flash1 flash2 flash3 flash4
 
   
Murrieta Dentist

Murrieta Dental Videos

Murrieta Dental Services, Murrieta Dentist, Murrieta Family Dentist, Murrieta Cosmetic Dentist, Murrieta General Dentist, Dr. Long Phan, TLC Dental
Murrieta Dental Before & After, Murrieta Dentist, Murrieta Family Dentist, Murrieta Cosmetic Dentist, Murrieta General Dentist, Dr. Long Phan, TLC Dental
Murrieta Dental Services, Murrieta Dentist, Murrieta Family Dentist, Murrieta Cosmetic Dentist, Murrieta General Dentist, Dr. Long Phan, TLC Dental
 

Unlike other dental web sites, our FAQ is not prepared by one or two doctors. We have compiled the best answers for our FAQ, organizing it all here for you. So instead of getting your answer from an individual doctor, you get it from the most reputable sources.

All the answers provided are for general information only. Your dentist will be able to answer any specific questions about your case. You should consult your dentist before making any decisions regarding treatment for your oral health issues.

Contact us if you have a question and you live in or around Murrieta.

Select a category for your question:

 

D.D.S. or D.M.D. Degree: What's the difference?

by Simon W. Rosenberg, D.M.D.
based on some Research by
Kimberly A. Loos, D.D.S. and Brad J. Loos

Background:
Many people, including dentists, are confused over the use of the D.D.S. and D.M.D. degrees. Today some dental schools grant a D.D.S. (Doctor of Dental Surgery) degree while others prefer to award the D.M.D. (Doctor of Dental Medicine) degree instead. The training the dentists receive is very similar but the name of the degree granted is different.

Ancient medicine was divided into two groups: 1) the surgery group that dealt with treating diseases and injuries using instruments; and 2) the medicine group that dealt with healing diseases using medicine. Originally there was only the D.D.S. degree, which stands for Doctor of Dental Surgery. It was given by independent schools of dentistry that were more like trade or apprenticeship schools and in the beginning were not affiliated with any university.

The Harvard Factor:
This all changed in 1867 when Harvard University added a dental school. Harvard University only grants degrees in Latin. Harvard did not adopt the D.D.S. or Doctor of Dental Surgery degree because the Latin translation was Chirurgae Dentium Doctoris or C.D.D. The people at Harvard thought that C.D.D. was cumbersome. A Latin scholar was consulted. The scholar suggested the ancient Medicinae Doctor be prefixed with Dentariae. This is how the D.M.D. or "Dentariae Medicinae Doctor" degree was started. (Congratulations! Now you probably know more Latin than most dentists!)

The Current Picture:
At the turn of the 20th century, there were 57 dental schools in the U.S. but only Harvard and Oregon awarded the D.M.D. In 1989, 23 of the 66 North American dental schools awarded the D.M.D. I think about half the Canadian dental schools now award the D.M.D. degree. In the Northeast, Tufts (my alma mata), Harvard, Boston Univ., Univ of Connecticut, New Jersey College of Medicine and Dentistry, Pennsylvania Univ., and Temple Univ. all issue D.M.D. degrees to their dental school graduates.

The American Dental Association (A.D.A.) is aware of the public confusion surrounding these degrees. The A.D.A. has tried on several occasions to reduce this confusion. Several sample proposals include: 1) eliminate the D.M.D. degree; 2) eliminate the D.D.S. degree; or 3) eliminate both degrees and invent a brand new degree that every dental school will agree to use. Unfortunately, this confusion may be with us for a long time. When emotional factors like school pride and tradition arise, it is difficult to find a compromise.

The California Dental Association (CDA) debated the differences between dental degrees during 1997 and could not form a consensus. In places like New York where D.D.S. is the most common degree, some dentists with D.M.D. degrees prefer to use the D.D.S. as their degree on their stationary or when they advertise. These dentists argue that in their areas the public understands that D.D.S. means "dentist". Indeed, many entities such as the New York and California State Boards of Dental Examiners communicate with all licensed dentists as D.D.S., even if they originally graduated with a D.M.D. or other similar dental degree. Some D.D.S. dentists object to D.M.D. dentists using D.D.S., mostly out of a desire to cut down on competition. Is this an educational or equality issue?

In my experience, where I have only used D.M.D. since receiving it from Tufts University in Boston, there are a group of patients that think the D.M.D. is a better degree. Some patients think that it is a variation of the M.D. medical degree or that the D.M.D. degree is “superior” in some way because it is given by what they consider to be better universities -- either Ivy League or the more elite colleges such as Tufts, Harvard, BU, Penn, etc. Generally, it is the state schools such as SUNY at Buffalo and at Stony Brook, or dental schools that started as independent schools that later affiliated with universities, such as NYU’s and Columbia’s dental schools, that give D.D.S. degrees.

In academic and political circles, advocates for the D.D.S. say it represents the "Doctor of Dental Surgery" aspect of treatment since most of dental treatment involves the cutting or removing of tooth, gum or jaw bone tissue before restoring it. D.M.D. advocates emphasize the so-called Medical model where emphasis is on information gathering and diagnosis before treatment is planned. In that approach to dental care the patient’s medical history, general health and the reasons the patient has sought care is gathered. Then all of the soft tissues of the head and neck are examined to identify abnormalities such as oral cancer, local oral pathology or oral signs of a systemic disease such as diabetes, blood disease, etc. Following this there is an assessment of the periodontal (gum) condition and the teeth are examined for decay, functional bite, esthetics as well as their orthodontic and jaw relation. All of these factors are considered and the dentist and patient act as “partners” in determining the treatment to be done and the priorities and treatment sequences.

Who’s “Right” in this argument about D.M.D. versus D.D.S.?

In my opinion, neither side.
Dentistry today demands proper diagnosis that takes into consideration all of your patient and dental factors and plans treatment geared to your desires and financial realities. All dental schools now emphasize excellence in both diagnosis and clinical skills and I think most dentists practice with that as their goals as well. You need to choose a dentist whom you feel has done a good job of examining you with all of the tools of modern dentistry, has an office with proper infection control and a “quality care” environment and whom you feel comfortable and confident that their dental team can provide you with the level of dental care you need and want.

I hope this article provides some historical and current details regarding these equivalent dental degrees.

back to top


FELLOWS AND MASTERS OF THE AGD

What do these designations mean?
Your general dentist cares about long-term dental health for you and your family and demonstrates that concern by pursing additional designations. The Fellowship and Mastership designations are two of the most rigorous continuing dental education programs today.

What are the Fellows of the AGD?
A general dentist who is a “Fellow” in the Academy of General Dentistry (FAGD) has been recognized by other general dentists as a leader and an example to other dentists of the importance of quality continuing dental education. To earn a FAGD, your dentist must complete a minimum of 500 continuing dental education credit hours, pass a comprehensive exam and have been an AGD member for three continuous years.

What are Masters of the AGD?
A general dentist who has earned the designation “Master” of the AGD (MAGD) has completed a structured and demanding set of requirements. To attain a MAGD, your dentist must first be a Fellow in the AGD. Then your dentist must earn an additional 600 approved continuing dental education credits, meeting minimum requirements in certain dental disciplines, of which 400 hours are hands-on courses.

How do these designations benefit my family and me?
Fellows and Masters of the AGD follow a lifelong pursuit of continuing education. They want to provide the highest quality of dental care to you and your family. The awards symbolize the professional responsibility of your dentist to remain current in their profession. These are awards however, and should not be confused with post-graduate degrees or certification. Every dentist who applies for the Fellowship or Mastership Award has their application reviewed by the AGD to ensure they meet AGD’s high standards.

How does my dentist’s membership in AGD benefit my family and me?
Your general dentist cares about long- term dental health for you and your family and demonstrates that concern by belonging to the AGD. Members are dedicated to continuing education to help them stay up-to-date on the latest procedures to provide you and your family with quality treatment. The general dentist who remains current in general dentistry is better able to offer you and your family a variety of diagnosis and treatment choices.

What are the requirements to become an AGD member?
Members never stop learning since the AGD requires its members to participate in 75-hours of voluntary continuing education every three years. However, surveys show that members average more than 40 hours each year.

Compiled for you by the Academy of General Dentistry
www.agd.ord

back to top


Are you taking new patients?

YES. Because our patients love us they often refer their friends and family because they want to see them receive the same level of care. We are proud of the confidence our patients have placed in us by being a referral only based practice.

We’d love for you to send in somebody as nice as you!

back to top

What happens at my first visit?

In order to treat each and every patient, as an individual with unique dental needs it is vital to completely assess their current oral health. We perform an oral cancer screening, we look at muscles and joints that open and close the mouth. We will look at your teeth, and your gums and bone that hold the teeth (the periodontium). We then take photos and x-rays when necessary. With this information we can determine the type of treatment that is right for you.

back to top

What Do You Offer for the Nervous, Anxious Patients?

We realize that even though dental care has come a long way in terms of patient comfort, there are still those with concerns and fears. Dental care should not be an unpleasant experience so we provide a full array of options for those patients. We offer several techniques to help you relax so please ask us about the different methods we offer.

back to top

What is Fluoride?

For decades, fluoride has been held in high regard by the dental community as an important mineral that is absorbed into and strengthens tooth enamel, thereby helping to prevent decay of tooth structures.

In nearly every U.S. community, public drinking supplies are supplemented with sodium fluoride because the practice is acknowledged as safe and effective in fighting cavities.

Some private wells may contain naturally fluoridated water.

What Is Fluoride?

Fluoride is a safe compound found throughout nature-from the water we drink and air we breathe, to many kinds of foods.

Why Is Fluoride Important To Teeth?

Fluoride is absorbed into structures, such as bones and teeth, making them stronger and more resistant to fractures and decay. A process in your body called "remineralization" uses fluoride to repair damage caused by decay.

How Do I Get Fluoride?

Just drinking public water will provide a certain measure of fluoride protection. But for years, health professionals have endorsed the practice of supplementing our intake with certain dietary products, and topical fluorides in many toothpastes and some kinds of rinses. Certain beverages such as tea and soda may also contain fluoride. Certain kinds of dental varnishes and gels may also be applied directly to teeth to boost fluoride intake.

Fluoride Safety

It is generally NOT safe to swallow toothpastes, rinses, or other products containing topical fluoride. In rare cases, some people may be overexposed to high concentrations of fluoride, resulting in a relatively harmless condition called fluorosis, which leaves dark enamel stains on teeth.

back to top


How to Treat Canker Sores?

Common causes of canker sores:

  • Local trauma and stress
  • Diet and food allergies
  • Hormonal changes
  • Use of certain medications

Common treatments of canker sores:

  • Antimicrobial mouthwashes
  • Local painkillers
  • Over-the-counter remedies (oral adhesive patches, liquids and gels)

Updated: October 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

Nutrition and your teeth

It has long been known that good nutrition and a well-balanced diet is one of the best defenses for your oral health. Providing your body with the right amounts of vitamins and minerals helps your teeth and gums-as well as your immune system-stay strong and ward off infection, decay and disease.

Harmful acids and bacteria in your mouth are left behind from eating foods high in sugar and carbohydrates. These include carbonated beverages, some kinds of fruit juices, and many kinds of starch foods like pasta, bread and cereal. While no links have been actually made between gum disease and a poor diet, nutrition problems (including obesity and overeating) can create conditions that make gum disease easier to contract.

Children's Nutrition and Teeth

Good eating habits that begin in early childhood can go a long way to ensuring a lifetime of good oral health.

Children should eat foods rich in calcium and other kinds of minerals, as well as a healthy balance of the essential food groups like vegetables, fruits, dairy products, poultry and meat. Fluoride supplements may be helpful if you live in a community without fluoridated water, but consult with our office first. (Be aware that sugars are even found in some kinds of condiments, as well as fruits and even milk.)

Allowing your children to eat excessive amounts of junk food (starches and sugars)-including potato chips, cookies, crackers, soda, even artificial fruit rollups and granola bars-only places them at risk for serious oral health problems down the road, including obesity, osteoporosis and diabetes. The carbonation found in soda, for example, can actually erode tooth enamel. Encourage your child to use a straw when drinking soda; this will help keep at least some of the carbonated beverage away from the teeth.

Adult Nutrition and Teeth

There's no discounting the importance of continuing a healthy balanced diet throughout your adult life.

If you develop a weight problem, change your diet and get regular exercise. Be aware that some so-called fad diets have been known to cause serious deficiencies in recommended levels of minerals and vitamins.

Of course, good oral hygiene helps ensure that harmful bacteria and plaque-the sticky substance that coats your teeth during sleep and after meals-are effectively minimized. Adults also are encouraged to avoid eating "sticky" foods such as caramels and dried fruits because they leave behind stubborn substances on teeth and only encourage needless plaque formation.

back to top


What Causes Bad Breath?

More than 80 million people suffer from chronic halitosis, or bad breath. In most cases it originates from the gums and tongue. The odor is caused by wastes from bacteria in the mouth, the decay of food particles, other debris in your mouth and poor oral hygiene. The decay and debris produce a sulfur compound that causes the unpleasant odor.

What causes bad breath?

Bad breath is primarily caused by poor oral hygiene but can also be caused by retained food particles or gum disease.

Does bad breath come from other sources than the mouth?

Bad breath also may occur in people who have a medical infection, diabetes, kidney failure or a liver malfunction. Xerostomia (dry mouth) and tobacco also contribute to this problem. Cancer patients who undergo radiation therapy may experience dry mouth. Even stress, dieting, snoring, age and hormonal changes can have an effect on your breath. An odor that comes from the back of your tongue may indicate postnasal drip. This is where mucus secretion, which comes from the nose and moves down your throat, gets stuck on the tongue and causes an odor.

Why is saliva so important in the fight against bad breath?

Saliva is the key ingredient in your mouth that helps keep the odor under control because it helps wash away food particles and bacteria, the primary cause of bad breath. When you sleep, however, salivary glands slow down the production of saliva, allowing the bacteria to grow inside the mouth. To alleviate "morning mouth," brush your teeth and eat a morning meal. Morning mouth also is associated with hunger or fasting. Those who skip breakfast, beware, because the odor may reappear even if you've brushed your teeth.

Do certain foods cause bad breath?

Very spicy foods, such as onions and garlic, and coffee may be detected on a person's breath for up to 72 hours after digestion. Onions, for example, are absorbed by the stomach, and the odor is then excreted through the lungs. Studies even have shown that garlic rubbed on the soles of the feet can show up on the breath.

How do I control bad breath?

It is important to practice good oral hygiene, such as brushing and flossing your teeth at least twice a day. Proper brushing, including brushing the tongue, cheeks and the roof of the mouth, will remove bacteria and food particles. Flossing removes accumulated bacteria, plaque and food that may be trapped between teeth. To alleviate odors, clean your tongue with your toothbrush or a tongue scraper, a plastic tool that scrapes away bacteria that builds on the tongue. Chewing sugar-free gum also may help control odor. If you have dentures or a removable appliance, such as a retainer or mouth-guard, clean the appliance thoroughly before placing it back in your mouth. Before you use mouth-rinses, deodorizing sprays or tablets, talk with your dentist, because these products only mask the odor temporarily and some products work better than others.

What is my dentist's role?

Visit your dentist regularly, because checkups will help detect any physical problems. Checkups also help get rid of the plaque and bacteria that build up on your teeth. If you think that you suffer from bad breath, your dentist can help determine its source. He or she may ask you to schedule a separate appointment to find the source of the odor. Or, if your dentist believes that the problem is caused from a systemic (internal) source, such as an infection, he or she may refer you to your family physician or a specialist to help remedy the cause of the problem.

Updated: February 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top


Electric or Manual Toothbrush?

Never before has there been such a dizzying array of toothbrushes on the market. Consumers are inundated with new designs, materials, attachments, and colors.

Whatever toothbrush design you choose, the most important thing is that you use the toothbrush--at least two or three times a day. Toothbrushes accomplish one major purpose: removing plaque. A good quality toothbrush with well-made bristles will accomplish that.

Moreover, how long you spend brushing your teeth is as critical as how often you brush your teeth. Many people simply brush for a few seconds, spit, and place the toothbrush back in the cup. It is very important to spend at least 2-3 minutes brushing your teeth. This helps to ensure that the brush doesn't miss hard-to-reach or often neglected surfaces. Use short, circular motions and brush at a 45-degree angle.

Following are some tips for choosing a toothbrush:

  • Choose toothbrushes with soft, round-headed bristles
  • Avoid big-headed toothbrushes. Dental associations recommend that you buy a toothbrush with a compact head-1" by 1/2"-so you can easily reach the small areas of your mouth.
  • Some toothbrushes today have wide handles. This helps you control the toothbrush better. So, choose a toothbrush with a handle that is long enough and wide enough for you to handle.
  • You should replace your toothbrush at least four times a year-more often if you have been sick.

Electric vs. Manual Toothbrushes

There are a wide variety of electric toothbrushes on the market today. Some are even disposable. A few models have even received positive reviews by the American Dental Association.

Electric toothbrushes, for the most part, can be just as effective as the old-fashioned, non-powered varieties. Some studies have shown electric toothbrushes cover more area quickly because of their rapid, rotating bristles.

If only the novelty of them, electric toothbrushes may encourage more frequent brushing among people who normally hate to brush. They also may be advantageous for people who have arthritis, or for children with braces who find it more difficult to navigate around the appliances with a manual toothbrush.

After testing numerous brushes, we have concluded that electric, if used, is the best. We usually recommend electric toothbrushes because of their design, ease of use, and availability. There are numerous models on the market that work well. If you have a question about a specific brand, please ask us.

 back to top


What is the Best Technique for Brushing?

There are a number of effective brushing techniques. Patients are advised to check with their dentist or hygienist to determine which technique is best for them, since tooth position and gum condition vary. One effective, easy-to-remember technique involves using a circular or elliptical motion to brush a couple of teeth at a time, gradually covering the entire mouth.

Place a toothbrush beside your teeth at a 45-degree angle and gently brush teeth in an elliptical motion. Brush the outside of the teeth, inside the teeth, your tongue, the chewing surfaces and between teeth. Using a back-and-forth motion causes the gum surface to recede, can expose the root surface or make the root surface tender. You also risk wearing down the gum line.

Soft or hard bristles?

In general, a toothbrush head should be small (1" by 1/2") for easy access. It should have a long, wide handle for a firm grasp and soft, nylon bristles with round ends. Some brushes are too abrasive and can wear down teeth. A soft, rounded, multi-tufted brush can clean teeth effectively. Press just firmly enough to reach the spaces between the teeth as well as the surface. Medium and hard bristles are not recommended.

How long should I brush?

It might be a good idea to brush with the radio on, since dentists generally recommend brushing three to four minutes, the average length of a song. Using an egg timer is another way to measure your brushing time. Patients generally think they're brushing longer, but most spend less than a minute brushing.

To make sure you're doing a thorough job and not missing any spots, patients are advised to brush the full three to four minutes twice a day, instead of brushing quickly five or more times through the day.

Should I brush at work?

Definitely, but most Americans don't brush during the workday. Yet a survey by Oral-B Laboratories and the Academy of General Dentistry (AGD) shows if you keep a toothbrush at work, the chances you will brush during the day increase by 65 percent.

Getting the debris off teeth right away stops sugary snacks from turning to damaging acids and catches starchy foods like potato chips before they turn to cavity-causing sugar. If you brush with fluoride toothpaste in the morning and before going to bed, you don't even need to use toothpaste at work. You can just brush and rinse before heading back to your desk. If you don't have a toothbrush, rinsing your mouth with water for 30 seconds after lunch also helps.

Tips to improve your office brushing habits:

  • Post a sticky note on your desk or computer as a reminder to brush teeth after lunch.
  • Brush teeth right after lunch, before you become absorbed in work.
  • Store your toothbrush and toothpaste at work in a convenient and handy place.
  • Make brushing your teeth part of your freshening-up routine at work.
  • When brushing at the office or away from home, it's important to make an extra effort to keep your toothbrush germ-free.

Tips on how to properly store and care for your toothbrush at work:

  •  Always store your toothbrush in a travel container.
  • Dry your toothbrush after use and before returning to its container.
  • Change the toothbrush you take to work more often than your toothbrush at home to avoid bacteria build-up.

Updated: February 2007

© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top


Why is Brushing With Toothpaste Important?

Brushing with toothpaste is important for several reasons. First and foremost, a toothpaste and a correct brushing action work to remove plaque, a sticky, harmful film of bacteria that grows on your teeth that causes cavities, gum disease and eventual tooth loss if not controlled. Second, toothpaste contains fluoride, which makes the entire tooth structure more resistant to decay and promotes demineralization, which aids in repairing early decay before the damage can even be seen. Third, special ingredients in toothpaste help to clean and polish the teeth and remove stains over time. Fourth, toothpastes help freshen breath and leave your mouth with a clean feeling.

Is brushing with toothpaste enough to fight cavities and gum disease?

No. Although brushing thoroughly after each meal helps, flossing your teeth every day to remove plaque and food particles between teeth and at the gum line is just as important. Studies show that plaque will re-grow on teeth that are completely clean within three to four hours of brushing.

Reviewed: January 2011

What Type of Toothpaste To Use

As long as your toothpaste contains fluoride, the brand you buy really does not matter, neither does whether or not it is in paste, gel or even powder form, or containing a certain flavor. All fluoride toothpastes work effectively to fight plaque and cavities and clean and polish tooth enamel. Your toothpaste brand should bear the ADA (American Dental Association) seal of approval on the container, which means that adequate evidence of safety and efficacy have been demonstrated in controlled, clinical trials.

If your teeth are hypersensitive to hot or cold, consider trying a toothpaste designed for sensitive teeth. These "desensitizing" toothpastes, which contain strontium chloride or potassium nitrate, protect exposed dentin by blocking the tubes in the teeth that are connected to nerves. Desensitizing pastes must be used for at least one month before any therapeutic effects are felt.

Toothpastes containing baking soda and/or hydrogen peroxide (which are both good cleansing agents) give the teeth and mouth a clean, fresh, pleasant feeling that can offer an incentive to brush more, but fluoride is the true active ingredient at work protecting your teeth. Some prefer a tartar-control toothpaste containing pyrophosphates to prevent the build-up of soft calculus (tartar) deposits on their teeth. New pastes offer advanced whitening formulas aimed at safely removing stains to make teeth brighter and shinier, although they can't nearly match the effectiveness of a professional bleaching formula administered or prescribed by a dentist.

Reviewed: January 2011

How Much Toothpaste To Use

Contrary to what toothpaste commercials show, the amount of paste or gel needed on your brush for effective cleaning does not have to be a heaping amount. Simply squeeze a pea-sized dab of paste on the top half of your brush. If you brush correctly, holding the toothbrush at a 45-degree angle and brush inside, outside and between your teeth, the paste should foam enough to cover all of your teeth. Children under age 6, however, should be given a very small, baby pea-sized dab of toothpaste on their brush.

Reviewed: January 2011

© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top


What Kind of Toothpaste is Best?

The most important part of brushing your teeth is the technique used. Toothpaste is important for what it supplies, fluoride and tartar control. Be careful of the whitening brands because some are abrasive and they can remove enamel from teeth.

back to top

Should I Floss?

Do I Really Need to Floss?

Yes. Floss removes plaque and debris that sticks to teeth and gums in between teeth, polishes tooth surfaces, and controls bad breath. Plaque is a sticky layer of material containing bacteria that accumulates on teeth, including places where toothbrushes can't reach. This can lead to gum disease. By flossing your teeth daily, you increase the chance of keeping them for a lifetime and decrease the chance of getting gum disease.

Why should I floss?

Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces and controls bad breath. By flossing your teeth daily, you increase the chances of keeping your teeth a lifetime and decrease your chance of having periodontal (gum) disease and tooth decay.

Flossing is the single most important weapon against plaque, perhaps more important than the toothbrush. A toothbrush cleans the tops and sides of your teeth. Dental floss cleans between them. Some people use waterpicks, but floss is the best choice. Many people just don't spend enough time flossing and many have never been taught to floss properly. When you visit your dentist or hygienist, ask to be shown.

Which type of floss should I use?

Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridge work. Tapes are usually recommended when the spaces between teeth are wide. They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss but does tear more than waxed floss.

How should I floss?

There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don't cut off your finger's circulation!) Wind the rest of the floss similarly around the same finger of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don't pull it down hard against your gums or you will hurt them. Don't rub it side to side as if you're shining shoes. Bring the floss up and down several times, forming a "C" shape around the tooth and being sure to go below the gumline.

The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gumline and forming a "C" on the side of the tooth.

How often should I floss?

At least once a day. To give your teeth a good flossing, spend at least two or three minutes.

What are floss holders?

You may prefer a pre-threaded flosser or floss holder, which often looks like a little hacksaw. Flossers are handy for people with limited dexterity, for those who are just beginning to floss or for caretakers who are flossing someone else's teeth.

Is it safe to use toothpicks?

In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. When you use a toothpick, don't press too hard, as you can break off the end and lodge it in your gums.

Do I need a waterpick (irrigating device)?

Don't use waterpicks as a substitute for brushing and flossing. But they are effective around orthodontic braces, which retain food in areas where a toothbrush cannot reach. However, they do not remove plaque. Waterpicks are frequently recommended by dentists for persons with gum disease; solutions containing antibacterial agents like chlorhexidine or tetracycline, available through a dentist's prescription, can be added to the reservoir in these cases.

Updated: September 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top


Types of floss

Dental floss comes in a variety of colors, materials and even flavors. Waxed varieties are slipperier, allowing people with extremely tight spaces between their teeth to floss more easily. Popular flavors of floss include wintergreen and cinnamon. Waxed floss does tend to fray more than unwaxed floss.

A type of material called wide floss can be effective for people with large spaces between their teeth, or for people with delicate bridge work.

Floss can be purchased in small self-dispensing boxes. Floss can also be purchased in special, single-use holders, which are useful for people who have a hard time wrapping floss around their fingers, including those with dexterity problems or arthritis.

back to top


Water Picks

There is never a suitable substitute for daily brushing and flossing.

While some products, including water irrigation devices (or "water picks"), may be useful for specific applications, they do not accomplish one major task: removing plaque.

Water picks use powerful tiny bursts of water to blast away food particles and other debris in hard-to-reach areas of your mouth. Dentists use professional-grade water picks when preparing a tooth for restoration, or in general cleaning and exams.

People with painful gum disease or highly sensitive gums may find water picks useful for supplementing their brushing regimen. And people with orthodontia, including braces, have found water picks quite useful because toothbrush bristles often get stuck.

back to top

What are Mouth Rinses?

Mouth rinse or mouthwash is a product used for oral hygiene. Antiseptic and anti-plaque mouth rinse claims to kill the germs that cause plaque, gingivitis, and bad breath. Anti-cavity mouth rinse uses fluoride to protect against tooth decay. Mouth rinses are generally classified either as cosmetic, therapeutic, or a combination of the two. Cosmetic rinses are commercial, over-the-counter (OTC) products that help remove oral debris before or after brushing, temporarily suppress bad breath, diminish bacteria in the mouth, and refresh the mouth with a pleasant taste. Therapeutic rinses have all of the benefits of cosmetic rinses but also contain an added active ingredient that helps protect against some oral diseases. Therapeutic rinses also can be categorized according to use: anti- plaque/anti-gingivitis rinses or anti-cavity fluoride rinses, for example.

Dentists will prescribe special rinses for patients with more severe oral problems, such as cavities, periodontal disease, gum inflammation, and xerostomia (dry mouth). Therapeutic rinses also are strongly recommended for those who can't brush due to physical impairments or medical reasons.

Should I use a mouth rinse?

Whether or not you should use a mouth rinse depends upon your needs. Many dentists consider the use of fluoride toothpaste alone to be more than adequate protection against cavities. Although anti-cavity rinses with fluoride have been clinically proven to fight up to 50 percent more of the bacteria that cause cavities, and most rinses are effective at curbing bad breath and freshening the mouth for up to three hours, initial studies have shown that most OTC anti-plaque rinses and antiseptics are not much more effective against plaque and gum disease than rinsing with water.

Most dentists are skeptical about the value of these anti-plaque products, and studies point to only a 20 to 25 percent effectiveness, at best, in reducing the plaque that causes gingivitis. Mouth rinses can cause harm by masking the symptoms of an oral health disease or condition.

How should I use a mouth rinse?

Before using mouth rinses, dentists suggest that you brush and floss your teeth well. Then, measure the proper amount of rinse as specified on the container or as instructed by your dentist. With your lips closed and the teeth kept slightly apart, swish the liquid around with as much force as possible. Many rinses suggest swishing for 30 seconds or more. Finally, thoroughly spit the liquid from your mouth. Teeth should be as clean as possible before applying an anti-cavity rinse to reap the full preventive benefits. Consumers should not rinse, eat, or smoke for 30 minutes after using rinses, as these practices will dilute the fluoride and rinse it away.

Are there any side effects?

Yes, and they can vary depending on the type of rinse. Habitual use of antiseptic mouthwashes that contain high levels of alcohol (18 to 26 percent) may produce a burning sensation in the cheeks, teeth, and gums. Many rinses with more concentrated formulas can lead to mouth ulcers, sodium retention, root sensitivity, stains, soreness, numbness, changes in taste sensation, and painful mucosal erosions. Most anti-cavity rinses contain sodium fluoride, which can lead to fluoride toxicity if taken excessively or swallowed. Because children tend to accidentally swallow mouthwash, they should only use rinses under adult supervision. If you experience any irritating or adverse reactions to a mouth rinse, discontinue its use immediately and talk to your dentist.

© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What is Cosmetic Dentistry?

How Can My Dentist Improve My Smile?

From subtle changes to major repairs, your dentist can perform a variety of procedures to improve your smile. There are many techniques and options to treat teeth that are discolored, chipped, misshapen or missing. Your dentist can reshape your teeth, close spaces, restore worn or short teeth or alter the length of your teeth. Common procedures include bleaching, bonding, crowns, veneers and reshaping and contouring.

These improvements are not always just cosmetic. Many of these treatments can improve oral problems, such as your bite.

Bleaching

Bleaching is a common and popular chemical process used to whiten teeth. Some people get their teeth bleached to make stains disappear, while other just want a whiter shade.

Discoloration occurs in the enamel and can be caused by medication, coffee, tea and cigarettes. Discoloration also can be hereditary or due simply to getting older.

Bleaching can be performed by your dentist in the office or, under dental supervision, at home. Many patients enjoy bleaching at home because it is more convenient. Treatment begins when your dentist creates a custom mouthpiece to ensure the correct amount of whitening solution is used and that your teeth are properly exposed. Typically, whitening at home takes two to four weeks, depending on the desired shade you wish to achieve. Whitening in the office may call for one or more 45-minute to one-hour visits to your dentist's office.

Bonding

Bonding is tooth-colored material used to fill in gaps or change the color of teeth. Requiring a single office visit, bonding lasts several years. Bonding is more susceptible to staining or chipping than other forms of restoration. When teeth are chipped or slightly decayed, bonded composite resins may be the material of choice. Bonding also is used as a tooth-colored filling for small cavities. Additionally, it can be used to close spaces between teeth or cover the entire outside surface of a tooth to change its color and shape.

Crowns

Crowns, also known as caps, cover a tooth to restore it to its normal shape and appearance. Due to their cost, they are used in cases where other procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations, but are the most time-consuming.

Veneers

Veneers are thin pieces of porcelain or plastic placed over the front teeth to change the color or shape of your teeth. Veneers are used on teeth with uneven surfaces or are chipped, discolored, oddly shaped, unevenly spaced or crooked. Little or no anesthesia is needed. Veneers are used to treat some of the same problems as bonding.

This treatment is an alternative to crowns, which are more expensive. The procedure requires your dentist to take an impression of your tooth. Before the custom-made veneer is cemented directly onto the tooth, your dentist will lightly buff the tooth to compensate for the added thickness of the veneer. Once the cement is between the veneer and your tooth, a light beam is used to harden it. Porcelain veneers require more than one visit because they are fabricated in a laboratory. Veneers have a longer life expectancy and color stability than bonding.

Contouring and reshaping

Tooth reshaping and contouring, is a procedure to correct crooked teeth, chipped or irregularly shaped teeth or even overlapping teeth in a single session. Tooth reshaping and contouring, is commonly used to alter the length, shape or position of your teeth. Contouring teeth may also help correct small problems with bite. It is common for bonding to be combined with tooth reshaping.

This procedure is ideal for candidates with normal, healthy teeth but who want subtle changes to their smile. Your dentist will take X- rays to evaluate the size and location of the pulp of each tooth to ensure that there's enough bone between the teeth to support them.

Which procedure is right for me?

Your dentist can answer any questions you may have about techniques used to improve your smile. The condition of your teeth and desired result you want often dictates the best procedure. If you are considering a treatment, there are a few questions you can ask your dentist before deciding if a particular procedure is right for you.

  • What will the changes look like?
  • What should I expect through the course of treatment?
  • What type of maintenance will be required?

What should I look for in a cosmetic dentist?

In order to make sure your dentist is skilled in cosmetic dentistry, the American Academy of Cosmetic Dentistry (AACD) recommends that you ask your dentist for the following items before undergoing treatment:

  • Before and after photos.

 These photos will allow you to examine the results of other patients being treated by the dentist to make sure his or her work fits your dental needs.

  • References.

 References allow you to get a sense of the quality of care the dentist provides.

  • Proof of continuing education.

Be certain that your dentist has taken continuing education courses to keep him or her up-to-date with the latest techniques in clinical cosmetic dentistry.

 Your dentist can answer the questions you have about the techniques used to improve your smile. The condition of your teeth and your desired result often indicate the best procedure for you.

Why would someone need or be interested in cosmetic dentistry?

Cosmetic dentistry provides more than just a beautiful smile and a healthy mouth.  According to the American Academy of Cosmetic Dentistry (AACD), cosmetic dentistry has also been shown to improve a person's overall health and emotional well-being.  An improved smile can boost a person's self-image, making them more confident in their daily lives.  Cosmetic dentistry is for anyone who desires to improve the quality of their smile, their oral health and their quality of life.  The very essence of cosmetic dentistry almost always improves one’s bite, health and function.

Updated: September 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

How Can I Brighten My Smile?

Your wedding is coming up, and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for movie stars, and it isn't just for one day. Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth bleaching safely lightens the color of the teeth, lasting for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.

Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond better to bleaching. Gray stains caused by fluorosis, smoking or tetracycline use can be lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal (gum) disease or teeth with worn enamel, your dentist may discourage bleaching.

Updated: February 2007

 

What's Involved?

First, the dentist will determine whether you are a candidate for tooth bleaching and what type of bleaching system would provide the best results. If you're in a hurry for whiter teeth, you may decide to have your teeth lightened immediately. Your dentist will use either an in-office bleaching system or laser bleaching while you sit in the dental chair. Some patients choose dentist-supervised at- home bleaching, which is more economical and provides similar results.

If you don't choose laser bleaching, at your next appointment your dentist or hygienist will make impressions of your teeth to create a mouthguard appliance. The mouthguard is custom-made for your mouth and is lightweight so that it can be worn comfortably while you are awake or sleeping. The mouthguard is so thin that you should even be able to talk and work while wearing it. Along with the mouthguard, you'll receive the bleaching materials. You'll be given instructions on how to wear the mouthguard.

Some bleaching systems recommend bleaching your teeth for several hours a day. Generally this type of system requires two to four weeks to complete. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10 to 14 days to complete.

Over-the-counter bleaching systems are also available and are generally safe and effective, although it is best to check with your dentist before using these products. These systems, which come in the form of strips and gels, usually contain a lower strength of bleaching agent than products used in the dentist's office. For this reason, they must be used longer to achieve a desired effect, but they are also cheaper.

Updated: October 2008

 

How it Works and Safety

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee and tea. At this point you may choose to get a touch-up. The retreatment time is much shorter than the original treatment time.

The active ingredient in most of whitening agents is carbamide peroxide; when water comes into contact with this white crystal, the release of hydrogen peroxide lightens the teeth.

Several studies have proven bleaching to be safe and effective. The American Dental Association has granted its seal of approval to some tooth bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

Updated: October 2008

 

Create Realistic Expectations

No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two-shade improvement as seen on a dentist's shade guide. The success rate depends upon the type of stain involved, the type of bleaching procedure and your compliance. Bleaching can only provide a shift in color from gray to a lighter shade of gray, for example. Bleaching does not lighten artificial materials such as bonding or veneers.

Updated: October 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What are Crowns?

A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to restore a tooth when there isn't enough of the tooth remaining to provide support for a large filling, attach a bridge, protect weak teeth from fracturing, restore fractured teeth or cover badly shaped or discolored teeth.

How is a crown placed?

To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.

Will it look natural?

Yes. The dentist's main goal is to create a crown that looks like a natural tooth. That is why your dentist takes an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape and length of your natural teeth. Any one of these factors alone can affect your appearance.

If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

Why crowns and not veneers?

Crowns require more tooth structure removal, hence they cover more of the tooth than veneers. Crowns are customarily indicated for teeth that have sustained significant loss of structure or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.

What is the difference between a cap and a crown?

There is no difference between a cap and a crown.

How long do crowns last?

Crowns should last approximately five to eight years. However, with good oral hygiene and supervision, most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice or fingernail biting may cause this period of time to decrease significantly.

How should I take care of my crown?

To prevent damaging or fracturing the crown, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.

Updated: January 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What are Veneers?

Veneers are ultra-thin shells of ceramic (porcelain) or a composite resin material, which are bonded to the front of teeth. This procedure requires little or no anesthesia and can be the ideal choice for improving the appearance of the front teeth. Veneers are placed to mask discolorations, to brighten teeth and to improve a smile.

Veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's color, size or shape. Veneers can mask undesirable defects, such as teeth stained by tetracycline and damage due to an injury or as a result of a root-canal procedure. They are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.

Updated: October 2008

 

Process for Getting Veneers

Patients may need up to three appointments for the entire procedure: diagnosis and treatment planning, preparation and bonding.

It's critical that you take an active role in the smile design. Spend time in the planning of the smile. Understand the corrective limitations of the procedure. Have more than one consultation, if necessary, to feel comfortable that your dentist understands your objectives.

To prepare the teeth for the veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about half a millimeter of the tooth is removed, which may require a local anesthetic. Composite resin veneers are generally done in one appointment. After the tooth is prepared, the dentist carefully bonds and sculpts the composite material onto your teeth. For ceramic veneers, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This may take several days. If the teeth are too unsightly, a temporary veneer can be placed, at an additional cost.

When your ceramic veneers are ready, the dentist places each veneer on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the results, and pay particular attention to the color. At this point, the color of the veneers can still be adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a light beam hardens the cement.

Updated: October 2008

 

What to Expect with Veneers

For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have changed in size and shape. Brush and floss daily. After one or two weeks, your dentist will ask you to return for a follow-up appointment.

Veneers are reasonable facsimiles of natural teeth, not perfect replacements. It's not uncommon to see slight variations in the color of veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance your smile and can heighten self-esteem.

Updated: October 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What are Bridges?

Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.

Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.

Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.

Appliances called implant bridges are attached to an area below the gum tissue, or the bone.

back to top

What is a Dental Implant?

A dental implant is an artificial tooth root that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don't rely on neighboring teeth for support and they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth.

Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: the first is placed directly into the jawbone, like natural tooth roots; the second is used when the jaw structure is limited, therefore, a custom-made metal framework fits directly on the existing bone.

How do they work?

Strategically placed, implants can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble real teeth.

Can anyone receive dental implants?

Talk with your dentist about whether you are an implant candidate. You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates.

What can I expect during this procedure?

The dentist must perform surgery to anchor the "artificial root" into or on your jawbone. The procedure is done in the dental office with local anesthesia. The gum is then secured over the implant, which will remain covered until it fuses with the bone. The dentist then uncovers the implant and attaches an extension, or post, to the implant. With some implants, the implant and post are a single unit placed in the mouth during the initial surgery. Finally, the dentist makes an artificial tooth, or crown, that is attached to the implant post.

How long does the process take?

The process can take up to nine months to complete. Each patient heals differently, so times will vary. After the implant and posts are placed surgically, the healing process can take up to six months and the fitting of replacement teeth no more than two months. Sometimes, if a patient has good bone quality, posts can be placed and replacement teeth fitted in one appointment.

What is the success rate of implants?

The success rate for implants depends on the tooth's purpose and location in the mouth, as well as a patient's overall health.

How do I care for implants?

Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the fixtures at least twice a day. Your dentist will give you specific instructions on how to care for your new implants. Additional cleanings of up to four times per year may be necessary to ensure that you retain healthy gums.

What is the cost of implants?

Since implants involve surgery and are more involved, they cost more than traditional bridgework. However, some dental procedures and portions of the restoration may be covered by dental and medical insurance policies. Your dentist can help you with this process.

Updated: February 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What is a Denture?

A denture is a removable replacement for missing teeth and the tissues connected to those teeth. It is made of acrylic plastic and sometimes porcelain and metal materials. A denture closely resembles natural gum tissue and teeth.

Complete dentures replace all of the teeth, while partial dentures fill in the spaces created by missing teeth and prevent other teeth from shifting position. Complete dentures are "immediate" or "conventional." An immediate denture is a complete denture or partial denture that is inserted on the same day, immediately following the removal of the natural teeth. The immediate denture acts as a Band-Aid to protect the tissues and reduce bleeding after tooth extraction. The conventional denture is ready for placement in the mouth about 8 to 12 weeks after the teeth have been removed and the gum tissue has healed. However, some dentists may recommend more time before placing a conventional denture.

Who needs a denture?

A partial denture is for people who still have some of their natural teeth. Dentures are not just for elderly patients. Patients of any age may lose some or all of their teeth and may require a denture of some sort. Because teeth are a permanent part of the body, tooth loss can have an emotional impact on some people. It is important to talk to your dentist about any fears, anxiety, or other emotions you are feeling about tooth loss.

What happens when you get a denture?

A dentist can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient's final denture is placed, following any minor adjustments.

New denture wearers need time to get accustomed to their new "teeth," because even the best-fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days to a few weeks. To get accustomed to chewing with a new denture, start with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change in facial appearance, increased salivary flow or minor irritation or discomfort.

How do you care for a denture?

  • Denture adhesives may be recommended, especially for the first-time denture wearer. Adhesives may improve the retention and stability of dentures for those with minimal bone support or small ridges. Stability of the denture will help the wearer's confidence.
  • Remove and brush the denture daily with a denture cleanser and a brush (one specifically designed for cleaning dentures or a soft toothbrush).
  • Avoid using boiling water to sterilize the denture, because hot water can cause the denture to lose its shape.
  • If you wear a partial denture, remove it before brushing your natural teeth.
  • When you're not wearing the denture, soak it in denture cleanser or water.
  • To avoid misplacing your denture, store it in the same place after removal.

Should a denture be worn at night?

While you may be advised to wear your denture almost constantly during the first two weeks - even while you sleep - under normal circumstances it is considered best to remove it at night and soak the denture in cleansing solution or water. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums.

Continue seeing your dentist regularly

It is important to continue having regular dental checkups so that your dentist can examine oral tissues for signs of disease or cancer. With age, your mouth will continue to change as the bone under your denture shrinks or recedes. To maintain a proper fit over time, it may be necessary to adjust your denture or possibly remake your denture. Never attempt to adjust a denture yourself, and do not use denture adhesives for a prolonged period because this can contribute to bone loss. When in doubt, consult your dentist.

Are there any alternatives to dentures?

Dental implants are a possible alternative to dentures. Implants are artificial tooth roots that are surgically anchored into your jaw to hold a replacement tooth or bridge in place. Implants and bridges may resemble the "feel" of real teeth, but they may be more expensive than dentures. Not all patients are good candidates for implants, so be sure to talk to your dentist about which treatment option is best for you.

Updated: September 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What is a Root Canal?

Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the pulp tissue. While a tooth's pulp tissue does contain nerve fibers, it is also composed of arteries, veins, lymph vessels, and connective tissue. Each tooth's nerve enters the tooth at the very tip of its roots. From there, the nerve runs through the center of the root in small "root canals," which join up with the tooth's pulp chamber. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but no more than four root canals.

Why do I feel pain?

When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow and cellular activity, and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks.

Why do I need root canal therapy?

Root canal therapy is necessary because the tooth will not heal by itself. Without treatment, the infection will spread, bone around the tooth will begin to degenerate and the tooth may fall out. Pain usually worsens until one is forced to seek emergency dental attention. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift crookedly, resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal therapy. If you have the choice, it's always best to keep your original teeth.

What is a root canal procedure?

A root canal is a procedure done to save the damaged or dead pulp in the root canal of the tooth by cleaning out the diseased pulp and reshaping the canal. The canal is filled with a rubberlike substance called gutta percha or another material to prevent recontamination of the tooth. The tooth is then permanently sealed, with possibly a post and/or a crown made of porcelain or metal alloy. This enables patients to keep the original tooth.

What is involved in root canal therapy?

Once your general dentist performs tests on the tooth and recommends therapy, he or she can perform the treatment or refer you to an endodontist (a pulp specialist). Treatment usually involves one to three appointments.

First, you will probably be given a local anesthetic to numb the area. A rubber sheet is then placed around the tooth to isolate it. Next, an opening is drilled from the crown into the pulp chamber, which, along with the root canal, is cleaned of all diseased pulp and reshaped.

Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, the tooth may be left open to drain or the dentist may go right ahead and fill the canals.

If you're given a temporary filling, usually on the next visit it's removed and the pulp chamber and canal(s) are filled with gutta percha or another material to prevent recontamination. If the tooth is still weak, a metal post may be inserted above the canal filling to reinforce the tooth. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve appearance.

What are the risks and complications?

More than 95 percent of root canal treatments are successful. However, sometimes a procedure needs to be redone due to diseased canal offshoots that went unnoticed or the fracture of a filing instrument, both of which rarely occur. Occasionally, a root canal therapy will fail altogether, marked by a return of pain.

What happens after treatment?

Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic. A follow- up exam can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods with the treated tooth, and see your dentist regularly.

Are there options to root canal therapy?

The only alternative to root canal therapy is to extract the tooth; however, this alone can cause the surrounding teeth to move, resulting in a bad bite. Though a simple extraction may be perceived as less expensive, the empty space left behind will require an implant or a bridge, which ultimately can be more costly than root canal therapy.

Updated: February 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What is a Sealant?

A dental sealant is a thin plastic film painted on the chewing surfaces of teeth to prevent cavities.

How effective are sealants?

Studies have proven that properly applied sealants are 100-percent effective in protecting the tooth surfaces from cavities. As long as the sealant remains intact, small food particles and bacteria that cause cavities cannot penetrate through or around a sealant. Sealant protection is reduced or lost when part or all of the bond between the tooth and sealant is broken. However, clinical studies have shown that teeth that have lost sealants are no more susceptible to tooth decay than teeth that were never sealed.

Why can't I just brush and floss?

While brushing and flossing help to remove food particles and plaque from smooth surfaces of teeth, toothbrush bristles often can't reach into the teeth's depressions and grooves. Sealants protect those areas and prevent food and bacteria from getting in.

How are sealants applied?

Your dentist can apply sealants easily, and it takes only a few minutes to seal each tooth. The dentist first cleans the teeth that will be sealed, which may require the use of a dental drill to open the grooves of the teeth and determine if decay is present. Then he or she will roughen the chewing surfaces with an acid solution, which will help the sealant stick to the teeth. The dentist then "paints" the sealant on the tooth. It bonds directly to the tooth and hardens. Sometimes your dentist will use a special curing light to help the sealant harden. Sealant treatment is painless and takes anywhere from five to 45 minutes to apply, depending on how many teeth need to be sealed. Sealants must be applied properly for good retention.

How long will a sealant last?

As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and usually last several years before a reapplication is needed. The risk of decay decreases significantly after sealant application. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.

Who should receive sealant treatment?

Children, because they have newly erupted, permanent teeth, receive the greatest benefit from sealants. The chewing surfaces of a child's teeth are most susceptible to cavities. Surveys show that the majority of all cavities occur in the narrow pits and grooves of a child's newly erupted teeth because food particles and bacteria cannot be cleaned out. Other patients also can benefit from sealant placement, such as those who have existing pits and grooves susceptible to decay. Research has shown that almost everybody has a 95-percent chance of eventually experiencing cavities in the pits and grooves of their teeth.

Aren't sealants just for kids?

Decay can begin early in life, so dentists usually apply sealants to children's and teenagers' premolars and molars to protect them. But sealants can protect adults' teeth, too. Ask your dentist about sealants for your children or for yourself to see if they would be beneficial.

Are sealants covered by insurance?

Insurance benefits for sealant procedures have increased considerably, especially as companies start to realize that sealants are a proven preventive technique. This preventive measure can help reduce future dental expenses and protect the teeth from more aggressive forms of treatment.

Updated: February 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What are Wisdom Teeth?

Wisdom teeth are the third molars. Normally people have three permanent molars that develop in each quadrant of the mouth; upper, lower, right and left. The first molars usually grow into the mouth at around six years of age. The second molars grow in at around age 12. The third molars usually will try to grow in at around age 17 to 21 years. Since that is considered to be the age when people become wiser, third molars gained the nickname, "wisdom teeth." Actually, they are no different than any other tooth except that they are the last teeth to erupt, or grow into the mouth. They are just as useful as any other tooth if they grow in properly, have a proper bite relationship and have healthy gum tissue around them. Unfortunately, this does not always happen.

Updated: October 2008

 

What is an Impaction?

When wisdom teeth are prevented from erupting into the mouth properly, they are referred to as impacted. Teeth that have not erupted are not necessarily impacted. It may be that it is still too early in someone's dental development, and if time passes they might grow in properly. A dentist must examine a patient's mouth and his or her X-rays to determine if the teeth are impacted or will not grow in properly. Impacted teeth may cause problems, such as infection, decay of adjacent teeth, gum disease or formation of a cyst (fluid- filled sac) or tumor from the follicle, which is the tissue that formed the crown of the tooth. Many dentists recommend removal of impacted wisdom teeth to prevent potential problems.

Erupted wisdom teeth may also need to be removed. The dentist may recommend this if the tooth is nonfunctional, interfering with the bite, badly decayed, involved with or at risk for periodontal disease, or interfering with restoration of an adjacent tooth. Once again, every case is different, and only your dentist can determine if there is a reason for you to have a tooth removed.

Updated: October 2008

 

When to Remove Wisdom Teeth

The following symptoms may indicate that the wisdom teeth have erupted and surfaced, and should be removed before they become impacted, in other words, the teeth have surfaced and have no room in the mouth to grow. However, each individual may experience symptoms differently.

Symptoms may include:

  • Pain
  • Infection in the mouth
  • Facial swelling
  • Swelling of the gumline in the back of the mouth

Many oral health specialists will recommend removal of the wisdom teeth before they are fully developed, usually in the adolescent years, as early removal will help to eliminate problems, such as an impacted tooth that destroys the second molar.

Wisdom tooth extraction involves accessing the tooth through the soft and hard tissue, gently detaching the connective tissue between the tooth and the bone and removing the tooth. Extractions can be performed under local anesthesia.

Following the extraction, you may experience some swelling and discomfort, which is a normal part of the healing process. Cold compresses can help decrease the swelling, and your dentist may prescribe medication to help relieve discomfort.

Updated: October 2008

 

Dry Sockets

Dry socket, the most common postoperative complication from tooth extractions, delays the normal healing process and results when the newly formed blood clot in the extraction site does not form correctly or is prematurely lost. The blood clot lays the foundation for new tissue and bone to develop over a two-month healing process. Women who take oral contraceptives are at a higher risk of developing dry socket after wisdom teeth extraction due to high levels of estrogen.

Tips for preventing dry socket:

  • Schedule extractions during the last week of the menstrual cycle, when estrogen levels are lower.
  • Avoid drinking through a straw, as the suction may interfere with clotting.
  • Avoid smoking, which can irritate the extraction site.
  • Avoid excessive mouth rinsing, which may interfere with clotting. Updated:

October 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What is a Dental Emergency?

Injuries to the mouth may include teeth that are knocked out (avulsed), forced out of position and loosened (extruded) or fractured. In addition, lips, gums or cheeks are often cut. Oral injuries are often painful and should be treated by a dentist as soon as possible.

How soon should I see a dentist?

Immediately. Getting to a dentist within 30 minutes can make the difference between saving or losing a tooth.

What should I do when a tooth is knocked out?

  • Immediately call your dentist for an emergency appointment.
  • Handle the tooth by the crown, not the root. Touching the root (the part of the tooth below the gum) can damage cells necessary for bone reattachment.
  • Gently rinse the tooth in water to remove dirt. Do not scrub.
  • If possible, gently place the clean tooth in the socket to keep it moist. It is important not to let the tooth dry out.
  • If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse in milk or saliva.

What should I do when a tooth is pushed out of position?

  • Attempt to reposition the tooth to its normal alignment using very light finger pressure, but do not force the tooth.
  • Bite down to keep the tooth from moving.

What should I do when a tooth is fractured?

  • Rinse mouth with warm water.
  • Use an ice pack or cold compress to reduce swelling.
  • Use ibuprofen, not aspirin, for pain.
  • Immediately get to your dentist, who will determine treatment based on how badly the tooth is broken. Only a dentist can tell how bad the break is.

Minor fracture: Minor fractures can be smoothed by your dentist or simply left alone. Another option is to restore the tooth with a composite restoration. In either case, treat the tooth with care for several days.

Moderate fracture: Moderate fractures include damage to the enamel, dentin and/or pulp (nerve and other live tissues). If the pulp is not permanently damaged, the tooth may be restored with a full permanent crown. If damage to the pulp does occur, further dental treatment will be required.

Severe fracture: Severe fractures often mean a traumatized tooth with slim chance of recovery.

What should I do when tissue is injured?

Injuries to the inside of the mouth include tears, puncture wounds and lacerations to the cheek, lips or tongue. The wound should be cleaned right away with warm water, and the injured person taken to a hospital emergency room for the necessary care. Bleeding from a tongue laceration can be reduced by pulling the tongue forward and using gauze to place pressure on the wound.

What can I do to be prepared?

Pack an emergency dental-care kit, including:

  • Dentist's phone numbers (home and office)
  • Handkerchief
  • Gauze Small container with lid
  • Ibuprofen (Not aspirin. Aspirin is an anticoagulant, which may cause excessive bleeding in a dental emergency.)

Updated: January 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What Causes a Toothache?

While decay often is cited as the primary cause of a toothache, it's important for you to have a complete oral examination to determine the cause. Other dental causes of a toothache include: infection, gum disease, grinding teeth (bruxism), tooth trauma and an abnormal bite. Tooth eruption may be the cause of tooth or jaw pain in babies and school-age children.

TMJ, sinus or ear infections and tension in the facial muscles can cause discomfort that resembles a toothache, but often these health problems are accompanied by a headache. Pain around the teeth and the jaws can be symptoms of heart disease such as angina. If your dentist suspects a medical illness could be the cause of your toothache, he or she may refer you to a physician.

Why does my toothache?

You may have a dental cavity or advanced gum disease. The first sign of decay may be the pain you feel when you eat something sweet, very cold or very hot. If the pulp - the inside of the tooth that has tissue and nerves - has become irritated, this can cause pain in your tooth.

What are the symptoms of a toothache?

Because the symptoms of a toothache may resemble other medical conditions or dental problems, it can be difficult to diagnose the cause without a complete evaluation by your dentist. If you notice pus near the source of the pain, your tooth may have become abscessed, causing the surrounding bone to become infected. Or the pus could indicate gum disease, which usually is characterized by inflammation of the soft tissue and abnormal loss of bone surrounding the teeth.

Contact your dentist immediately if you have any of the following symptoms:

  • Fever
  • Difficulty breathing or swallowing
  • Swelling around the tooth area
  • Pain when you bite
  • A foul-tasting discharge

How do I alleviate the pain if I cannot see my dentist right away?

Anyone with a toothache should see a dentist at once for diagnosis and treatment because, if left untreated, your condition can worsen. However, if you are unable to schedule an emergency appointment, a self-care treatment can temporarily alleviate pain and inflammation from a toothache:

  • Rinse with warm salt water.
  • Gently floss teeth to dislodge any food particles trapped between teeth.
  • Take an over-the-counter pain reliever such as aspirin, ibuprofen or acetaminophen to relieve pain. If your child has a toothache, use acetaminophen.
  • Never put aspirin or any other painkiller against the gums near the aching tooth, as it may burn the gum tissue.
  • Apply an over-the-counter antiseptic containing benzocaine directly to the irritated tooth and gum to temporarily relieve pain. Direct application of oil of cloves (eugenol) may also help to numb the gums. The oil may be rubbed directly on the sore area or soak a small piece of cotton and apply it to the sore tooth.
  • If there has been some trauma to the tooth, a cold compress may be applied on the outside cheek to relieve pain or swelling. If your tooth has been knocked out, forced out of position, loosened or fractured, visit the dentist's office or a hospital emergency room immediately.

How can my dentist help?

Your dentist will conduct a complete oral examination to determine the location and cause of the toothache, looking for signs of swelling, redness and obvious tooth damage. He or she may also take X-rays looking for evidence of tooth decay between teeth, a cracked or impacted tooth or a disorder of the underlying bone - problems that the dentist may not be able to find through a routine exam.

Your dentist also may prescribe pain medication or antibiotics to speed the healing of your toothache. If, by the time you see your dentist, your tooth has become infected, then treatment could require removal of the tooth or a root canal procedure, which involves removing the damaged nerve tissue from the middle of a tooth.

Is there a way to prevent a toothache?

The key to preventing toothaches is establishing a regular oral hygiene routine and sticking to it. For example, failure to brush and floss regularly after meals can significantly increase your risk of developing cavities. After you eat, bacteria in your mouth feed on sugar and starch and produce acid that can "eat" a hole (or cavity) in your tooth's enamel. If the cavity is not filled, it can cause considerable pain and potentially destroy the dentin, pulp and the tooth's nerve.

Here are a few tips to help reduce your risk for developing a toothache:

  • Brush at least twice a day, preferably after every meal and snack.
  • Floss once a day to prevent gum disease.
  • Visit your dentist twice a year for oral examinations and a professional cleaning.

Updated: February 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What is Tooth Decay?

Tooth decay, also known as caries or cavities, is an oral disease that affects many people. Unlike other diseases, however, caries is not life-threatening and is highly preventable, though it affects most people to some degree during their lifetime.

Natural bacteria live in your mouth and form plaque. The plaque interacts with deposits left on your teeth from sugary and starchy foods and produces acids. These acids damage tooth enamel over time by dissolving, or demineralizing enamel, which weakens the teeth and leads to tooth decay.

Foods containing carbohydrates (starches and sugars), such as soda pop, candy, ice cream, milk, and cake, and even some fruits, vegetables, and juices, may contribute to tooth decay.

Updated: February 2007

 

How Are Cavities Prevented?

The acids formed by plaque can be counteracted simply by saliva in your mouth, which acts as a buffer and remineralizing agent. Dentists often recommend chewing sugarless gum to stimulate your flow of saliva. However, though it is the body's natural defense against cavities, saliva alone is not sufficient to combat tooth decay. The best way to prevent cavities is to brush and floss regularly. To rebuild the early damage caused by plaque bacteria, we use fluoride, a natural substance that helps to remineralize the tooth structure. Fluoride is added to toothpaste to fight cavities. The most common source of fluoride is in the water we drink. Fluoride is added to most community water supplies and to many bottled and canned beverages.

If you are at medium-to-high-risk for cavities, your dentist may recommend special high-concentration fluoride gels, mouth rinses or dietary fluoride supplements. Your dentist may also use professional strength anti-cavity varnish, or sealants - thin, plastic coatings that provide an extra barrier against food and debris.

Updated: October 2008

 

Who Is At Risk For Cavities?

Because we all carry bacteria in our mouths, everyone is at risk for cavities. Those with a diet high in carbohydrates and sugary foods and those who live in communities without fluoridated water are likely candidates for cavities. And because the area around a restored portion of a tooth is a good breeding ground for bacteria, those with a lot of fillings have a higher chance of developing tooth decay. Children and senior citizens are the two groups at highest risk for cavities.

Updated: October 2008

 

Three Ways To Prevent Cavities

  1. Cut down on sweets and between-meal snacks. Remember, it's these sugary and starchy treats that put your teeth at extra risk. Some research says certain foods, such as peanuts or sugar-free chewing gum, may be "friendly" to teeth. Eating these foods along with or after foods that contain carbohydrates may help to counter the effects of acids produced by bacteria. Drinking plenty of water can help wash away food particles. Of course, dentists encourage their patients to eschew these sugary snacks in favor of healthy alternatives.
  2. Brush after every meal and floss daily. Cavities most often begin in hard-to-clean areas between teeth and in the fissures and pits - the edges in the tooth crown and gaps between teeth. Hold the toothbrush at a 45-degree angle and brush inside, outside and between your teeth and on the top of your tongue. Be sure the bristles are firm, not bent, and replace the toothbrush after a few weeks to safeguard against re-infecting your mouth with old bacteria than can collect on the brush. Only buy toothpastes and rinses that contain fluoride (antiseptic rinses also help remove plaque) and that bear the American Dental Association seal on the package. Children under age 6 should only use a small pea-sized dab of toothpaste on the brush and should spit out as much as possible, because a child's developing teeth are sensitive to higher fluoride levels. Finally, because caries is a transmittable disease, toothbrushes should never be shared, especially with your children.
  3. See your dentist at least every six months for checkups and professional cleanings. Because cavities can be difficult to detect, a thorough dental examination is very important. If you get a painful toothache, if your teeth are very sensitive to hot or cold foods or if you notice signs of decay like white spots, tooth discolorations or cavities, make an appointment right away. The longer you wait to treat infected teeth, the more intensive and lengthy the treatment will be. Left neglected, cavities can lead to root canal infection, permanent deterioration of decayed tooth substance and even loss of the tooth itself.

Updated: October 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

How Can Parents Help Prevent Tooth Decay?

Parents should take their children to the dentist regularly, beginning with the eruption of the first tooth. Then we can recommend a specific program of brushing, flossing, and other treatments for parents to supervise and teach to their children. These home treatments, when added to regular dental visits and a balanced diet, will help give your child a lifetime of healthy habits.

back to top

What is Dry Mouth?

Dry mouth (xerostomia) is caused by a decrease in the amount of saliva in the mouth when the salivary glands do not work properly. The salivary glands help keep your mouth moist, which helps prevent tooth decay and other oral health problems.

Prescription and over-the-counter medications are the most common cause of dry mouth. In fact, more than 400 medications can contribute to mouth dryness. The most common troublemakers are antihypertensive, antidepressants, painkillers, tranquilizers, diuretics, and antihistamines.

Dry mouth may be a sign of a serious health condition or may occur when a person is upset or experiences stress. It also can be caused by radiation therapy and chemotherapy, hormonal alterations or diseases such as AIDS, diabetes, or Sjogren’s syndrome. Patients with Alzheimer's disease or those who suffer a stroke may experience dry mouth. Approximately 30 percent of persons over the age of 65 are affected by dry mouth.

Can dry mouth cause health problems?

Yes. You want to prevent dry mouth if possible, because it can cause difficulty in tasting, chewing, or swallowing. It also allows plaque to build up on your teeth faster, leading to a higher risk of cavities. In certain cases, a lack of moisture can make your tongue become very sensitive, causing a condition called burning mouth syndrome. Dry mouth can also lead to bad breath, ulceration or soreness of the mouth, gum disease, and difficulty in wearing dentures.

Why is saliva important?

Saliva helps wash away cavity-causing bacteria, provides enzymes to help digest food, protects teeth from decay by neutralizing harmful acids, and keeps oral tissues healthy. Without saliva you would lose your teeth much faster.

What is Sjogren’s syndrome?

Sjogren’s syndrome is an autoimmune disease in which a person's white blood cells attack their own moisture-producing glands. Approximately 4 million Americans have this condition. The majority of sufferers are women who are in their late 40s at the time of diagnosis.

Sjogren’s syndrome is difficult to diagnose because symptoms vary greatly. Patients may experience dryness in the eyes and mouth, fatigue, or joint pain, and it also mimics the natural signs of aging.

How can my dentist help?

Your dentist will want to know if you have difficulty swallowing or speaking, oral soreness, or a dry throat. Help your dentist to diagnose the problem by paying close attention to the symptoms associated with dry mouth. If you have any questions about this condition, ask your dentist.

There are many treatments that can help ease the symptoms of dry mouth, including over-the-counter saliva substitutes. To ease discomfort, your dentist may also recommend the following:

  • Brush and floss twice a day
  • Chew sugar-free gum
  • Avoid alcohol and caffeine
  • Avoid smoking
  • Avoid acidic juices (i.e., tomato, orange, grapefruit)
  • Avoid dry foods, such as toast or crackers
  • Avoid overly salty foods
  • Drink plenty of water
  • Regular dentist visits

Updated: December 2009
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What is Gum Disease?

Gum disease, or periodontal disease is a chronic inflammation and infection of the gums and surrounding tissue. It is the major cause of about 70 percent of adult tooth loss, affecting three out of four persons at some point in their life. Periodontal diseases include gingivitis and periodontitis.

What causes gum disease?

Bacterial plaque - a sticky, colorless film that constantly forms on the teeth - is recognized as the primary cause of gum disease. If plaque isn't removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar). Toxins produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets that fill with even more toxins and bacteria. As the disease progresses, pockets extend deeper, and the bacteria moves down until the bone that holds the tooth in place is destroyed. The tooth eventually will fall out or require extraction.

Are there other factors?

Yes. Genetics is also a factor, as are lifestyle choices. A diet low in nutrients can diminish the body's ability to fight infection. Smokers and spit tobacco users have more irritation to gum tissues than non-tobacco users, while stress can also affect the ability to ward off disease. Diseases that interfere with the body's immune system, such as leukemia and AIDS, may worsen the condition of the gums. In patients with uncontrolled diabetes, where the body is more prone to infection, gum disease is more severe or harder to control. Pregnant women experience elevated levels of hormones that cause the gums to react differently to the bacteria found in plaque, and in many cases can cause a condition known as "pregnancy gingivitis."

What are the warning signs of gum disease?

Signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, loose or separating teeth, pus between the gum and tooth, persistent bad breath, a change in the way teeth fit together when the patient bites and a change in the fit of dentures. While patients are advised to check for the warning signs, there might not be any discomfort until the disease has spread to a point where the tooth is unsalvageable. That's why patients are advised to get frequent dental exams.

What does periodontal treatment involve?

In the early stages of gum disease, most treatment involves a special cleaning called scaling and root planning, which removes plaque and tartar around the tooth and smoothing the root surfaces. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, called gingivitis, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums - sometimes with the assistance of a laser - and removing the hardened plaque build-up and recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean.

How do you prevent gum disease?

Removing plaque through daily brushing, flossing and professional cleaning is the best way to minimize your risk. Your dentist can design a personalized program of home oral care to meet your needs.

What is the role of the general dentist?

The general dentist usually detects gum disease and treats it in the early stages. Some general dentists have acquired additional expertise to treat more advanced conditions of the disease. If the general dentist believes that the gum disease requires treatment by a specialist, the patient will be referred to a periodontist. The dentist and periodontist will work together to formulate a treatment plan for the patient.

How can I maintain treatment at home?

Sticking to a regular oral hygiene regimen is crucial for patients who want to sustain the results of periodontal therapy. Patients should visit the dentist every three to four months (or more, depending on the patient) for spot scaling and root planing and an overall exam. In between visits, they should brush at least twice a day, floss daily and brush their tongue. Manual soft nylon bristle brushes are the most dependable and least expensive. Electric brushes are also a good option, but don't reach any further into the pocket than manual brushes. Proxy brushes (small, narrow brushes) and other interdental cleaners are the best way to clean between the recesses in the teeth and should be used once a day. Wooden toothpicks and rubber tips should only be used if recommended by your dentist.

Updated: September 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

What is Oral Piercing?

Oral piercing can cause pain, swelling, infection, drooling, taste loss, scarring, chipped teeth, and tooth loss. Most dentists discourage oral piercing due to the many risks involved. If you do decide to get an oral piercing it is important to understand the regulations, associated problems and proper maintenance.

What should I know before getting an oral piercing?

Regulations on piercing vary from state to state, so it is important to be careful and find a professional who is prepared to answer any and all questions. They should use a fresh needle every time and sterilize all needles and instruments in an autoclave, which uses extreme heat to sanitize the instruments, to avoid serious infections such as HIV or Hepatitis. Also, make sure that they use the right kind of metal, such as surgical-grade stainless steel. Some people have allergic reactions to certain metals, which can lead to further complications.

What problems can the piercing cause?

Fractured teeth are a common problem for people with an oral piercing. People chip teeth on the piercing while eating, sleeping, talking or by chewing on the jewelry. It is possible for the fracture to go deep into your tooth, which may require a root canal or extraction.

Are there serious complications?

While it is not unusual for the tongue to swell after being punctured, in some cases the swelling indicates infection. When that happens, it is possible the swelling will cut off your breathing. In rare cases, doctors may pass a breathing tube through a patient's nose until such an infection passes. Also, rubbing of the barbell on the gums excessively can cause the gums to recede. Any infection can be serious and it is necessary to see a dentist at the first sign of a problem.

How do I maintain my piercing?

It takes three to four weeks for an oral piercing to heal. Unless complications occur, you will be able to remove the jewelry for short periods of time without the hole closing. Dentists suggest removing the jewelry to protect your teeth every time you eat or sleep. The piercer will place a larger, starter "barbell" in your tongue to give it enough room to heal when your tongue swells. If you decide to keep the piercing, after the swelling goes down, get a smaller barbell which will be less likely to get in the way of your teeth and more difficult for you to chew on.

Keep it clean

  • Use an antiseptic mouthwash after every meal and brush the jewelry the same as you would your teeth.
  • After your tongue has healed, take the piercing out every night and brush it to remove any unseen plaque.
  • Consider removing the piercing before eating, sleeping, or strenuous activity.

Updated: September 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

Why Are My Teeth Sensitive?

Tooth sensitivity is caused by the movement of fluid within tiny tubes located in the dentin (the layer of tissue found beneath the hard enamel that contains the inner pulp), which results in nerve irritation. When the hard enamel is worn down or gums have receded, causing the tiny tube surfaces to be exposed, pain can be caused by eating or drinking foods or hot or cold beverages, touching your teeth, or exposing them to cold air.

Exposed areas of the tooth can cause pain and even affect or change your eating, drinking, and breathing habits. Taking a spoonful of ice cream, for example, can be a painful experience for people with sensitive teeth. The excessive consumption of acid-containing foods and beverages, such as citrus juices and fruits and soft drinks, can also put you at risk for tooth sensitivity. Bulimia and acid reflux can also result in erosion of the hard enamel and sensitivity due to acid in the mouth.

Is tooth sensitivity a common condition?

Tooth sensitivity is one of the most common complaints among dental patients. At least 40 million adults in the United States suffer at some time from sensitive teeth.

How can I avoid sensitivity?

Some toothpastes contain abrasive ingredients that may be too harsh for people who have sensitive teeth. Ingredients found in some whitening toothpastes that lighten and/or remove certain stains from enamel and sodium pyrophosphate, the key ingredient in tartar- control toothpaste, may increase tooth sensitivity.

What can I do about sensitive teeth?

Tooth sensitivity can be reduced by using a desensitizing toothpaste; having your dentist apply sealants and other desensitizing and filling materials, including fluoride; and decreasing the intake of acid-containing foods. Using tartar-control toothpaste will sometimes cause teeth to be sensitive as well as drinking soft drinks throughout the day, so these habits should be avoided.

Avoid using hard-bristled toothbrushes and brushing your teeth too hard, which can wear down the tooth's surface and expose sensitive spots. The way to find out if you're brushing your teeth too hard is to take a good look at your toothbrush. If the bristles are pointing in multiple directions, you're brushing too hard.

How do I know when it's time to see a dentist?

If a tooth is highly sensitive for more than three or four days and reacts to hot and cold temperatures, it's best to get a diagnostic evaluation from your dentist to determine the extent of the problem. Before taking the situation into your own hands, an accurate diagnosis of tooth sensitivity is essential for effective treatment to eliminate pain. Because pain symptoms can be similar, some people might think that a tooth is sensitive, when instead, they actually have a cavity or abscess that's not yet visible.

How do I describe my symptoms to my dentist?

Sensitivity may be defined as a short, sharp pain that is usually initiated by eating hot or cold foods or exposure to cold air. Aching often follows. Because sensitivity may mean different things to a patient and dental professional, be sure to clarify exactly what you feel when you discuss the condition with your dentist. Be sure to tell the dentist when the pain started and if there is anything, such as the application of a warm compress, that helps eliminate the pain.

Do some products help decrease sensitivity?

Toothpaste for sensitive teeth usually contains a desensitizing agent that protects the exposed dentin by blocking the tubes in the teeth that are connected to nerves. In most cases, these products must be used on a regular basis for at least a month before any therapeutic benefits may be noticed.

What can the dentist do for my sensitive teeth?

Dentists have a variety of regimens to manage tooth hypersensitivity, including both in-office treatments and patient-applied products for home use. If you are diagnosed with dentin hypersensitivity, your dentist may apply a desensitizing agent or a protective coating. You may be prescribed a stannous fluoride gel or an over-the-counter desensitizing toothpaste containing fluoride and either potassium nitrate or strontium chloride. These ingredients help block the transmission of sensation from the tooth to the nerve. It also might help to massage the special paste onto your gums with your finger after brushing.

What should I do after the dentist has applied a desensitizing agent?

Listen closely to your dentist's instructions. He or she may advise you not to eat or drink for a short period of time to eliminate all sources of irritation, such as acidic foods, medication, or flavored toothpastes. You may also be instructed to change oral hygiene habits that are likely to cause abrasion or use a daily fluoride application (a rinse or brush-on gel).

Updated: December 2009
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com

back to top

How Safe are Dental X-Rays?

X-rays, also called radiography, provide an important tool that shows the condition of your teeth, roots, jaw, and overall facial bone composition. X-rays can reveal the advanced nature of periodontal disease, as well as tumors and abscesses.

There are three basic kinds of X-rays:

  • Bitewings are the most conventional kind of dental X-rays and are used to spot cavities and decay.
  • Periapical X-rays are broad pictures of an entire tooth structure and are used to spot deep tooth problems, such as impacted teeth, bone loss, and abscesses.
  • Panoramic X-rays are designed to capture an entire mouth, and have been used to spot tumors and cysts, as well as wisdom teeth.

Radiation Concerns

Patients have little reason to be concerned about the health effects of dental X-rays; chances are you receive more radiation from sunlight in one day than one sitting involving dental X-rays.

Exposure to radiation is extremely brief and minimal. Safety precautions such as high-speed film minimize exposure time, and lead aprons prevent exposure to surrounding areas of the body such as the head, neck and upper chest.

back to top

 
 

 
   

40986 California Oaks Road, Murrieta CA 92562
Dental Website by Solution21 - Legal Notices - Sitemap