How often should I have a dental exam and cleaning?
Unless your doctor recommends otherwise, you should have your teeth checked and cleaned at least twice a year.
Regular dental visits are essential to prevent problems and maintain healthy teeth and gums. At these visits, we clean your teeth, of course, and check for cavities, but we also:
Review Your Medical History: Knowing the status of any current medical conditions, new medications, or illnesses gives us insight into your overall health as well as your dental health.
Review Your X-Rays (radiographs): Essential for detecting decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
Oral Cancer Screening: We check the face, neck, lips, tongue, throat, and gums for any cancer signs.
Screen for Gum Disease: We check the gums and bones around the teeth for periodontal disease signs.
Screen for Tooth Decay: We check all tooth surfaces for decay with special dental instruments.
Evaluate Existing Restorations: We check current fillings, crowns, etc.
Remove Plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is composed of a growing colony of living bacteria, food debris, and saliva. The bacteria inflame the gums. This inflammation is the start of periodontal disease!
Remove Calculus (Tartar): Calculus is a plaque that has been left on the tooth and hardens until it becomes firmly attached to the tooth surface. Calculus forms above and below the gum and can only be removed with special dental instruments.
Polish Teeth: Polishing removes any stains and plaque not removed during tooth brushing and scaling.
Review Your Oral Hygiene: We review and recommend oral hygiene aids as needed (electric toothbrushes, special cleaning aids, fluorides, rinses, etc.).
Review Your Dietary Habits: Your eating habits play a significant role in your dental health.
Why is it important to use dental floss?
Brushing teeth removes food particles, plaque, and bacteria from tooth surfaces, but not between the teeth. Your toothbrush can’t reach these areas, so they’re especially susceptible to decay and periodontal (gum) disease.
Daily flossing is the best way to clean between the teeth and under the gum line. Flossing not only helps clean these spaces, but it also disrupts the build-up of plaque colonies that damage the gums, teeth, and bone.
When plaque is not removed above and below the gum line, it hardens and turns into calculus (tartar). This irritates and inflames the gums and slowly destroys the bone. Daily flossing will help you keep a healthy, beautiful smile for life!
Click here to learn about “Best technique for flossing.”
• Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
• Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
• Curve the floss into a “C” shape around each tooth and under the gum line. Gently move the floss up and down, cleaning the side of each tooth.
How often should I brush my teeth?
Brushing and flossing help control the plaque and bacteria that cause dental disease.
Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.
We also recommend electric toothbrushes: They remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job.
Click here to learn about “How to brush teeth properly”
• Brush at a 45-degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
• Brush the outer, inner, and biting surfaces of each tooth.
• Use the tip of the brush head to clean the inside front teeth.
• Brush your tongue to remove bacteria and freshen your breath.
How can I tell if I have gingivitis or periodontitis (gum disease)?
Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is painless in its early stages. Unlike decay, which often causes discomfort, you can have periodontal disease without noticeable symptoms. Regular dental check-ups are essential to detect periodontal disease before it becomes painful and expensive.
What is plaque?
Plaque is a sticky, almost invisible film that forms on the teeth. It is composed of a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
Poor oral hygiene is the leading cause of periodontal disease, but there are other important factors that increase your risk of this disease:
Click here to learn about “Other Factors That May Increase Your Risk of Periodontal Disease.”
Smoking or chewing tobacco: Tobacco users are more likely than non-users to form plaque and tartar on their teeth.
Certain tooth or appliance conditions
Bridges that no longer fit properly, crowded teeth, or defective fillings trap plaque and bacteria.
Many medications
Steroids, cancer therapy drugs, blood pressure medications, and oral contraceptives all have side effects that reduce saliva and make it easy for plaque to adhere to the teeth and gums.
Pregnancy, oral contraceptives, and puberty
Cause changes in hormone levels that can make your gums especially sensitive to bacterial toxins.
Systemic diseases
Such as diabetes, blood cell disorders, or HIV/AIDS, all increase your risk of periodontitis.
Genetics
Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay special attention to their gums.
Signs and Symptoms of Periodontal Disease: red and puffy gums – Gums should never be red or swollen.
1. Bleeding gums
Gums should never bleed, even when you brush vigorously or use dental floss.
2. Persistent bad breath
Caused by bacteria in the mouth.
3. New spacing between teeth
Caused by bone loss.
4. Loose teeth
Also caused by bone loss or weakened periodontal fibers that connect the tooth to the bone.
5. Pus around the teeth and gums
Indicate that infection is present.
6. Receding gums
Loss of gum around a tooth.
7. Tenderness or Discomfort
Caused by plaque, calculus, and bacteria that irritate the gums and teeth.
Good oral hygiene, a balanced diet, and regular dental visits can reduce your risk of periodontal disease.
What should I do if I have bad breath?
Bad breath (halitosis) can be unpleasant and embarrassing. Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.
In healthy people, the primary cause is microbial deposits on the tongue, especially on the back of the tongue. Simply brushing the tongue can reduce bad breath by as much as 70 percent.
Click here to learn about “What may cause bad breath?”
1. Morning time
Saliva flow declines dramatically during sleep and allows bacteria to grow, causing bad breath.
2. Certain foods
Garlic, onions, etc. contain odor-causing compounds that enter the bloodstream and are exhaled through the lungs.
3. Poor oral hygiene
Food particles remaining in the mouth promote bacterial growth.
4. Periodontal (gum) disease
Colonies of bacteria and food debris residing under inflamed gums.
5. Dental cavities and improperly fitted dental appliances
Contribute to bad breath.
6. Dry mouth (Xerostomia)
May be caused by medications, salivary gland problems, or mouth breathing.
7. Tobacco products
Dry the mouth, causing bad breath.
8. Dieting
Certain chemicals called ketones are released in the breath as the body burns fat.
9. Dehydration, hunger, and missed meals
Drinking water and chewing food increases saliva flow and washes away bacteria.
10. Certain medical conditions
Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia, may contribute to bad breath.
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.
What can I do to prevent bad breath?
1. Practice good oral hygiene
Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque between the teeth and under the gum line. Brush or use a tongue scraper to clean the tongue and reach the back areas. Replace your toothbrush every 2 to 3 months. If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
2. See your dentist regularly
Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, your dentist will recommend more frequent visits.
3. Stop smoking/chewing tobacco
Ask your dentist what you can do to break the habit.
4. Drink water frequently
Water will help keep your mouth moist and wash away bacteria.
5. Use mouthwash/rinses
Some over-the-counter products provide a temporary solution to mask unpleasant mouth odor. Ask your dentist about antiseptic rinses that not only alleviate bad breath but also kill the germs that cause the problem.
In most cases, your dentist can treat the cause of bad breath. If your bad breath is persistent, we may refer you to another physician to determine the root cause and plan appropriate treatment.
How can cosmetic dentistry help improve the appearance of my smile?
If you are self-conscious about your teeth and want to improve your smile, cosmetic dental treatments can give you more confidence.
Cosmetic Procedures:
Teeth Whitening:
Bleaching lightens teeth that have been stained or discolored by age, food, drink, injury, or medications.
Composite (tooth-colored) Fillings:
Also known as “bonding,” composite fillings are now widely used instead of amalgam (silver) to repair chipped, broken, or discolored teeth. This type of filling is also used to fill or protect root surfaces exposed by gum recession.
Porcelain Veneers:
Veneers are thin, custom-made, tooth-colored shells bonded onto the fronts of teeth to create a beautiful smile. They can restore or conceal damaged, malformed, discolored, or misaligned teeth. Unlike crowns, veneers require minimal tooth structure removal.
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.
Dental Implants:
Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth. Porcelain teeth, bridges, or dentures attach to the implants to give you a strong, stable, and durable alternative to removable dental appliances.
Orthodontics:
Less visible and more effective brackets and wires are making straightening teeth much more appealing to adult patients. Teeth may be straightened with custom-made, clear, removable aligners that are invisible and require no braces.
What are porcelain veneers, and how can they improve my smile?
Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth. They are durable and don’t stain, making them a popular solution to restore or enhance the beauty of your 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.
Veneers usually require two visits. They 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 smile.
With little or no anesthesia, we lightly buff and shape the front surface to make room for the thin veneers. They are fitted to the tooth surface with special bonding cement, and a specialized light may be used to harden and set the bond.
Veneers can dramatically improve your teeth and give you a natural, beautiful smile.
What can I do about stained or discolored teeth?
Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and enhances the brightness 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, revealing a darker or yellow shade. Smoking, coffee, tea, wine, some medications, and even excessive fluoridation (fluorosis) during tooth development contribute to tooth discoloration.
Have your teeth evaluated by our specialists to determine if you’re a candidate for bleaching. Since teeth whitening only works on natural tooth enamel, it is crucial to assess old fillings, crowns, etc. before bleaching. Once the bleaching is done, your dentist can match any new restorations to the shade of the newly whitened teeth.
A touch-up maybe needed every several years to keep your smile looking bright.
The most widely used teeth whitening systems:
Home whitening systems: At-home products usually come in a gel that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth. The trays are worn either twice a day for 30 minutes or overnight. It usually takes several weeks to achieve the desired results.
Professional whitening: This treatment is done in our dental office, and you’ll see the results immediately. We protect your gums and apply a bleaching solution to the teeth. A special light may be used to enhance the action.
Some patients may experience tooth sensitivity after having their teeth whitened. This is temporary and subsides quickly.
Are amalgam (silver) fillings safe?
Some people ask us about the safety of amalgam (silver) fillings. An amalgam is a blend of copper, silver, tin, and zinc bound by elemental mercury. Dentists have used amalgam to fill teeth for more than 100 years. The controversy is over claims that minute particles from the mercury may cause health problems.
The American Dental Association (ADA states that silver fillings are safe and that studies have failed to find any link between silver containing mercury and any medical disorder.
The professional consensus is that amalgam (silver) fillings are safe. The Center for Disease Control (CDC), the World Health Organization, the FDA, and others all support the use of silver fillings as safe, durable, and cost-effective. The U.S. Public Health Service says that the only reason to avoid silver fillings is when you have a known allergy to any of amalgam’s components; however, out of millions of silver fillings used over many decades, the ADA has had fewer than 100 reported incidents of an allergy to their components.
Mercury is a toxic material if you are exposed at high levels. We’ve been warned to limit the consumption of certain types of fish that carry high levels of mercury. However, the ADA maintains that when the mercury combines with the other components of amalgam fillings, it becomes inactive and is safe.
There are many options to silver fillings, including tooth-colored composite fillings, porcelain, and gold.
What are my options if I have missing teeth?
Injury, accident, severe decay, and gum disease are the primary reasons for tooth loss. It is important that missing teeth are replaced to avoid cosmetic and dental problems in the future.
When a tooth is lost, the jawbone that supported the tooth begins to atrophy, causing the teeth on either side to shift into the open space. The tooth above or below will also move towards the open space because there is no opposing tooth to bite on. The resulting misalignment can create decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems.
1. Removable bridges
This type of bridge is the right solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are impossible. They are 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 maybe less aesthetically pleasing because it is often impossible to completely conceal the metal clasps.
2. Fixed bridges
Made of porcelain or composite material and are anchored (cemented) permanently to natural teeth adjacent to the missing tooth. This type of bridge is fixed (not removable), and it is very sturdy. However, to create a fixed appliance, two healthy teeth will have to be crowned (capped) to hold the bridge in place.
3. Dentures
These are removable artificial teeth that are made to resemble the patients’ original teeth closely. This type of tooth replacement is used when most or all the natural teeth are missing in one dental arch.
4. Implants
A dental implant is an artificial root that is surgically placed into the jawbone to replace a missing tooth. An artificial tooth is attached on top of the implant, giving the appearance, feel, and stability of your natural tooth. Implants are very durable and are the most aesthetic tooth-replacement option. These artificial roots are also a great way to anchor ill-fitting dentures firmly.
Prevention and early treatment of missing teeth are always simpler than delaying treatment and allowing a serious and expensive problem to develop.
What can be done about old, unattractive, or discolored fillings?
Most of us have fillings in our mouths that date back many years. These fillings may now be dark, unattractive, or defective. When a filling is old, the margins (space between the tooth and filling) may spread. This allows bacteria and food debris to enter, inviting decay.
We can check your fillings and evaluate if they need replacement. There are many state-of-the-art dental filling materials and procedures available today that are quick and cost-effective for replacing old, unattractive, or defective fillings.
Options to replace old, unattractive, or discolored fillings:
1. Composite (bonding) fillings
These are tooth-colored fillings that can be closely matched to the color of your existing teeth. They are well suited for use in front teeth and are one of the best ways to improve the oral health and beauty of your smile.
2. Crowns (Caps)
This method of restoration is used when a tooth is too damaged to repair with a filling. A crown encases the entire tooth surface restoring its original shape and size. A crown protects and strengthens the remaining tooth structure and can be made of gold, porcelain, or other tooth-colored materials.
3. Inlays/Onlays
These are custom-made fillings. They can be composite resin, porcelain, or gold. They are made in a specialized dental laboratory but installed by your dentist. Inlays/Onlays are usually best for the posterior chewing surfaces of teeth to repair teeth with large defective/unattractive fillings or have been damaged by decay or trauma.
4. Porcelain veneers
These are primarily used in front teeth. They are very thin shells of porcelain that are individually formed, fitted, and permanently cemented to the front surface of your teeth. They are an excellent solution for discolored, pitted, chipped, malformed, or crooked teeth. Veneers are also used to fill unwanted spaces. Veneers are durable, natural-looking, and do not stain.
What do heart disease and other medical conditions have to do with periodontal (gum) disease?
Many people are unaware that periodontal disease can affect your overall health. Periodontal disease is common, often more prevalent than the common cold! It is not only the number one reason people lose teeth but can also profoundly affect the overall health of your body!
Periodontal disease is a bacterial infection. In its early stages, it’s called gingivitis. Good oral hygiene, a balanced diet, and regular dental visits can reduce your risk of developing periodontal disease.
Poor oral hygiene is the main cause of periodontal disease, but there are other important factors that increase your risk of this disease:
Click here to learn about “Other Factors That May Increase Your Risk of Periodontal Disease.
Smoking or chewing tobacco
Tobacco users are more likely than non-users 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 medications, and oral contraceptives all have side effects that reduce saliva and make it easy for plaque to adhere to the teeth and gums.
Pregnancy, oral contraceptives, and puberty
Cause changes in hormone levels that can make your gums especially sensitive to bacterial toxins.
Systemic diseases
Such as diabetes, blood cell disorders, or HIV/AIDS, all increase your risk of periodontitis.
Genetics
Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay special attention to their gums.
Signs and Symptoms of Periodontal Disease: red and puffy gums – Gums should never be red or swollen.
- Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
- Persistent bad breath – Caused by bacteria in the mouth.
- New spacing between teeth – Caused by bone loss.
- Loose teeth – Also caused by bone loss or weakened periodontal fibers that connect the tooth to the bone.
- Pus around the teeth and gums –Indicate that infection is present.
- Receding gums – Loss of gum around a tooth.
- Tenderness or Discomfort – Caused by plaque, calculus, and bacteria that irritate the gums and teeth.
When periodontal disease is not treated, it can eventually lead to tooth loss!
People with periodontal disease are at higher risk of systemic disease because oral bacteria may enter the bloodstream, travel to major organs, and begin new infections. Periodontal bacteria in the bloodstream 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 pre-term, low-birth weight baby.
There is still much research to be done to understand the complex links between periodontal disease and systemic diseases, but fortunately, it can be prevented. Regular dental check-ups and cleanings, which include a periodontal evaluation and proper diet, and faithful home dental hygiene, can ensure a healthy mouth and improve your overall health!
When are sealants recommended?
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 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 easier to clean and thus keep these areas free of decay.
Who may need sealants?
Children and teenagers – As soon as the first permanent back teeth appear or any time throughout the cavity prone years of 6-16.
Infants
Baby teeth are occasionally sealed if the teeth have deep grooves, and the child is cavity prone.
Adults
Tooth surfaces without decay that have deep grooves or depressions that are difficult to clean.
Sealants are easily applied, and the process takes only minutes per tooth.
The chewing surfaces are first roughened with a solution that helps the sealant; then, the sealant is “painted” onto the tooth, where it hardens and bonds to the tooth. Sometimes a special light will be used to help the sealant material hardens.
After the sealant treatment, it’s important to avoid chewing on hard or sticky foods. Your sealants will be checked for wear and chipping at your regular dental check-up.
What should I do if a tooth is knocked out?
Teeth that are knocked out may be saved and re-implanted if we act quickly and follow these simple steps:
1. Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
2. 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 saliva or whole milk. If that is not possible, rinse it very gently with water.
3. Place the tooth back in its socket immediately. Gently bite down on gauze, a wet tea bag, or on your teeth to keep the tooth in place. Apply a cold compress to the mouth for pain and swelling as needed.
4. If the tooth cannot be placed back into the socket, put the tooth in a container and cover it with a small amount of your saliva or whole milk, or you can 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.
5. Get to a dentist within 30 minutes. The longer you wait, the less chance there is for successful re-implantation.
6. 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 liquid solution for easy tooth transport.
Avoid traumatic tooth loss by following these simple steps.
- Wear a mouthguard when playing sports.
- Always wear your seatbelt.
- Avoid fights.
- Avoid chewing hard items such as ice, popcorn kernels, hard bread, etc.
Regular dental check-ups and cleanings, including a periodontal evaluation, proper diet, and faithful home dental hygiene, can ensure a healthy mouth and improve your overall health!