Frequently asked questions

In our practice, we love what we do and enjoy answering questions. Here are some of the most frequently asked questions we encounter. Feel free to click on any of the questions below that interest you. We hope you enjoy the information, and we look forward to seeing you at your next appointment.

What causes cavities, and how do I prevent them?

Generally speaking, cavities require three things: teeth, bacteria, and sugar. A cavity begins when dental plaque (which is a mixture of food debris, bacteria, and saliva) sticks to the surface of a tooth. In the presence of sugar, the bacteria found in dental plaque produce acid that begins to break down the tooth. If enough breakdown of the tooth occurs, a cavity develops.

You can prevent cavities, or decrease your risk of developing cavities, by reducing the amount of cavity-forming bacteria in your mouth and curtailing your sugar intake. Brushing twice per day and flossing daily disrupts the dental plaque that forms on your teeth and reduces the amount of bacteria present. In addition, fluoride found in toothpaste creates a stronger enamel surface that slows tooth breakdown. Finally, eating foods that are lower in sugar—and cutting back even on lower-sugar foods—will reduce your risk of developing cavities.

What causes gum disease and how do I prevent it from developing?

Gum disease can be classified as either gingivitis or periodontitis. Gingivitis is inflammation of the gums; periodontitis is inflammation of the gums and loss of bone surrounding your teeth. Gum disease develops chiefly from dental plaque that contains bacteria, and the individual immune response to these bacteria. Over time, this combination leads to inflammation that causes bone destruction and periodontal disease. Other risk factors that increase your likelihood of gum disease include diabetes, smoking, genetics, pregnancy, and immune dysfunction. Twice-daily brushing and daily flossing will help you prevent the development of periodontal disease.

What is a root canal?

A root canal is a procedure for removing the nerve and blood supply from a tooth in which the nerve has been infected or traumatized. We begin by placing a barrier (rubber dam) over the affected tooth; then we access the root-canal system through the tooth’s crown. We use files to remove the nerve and bacterial infection from inside the canal. After that, we shape, clean, and fill the tooth. Depending on the location of the treated tooth, we may find it necessary to place a crown over the tooth to protect it after the root canal is finished.

What is a dental implant?

A dental implant, used to replace a missing tooth, is a titanium screw surgically placed into the bone that supports your teeth. The implant integrates itself into the bone and provides a base for a future crown. After a period of healing (up to six months), we begin the process of fabricating an artificial tooth crown. After taking impressions of your mouth, we create a crown that looks like a real tooth.

When do children get their baby teeth? When do they lose their baby teeth and start getting their permanent teeth?

On average, the first tooth erupts when a child is between six and eight months old, though variation in the timing and sequence of tooth eruption is perfectly normal. A child’s first set of teeth—”primary teeth” or “milk teeth”—generally erupts from front to back, beginning with the lower front teeth (central incisors). The last of the primary teeth come in when the child is between two and three years old.

Most children begin to lose their primary teeth around age six, a process that continues until they reach 10-12 years of age. The first permanent teeth to show up are typically either the first molars—called the “six-year molars”—or the lower central incisors. Aside from wisdom teeth, the last teeth to come in are generally the second molars. Again, variability in the timing and sequence of this process is normal.

The last teeth to erupt are the third molars, or “wisdom teeth.” This usually happens somewhere between the ages of 17 and 21.

Should teenagers have their wisdom teeth removed? When is the best age to have them taken out?

We recommend wisdom-teeth removal if a teenager has any of the following problems: pain; damage to adjacent teeth; gum disease; tooth decay; lack of space to accommodate the teeth; infection; or cysts. If wisdom teeth must be removed, it is best to wait until the roots are approximately two-thirds formed. This stage of root growth usually corresponds to late adolescence and allows for an easier procedure with an easier recovery.

What filling materials do you use?

Direct fillings are those placed immediately into the clean cavity preparation in one visit. The materials that we use for direct fillings are either composite (resin), glass ionomer, or amalgam. Most of the time we use composite fillings—”tooth-colored” fillings that are bonded directly to the tooth. Less frequently, we use glass-ionomer fillings, which are not as strong as composite and amalgam fillings. However, they are also tooth-colored and work very well for fillings close to the gum line. Finally, when a stronger material is needed and/or it is extremely difficult to keep the tooth dry, we use dental amalgam.

How often do I need x-rays?

There is no specific answer for how often a person needs dental x-rays. The frequency depends on your overall oral-health condition; risk for dental disease; age; and whether you have any symptoms associated with your teeth. In our practice we use digital x-rays, which require less radiation than film. We also use lead aprons with thyroid collars to further minimize a patient’s exposure to radiation.

How can I whiten my teeth?

Stained teeth are usually caused by coffee, tea, tobacco, increased age, too much fluoride, or exposure to certain antibiotics during tooth development. Tooth whitening is a good option for reducing certain types of staining, but not all. We will be happy to discuss tooth-whitening options with you. There are three basic approaches for whitening teeth: using over-the-counter products; following a doctor-recommended in-home system; or following an in-office procedure. In our experience, the most predictable option is the doctor-recommended in-home system, in which a whitening solution (carbamide peroxide) is placed in a plastic tray that has been custom-fit to your mouth.

What causes dry mouth and how can I improve my symptoms?

The sensation of a dry mouth (xerostomia), whether caused by an actual or perceived reduction of salivary flow, is a common problem. Dry mouth is common in older adults and is usually a result of medications such as antihistamines, decongestants, high blood pressure medications, painkillers, and drugs for urinary incontinence. Less-common causes include radiation or chemotherapy to the head and neck, Sjögren’s syndrome, and mouth-breathing.

Saliva plays a central role in food digestion, lubrication of the oral mucosa, and taste perception. Its antimicrobial properties protect you against cavities as it mechanically rinses away dental plaque. Without adequate salivary flow, you increase your risk of cavities and gum disease, and may experience problems with chewing and tasting food. You can improve symptoms by avoiding caffeine, smoking, and alcohol; drinking more water; sucking on sugar-free candy; and using over-the-counter products to relieve dry mouth. Some patients with severe cases opt for salivary substitutes.

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