bleaching and will have to do it
longer and more frequently. You do have other options, such as
porcelain veneers, that can give you the color you want without
relying on tooth bleaching.
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3)
Dental Treatments
a)
Root Canal
Q.
Does
a root canal have to take many visits to the dentist?
Q.
What does
a root canal hurt?
Q.
I had a root canal and then my tooth broke. Why did that happen?
Q.
Why do people need
a root canal?
Q.
What is
a root canal treatment?
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Q.
Does root canal have to take many visits to the dentist?
A. A root canal is
done to remove the infection and seal the canals in the tooth. This
can often be done in one visit. Sometimes two or three visits are
needed depending on the individual tooth and degree of infection.
Q.
What does a root canal hurt?
A. Root canal
treatment is done in the case of an infected nerve. Usually a tooth
having root canal treatment can be made numb with a local anesthetic
and it doesn’t hurt at all. Sometimes, a tooth with an infected
nerve does not react to Novocain as well as a normal tooth and takes
more work to get it completely not sensitive.
Q.
I had a root canal and then my tooth broke. Why did that happen?
A. The root canal
treatment was fine. The problem is the tooth was weakened by prior
decay and required a cap to fix the tooth. If that was not done, the
tooth. even with a successful root canal can break.
Q.
Why do people need a root canal?
A. A root canal is
needed due to an infection in the tooth. This is usually due to an
extremely deep cavity or, less often, due to a blow to the tooth. A
tooth could have a deep cavity and the doctor might not know that the
tooth needs a root canal because nothing shows in an x-ray and the
patient has no pain. Then, a week or a year or many years later,
something may show up in an x-ray or the patient could report pain. If
that happens, root canal treatment would be done at that time.
Q.
What is a root canal treatment?
A. A root canal is a
process where infection is cleaned out of the inside of the tooth and
the canal is sealed to prevent re-infection.
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b)
Gum Treatment
Q.
If I have my gums treated, can gum diseases come back?
Q.
If my gums aren’t that bad, do I still need surgery?
Q.
Are
there any options besides gum surgery for bleeding gums?
Q.
Can gum recession be prevented?
Q.
How is gum recession treated?
Q.
If my tooth is loose, how can it be tightened?
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Q.
If I have my gums treated, can gum diseases come back?
A. Gum disease can be
controlled and slowed down, but in cannot be permanently cured. Anyone
with teeth can develop gum disease. If you have already had problems
with your gums, you know you have the potential for future problems.
However, you do not need to lose your teeth because of it. If you can
control the cause of gum disease your gums can be returned to a state
of health and you can consider yourself a “healed periodontal
patient”.
Q.
If my gums aren’t that bad, do I still need surgery?
A. Periodontal surgery
is done in a case where there is extensive gum disease, bone loss or
gum recession. In cases where the gum disease is more moderate, more
conservative procedures such as scaling and root planing may be
performed.
Q.
Are there any options besides gum surgery for bleeding gums?
A. Bleeding gums is a
sign of infection but bleeding gums alone do not tell us how extensive
the damage is or what treatment is needed. Unless there is an acute
abscess, we always start with cleanings, scaling and root planing and,
especially, home care instructions. Sometimes that is all that is
needed to treat the gum infection.
Q.
Can gum recession be prevented?
A. Gum recession can
usually be prevented by detecting a condition that could cause the
recession and then stopping it before recession occurs. Examples of
causes of gum recession are gum inflammation that could lead to
recession and bone loss, tooth clenching and grinding that can lead to
bone loss, developmental defects in the gum tissue or cheek muscles
and, rarely, people who brush compulsively with a very hard tooth
brush.
Q.
How is gum recession treated?
A. Gum recession is
treated by first stopping the cause. Then periodontal grafting
procedures can be performed to replace the missing gum tissue.
Q.
If my tooth is loose, how can it be tightened?
A. Loose teeth are a
sign of bone loss. A tooth with healthy bone will never be obviously
loose. If the damage is not too severe, especially if it is due to
tooth clenching or grinding, the damage can usually be reversed by
fixing the bite. If the tooth is moderately loose due to bone loss, it
is often possible to join it to a stronger adjacent tooth, often with
a cap to strengthen it. If it is very loose due to severe bone loss,
it may not be treatable at all.
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c)
Dental Implants
Q.
Do dental implants hurt?
Q.
Do dental implants look and feel natural?
Q.
How long does it take to get implants?
Q.
Can you be too old for dental implants?
Q.
Can you be too young for dental implants?
Q.
Are there any medical conditions why a person couldn’t have
dental implants?
Q.
Can dental implants replace a single tooth?
Q.
Can dental implants replace many teeth at the same time?
Q.
If you already have removable bridge work or dentures, could they
be replaced by dental implants.
Q.
Why would I get a dental implant compared to a fixed bridge to
replace a missing tooth?
Q.
Are there any disadvantages to a dental implant compared to a more
traditional fixed bridge?
Q.
Are there cases when an implant is not the best way to replace a
missing tooth?
Q.
Do implants always look as good as other tooth replacement methods?
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Q.
Do dental implants hurt?
A. Placing dental
implants is a surgical procedure, so there is definitely some mild
discomfort after the surgical phase. After the initial healing phase
passes, there is nothing to be fearful of in so far as pain is
concerned.
Q.
Do dental implants look and feel natural?
A. Dental implants
can be made to look great. Patients with dental implants report that
biting and chewing feel perfectly natural.
Q.
How long does it take to get implants?
A. Placing an implant
requires one surgical visit and several follow up visits to check the
healing and remove the sutures. The purpose of the dental implants is
to replace missing teeth, so in addition to the surgical placement of
the implants, the patient must wait 3 to 6 months while the bone heals
and then another month or two for the final dental bridgework.
Q.
Can you be too old for dental implants?
A. You cannot be too
old for dental implants. The issue is your health. As long as the
patient is a candidate for elective surgery, they can have dental
implants. A patient with medical conditions such as uncontrolled
diabetes, heart disease, severe hypertension etc., would not be an
appropriate candidate for dental implants.
Q.
Can you be too young for dental implants?
A. Usually dental
implants are done for patients whose jaw bones are fully formed, so
that would be late teenage years.
Q.
Are there any medical conditions why a person couldn’t have dental
implants?
A. Medical conditions
that would preclude the placement of dental implants would include
people with problems healing, such as people with AIDS and people who
are not candidates for elective surgery, such as people who have
uncontrolled diabetes, severe high blood pressure or heart disease.
Q.
Can dental implants replace a single tooth?
A. Dental implants are
a good way to replace a single missing tooth as long as the adjacent
teeth are in good health and good alignment.
Q.
Can dental implants replace many teeth at the same time?
A. Dental implants are
often used to replace several missing teeth when there aren’t
sufficient teeth for fixed or non-removable bridgework. In that case,
one implant is generally placed for each missing tooth to be replaced.
Q.
If you already have removable bridge work or dentures, could they be
replaced by dental implants.
A. Many patients who
get dental implants do so because they are uncomfortable with the old
removable bridgework that they had.
Q.
Why would I get a dental implant compared to a fixed bridge to replace
a missing tooth?
A. Placing dental
implants and then putting a cap on it is a great way to replace a
missing tooth if you do not want to put caps on the teeth adjacent to
the missing tooth, or if there aren’t enough strong teeth to support
a fixed bridge near the missing tooth. This is especially true if the
adjacent teeth are perfectly healthy, straight, decay free-teeth and
the patient would rather avoid capping them.
Q.
Are there any disadvantages to a dental implant compared to a more
traditional fixed bridge?
A. The disadvantage of
the implant is that two surgical procedures need to be done to place
the implant and then place the supporting post in the implant so that
a cap can be placed to replace the missing tooth. This takes several
months. And the cost for a dental implant, plus the post and crown, is
greater than a conventional fixed bridge. If the patient has perfectly
good teeth adjacent to the missing tooth, the benefits of not having
to cap those teeth may be worth the extra time and expense.
Q.
Are there cases when an implant is not the best way to replace a
missing tooth?
A. If the teeth
adjacent to the missing tooth are crooked, decayed or already have big
leaking fillings, and need to be capped anyway, it makes no sense to
go through the time and expense of a dental implant and then have to
cap the adjacent teeth anyway. Also, if there is not an adequate
amount of jaw bone to hold the dental implant, bone grafting
procedures may need to be done and the patient would need to evaluate
the benefits of the implant approach versus the time and expense of
the implants and bone graft.
Q.
Do implants always look as good as other tooth replacement methods?
A. There are times
when dental conditions such as bone loss or gum recession may allow a
dentist to use a dental implant to adequately replace a missing tooth
but not restore the normal shape and contour of the gum tissue. In the
back of the mouth, where it doesn’t show, this may not matter. In
the front of the mouth, it could result in a chewing success but an
appearance failure. That is one reason why dental implants, as great
as they are, are not a panacea for the replacement of all missing
teeth.
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4)
Gums
Q.
My gums bleed. Is that normal?
Q.
If I brush my teeth regularly at home, do I need to use dental floss?
Q.
My gums have receded; can that be fixed?
Q.
My gums receded and the tooth is sensitive, can that be stopped?
Q.
I’ve always had gum problems, will I lose my teeth?
Q.
Does gum disease cause bad breath?
Q.
My gums are red, why is that?
Q.
Does the monthly menstrual cycle affect your gums?
Q.
Do certain medicines cause bleeding gums?
Q.
My gums are receded but don’t bleed or hurt, is that a problem?
Q.
My gums hurt. What could cause that?
Q.
I have a bump on my gum that comes and goes. What could that be?
Q. My gums have a whitish color between the teeth. What could that be?
Q.
My gums have receded, especially in the front in between the teeth.
What could that be?
Q. I have a bad taste in my mouth. Could that be from my gums?
Q.
I am concerned about bad breath. Could that come from gum disease?
Q.
Does Listerine help treat gum disease?
Q.
Are there any toothpastes or mouthwashes that can prevent gum
disease?
Q.
What is plaque?
Q.
What is calculus or tartar?
Q.
Is plaque the problem or is it tartar?
Q.
How can I have gum disease, my gums don’t hurt?
Q.
How often do I need professional cleanings?
Q.
I’ve heard hard brushing can cause gum recession. Is that true?
Q.
What kind of toothbrush is best for your gums?
Q.
I have a receded area on my gums and the dentist put in a filling
because the tooth was sensitive. Can the recession still be fixed?
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Q.
My gums bleed. Is that normal?
A. No, that is not
normal. Bleeding gums are a sign of infection. Start brushing and
flossing and seek professional care.
Q.
If I brush my teeth regularly at home, do I need to use dental floss?
A. Yes you need to
floss because flossing cleans in between the teeth where even the best
brushing cannot clean.
Q.
My gums have receded; can that be fixed?
A. Gum recession can
often be repaired by periodontal reconstruction procedures. Even if
the tooth has a filling or crown, it can usually be done.
Q.
My gums receded and the tooth is sensitive, can that be stopped?
A. The sensitivity can
be treated by fluoride treatment, repairing the gum recession or
replacing a bonded filling in the tooth, depending on the situation.
Finding the cause ofthe recession is very important so the process can
be stopped or it will continue.
Q.
I’ve always had gum problems, will I lose my teeth?
A. If you don’t stop
the gum problems, it is likely that you will lose teeth. However, gum
disease can be successfully treated and controlled with modern
state-of-the-art periodontal care as long as you catch it soon enough.
Do not wait till it gets so bad that it is too late.
Q.
Does gum disease cause bad breath?
A. Most bad breath is
caused by bacteria and bacterial by-products in the mouth. Gum disease
is a major cause of bad breath
Q.
My gums are red, why is that?
A. Redness is usually
a sign of gum infection. The classic signs of infection, whether in
the gums or any other part of the body are swelling, increased
temperature and redness.
Q.
Does the monthly menstrual cycle affect your gums?
A. Hormonal changes
affect all of the body, including the reaction of our gums to the
germs in plaque. In other words, the plaque causes gum problems. The
hormonal changes lower the body's resistance to plaque. Extra flossing
and brushing should stop bleeding gums during menstrual cycles and
pregnancy.
Q.
Do certain medicines cause bleeding gums?
A. No, they don’t
cause gums to bleed. Germs cause gums to bleed. However, certain
medicines, like anti-convulsion drugs such as dilantin and blood
pressure drugs such as Norvasc, do make your gums more sensitive to
plaque that is already there, resulting in more bleeding.
Q.
My gums are receded but don’t bleed or hurt, is that a problem?
A. Yes, it is a
problem. When the gums recede, the bone that holds the teeth also
recedes. That can reduce the support for the teeth and result in tooth
loosening and ultimate loss of teeth.
Q.
My gums hurt. What could cause that?
A. Pain in the gums is
the result of an acute gum infection. Causes could be gum abscess or
an abscess originating from a tooth. Virus infections such as herpes
can make gums sore. Canker sores, cold sores and trench mouth (ANUG)
can also make the gums hurt.
Q.
I have a bump on my gum that comes and goes. What could that be?
A. It is probably an
abscess that is draining through the gum tissue. It is very important
to cure the infection because damage to the bone is happening all the
time, even when the bump goes away.
Q.
My gums have a whitish color between the teeth. What could that be?
A. It could be a sign
of a gum infection called ANUG. This also used be called Trench Mouth
and typically occurs in teenagers and young adults who don’t brush
and floss regularly when they are going through a period of high
stress.
Q.
My gums have receded, especially in the front in between the teeth.
What could that be?
A. It could be due to
teeth clenching or grinding, damaging the bone. As the bone recedes,
so does the gum tissue causing gum recession.
Q.
I have a bad taste in my mouth. Could that be from my gums?
A. Yes, it could.
Bacteria and bacterial products such as sulfur compounds can
accumulate and putrefy. These compounds taste and smell like rotting
meat - a most unpleasant taste and smell. Unfortunately, most people
cannot smell their own breath and don’t notice the foul taste of gum
disease because they get used to it.
Q.
I am concerned about bad breath. Could that come from gum disease?
A. Gum disease is by
far the number one cause of bad breath. But it can be treated.
Q.
Does Listerine help treat gum disease?
A. Listerine can kill
some germs but not the germs that cause periodontal disease, so it is
not an effective treatment for gum disease.
Q.
Are there any toothpastes or mouthwashes that can prevent gum disease?
A. Today, the most
effective toothpastes and mouth washes to fight periodontal disease
are the ones that contain chlorine dioxide. There are several brands,
most of which have been developed by a dentist and dispensed directly
from dentist offices. They are designed to neutralize and break up the
volatile sulfur compounds that are made by bacteria to break down the
gum tissue.
Q.
What is plaque?
A. Plaque is a film
that accumulates on the teeth and contains bacteria, bacterial
by-products and food particles.
Q.
What is calculus or tartar?
A. They are both the
same thing. If plaque builds up on the teeth and is not removed every
day, calcium in the saliva may be deposited into the plaque, creating
a hard layer on the teeth. If that is not cleaned off by your dentist
or hygienist, it encourages more plaque to form and leads to gum
disease.
Q.
Is plaque the problem or is it tartar?
A. The problem is the
bacteria and bacterial by-products in plaque. Tartar or calculus on
the tooth makes plaque accumulate faster and together leads to bone
loss and gum disease.
Q.
How can I have gum disease, my gums don’t hurt?
A. Gum disease rarely
hurts. In fact, sometimes the only sign of gum disease is when a
patient notices a tooth has become loose or a bad taste develops in
their mouth. At that point, it may be too late to save the tooth.
Regular cleanings and check-ups are the key to discover these problems
before they get too bad.
Q.
How often do I need professional cleanings?
A. The frequency of
professional cleanings depends on the individual. Everyone is
different. Some people need more sleep than others to be properly
rested, and cleanings are no different. People with good plaque
control, daily brushing and flossing and high natural resistance can
have cleanings twice a year and still maintain optimal dental health.
People with less effective plaque control at home and lower natural
resistance need cleanings three or four times a year.
Q.
I’ve heard hard brushing can cause gum recession. Is that true?
A. Hard brushing with
a hard toothbrush could cause gum recession over a long period of time
but hard brushing is usually not the problem, especially if you use a
soft brush. Gum recession is usually due to other factors such as
tooth grinding.
Q.
What kind of toothbrush is best for your gums?
A. The best type of
brush to use is a soft brush with round ended bristles in the case of
a manual brush. Electric brushes are good too, such as the Rotadent.
Q.
I have a receded area on my gums and the dentist put in a filling
because the tooth was sensitive. Can the recession still be fixed?
A. Even if there is a
filling in the tooth in the receded area, it probably can be fixed.
You’ll need to consult with a Periodontist to be sure. The procedure
is to remove the old filling or even a crown, graft the gum tissue to
fix the recession and, in the case of a crown, make a new one. In the
case of a filling, a replacement is usually not needed.
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