We have found that in our very busy lives, it’s become more difficult to spend enough time caring for ourselves, and our teeth. If you find that you’re not brushing effectively for 2 minutes twice a day and getting all the surfaces of your teeth, you may be a candidate for an electric toothbrush.
If you’re only brushing for 45 seconds, make it the most effective 45 seconds you can. In some situations the using an electric toothbrush can improve a periodontal (gums and bone) problem.
Our Hygienists or Doctors can recommend a powered tooth brush for your specific needs.
+ What kind of toothpaste should I use?
Any ADA approved Fluoride toothpaste is fine for most patients. For patients with a elevated decay rate we recommend using a toothpaste with a high Xylitol content. Xylitol acts as a kind of “birth control” for bacteria and helps to keep the acids from building up to the point that they cause decay.
+ Why do most wisdom teeth need to be removed?
Wisdom teeth (third molars) that are cleanable well maintained do not need to be removed.
Many times, however, there is not enough room for a third molar to erupt above the gum line (this may be due to the direction in which the third molar developed and/or the positioning of the teeth farther forward, or the lack of wear between the teeth farther forward). Third molars that are trapped below the gum (soft tissue impaction) may also be tipped or angled in such a way that that some of the tooth is under bone (partial boney impaction), or completely under the bone (full boney impaction), or horizontally placed (horizontal impaction). In most of these situations, the trapped tooth can cause bone loss, decay, or cysts on or around the second molars. Given the unpredictable outcomes of such conditions, dentists usually opt for removal of the third molars.
When a third molar is removed, it’s usually recommended that the opposing third molar is also removed. With no tooth to contact, the opposing molar will continue to erupt into the open space. (See “Pros and Cons of Replacing Missing Teeth”)
+ What can be done to make my teeth less sensitive?
There are many different approaches to helping with tooth sensitivity, and we would be happy to make recommendations for your particular sensitivity problem.
+ Will I be charged if I miss an appointment?
We request that our patients give 48 hours notice if they’re unable to make their appointed time. This allows others, who may be on a waiting list, to have the opportunity to receive needed care. Of course we understand that on rare occasions a situation may arise that our patients cannot anticipate. Such occurrences are considered on a case-by-case basis.
+ Will you take whatever my insurance pays as full payment?
Unfortunately we have no control over the reimbursement levels paid by your insurance company, which is based on the plan your employer purchased for you. And not charging you for your portion, after the insurance company has paid their portion, essentially amounts to insurance fraud.
+ Why won't my insurance cover all of the treatment I need?
Each employer that purchases dental insurance for their employees determines what their benefit plan will pay toward specific procedures. Every plan is different. While we’re interested in helping you utilize as much of your insurance benefit as is legally possible, our number one responsibility is to you and your well being, and we diagnose and treat based on your particular needs.
We encourage patients who have concerns about their insurance coverage, to work with their respective employer’s HR department to advocate for better benefit coverage.
+ I've previously had some bad experiences in the dental chair. What can you do to minimize my concerns?
We’re sorry you haven’t always had great experiences with your previous dental encounters. We hope that our unique approach will put you at ease. First, we’ll listen to you. We want to know what you’ve experienced and we’ll always try to make your time with us as comfortable as possible. We’ll answer your questions completely. We find facing the unknown to be stressful, so we’ll review what you can anticipate prior to your treatments. For patients that require local anesthesia, we pride ourselves on giving virtually painless anesthesia, and we wait until our patients are profoundly numb before beginning treatment. We’ll ask for your feed back during your procedure with regard to comfort and the level of anesthesia. And we’ll keep you fully informed of what we find and what we’re doing.
+ What should I expect at my first visit to your office?
After you’re greeted by our team, you’ll be asked to complete a brief health and dental history form. We’ll be happy to give you a tour of our facilities if you like. Then—and most important—we take the time to listen to you. We want to know about your prior dental experiences and how we can help you. We’ll review your medical history and current medications. We’ll conduct a comprehensive clinical examination, which will include an exploration of your gums, an oral cancer screening, an evaluation of your existing restorations, and an assessment of your bite and your Tempromandibular joint (TMJ). We’ll then take the necessary x-rays to diagnose any conditions that may be hiding under the gums and between the teeth. Subsequently, we’ll review our findings with you and give you a video tour of your mouth, highlighting any issues we may have found. And finally, we’ll discuss with you the various options for solving any discovered problems.
+ I used to hear a lot about "bridges." Why don't I hear much about them anymore?
Prior to the development of dental implants, the only options for replacing missing teeth included the creation of a removable partial denture, or the fabrication of a bridge which involves placing crowns on the teeth on either side of the missing tooth and hanging a “false” tooth between them (a bridge). This required that the two anchor teeth must have crowns whether they needed them or not.
The current standard of care is to place an implant in the location of the missing tooth with an abutment and crown and not to touch the teeth on either side.
+ What is an implant? How do I know if I'm a good candidate for it?
An implant is an artificial root replacement, made of titanium. On top of this artificial replacement root, a crown (or bridge or denture) can be attached. We can determine if you’re a good candidate with a clinical and x-ray evaluation.
+ I lost a tooth when I was younger. Is it possible to replace it now?
In most cases, replacement is possible. Depending on the movement of the other teeth and the condition and shape of the bone in the area of the lost tooth, additional treatment may be needed before replacement.
+ If I lose a tooth, what are the pros and cons of replacement?
Although we hope to help you keep from loosing any teeth, accidents do happen. If a back tooth is lost, the body tries to compensate for the space by shifting the surrounding teeth into the spaces. Often times the teeth in front and behind the tooth will tip into the space. The opposing tooth may start to move down (or up) into the opening. This shifting may not be limited to the specific area. Front teeth may flair, opening spaces between teeth (posterior bite collapse). It can also change the way you’re able to chew and may change the pattern of muscle movement. In extreme cases it can lead to headaches and sore muscles especially while chewing.
It is true that some people who have lost teeth say that they don’t miss those teeth, which points out the fact that that everyone’s tolerance of neuromuscular feedback is different. Generally speaking, replacement of missing teeth in a prompt manner can minimize a myriad of problems.
+ I've been told that I grind my teeth, but I doubt it. Can you tell from the appearance?
We often have patients tell us that they don’t think they grind or clench their teeth. However, most destructive nocturnal grinding is done without the patient being aware of it. We can do an oral video tour that can show patients any wear facets and damage that clenching and grinding may have created. Many times we’ve asked a patient’s significant other if the patient grinds his/her teeth, and the answer is usually, “Absolutely.”
+ I wake up with headaches. Could this be a dental issue?
There are several possible factors that could contribute to morning headaches. Clenching of the teeth, grinding (bruxism) of the teeth, sore teeth, bite problems, head posture, and sleep apnea are all possible sources of morning headaches. Many times the headaches are only on one side of the head (unilateral). Often times these are muscular in origin and can be treated with an oral appliance or an adjustment of the bite.
+ How long does teeth whitening last?
Most of our patients find that the lightening is maintained for 6 to 18 months. But keep in mind that every patient is different.
+ What are my options for whitening my teeth?
Over the counter whitening strips can do a very good job. They work best for people with very straight teeth. They’re designed to treat the front six teeth. Some people with very broad smiles have found that the strips don’t have broad enough coverage to whiten their back teeth. We offer an array of whitening options:
One-visit, in-office, Ozone enhanced whitening.
At home whitening with custom fabricated trays for whitening in 5-14 days.
Whitening pens — very portable pens that allow you to brush on the whitening gel and touch up for special occasions.
For information on which option may be best for you, contact our office for a whitening consultation.
+ What is "Invisalign?"
Invisalign® is a new way to straighten teeth using clear plastic material (the aligner) that covers the entire tooth. The aligner is replaced every 2-3 week with a new one that is designed to move your teeth incrementally into a straighter position. Not all tooth misalignments can be treated with Invisalign. The best way to determine if you’re a good candidate for Invisalign is to ask for an evaluation at your next visit.
+ Is it true that I'm too old for braces?
The biological processes that allow teeth to move never stop. It is these processes that allow our bones to heal and reshape themselves throughout our lives. We’ve had patients in braces as old as 82. The only limiting factor is wanting to have straighter teeth and a nicer smile.
+ Can I just get a cleaning?
Every patient is different, and every patient’s needs are different. After each cleaning, we carefully examine the patient’s teeth, diagnose the patient’s needs, thoroughly explain our findings, and then discuss the various options with the patient. People who request, “just a cleaning,” could be unaware of an accumulation of calculus (tarter) that may be under the gums; or unaware of the insidious nature of periodontal disease (inflammation and bone loss) that may exist in their mouth. It’s always better to be safe than sorry. We provide information with our diagnosis so that the patient can make the best informed decision for them.
+ What is a root canal? Does it hurt?
Root canal therapy (Endodontic therapy) is used to treat the pulps of teeth that are damaged to the point that they are painful or have degraded to the point of nerve death, (necrotic pulp). After making sure that the patient is profoundly numb and isolating the tooth using a non-latex barrier (like a surgical drape for the tooth), a small manhole is made to give access to the pulp space. The dead or dying tissue is removed and the remaining space (root canal) is cleaned and shaped using cleaning solutions and state of the art instruments. The canal is dried and sealed with a resin stopper to prevent re-infection. The access hole is then sealed with a bonded restoration. Some post-operative soreness can be expected.
+ If I get a crown, do I also need a root canal?
Crowns are used to reinforce the remaining tooth structure in teeth that have: been damaged by trauma, been deteriorated by decay, had fractures develop, or that need renewal for esthetic reasons.
Frequently, the process that caused a tooth to need a root canal also dictates a need for a crown, e.g., large leaking fillings, fractures of the crown, extensive decay, etc.
+ What's the difference between a cap, a crown, and an onlay?
A cap is the common term for a crown. A crown is like a thimble that covers over the damaged tooth. That thimble can be made of gold, porcelain covered gold, or made completely of porcelain. Different situations may indicate the use of one or another material.
An onlay is a very conservative way of holding a tooth together while minimizing the amount of natural tooth that needs to be removed. The most conservative on-lays are made completely of gold, to minimize the amount of tooth structure removed and maximize strength. They are usually used only on back teeth. Porcelain on-lays are used in areas that may be more visible.
+ Can tooth decay be healed?
The latest research shows that early decalcification (decay) can be reversed. Decay that has only invaded the dentin, the inner structure of the tooth, can be arrested and hardened against further decay. Our practice uses ozone therapy that kills the bacteria on the surface of the tooth and penetrates into the grain of the tooth, killing the active bacteria and breaking down their bio-products that remain. This enables the pulp (nerve) and the saliva to remineralize the damaged tooth structure.
+ Why do my gums bleed when I brush and floss?
When gums habitually bleed (i.e., due to gingivitis), it is the gums reaction to irritations caused by the bacteria that live in the mouth — it’s your body’s response to that irritation. If the gums are inflamed, the body responds by making the tissues “leaky” so that the blood can get to the problem. Unfortunately, in most cases, the blood cannot deal with the problem on its own. Sometimes the situation can be improved by increasing the frequency of brushing and flossing, changing the flossing and brushing techniques, or changing the type of brush. And sometimes a procedure may be needed that meticulously removes the material near the roots of the teeth (and around any crowns). This procedure (called root plaining and scaling) can reset the conditions to allow the body to get the upper hand on the inflammation.
+ What is minimally invasive dentistry?
Minimally Invasive Dentistry (MID) is a philosophy of practice. It means that as we’re restoring a problem tooth, we strive to conserve as much healthy tooth structure as possible. This includes reversing decay before it requires drilling, disinfecting and sealing the surfaces of the teeth before decay can get a toe-hold in the nooks and crannies, and utilizing other advanced techniques to protect and restore teeth. We feel what you were created with equipment that belongs to you and you should keep as much of it as possible for as long as possible.
+ At what age should a child start dental visits?
The American Association of Pediatric Dentistry now recommends seeing the dentist by age 2 for evaluation. We urge parents to “Lift the Lip”by age 1. This means they should be lifting up the upper lip to inspect the erupting teeth. By noticing imperfections (white lines at the gum line, or brown spots) we hope to arrest problems before they progress.
+ Should I be worried about my silver/mercury fillings?
Current research tells us that there is no harm in leaving existing amalgam restorations in place. However, there are now many, far more superior restorative options that make the tooth stronger, seal better, and are more attractive.
Our office made the clinical judgment that there are no good indications that justify the continued use of silver amalgam to restore teeth. Our patients have come to expect the best of care, so we have not used silver amalgam to restore teeth for over 18 years.
