FAQ
Patients often have questions about various dentally related topics. We have included answers to some frequently asked questions.
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I brush twice per day and floss every evening. Why do I need to have my teeth professionally cleaned?
Even with impeccable oral hygiene, over time, your teeth will build up calculus which is also known as tartar. Calculus is a hard calcium deposit which builds up on your teeth, both above and under the gums. It creates a barrier to cleaning and provides a trap for food and plaque bacteria. This situation can lead to periodontal (gum) disease; gum inflammation, irreversible loss of bone supporting your teeth and can eventually end in tooth loss. Plaque accumulation can also result in the development of tooth decay. The longer calculus remains on your teeth, the harder it is to remove and your dentist or dental hygenist may use a device called an ultrasonic scaler to aid in its removal. An ultrasonic scaler uses high frequency vibration combined with water spray to dislodge the calculus. The photos below show calculus which developed over a 6 month period and what the teeth looked like after a professional cleaning.
Calculus present along gum line.
Calculus removed along gum line and teeth polished.
Calculus removed between the teeth .
Calculus present along gum line.
I don't have any discomfort or sensitivity on my teeth or gums. Doesn't that mean everything is fine?
Unfortunately, not always. Tooth decay may not cause discomfort until it has become extensive and approaches the nerve of the tooth which is located in the center. By this time, there has been significant tooth destruction and the risk of the nerve becoming irreversibly damaged is much greater. It would be preferable to discover and restore tooth decay before you become aware of the problem. The same is true of periodontal (gum) disease. You may not experience any discomfort until there has been significant and irreversible damage to the gums and bone supporting your teeth.
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Why is it necessary to take dental x-rays?
Dentists are able to diagnose dental conditions using their eyes as well as diagnostic tools and equipment. There are areas invisible to visual inspection such as in between the teeth, within the teeth, under the gums and inside the bone. X-rays allow us to examine these areas and detect problems at an earlier stage, resulting in a better outcome. Everyone is concerned about exposure to x-ray radiation. In order to minimize patient exposure, we have switched from conventional film to digital sensors. In addition to requiring significantly less radiation, digital radiographs allow for improved diagnostic ability since the image is viewed on a large computer screen rather than a 1.25"x1.6" film.
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I have been told that daily flossing is important to maintain my tooth and gum health. Can't I just do a thorough brushing two or three times per day? What is the correct flossing technique?
Flossing, when done properly, removes food and plaque from in between the teeth and under the gums which is not accessible to your toothbrush. This hidden food and plaque can cause tooth decay as well as bleeding gums, periodontal pocket formation and irreversible loss of bone supporting your teeth. This bone loss may eventually lead to tooth loss. Click on the Youtube link below to view a video on proper flossing technique.
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What is an interdental brush and can I use it in place of dental floss?
An interdental brush is a cleaning aid consisting of a small brush on a handle used to clean between your teeth where a toothbrush can not reach. It does not replace flossing because it can not remove food and plaque from under the gums which is essential for maintaining gum health. Click on the Youtube link below for more information on interdental cleaners.
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What is the advantage of using an electric toothbrush over a manual toothbrush and what is the proper way to use it?
When used properly, an electric toothbrush is more efficient at cleaning since it moves much more rapidly than your hand. Many people brush too hard and improperly with a manual brush, resulting in gum recession and tooth abrasion. This can lead to a whole host of problems. With light pressure, an electric toothbrush is more gentle on your teeth and gums. For brushing technique, see the Youtube video below.
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What are the common causes of bad breath (halitosis)? What can I do to get rid of it?
Bad breath, also known as halitosis results from the release of volatile sulfur compounds by bacteria in our mouths. Persistent halitosis may indicate the presence of dental caries (tooth decay), gum disease or a focal source of infection such as an abscessed tooth. If you wear a removable denture, it is important to soak it in a denture cleaner every night to eliminate bacteria as well as remove stain. A visit to your dentist can either confirm or rule out a dentally related source of halitosis. If dental causes of halitosis have been ruled out, you should also consult with your physician since there are many other causes for bad breath including, chronic sinus infections, tonsil stones, bronchitis, pneumonia, post nasal drip, diabetes, chronic acid reflux, as well as liver or kidney disease. People on a high protein, low carbohydrate diet may notice a peculiar odor resulting from a condition called ketosis, where the body burns fat instead of carbs and releases volatile compounds.
As we all know, the foods and beverages we consume also contribute to bad breath. Garlic and onions are notorious for causing bad breath. Alcoholic beverages as well as acidic beverages such as coffee or soda can result in the release of offensive odors. We can eliminate some of the odor by thoroughly brushing and flossing which cleans out food particles and bacteria. Don't forget to clean your tongue with your toothbrush or tongue cleaner since it acts like a sponge and absorbs odors as well as harbors bacteria, food particles and dead cells. Mouth washes and breath mints can temporarily masque the odors, but they will return. If you do use breath mints, make sure they are sugar-free or you will be feeding the bacteria in your mouth. Does your mouth feel dry? Many medications cause dry mouth. A lack of adequate saliva flow can contribute to bad breath, tooth decay and gum disease since saliva has antibacterial properties and washes away acid produced by bacteria. Keep your body hydrated and your mouth moist by drinking water throughout the day.
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My mouth feels dry...should I be concerned? What causes it and what can I do to get some relief?
Symptoms of dry mouth include frequent thirst, sticky/dry feeling in the mouth or throat, burning sensation in the mouth or on the tongue, problems tasting, chewing or swallowing food, hoarseness or bad breath.
Dry mouth is a common side effect of many prescription and non prescription medications. It can also be a side effect of certain diseases such as Sjogren's Syndrome, diabetes, Alzheimer's, HIV, rheumatoid arthritis, and Parkinson's. Medical treatments such as radiation to the head and neck area or chemotherapy for cancer treatment can reduce saliva production. Smoking and mouth breathing can also contribute to a dry mouth.
From a dental perspective, dry mouth can significantly increase the development of tooth decay, gum disease and a yeast infection called thrush. If you think your dry mouth maybe due to a prescription medication, you can consult with your physician to see if there is an alternative. If not, he or she may prescribe a medication which increases saliva flow. You may also use over the counter products such as Biotene which are made especially for the relief of dry mouth symptoms. It is also recommended that you remain hydrated and keep your mouth moist by sipping on water throughout the day. Some may also choose to suck on sugar-free candy or chew on sugar-free gum to stimulate saliva production. Alcohol containing mouth rinses or beverages are discouraged since they will irritate your tissues and dry your mouth out even more. Use a lip balm to keep your lips moist and prevent cracking.
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What are dental implants and does it hurt to have them placed?
Dental implants are made of medical grade Titanium, which is a biocompatible metal also used in the fabrication of artificial joints such as knees and hips. Dental implants are used in dentistry to replace the root portion of teeth that have been lost and are commonly placed by an Oral and Maxillofacial Surgeon or Periodontist at the time of tooth extraction or as a separate surgical procedure. Our patients have reported that they experienced little to no discomfort during or following the implant surgery and they were surprised that it was finished so quickly. Following implant placement, there is usually a healing period of 2-4 months during which time your bone integrates with the implant. This is similar to the mending of a broken bone. At the end of the healing period, your surgeon will verify that the implant is secure in the bone and send you back to the restorative dentist to have teeth placed on the implants.
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What is a root canal and how do I know if I need one?
Root canal treatment maybe necessary to save a tooth if the nerve on the tooth "dies" or becomes irreversibly injured. This can result from decay entering or being in close proximity to the nerve, trauma to the tooth such as from a blow, fracture or deep restoration as well as other less common pathological conditions. Root canal treatment involves gaining access to the pulp chamber and canals, cleaning out and shaping the canals and filling them with a material that seals the bacteria out of the root. Common signs that may indicate the need for root canal treatment are spontaneous tooth pain or lingering pain to hot or cold, pain to biting pressure, tooth feels "loose" or "high", gum is swollen or a tooth becomes significantly discolored. This list is not inclusive of all symptoms and only a dentist can provide a conclusive diagnosis.
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What is the difference between TMJ and TMD? What can I do to treat it?
TMJ is an abbreviation for Temporomandibular Joint which is where your lower jaw (mandible) articulates with the temporal bone of the skull, just in front of the ear. TMD is an abbreviation for Temporomandibular Disorder and it encompasses disorders of the jaw muscles, temporomandibular joints, and the nerves associated with chronic facial pain. Any problem that prevents the complex system of muscles, bones, and joints from working together in harmony may result in temporomandibular disorder. Tooth grinding (bruxing) and clenching, trauma to the face and jaw, as well as degenerative joint disease like osteoarthritis may contribute to the development of TMD.
In some instances, TMD will resolve on its own after a few weeks of conservative, palliative treatment which may include a soft diet, avoiding chewing gum or other prolonged jaw movement, cold/warm compress, stretching exercises, relaxation/meditation, and short term NSAID or other doctor prescribed medications. This is especially true for TMD caused by tooth grinding or clenching. If pain remains unresolved, a multidisciplinary approach may be necessary. Occlusal splint therapy by a dentist which realigns the jaw into a more relaxed position may relieve pressure on the TMJ and associated structures. An Orthodontist may be able to correct tooth alignment problems which may contribute to TMD. Chiropractic, physical therapy and acupuncture professionals may be able to provide TMD associated pain relief. Orthopedic surgery may be necessary in cases where irreversible physical damage has been done to the TMJ.