Common Questions | Ashton Prince MD

Common Topics and Online Dental Education Library

Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. We are very aware that many procedures and preventative methods can get confusing. We have thus included a list of most commonly asked about topics. In addition to these areas, please use our dental library search finder located at the bottom of the list to learn more about other dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.

Medication and Heart Disease

Certain kinds of medications can have an adverse effect on your teeth.

Long ago, children exposed to tetracycline developed tooth problems, including discoloration, later in life. The medication fell out of use, however, and is not an issue today.

The best precaution is to ask your family physician if any medications he or she has prescribed can have a detrimental effect on your teeth or other oral structures.

A condition called dry mouth is commonly associated with certain medications, including antihistamines, diuretics, decongestants and pain killers. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Other causes are related to aging (including rheumatoid arthritis), and compromised immune systems. Garlic and tobacco use are other known culprits.

Dry mouth occurs when saliva production drops. Saliva is one of your body’s natural defenses against plaque because it acts to rinse your mouth of cavity-causing bacteria and other harmful materials.

Some of the less alarming results of dry mouth include bad breath. But dry mouth can lead to more serious problems, including burning tongue syndrome, a painful condition caused by lack of moisture on the tongue.

If dry mouth isn’t readily apparent, you may experience other conditions that dry mouth can cause, including an overly sensitive tongue, chronic thirst or even difficulty in speaking.

Heart Disease

Poor dental hygiene can cause a host of problems outside your mouth—including your heart.

Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use.

A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.

In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That’s why it’s critical to practice good oral hygiene to keep infections at bay—this includes a daily regimen of brushing, flossing and rinsing.

Antibiotic Prophylaxis

In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.

It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection.

However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.

Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.

Fluoride

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

Water fluoridation is endorsed by nearly every major health and safety-related organization in the world. Communities make it a common practice to “fluoridate” their drinking supplies in order for the general population to benefit from this inexpensive and effective preventative treatment. According to the American Dental Association, more than 144 million U.S. residents in more than 10,000 communities drink fluoridated water, most from public water supplies with sodium fluoride added artificially.

Bottled water, home water treatment systems, and fluoride exposure
Can the consistent use of bottled water result in individuals missing the benefits of optimally fluoridated water? Can home water treatment systems (e.g., water filters) affect optimally fluoridated water supplies? The answer is yes to both. Read how you can avoid some of the pitfalls that may be preventing you from getting the maximum value of fluoride, in this article from the American Dental Association.

ADA statement on FDA toothpaste warning labels
The American Dental Association`s Council on Scientific Affairs believes that one part of the warning now required on fluoride toothpastes by the Food and Drug Administration (FDA) could unnecessarily frighten parents and children, and that the label greatly overstates any demonstrated or potential danger posed by fluoride toothpastes. The label language, “If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately,” is now required on all fluoride toothpastes. But the ADA, in a letter sent to the FDA last year, pointed out that a child could not absorb enough fluoride from toothpaste to cause a serious problem and that the excellent safety record on fluoride toothpaste argues against any unnecessary regulation.

Enamel fluorosis
According to the American Academy of Pediatric Dentistry, a child may face a condition called enamel fluorosis if he or she receives too much fluoride during the years of tooth development. Too much fluoride can result in defects in tooth enamel.

CDC web site provides information on community water fluoridation
People seeking information on whether their water system is fluoridated can now find out by visiting a new Web site at the Centers for Disease Control and Prevention (CDC). The new feature, “My Water`s Fluoride,” allows consumers in participating states to check out basic information about their water system, including the number of people served by the system and the target fluoridation level. Optimal levels recommended by the U.S. Public Health Service and CDC for drinking water range from 0.7 parts per million (ppm) for warmer climates, to 1.2 ppm for cooler climates accounting for the tendency to drink more water in warmer climates. States that are currently participating include Arizona, Colorado, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, Nevada, North Dakota, Oklahoma, Pennsylvania and Wisconsin.

Flossing

What is flossing?
Flossing is a method for removing bacteria and other debris that cannot be reached by a toothbrush. It generally entails a very thin piece of synthetic cord you insert and move up and down between the sides of two adjoining teeth.

Why is flossing important?
Many dentists believe that flossing is the single most important weapon against plaque. In any event, daily flossing is an excellent and proven method for complementing your brushing routine and helping to prevent cavities, periodontal disease, and other dental problems later in life. It also increases blood circulation in your gums. Floss removes plaque and debris that stick to your teeth and gums.

How often to floss
Floss at least once every day. Like brushing, flossing should take about three minutes and can easily be done while doing another activity, such as watching television. Do not attempt to floss your teeth while operating a motor vehicle or other machinery.

Flossing techniques
There are two common methods for flossing, the “spool method” and the “loop method”.

The spool method is the most popular for those who do not have problems with stiff joints or fingers. The spool method works like this: Break off about 18 inches of floss and wind most of it around your middle finger. Wind the rest of the floss similarly around the middle finger of your other hand. This finger takes up the floss as it becomes soiled or frayed. Move the floss between your teeth with your index fingers and thumbs. Maneuver the floss up and down several times forming a “C” shape around the tooth. While doing this, make sure you go below the gum line, where bacteria are known to collect heavily.

The loop method is often effective for children or adults with dexterity problems like arthritis. The loop method works like this: Break off about 18 inches of floss and form it into a circle. Tie it securely with two or three knots. Place all of your fingers, except the thumb, within the loop. Use your index fingers to guide the floss through your lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gum line and forming a “C” on the side of the tooth.

With either method of flossing, never “snap” the floss because this can cut your gums. Make sure that you gently scrape the side of each tooth with the floss.

Your gums may be tender or even bleed for the first few days after flossing – a condition that generally heals within a few days.

Denture Care

Dentures today are made from very advanced materials designed to give you a natural appearance.

However, keep in mind that just like your teeth, dentures should be cared for with the same diligence. This means daily brushing and regular visits to your dentist.

Regular visits to your dentist are critical. Your dentist also can make minor adjustments that ensure that your dentures continue fitting naturally and comfortably.

Just like natural teeth, dentures need to be cleansed of plaque, food particles and other debris. Keeping your dentures in top shape will also help keep the soft tissues of your mouth healthy; an unclean or malformed denture can cause infections and irritation.

Cleaning Techniques
Remember to rinse and brush your dentures after every meal, and soak them in denture solution overnight. This also allows your gums to breathe while you sleep.

Here are some simple techniques for keeping your dentures clean:

People can brush their dentures in a variety of ways. Some people use soap and water or a slightly abrasive toothpaste. Popular denture pastes and creams also can be used.
Avoid using highly abrasive chemicals or pastes, or vigorously brushing with hard bristled toothbrushes. These can scratch or even crack dentures.
Hold your dentures gently to avoid loosening a tooth.
Clean your dentures with cool or tepid water over a water-filled sink. Hot water may warp a denture. A small washcloth placed in the bottom of the bowl will ensure that your denture isn’t damaged if it falls.
Soak your dentures overnight in any commercially available product like Efferdent or Polident, and remember to rinse your dentures before placing them back in your mouth.
Remember to use a separate toothbrush to clean your own natural teeth, as well as all of your gum tissues. In lieu of a toothbrush, a soft washcloth may be used to wipe your gums.

Over time, even daily care of your dentures may require them to be cleaned by the dentist. A powerful ultrasonic cleaner may be used to remove hard accumulations of tartar and other substances.

Prevention Tips for Children

Infants
Infants should be seen by our office after the first six months of age, and at least by the child’s first birthday. By this time, the baby’s first teeth, or primary teeth, are beginning to erupt and it is a critical time to spot any problems before they become big concerns.

Conditions like gum irritation and thumb-sucking could create problems later on. Babies who suck their thumbs may be setting the stage for malformed teeth and bite relationships.

Another problem that can be spotted early is a condition called “baby bottle tooth decay,” which is caused by sugary substances in breast milk and some juices, which combine with saliva to form pools inside the baby’s mouth.

If left untreated, this can lead to premature decay of your baby’s future primary teeth, which can later hamper the proper formation of permanent teeth.

One of the best ways to avoid baby bottle tooth decay is to not allow your baby to nurse on a bottle while going to sleep. Avoid dipping pacifiers in sweet substances such as honey, because this only encourages early decay in the baby’s mouth. Encouraging your young child to drink from a cup as early as possible will also help stave off the problems associated with baby bottle tooth decay.

Teething, Pacifiers and Thumb-Sucking
Teething is a sign that your child’s gums are sore. This is perfectly normal. You can help relieve this by allowing the baby to suck on a teething ring, or gently rubbing your baby’s gums with the back of a small spoon, a piece of wet gauze, or even your finger.

For babies under the age of 4, teething rings and pacifiers can be safely used to facilitate the child’s oral needs for relieving gum pain and for suckling. After the age of 4, pacifiers are generally discouraged because they may interfere with the development of your child’s teeth.

Moreover, thumb-sucking should be strongly discouraged because it can lead to malformed teeth that become crooked and crowded.

Primary and Permanent Teeth
Every child grows 20 primary teeth, usually by the age of 3. These teeth are gradually replaced by the age of 12 or so with a full set of 28 permanent teeth, and later on, four molars called “wisdom teeth.”

It is essential that a child’s primary teeth are healthy, because their development sets the stage for permanent teeth. If primary teeth become diseased or do not grow in properly, chances are greater that their permanent replacements will suffer the same fate. For example, poorly formed primary teeth that don’t erupt properly could crowd out spaces reserved for other teeth. Space maintainers can sometimes be used to correct this condition, if it is spotted early enough.

Brushing

Babies’ gums and teeth can be gently cleaned with special infant toothbrushes that fit over your finger. Water is suitable in lieu of toothpaste (because the baby may swallow the toothpaste). Parents are advised to avoid fluoride toothpastes on children under the age of 2.

Primary teeth can be cleansed with child-sized, soft-bristled toothbrushes. Remember to use small portions of toothpaste (a pea-sized portion is suitable), and teach your child to spit out, not swallow, the toothpaste when finished.

Fluoride

Fluoride is generally present in most public drinking water systems. If you are unsure about your community’s water and its fluoride content, or learn that it has an unacceptable level of fluoride in it, there are fluoride supplements your dentist can prescribe. Your child may not be getting enough fluoride just by using fluoride toothpaste.

Toothaches

Toothaches can be common in young children. Sometimes, toothaches are caused by erupting teeth, but they also could indicate a serious problem.

You can safely relieve a small child’s toothache without the aid of medication by rinsing the mouth with a solution of warm water and table salt. If the pain doesn’t subside, acetaminophen may be used. If such medications don’t help, contact your dentist immediately.

Injuries

You can help your child prevent oral injuries by closely supervising him during play and not allowing the child to put foreign objects in the mouth.

For younger children involved in physical activities and sports, mouth guards are strongly encouraged, and can prevent a whole host of injuries to the teeth, gums, lips and other oral structures.

Mouth guards are generally small plastic appliances that safely fit around your child’s teeth. Many mouth guards are soft and pliable when opened, and mold to the child’s teeth when first inserted.

If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see our office. Remember to hold the dislocated tooth by the crown—not the root. If you cannot relocate the tooth, place it in a container of cold milk, saline or the victim’s own saliva. Place the tooth in the solution.

First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.

For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.

If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.

If a child’s primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.

Irritation caused by retainers or braces can sometimes be relieved by placing a tiny piece of cotton or gauze on the tip of the wire or other protruding object. If an injury occurs from a piece of the retainer or braces lodging into a soft tissue, contact our office immediately and avoid dislodging it yourself.

Sealants

Sealants fill in the little ridges on the chewing part of your teeth to protect and seal the tooth from food and plaque. The application is easy to apply and typically last for several years.

Seniors and Oral Health

More and more people are avoiding the need for dentures as they grow older, going against the notion that false teeth are a normal part of growing older.

In fact, there’s usually no reason for you NOT to keep your teeth your entire life, providing you maintain a healthy balanced diet and practice good oral hygiene.

Another desirable side effect of good oral hygiene: avoiding more serious problems such as hypertension, cardiovascular disease, diabetes, and even stroke. Indeed, medical research is beginning to show that a healthy mouth equates to a healthy body and a longer life.

Dexterity and Arthritis
People who suffer from arthritis or other problems of dexterity may find it difficult and painful to practice good oral hygiene.

Thankfully, industry has responded with ergonomically designed devices such as toothbrushes and floss holders that make it easier to grasp and control.

You can also use items around the house to help you. Inserting the handle of your toothbrush into a small rubber ball, or extending the handle by attaching a small piece of plastic or Popsicle stick may also do the trick.

Floss can also be tied into a tiny loop on either side, making it easier to grasp and control the floss with your fingers.

Bad Breath (halitosis)

An estimated sixty-five percent of Americans have bad breath. Over forty-million Americans have “chronic halitosis,” which is persistent bad breath. Ninety percent of all halitosis is of oral, not systemic, origin.

Americans spend more than $1 billion a year on over the counter halitosis products, many of which are ineffective because they only mask the problem.

What causes bad breath?
Bad breath is caused by a variety of factors. In most cases, it is caused by food remaining in the mouth – on the teeth, tongue, gums, and other structures, collecting bacteria. Dead and dying bacterial cells release a sulfur compound that gives your breath an unpleasant odor. Certain foods, such as garlic and onions, contribute to breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is exhaled. Brushing, flossing and mouthwash only mask the odor. Dieters sometimes develop unpleasant breath from fasting.

Periodontal (gum) disease often causes persistent bad breath or a bad taste in the mouth, and persistent bad breath may mean a sign that you have gum disease.

Gum disease is caused by plaque – the sticky, often colorless, film of bacteria that constantly forms on teeth. Dry mouth or xerostomia may also cause bad breath due to decreased salivary flow. Saliva cleans your mouth and removes particles that may cause odor. Tobacco products cause bad breath, stain teeth, reduce your ability to taste foods and irritate your gum tissues. Bad breath may also be a sign that you have a serious health problem, such as a respiratory tract infection, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment.

Here are characteristic bad breath odors associated with some of these illnesses:

Diabetes – acetone, fruity
Liver failure – sweetish, musty
Acute rheumatic fever – acid, sweet
Lung abscess – foul, putrefactive
Blood dyscrasias – resembling decomposed blood
Liver cirrhosis – resembling decayed blood
Uremia – ammonia or urine
Hand-Schuller-Christian disease – fetid breath and unpleasant taste
Scurvy – foul breath from stomach inflammation
Wegner`s granulomatosis – Necrotic, putrefactive
Kidney failure – ammonia or urine
Diphtheria, dysentery, measles, pneumonia, scarlet fever, tuberculosis – extremely foul, fetid odor
Syphilis – fetid

Bad breath may also be caused by medications you are taking, including central nervous system agents, anti-Parkinson drugs, antihistamines/decongestants, anti-psychotics, anti-cholinergics, narcotics, anti-hypertensives, and anti-depressants.

Caring for bad breath
Daily brushing and flossing, and regular professional cleanings, will normally take care of unpleasant breath. And don’t forget your often overlooked tongue as a culprit for bad breath. Bacterial plaque and food debris also can accumulate on the back of the tongue. The tongue’s surface is extremely rough and bacteria can accumulate easily in the cracks and crevices.

Controlling periodontal disease and maintaining good oral health helps to reduce bad breath. If you have constant bad breath, make a list of the foods you eat and any medications you take. Some medications may contribute to bad breath.

Improperly cleaned dentures can also harbor odor-causing bacteria and food particles. If you wear removable dentures, take them out at night and clean them thoroughly before replacing them.

If your dentist determines that your mouth is healthy and that the odor is not oral in nature, you may be referred to your family physician or to a specialist to determine the cause of the odor and possible treatment. If the odor is due to gum disease, your dentist can either treat the disease or refer you to a periodontist, a specialist in treating gum tissues. Gum disease can cause gum tissues to pull away from the teeth and form pockets. When these pockets are deep, only a professional periodontal cleaning can remove the bacteria and plaque that accumulate.

Mouthwashes are generally ineffective on bad breath. If your bad breath persists even after good oral hygiene, there are special products your dentist may prescribe, including Zytex, which is a combination of zinc chloride, thymol and eucalyptus oil that neutralizes the sulfur compounds and kills the bacteria that causes them. In addition, a special antimicrobial mouth rinse may be prescribed. An example is chlorhexidine, but be careful not to use it for more than a few months as it can stain your teeth. Some antiseptic mouth rinses have been accepted by the American Dental Association for their breath freshening properties and therapeutic benefits in reducing plaque and gingivitis. Instead of simply masking breath odor, these products have been demonstrated to kill the germs that cause bad breath. Ask your dentist about trying some of these products.

Dry Mouth

Saliva is one of your body’s natural defenses against plaque because it acts to rinse your mouth of cavity-causing bacteria and other harmful materials. Dry mouth (also called Xerostomia) is a fairly common condition that is caused by diminished saliva production. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Eating foods such as garlic, tobacco use, and some kinds of medications, including treatments such as cancer therapy can diminish the body’s production of saliva, leading to dry mouth. Other causes are related to aging (including rheumatoid arthritis), and compromised immune systems.

If dry mouth isn’t readily apparent, you may experience other conditions that dry mouth can cause, including an overly-sensitive tongue, chronic thirst or even difficulty in speaking.

If you don’t have a medical condition that causes it, dry mouth can be minimized by sipping water regularly, chewing sugarless gum and avoiding smoking. Of course, there is no substitute for regular checkups and good oral hygiene.

Bleaching

Bleaching and non-bleaching products are the two basic kinds of whitening products available today.

Non-bleaching products normally use abrasives or chemicals and only remove surface stains on teeth.

Bleaching products work with a chemical called peroxide and can brighten your teeth several shades.

Another process employs the use of a special gel that is placed inside a flexible device you wear around your teeth for a certain period of time. After you remove the device, you must use a second bleaching agent, followed by a special light to activate the chemical action.

Mildly stained teeth usually only require one session of bleaching.

Oral Health Topics

Introduction

Does mercury in the silver fillings in your mouth pose any long-term health risks? Does fluoride, in spite of everything we’ve been told since childhood, actually cause more harm than good? What does the latest research reveal about tobacco use on your overall oral health?

This section is dedicated to the latest information about these and other oral health topics, pulled from authoritative sources such as the American Dental Association.

Click here for the latest news from the American Dental Association.

Fluoride

The Preventive Program

Both natural teeth and teeth with restorations survive best in an oral environment that is clean and where the intake of harmful foods is controlled. Our program is designed to help prevent new cavities, preserve teeth that have been restored and manage periodontal disease. At the initial visit oral hygiene instructions are reviewed and are reinforced at subsequent recall visits. The following are helpful recommendations:

Brush your teeth twice a day in a circular motion with a soft bristled toothbrush aimed at the gum.
Floss every night in an up-and-down motion while keeping the floss in a U-shape and against the tooth surface.
Avoid smoking.
Avoid sticky sugary foods.
Eat a balanced diet.
Use antiseptic and fluoride rinses as directed.
Have sealants placed on young permanent teeth.

Fillings

Infection Control

Medication and Heart Disease

Latex Allergy

Naturally occurring latex has been linked in recent years to allergic reactions in people who use such products as latex gloves. The proteins in the latex, which can also become airborne, can cause problems in vulnerable people such as breathing problems and contact dermatitis. Some allergic reactions, including anaphylactic shock, have been more severe.

Many health experts have rightly attributed the dramatic increase of allergic reactions to latex in the health care community to the increased use of gloves and other personal protection equipment in light of the AIDS epidemic.

Latex is a pervasive substance in many household items—from toys and balloons to rubber bands and condoms.

Latex allergies could cause the following symptoms:

Dry skin
Hives
Low blood pressure
Nausea
Respiratory problems
Tingling sensations

People with high-risk factors for latex allergy include those who have undergone multiple surgical operations, have spina bifida, or are persistently exposed to latex products.

If you are vulnerable to latex or have allergies related to it, please notify our office and, by all means, seek medical attention from your family physician.

Age and Oral Health

Oral changes with age
Is tooth loss inevitable in your later years? How much should adults be concerned about cavities? Here you will find helpful answers to some frequently asked questions about oral health questions you may have as you get older.

National survey reveals baby boomers miss links between oral and overall health

Baby boomers looking for the warning signs of adult-onset diseases may be overlooking key symptoms in their mouth that should signal alarms about their overall health. According to a survey commissioned by the Academy of General Dentistry, 63 percent of baby boomers (ages 45-64) with an oral symptom considered to be a key indicator of a more serious health condition, were unaware of the symptom`s link to the condition. Boomers` failure to recognize that oral health holds valuable clues could negatively impact their overall health.

Tobacco

General Dentistry

The first line of defense against oral health problems

In general dentistry, the dentist is the primary care provider for patients of all ages and is responsible for the prevention, diagnosis and treatment of a wide variety of conditions, disorders and diseases affecting the teeth, gums and maxillofacial (jaw and face) parts of the body. Even though general dentists primarily provide preventative care and minor restorative therapy, they are often able to perform a wide array of other dental procedures, including some minor cosmetic treatments.

The American Dental Association (ADA) recommends that patients visit their general dentist at least once every six months to ensure proper oral health and functionality. Regular oral health check-ups and maintenance help to prevent the development of serious dental problems that may require more extensive and costly treatments. General dentists are highly educated and trained in multiple facets of dentistry, providing a variety of different services for you and your family including:

Crowns and bridges
Dentures
Dental implants
Gum disease (Periodontal) treatment
Orthodontics
Root canal therapy
Teeth cleanings
Bonding
Dental fillings

General dentists who do not perform a certain treatment will provide you with a specialist referral.

Tooth Care

Plaque is an insidious substance—a colorless, sticky film—that blankets your teeth and creates an environment in which bacteria erode tooth enamel, cause gum irritation, infection in inner structures such as pulp and the roots, and in extreme cases, tooth loss.

Some of the biggest culprits causing plaque are foods rich in sugar and carbohydrates, including soda beverages, some juices, candy and many kinds of pasta, breads and cereals.

Plaque also can attack fillings and other restorations in your mouth, which can lead to more costly treatment down the road.

Plaque is the main cause of tooth decay. It can also cause your gums to become irritated, inflamed, and bleed. Over time, the plaque underneath your gums may cause periodontal disease, which can lead to bone loss and eventual tooth loss.

Inside your teeth, decay can gradually destroy the inner layer, or dentin. It can also destroy the pulp, which contains blood vessels, nerves and other tissues, as well as the root.

Periodontal disease is advanced gum disease. This serious condition occurs when the structures that support your teeth—the gums and bone—break down from the infection. Pain, hypersensitivity and bleeding are some of the signs of periodontal disease.

Simple Preventative Measures
The two best defenses against tooth decay and gum disease are a healthy, well-balanced diet and good oral hygiene, including daily brushing with fluoride toothpaste, flossing and rinsing. Most public drinking water contains fluoride, but if you are unsure of your water supply, then use a good quality mouth rinse containing fluoride.

A good way to help your oral health between brushing is chewing sugarless gum; this stimulates your body’s production of saliva, a powerful chemical that actually neutralizes plaque formation and rinses decay-causing food particles and debris from your mouth.

In some cases, our office can prescribe anti-cavity rinses or apply special anti-cavity varnishes or sealants to help fight decay.

Brushing

Flossing

Fluoride Facts

Mouth Rinses

The Food and Drug Administration classifies mouth rinses into two categories – therapeutic and cosmetic.

In general, therapeutic rinses with fluoride have been shown to actually fight cavities, plaque and gingivitis.

On the other hand, cosmetic rinses merely treat breath odor, reduce bacteria and/or remove food particles in the mouth. They do nothing to treat or prevent gingivitis.

People who have difficulty brushing (because of physical difficulties such as arthritis) can benefit from a good therapeutic mouth rinse.

Caution: Even rinses that are indicated to treat plaque or cavities are only moderately effective. In fact, regular rinsing with water and use of good quality fluoride toothpaste are just as or more effective.

Sealants

Sealants are liquid coatings that harden on the chewing surfaces of teeth and are showing a great deal of effectiveness in preventing cavities—even on teeth where decay has begun.

The pits and grooves of your teeth are prime areas for opportunistic decay. Even regular brushing sometimes misses these intricate structures on the chewing surfaces of your teeth.

The sealants are applied to the chewing surfaces and are designed to prevent the intrusion of bacteria and other debris into the deep crevices on the tops of teeth.

Sealants actually were developed about 50 years ago, but didn’t become commonly used until the 1970s. Today, sealants are becoming widely popular and effective; young children are great candidates for preventative measures like sealants (especially on molars) because in many cases, decay has not set in. Even on teeth where decay is present, sealants have been shown to fight additional damage.

Application
Sealants are applied by first cleaning the tooth surface. The procedure is followed by “etching” the tooth with a chemical substance, which allows the sealant to better adhere. After the sealant is applied, a warm light source is directed to the site to promote faster drying. Sealants usually need re-application every five to 10 years.

X-Rays

When X-rays pass through your mouth during a dental exam, more X-rays are absorbed by the denser parts (such as teeth and bone) than by soft tissues (such as cheeks and gums) before striking the film. This creates an image on the radiograph. Teeth appear lighter because fewer X-rays penetrate to reach the film. Cavities and gum disease appear darker because of more X-ray penetration. The interpretation of these X-rays allows the dentist to safely and accurately detect hidden abnormalities.

How often dental X-rays (radiographs) should be taken depends on the patient`s individual health needs. It is important to recognize that just as each patient is different from the next, so should the scheduling of X-ray exams be individualized for each patient. Your medical and dental history will be reviewed and your mouth examined before a decision is made to take X-rays of your teeth.

The schedule for needing radiographs at recall visits varies according to your age, risk for disease and signs and symptoms. Recent films may be needed to detect new cavities, or to determine the status of gum disease or for evaluation of growth and development. Children may need X-rays more often than adults. This is because their teeth and jaws are still developing and because their teeth are more likely to be affected by tooth decay than those of adults.

Denture Care

Emergency Care

A knocked out tooth or bitten tongue can cause panic in any parent, but quick thinking and staying calm are the best ways to approach such common dental emergencies and prevent additional unnecessary damage and costly dental restoration. This includes taking measures such as application of cold compresses to reduce swelling, and of course, contacting our office as soon as possible.

Prevention Tips for Children

Women and Tooth Care

Women have special needs when it comes to their oral health. That’s because the physical changes they undergo through life—menstruation, pregnancy and childbirth, breast-feeding and menopause—cause many changes in the body, some harmful to teeth and gums.

Lesions and ulcers, dry sockets, as well as swollen gums, can sometimes occur during surges in a woman’s hormone levels. These periods would be a prime time to visit the dentist. Birth control pills have been shown to increase the risk of gingivitis, and hormone replacement therapy has been shown to cause bleeding and swollen gums. Gum disease can also present a higher risk for premature births.

Some research has shown that women may be more likely to develop dry mouth, eating disorders, jaw problems such as temporomandibular joint disorders, and facial pain—all of which can be difficult from a physical and emotional standpoint.

Taking care of your mouth with proper oral health care is essential, and can go a long way to helping you face the physical changes in your body over the years.

Seniors and Oral Health

Nutrition and Your Teeth

Periodontol Exams

Periodontal exams are vital in the maintenance of your oral health as they are used to assess the health of your gums and teeth. They can help your dentist diagnose gum diseases, gingivitis and periodontitis. These exams can also reveal receding gums, exposed roots, tooth grinding and other problems, making periodontal exams vital to maintaining proper oral health. Regular dental exams are important as they can reveal evidence of gum disease in its early stages.

During your periodontal examination, your dentist will check:

For any lumps or abnormal areas in the mouth
Whether any of your teeth are missing or loose
The color, texture, size and shape of your gums
Whether you have fillings, crowns, bridges, dentures or implants
How much plaque is on your teeth
The depth of the space between your tooth and gum

Gingivitis is the first stage of periodontal disease that causes inflammation of the gums. Dental x-rays can determine if the inflammation has spread to the supporting structures on the teeth so treatment can be started to correct the problem. Periodontitis occurs when gingivitis goes untreated, which makes periodontal exams vital to preventing and putting an end to gum diseases.

Your dentist will complete a periodontal exam with each visit, emphasizing the importance of regular, routine visits to your dentist’s office.

Dental Problems

Treatment of an abscessed tooth
An abscessed tooth is a pocket of pus, usually caused by some kind of infection and the spread of bacteria from the root of the tooth to the tissue just below or near the tooth.

In general, a tooth that has become abscessed is one whose underlying pulp (the tooth’s soft core) has become infected or swollen. The pulp contains nerves, blood vessels and connective tissue, and lies within the tooth. It extends from the crown of the tooth, to the tip of the root, in the bone of the jaws.

An abscessed tooth can be an extremely painful condition.

In some cases, antibiotics are administered in an attempt to kill an infection. If antibiotics are ineffective and an abscess is shown to be damaging the pulp or lower bony structures, a root canal procedure may be needed to remove the dead pulp and restore the tooth to a healthy state.

Bad Breath (halitosis)

Bulimia Nervosa

People with eating disorders can suffer from oral health problems as well. This is because many of the behaviors associated with anorexia nervosa and bulimia nervosa—such as binge eating, self-induced vomiting, and use of diuretics or laxatives—cause changes in the mouth.

For example, repeated episodes of vomiting, which is common in people with bulimia, release harmful stomach acids that pass through the mouth and can erode tooth enamel, causing cavities, discoloration and tooth loss. Other problems, such as poorly fitting fillings and braces, are another byproduct of such eating disorders.

Brushing after episodic vomiting is actually more harmful than one would think. The best practice is to rinse thoroughly with a neutral solution such as baking soda and water.

Canker/Cold Sores

People sometimes confuse canker sores and cold sores, but they are completely unrelated. Both can be painful, but knowing the differences can help you keep them in check.

A canker sore is typically one that occurs on the delicate tissues inside your mouth. It is usually light-colored at its base and can have a red exterior border.

A cold sore or fever blister, on the other hand, usually occurs on the outside of the mouth, usually on or near the nose or lips. A cold sore is contagious because it is caused by the herpes simplex virus, and it is usually painful and filled with fluid.

In most cases, patience is the best medicine for treating canker sores. A healthy diet and good oral hygiene are usually the best remedy, but some special rinses and anesthetics can help. Cold sores can be treated effectively with some over-the-counter topical creams; sometimes, an antiviral medication will be prescribed by your doctor.

Cavities and Tooth Decay

Toothaches

Simple toothaches can often be relieved by rinsing the mouth to clear it of debris and other matter. Sometimes, a toothache can be caused or aggravated by a piece of debris lodged between the tooth and another tooth. Avoid placing an aspirin between your tooth and gum to relieve pain, because the dissolving aspirin can actually harm your gum tissue.

Broken, Fractured, or Displaced Tooth
A broken, fractured or displaced tooth is usually not a cause for alarm, as long as decisive, quick action is taken.

If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see your dentist.

First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.

If you cannot locate the tooth back in its socket, hold the dislocated tooth by the crown – not the root. Next, place it in a container of warm milk, saline or the victim’s own saliva and keep it in the solution until you arrive at the emergency room or dentist’s office.

For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.

If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.

Diabetes

People living with diabetes are vulnerable to a host of systemic problems in their entire body. Unfortunately, the mouth and teeth are not immune from such problems, and many diabetics with oral problems go undiagnosed until conditions become advanced.

Infections and other problems such as receding gums and gum disease, or periodontal disease, are common afflictions among diabetics for many reasons; for instance, diabetics often are plagued by diminished saliva production, which can hamper the proper cleansing of cavity-causing debris and bacteria from the mouth. In addition, blood sugar levels that are out of balance could lead to problems that promote cavities and gum disease.

As with any condition, good oral hygiene, including regular brushing, flossing and rinsing, as well as the proper diabetic diet, will go a long way in preventing needless problems.

Dry Mouth

Fluorosis

Fluorosis is a condition in which your body has been exposed to too much fluoride.In normal doses (typically found in a safe drinking water system and an ADA-approved toothpaste), fluoride is a healthy compound that promotes strong teeth, which has the ability to fight cavities and other problems.

But sometimes, fluorosis occurs when fluoride-containing toothpastes or rinses are swallowed, instead of expelled.

Fluorosis causes a number of aesthetic problems, including abnormally darkened or stained teeth. While such problems are generally harmless to your health, they can create concerns with your appearance.

Gum Disease (Gingivitis)

Wisdom Teeth

Wisdom teeth are the third and final set of molars that erupt in the back corners of the upper and lower normal adult mouth. Unfortunately, most people experience problems from wisdom teeth; in most cases, this is because the teeth erupt too close to existing permanent teeth, causing crowding, improper bites, and other problems.

If wisdom teeth are causing a problem, this could mean that they are impacted. Impacted wisdom teeth can be extremely painful, as well as harmful to your oral health. Symptoms are easy to spot: pain, inflammation, and some kinds of infections.

Many people need to have their wisdom teeth extracted to avoid future serious problems. In general, the lack of the four wisdom teeth does not hamper one’s ability to properly bite down, speak or eat.

Lacerations and Cuts

Any kind of cut to your face and the delicate soft tissues inside your mouth should be addressed immediately in order to prevent further tissue damage and infection.

If a traumatic injury involves a broken facial bone such as the jaw, nose, chin or cheek, maxillofacial surgery may be required.

With jaw surgery, rubber bands, tiny wires, metal braces, screws or plates are often used to keep a fractured jaw in place following surgery. This allows the bone to heal and stay in proper alignment. Dental splints or dentures may also be required to supplement the healing process following jaw surgery.

Oral Cancer

Plaque

Plaque is a film of bacteria that forms on your teeth and gums after eating foods that produce acids. These foods may include carbohydrates (starches and sugars), such as candy and cookies, and starchy foods such as bread, crackers, and cereal.

Tooth decay, commonly known as cavities, occurs when plaque remains on your teeth for an extended period of time, allowing the bacteria to ‘eat away’ at the surfaces of your teeth and gums. Ironically, the areas surrounding restored portions of teeth (where fillings, or amalgams have been placed) are particularly vulnerable to decay and are a breeding ground for bacteria.

Plaque can lead to gum irritation, soreness, and redness. Sometimes, your gums may begin to bleed as a result of plaque. This gradual degeneration can often cause gums to pull away from teeth. This condition is called receding gums.

Long-term plaque can lead to serious problems. Sometimes, the bacteria can form pockets of disease around tooth structures, eventually destroying the bone beneath the tooth.

Sensitive Teeth

Teeth Grinding (Bruxism)

Teeth grinding, also called bruxism, is often viewed as a harmless, though annoying, habit. Some people develop bruxism from an inability to deal with stress or anxiety.

However, teeth grinding can literally transform your bite relationship and worse, severely damage your teeth and jaws over long periods of time.

Teeth grinding can cause abrasion to the chewing surfaces of your teeth. This abnormal wear and tear will prematurely age and loosen your teeth, and open them to problems such as hypersensitivity (from the small cracks that form, exposing your dentin). Bruxism can also lead to chronic jaw and facial pain, as well as headaches.

If no one has told you that you grind your teeth, here are a few clues that you may suffer from bruxism:

Your jaw is often sore, or you hear popping sounds when you open and close your mouth.
Your teeth look abnormally short or worn down.
You notice small dents in your tongue.

Bruxism is somewhat treatable. A common therapy involves use of a special appliance worn while sleeping. Less intrusive, though just as effective methods could involve biofeedback, and behavior modification, such as tongue exercises and learning how to properly align your tongue, teeth and lips.

Jaw Disorders

People who grind their teeth can sometimes develop a serious problem with their jaw, which left untreated, can adversely affect the teeth, gums and bone structures of the mouth. One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that connects your lower jaw to your skull, and allows your upper and lower jaw to open and close and facilitates chewing and speaking.

People with temporomandibular joint disorders (TMD) often have a clicking or popping sound when opening and closing their mouths. Such disorders are often accompanied by frequent headaches, neck aches, and in some cases, tooth sensitivity.

Some treatments for TMD include muscle relaxants, aspirin, biofeedback, or wearing a small plastic appliance in the mouth during sleep.

Minor cases of TMD involve discomfort or pain in the jaw muscles. More serious conditions involve improperly aligned joints or dislocated jaws. The most extreme form of TMD involves an arthritic condition of the jaw joint.

Treatment

Braces (Orthodontial)

Sealants

The pits and grooves of your teeth are prime areas for opportunistic decay. Even regular brushing sometimes misses some of these intricate structures on the chewing surfaces of your teeth.

Enter sealants, which are thin coatings applied to the chewing surfaces designed to prevent the intrusion of bacteria and other debris into the deep crevices on the tops of your teeth.

Sealants actually were developed about 50 years ago, but didn’t become commonly used until the 1970s. Today, sealants are becoming widely popular and effective; young children are great candidates for preventative measures like sealants because in many cases, decay has not set in. Even on teeth where decay is present, sealants have been shown to fight additional damage.

Sealants are applied by first cleaning the tooth surface. The procedure is followed by etching the tooth with an abrasive substance, which allows the sealant to better adhere. After the sealant is applied, a warm light source is directed to the site to promote faster drying. Sealants usually need re-application every five to 10 years.

Missing Teeth

Fixed bridges and implants are often used to replace missing teeth and to correct some kinds of bite problems.

Crowns and bridges are the most effective procedure for replacing missing teeth or bite problems.

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.

There are several types of fixed dental bridges (cannot be removed), including conventional fixed bridges, cantilever bridges and resin-bonded bridges. 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.

Crowns

Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.

Crowns are typically used to restore a tooth’s function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.

Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.

Procedures
A tooth must usually be reduced in size to accommodate a crown. A cast is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.

Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.

Caring For Your Crowns
With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.

Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.

Scaling and Root Planing

Some cases of acute periodontal (gum) disease that do not respond to more conventional treatment and self-care such as flossing may require a special kind of cleaning called scaling and root planing.

The procedure begins with administration of a local anesthetic to reduce any discomfort. Then, a small instrument called a “scaler,” or an ultrasonic cleaner, is used to clean beneath your gum line to remove plaque and tartar.

The root surfaces on the tooth are then planed and smoothed. If effective, scaling and root planing helps the gums reattach themselves to the tooth structure. Additional measures may be needed if the periodontal pockets persist after scaling and root planing.

Root Canal Therapy

Extraction

Flap Surgery

Your bone and gum tissue should fit snugly around your teeth like a turtleneck.When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth. Over time, these pockets become deeper, providing a larger space for bacteria to thrive and wreak havoc.

As bacteria accumulate and advance under the gum tissue in these deep pockets, additional bone and tissue loss follows. Eventually, if too much bone is lost, the teeth will need to be extracted.

Flap surgery is sometimes performed to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for you or your dental professional to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again.

A pocket reduction procedure is recommended if daily at-home oral hygiene and a professional care routine cannot effectively reach these deep pockets.

In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

Dentures

Jaw/TMJ

People who grind their teeth can sometimes develop a serious problem with their jaw, which left untreated, can adversely affect the teeth, gums and bone structures of the mouth.

One of the most common jaw disorders is related to a problem with the temporomandibular joint, the joint that connects your lower jaw to your skull, and allows your upper and lower jaw to open and close and facilitates chewing and speaking.

Some treatments for TMD include muscle relaxants, aspirin, biofeedback, or wearing a small plastic appliance in the mouth during sleep.

In these cases, jaw surgery may be required to correct the condition. Some jaw surgery can be performed arthroscopically.

Maxillofacial Surgery

Cosmetic Dentistry

Pain Management

Overview

Pain can occur in any number of places in your mouth: teeth, gums, roots, the palate, tongue and jaw.

Cavities are a common culprit causing pain. Untreated cavities can impact nerves because of infections of the tooth and gums. Impacted and abscessed teeth and sore jaws from teeth grinding are other common causes of pain.

Improper bite relationships and jaw disorders can also cause pain. Other sources of pain include sleep disorders, and headaches and neck aches.

Special splints can sometimes be applied to stabilize a bite. Bites can also be corrected with special orthodontic procedures, appliances and restoration techniques.

Managing Pain

There are many methods for relieving oral pain. They include:

Ice packs on the affected area.
Avoiding hard candy or ice.
Avoiding sleeping on your stomach.

Dentists use a wide array of pain management tools, including:

Anesthetics such as Novocaine.
Analgesics such as aspirin or ibuprofen.
Sedatives, including a procedure known as “conscious sedation” or general sedation (also known as “deep sedation”).

Anesthesia

Dentistry has advanced to the point in which pain is almost a thing of the past.

Powerful pain-killing medications known as anesthetics not only help a patient avoid discomfort during a procedure, but post-operatively as well.

Some patients, especially children, may require higher doses of anesthetic than others.

Types of pain-killing medications include:

Analgesics – These are also called pain relievers and include common non-narcotic medications such as ibuprofen and aspirin. Analgesics are usually used for mild cases of discomfort, and are typically prescribed following such procedures as a root canal or tooth extraction.
Anesthetics – Anesthetics can either be topically applied, injected or swallowed. Dentists often apply topical anesthetics with a cotton swab to an area of the mouth where a procedure such as a restoration will be performed. This numbs the affected area. Topical anesthetics are used in many dental procedures such as tooth restoration. Topical anesthetics also are used to prepare an area for injection of an anesthetic. Novocaine and Lidocaine are the most common kind of injectable anesthetics. Such medications block the nerves from transmitting signals and are used for more major types of procedures, such as fillings and root canals.
Sedatives – Sedatives are medications designed to help a patient relax. This can be a powerful tool in avoiding pain. Sedatives are sometimes used in combination with other types of pain relievers and pain-killers. Nitrous oxide, or laughing gas, is a form of sedative. Conscious sedation involves administering a sedative while the patient is alert and awake. Deep sedation or general anesthesia involves administering a medication that places a patient in a state of monitored and controlled unconsciousness.

Types of sedatives include:

Intravenous (IV) sedation – Usually in the form of a tranquilizing agent; patients given IV sedation are often awake, but very relaxed.
Inhalation sedation – a form of sedation in which nitrous oxide is administered through a special mask.

Air Abrasion

Many people associate the high-pitched whirring of a dental drill with pain. Just the sound alone can make many people wince.

A relatively new technique called air abrasion uses powerful particles of aluminum oxide to remove debris and decay. The most exciting thing for patients is that air abrasion is painless and, in some cases, doesn’t require an anesthetic.

Air abrasion leaves behind a gritty feeling in your mouth, which is simply rinsed away almost instantaneously using a small suction device.

Tiny cracks and imperfections on a tooth can be fixed using air abrasion. Although air abrasion is not suitable for work on crowns and bridges, it is often used for bonding procedures, and on tooth restorations involving composite, or tooth-colored fillings.

Medications

Some dental procedures, such as tooth extractions and oral surgery, may call for our office to prescribe medications before or after a procedure. These medications are used to prevent or fight an infection, or to relieve any post-operative discomfort and pain.

For these reasons, it is extremely important that you share your entire medical history – including any medications you are currently taking – with our office. Some medications used in dentistry, and other medical practices, could interact with those medications in a detrimental way. In addition, if you have any allergic reactions to certain medications, it is important for our office to know beforehand.

Finally, if you are prescribed any medication by our office, follow the dosage instructions very carefully, and if instructed, finish your entire prescription even if you are no longer feeling pain.

Patient Information

Your First Dental Visit

Your first dental visit promises to be a pleasant experience.

Making sound decisions about your dental care and oral health is an easy thing to do with the right preparation beforehand:

Make a list of questions to ask our office, so you don’t forget anything on the day of your appointment. This includes any concerns you have, or oral problems you’ve been experiencing.
If you have dental insurance, remember to bring your insurance card with you.

Dental Emergencies

Your Rights and Responsibilities as a Patient

Patient Rights

You have a right to choose your own dentist and schedule an appointment in a timely manner.
You have a right to know the education and training of your dentist and the dental care team.
You have a right to arrange to see the dentist every time you receive dental treatment, subject to any state law exceptions.
You have a right to adequate time to ask questions and receive answers regarding your dental condition and treatment plan for your care.
You have a right to know what the dental team feels is the optimal treatment plan as well as the right to ask for alternative treatment options.
You have a right to an explanation of the purpose, probably (short and long term) results, alternatives and risks involved before consenting to a proposed treatment plan.
You have a right to be informed of continuing health care needs.
You have a right to know in advance the expected cost of treatment.
You have a right to accept, defer or decline any part of your treatment recommendations.
You have a right to reasonable arrangements for dental care and emergency treatment.
You have a right to receive considerate, respectful and confidential treatment by your dentist and dental team.
You have a right to expect the dental team members to use appropriate infection and sterilization controls.
You have a right to inquire about the availability of processes to mediate disputes about your treatment.

(Adopted by the American Dental Association in 2009)

Your Responsibilities as a Patient

You have the responsibility to provide, to the best of your ability, accurate, honest and complete information about your medical history and current health status.
You have the responsibility to report changes in your medical status and provide feedback about your needs and expectations.
You have the responsibility to participate in your health care decisions and ask questions if you are uncertain about your dental treatment or plan.
You have the responsibility to inquire about your treatment options and acknowledge the benefits and limitations of any treatment that you choose.
You have the responsibilityfor consequences resulting from declining treatment or from not following the agreed upon treatment plan.
You have the responsibilityto keep your scheduled appointments.
You have the responsibilityto be available for treatment upon reasonable notice.
You have the responsibilityto adhere to regular home oral health care recommendations.
You have the responsibilityto assure that your financial obligations for health care received are fulfilled.

(Adopted by the American Dental Association in 2009)

American Dental Association Leads Fight for Patient Rights

The American Dental Association has supported legislation that will set a few basic rules to promote high-quality care and protect patients in an increasingly bottom line-driven health care system.

ADA member dentists have been instrumental in moving the patients’ rights issue into the national spotlight. The nation appears closer than ever to finally seeing a comprehensive patients’ bill of rights passed into law.

While Congress debates various versions of patient rights legislation, the insurance and managed care industries have long supported legislation that would fail to protect all privately insured Americans against unfair delays and denials of coverage by their health plans, according to the ADA. Some ill-fated bills left out critical protections, such as guaranteeing people the option of choosing their own doctors or creating mechanisms to address patients’ grievances against health plans. One proposal even omitted freestanding dental plans, which could have left more than 120 million dental patients without these vital protections.

The American Dental Association continues to lobby for the enactment of bipartisan legislation to help ensure that health plans treat patients fairly and do not discriminate against dentists. Here are some of the key issues identified by the ADA:

Coverage for freestanding dental plans, which account for the vast majority of Americans who have dental coverage.
Patient choice, by guaranteeing access to at least one plan with a point-of-service option that allows patients the opportunity to choose their own doctors.
Health plan accountability, through the availability of impartial, external review and by holding plans accountable when their decisions to delay or deny care harm patients.

Products Reviews

Oral Health Products

Visit any pharmacy or the health and beauty section of a supermarket today, and you are faced with a large, and many say confusing, array of over-the-counter remedies and devices designed to help you tend to your hygiene and health-care needs.

There are many high-quality products on the market today. There also are many products of dubious value.

Whatever over-the-counter dental product you buy, it is strongly advised that you ensure it has the American Dental Association’s Seal of Acceptance.

Over-the-counter dental instruments are fraught with danger. These include scaling devices and picks. Use of the products, even when following the instructions, can put your teeth and the soft tissue of your mouth at risk of tearing, bruising and other injury. You also may accidentally chip a tooth.

It is best to consult our office instead of trying to do a repair job yourself.

Choosing a 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 2-3 times a day. Moreover, how long you spend brushing your teeth is as critical as how often you brush. This ensures complete plaque removal in hard to reach areas.

Mechanical and manual toothbrushes

Our dental team highly recommends a mechanical (electric) toothbrush. The pulsations break up plaque efficiently. Many models now have timers to remind you to brush longer.

It is always nice to have a backup manual toothbrush. When choosing a manual toothbrush, look for a compact head with very soft, rounded bristles.

Types of Floss

Dental floss comes in a variety of colors, materials and even flavors. Waxed varieties slide through the teeth, allowing people with extremely tight spaces 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 dental tape can be effective for people with large spaces between their teeth, or for people with 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.

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 may not be as effective as traditional flossing in the removal of 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. People with orthodontia, including braces, have found water picks quite useful because toothbrush bristles often get stuck.

Mouth Guards

Anyone who participates in a sport that carries a significant risk of injury should wear a mouth protector. Sports like basketball, baseball, gymnastics, and volleyball all pose risks to your gum tissues, as well as your teeth. We usually think of football and hockey as the most dangerous to the teeth, but nearly half of sports-related mouth injuries occur in basketball and baseball.

A helmet can prevent serious injuries such as concussions, cerebral hemorrhages, incidents of unconsciousness, jaw fractures and neck injuries by helping to avoid situations where the lower jaw gets jammed into the upper jaw. Mouth guards are effective in moving soft tissue in the oral cavity away from the teeth, preventing laceration and bruising of the lips and cheeks, especially for those who wear orthodontic appliances.

Mouth protectors, which typically cover the upper teeth, can cushion a blow to the face, minimizing the risk of broken teeth and injuries to the soft tissues of the mouth. If you wear braces or another fixed dental appliance on your lower jaw, a mouth protector is available for these teeth as well.

A properly fitted mouth protector may be especially important for people who wear braces or have fixed bridge work. A blow to the face could damage the brackets or other fixed orthodontic appliances. A mouth protector also provides a barrier between the braces and your cheek or lips, limiting the risk of soft tissue injuries. Although mouth protectors typically only cover the upper teeth, your dentist or orthodontist may suggest that you use a mouth protector on the lower teeth if you have braces on these teeth too. If you have a retainer or other removable appliance, do not wear it during any contact sports.

Types of mouth guards
There are three types of mouth protectors:

Stock – Inexpensive and come pre-formed, ready to wear. Unfortunately, they often don’t fit very well. They can be bulky and can make breathing and talking difficult.
Boil and bite – Can be bought at many sporting goods stores and may offer a better fit than stock mouth protectors. They should be softened in water, then inserted and allowed to adapt to the shape of your mouth. If you don’t follow the directions carefully you can wind up with a poor-fitting mouth protector.
Custom-fitted – Made by your dentist for you personally. They are more expensive than the other versions, but because they are customized, they can offer a better fit than anything you can buy off the shelf.

Glossary

Amalgam – Material made from mercury and other alloy mixtures used to restore a drilled portion of a tooth.

Anesthesia – Medications used to relieve pain.

Anterior Teeth – Front teeth. Also called incisors and cuspids.

Arch – The upper or lower jaw.

Baby bottle tooth decay – Caused by sugary substances in breast milk and some juices, which combine with saliva to form pools inside the baby’s mouth.

Bicuspids -A premolar tooth; tooth with two cusps, which are pointed or rounded eminences on or near the masticating surface of a tooth.

Bitewings – X-rays that help a dentist diagnose cavities.

Bonding – Application of tooth-colored resin materials to the surface of the teeth.

Bridge – A prosthetic replacement of one or more missing teeth cemented or otherwise attached to the abutment teeth or implant replacements.

Bruxism – Teeth grinding.

Calculus – A hard deposit of mineralized substance adhering to crowns and/or roots of teeth or prosthetic devices.

Canal – The narrow chamber inside the tooth’s root.

Canines – Also called cuspids.

Canker sore – One that occurs on the delicate tissues inside your mouth. A canker sore is usually light-colored at its base and can have a red exterior border.

Caries – A commonly used term for tooth decay, or cavities.

Cold sore – Usually occurs on the outside of the mouth, usually on or near the nose or lips. A cold sore is contagious because it is caused by the herpes simplex virus, and it is usually painful and filled with fluid.

Composite filling – Tooth colored restorations, also known as resin fillings.

Composite resin – A tooth colored resin combined with silica or porcelain and used as a restoration material.

Contouring – The process of reshaping teeth.

Crown – An artificial tooth replacement that restores missing tooth structure by surrounding the remaining coronal tooth structure. It is also placed on a dental implant.

Cusps – The pointed parts on top of the back teeth’s chewing surface.

Cuspids – Front teeth that typically have a protruding edge.

Dentin – The tooth layer underneath the enamel.

Denture – A removable set of teeth.

Endodontics – A form of dentistry that addresses problems affecting the tooth’s root or nerve.

Fluoride – A harmless over-exposure to fluoride resulting in tooth discoloration.

Fluorosis – A harmless over-exposure to fluoride and resulting sometimes in tooth discoloration.

Gingiva – Another word for gum tissue.

Gingivitis – A minor disease of the gums caused by plaque.

Gum disease – An infection of the gum tissues. Also called periodontal disease.

Impacted teeth – A condition in which a tooth fails to erupt or only partially erupts.

Implant – A permanent appliance used to replace a missing tooth.

Incisor – Front teeth with cutting edges; located in the center or on the sides near the front.

Inlay – An artificial filling made of various materials, including porcelain, resin, or gold.

Laminate veneer – A shell that is bonded to the enamel of a front tooth. The shell is usually thin and made from porcelain resin.

Malocclusion – Bad bite relationship.

Mandible – The lower jaw.

Maxilla – The upper jaw.

Molar – Usually the largest teeth, near the rear of the mouth. Molars have large chewing surfaces.

Neuromuscular Dentistry – Addresses more than the aches and pains felt in and around the neck and head that are associated with your teeth and jaw.

Onlay – A filling designed to protect the chewing surface of a tooth.

Orthodontics – A field of dentistry that deals with tooth and jaw alignment.

Overdenture – A non-fixed dental appliance applied to a small number of natural teeth or implants.

Palate – Roof of the mouth.

Partial denture – A removable appliance that replaces missing teeth.

Pediatric Dentistry – A field of dentistry that deals with children’s teeth

Perio pocket – An opening formed by receding gums.

Periodontal disease – Infection of the gum tissues. Also called gum disease.

Periodontist – A dentist who treats diseases of the gums.

Permanent teeth – The teeth that erupt after primary teeth. Also called adult teeth.

Plaque – A sticky, colorless substance that covers the teeth after sleep or periods between brushing.

Posterior teeth – The bicuspids and molars. Also called the back teeth.

Primary teeth – A person’s first set of teeth. Also called baby teeth or temporary teeth.

Prophylaxis – The act of cleaning the teeth.

Prosthodontics – The field of dentistry that deals with artificial dental appliances.

Pulp – The inner tissues of the tooth containing blood, nerves and connective tissue.

Receding gum – A condition in which the gums separate from the tooth, allowing bacteria and other substances to attack the tooth’s enamel and surrounding bone.

Resin filling – An artificial filling used to restore teeth. Also called a composite filling.

Root canal – A procedure in which a tooth’s nerve is removed and an inner canal cleansed and later filled.

Root planing – Scraping or cleansing of teeth to remove heavy buildup of tartar below the gum line.

Sealant – A synthetic material placed on the tooth’s surface that protects the enamel and chewing surfaces.

TMJ – Temporomandibular joint disorder. Health problems related to the jaw joint just in front of the ear.

Tarter – A hardened substance (also called calculus) that sticks to the tooth’s surface.

Veneer – A laminate applied or bonded to the tooth.

Whitening – A process that employs special bleaching agents for restoring the color of teeth.

Wisdom tooth – Third set of molars that erupt last in adolescence.

Links

American Dental Association

Academy of General Dentistry

American Association of Public Health Dentistry

Federation of Special Care Organizations in Dentistry

Center for DiseaseControl/Oral Health Resources

Healthfinder.gov

Kidshealth

National Health Information Center