What should I do if I have bad breath?

Bad breath (halitosis) can be an unpleasant and embarrassing condition.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What may cause bad breath?

  • Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
  • Certain foods – Garlic, onions, etc.  Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
  • Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
  • Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
  • Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
  • Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
  • Tobacco products – Dry the mouth, causing bad breath.
  • Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
  • Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
  • Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath.  Also, review your current medications, recent surgeries, or illnesses with your dentist.

What can I do to prevent bad breath?

  • Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush.  Floss daily to remove food debris and plaque from in between the teeth and under the gumline.  Brush or use a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
  • See your dentist regularly – Get a check-up and cleaning at least twice a year.  If you have or have had periodontal disease, your dentist will recommend more frequent visits.
  • Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
  • Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
  • Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor.  Ask your dentist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem.

In most cases, your dentist can treat the cause of bad breath.  If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

How often should I brush and floss?

Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums.  The bacteria in plaque convert certain food particles into acids that cause tooth decay.  Also, if plaque is not removed, it turns into calculus (tartar).  If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

  • Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
  • Brush the outer, inner, and biting surfaces of each tooth.
  • Use the tip of the brush head to clean the inside front teeth.
  • Brush your tongue to remove bacteria and freshen your breath.

Electric toothbrushes are also recommended.  They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

  • Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
  • Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
  • Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

Are amalgam (silver) fillings safe?

Over the years there has been some concern as to the safety of amalgam (silver) fillings.  An amalgam is a blend of copper, silver, tin and zinc, bound by elemental mercury.  Dentists have used this blended metal to fill teeth for more than 100 years.  The controversy is due to claims that the exposure to the vapor and minute particles from the mercury can cause a variety of health problems.

According to the American Dental Association (ADA), up to 76% of dentists use silver containing mercury to fill teeth.  The ADA also states that silver fillings are safe and that studies have failed to find any link between silver containing mercury and any medical disorder.

The general consensus is that amalgam (silver) fillings are safe.  Along with the ADA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, and others support the use of silver fillings as safe, durable, and cost effective.  The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling.  The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, and this is out of countless millions of silver fillings over the decades.

Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material when we are exposed at high, unsafe levels.  For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them.  However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.

There are numerous options to silver fillings, including composite (tooth-colored), porcelain, and gold fillings.  We encourage you to discuss these options with your dentist so you can determine which is the best option for you.

How often should I have a dental exam and cleaning?

You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums.  At these visits, your teeth are cleaned and checked for cavities.  Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health.  These include:

  • Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
  • Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
  • Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
  • Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
  • Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
  • Examination of existing restorations: Check current fillings, crowns, etc.
  • Removal of calculus (tartar)Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line, and can only be removed with special dental instruments.
  • Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
  • Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
  • Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
  • Review dietary habits: Your eating habits play a very important role in your dental health.

As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth.  We are committed to providing you with the best possible care, and to do so will require regular check-ups and cleanings.

How can I tell if I have gingivitis or periodontitis (gum disease)?

Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.  Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

  • Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
  • Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
  • Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives.  Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
  • Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
  • Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
  • Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis.  Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

  • Red and puffy gums – Gums should never be red or swollen.
  • Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
  • Persistent bad breath – Caused by bacteria in the mouth.
  • New spacing between teeth – Caused by bone loss.
  • Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
  • Pus around the teeth and gums – Sign that there is an infection present.
  • Receding gums – Loss of gum around a tooth.
  • Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Why is it important to use dental floss?

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth.  Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums.  Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar).  This will further irritate and inflame the gums and also slowly destroy the bone.  This is the beginning of periodontal disease.

How to floss properly:

  • Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
  • Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
  • Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Daily flossing will help you keep a healthy, beautiful smile for life!

How can cosmetic dentistry help improve the appearance of my smile?

If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health.  This includes dental prevention and having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth and enhance your smile.  Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over.  Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry.

Cosmetic Procedures:

Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking.  Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present.

Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings.  Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth.  This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile.  They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth.  Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.

Porcelain Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size.  Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations.  They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.

Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth.  Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, and durable solution to removable dental appliances.

Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients.  Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

What are porcelain veneers and how can they improve my smile?

Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth.  They are very durable and will not stain, making them a very popular solution for those seeking to restore or enhance the beauty of their smile.

Veneers may be used to restore or correct the following dental conditions:

  • Severely discolored or stained teeth
  • Unwanted or uneven spaces
  • Worn or chipped teeth
  • Slight tooth crowding
  • Misshapen teeth
  • Teeth that are too small or large

Getting veneers usually requires two visits.  Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.

With little or no anesthesia, teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers.  The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and occasionally a specialized light may be used to harden and set the bond.

Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile.

What can I do about stained or discolored teeth?

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile.

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and is an ideal way to enhance the beauty of your smile.  Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the American Dental Association (ADA).

As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade.  The color of our teeth also comes from the inside of the tooth, which may become darker over time.  Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull.  Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline.  Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.

It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching.  Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains.  Since teeth whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins.  Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.

Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening systems:

Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth.  The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep.  It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening.

In office teeth whitening: This treatment is done in the dental office and you will see results immediately.  It may require more than one visit, with each visit lasting 30 to 60 minutes.  While your gums are protected, a bleaching solution is applied to the teeth.  A special light may be used to enhance the action of the agent while the teeth are whitened.

Some patients may experience tooth sensitivity after having their teeth whitened.  This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.

Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!

What are my options if I have missing teeth?

With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth.  When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function.  Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.

Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen.  Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth.  If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.

When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth.  Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on.  These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems.  These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.

Options for replacement of missing teeth:

Removable bridges – This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.

Fixed bridges – This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to a natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.

Dentures – This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.

Implants – Are a great way to replace one or more missing teeth. They may also be great to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.

If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.

What does heart disease and other medical conditions have to do with periodontal (gum) disease?

Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health.  Periodontal disease is one of the most common infections; often more prevalent than the common cold!  Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!

Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis.  It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth.  The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth.  When periodontal disease is not treated it can eventually lead to tooth loss!

There are numerous studies that have looked into the correlation between gum disease and major medical conditions.  These studies suggest people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections.  Research suggests that periodontal bacteria in the blood stream may:

  • Contribute to the development of heart disease
  • Increase the risk of stroke
  • Compromise the health of those that have diabetes or respiratory diseases
  • Increase a woman’s risk of having a preterm, low-birth weight baby

Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.

To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation.  Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.

Remember….the mouth body connection!  Taking care of your oral health may contribute to your overall medical health!

When are sealants recommended?

Although thorough brushing and flossing remove most food particles and bacteria from easy to reach tooth surfaces, they do not reach the deep grooves on chewing surfaces of teeth. More than 75 percent of dental decay begins in these deep grooves (called pits and fissures). Toothbrush bristles are too large to possibly fit and clean most of these areas. This is where sealants play an important role.

A sealant is a thin plastic coating that covers and protects the chewing surfaces of molars, premolars, and any deep grooves or pits on teeth. Sealant material forms a protective, smooth barrier covering natural depressions and grooves in the teeth, making it much easier to clean and help keep these areas free of decay.

Who may need sealants?

Children and teenagers – As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.

Infants – Baby teeth are occasionally sealed if the teeth have deep grooves and the child is cavity prone.

Adults – Tooth surfaces without decay that have deep grooves or depressions that are difficult to clean.

Sealants are easily applied by your dentist or dental hygienist and the process only takes minutes per tooth. After the chewing surfaces are roughened with an acid solution that helps the sealant adhere to the tooth, the sealant material is “painted” onto the tooth surface, where it hardens and bonds to the teeth. Sometimes a special light will be used to help the sealant material harden.

After sealant treatment, it’s important to avoid chewing on ice cubes, hard candy, popcorn kernels, or any hard or sticky foods. Your sealants will be checked for wear and chipping at your regular dental check-up.

Combined with good home care, a proper diet, and regular dental check-ups, sealants are very effective in helping prevent tooth decay.

What should I do if a tooth is knocked out?

We’re all at risk for having a tooth knocked out.  More than 5 million teeth are knocked out every year!  If we know how to handle this emergency situation, we may be able to actually save the tooth.  Teeth that are knocked out may be possibly reimplanted if we act quickly, yet calmly, and follow these simple steps:

  1. Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
  2. DO NOT scrub or use soap or chemicals to clean the tooth.  If it has dirt or debris on it, rinse it gently with your own saliva or whole milk.  If that is not possible, rinse it very gently with water.
  3. Get to a dentist within 30 minutes.  The longer you wait, the less chance there is for successful reimplantation.

Ways to transport the tooth

  • Try to replace the tooth back in its socket immediately.  Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place.  Apply a cold compress to the mouth for pain and swelling as needed.
  • If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk.  You can also place the tooth under your tongue or between your lower lip and gums.  Keep the tooth moist at all times.  Do not transport the tooth in a tissue or cloth.
  • Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit.  The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive and possibly last for many years.  So be prepared, and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

  • Wearing a mouthguard when playing sports
  • Always wearing your seatbelt
  • Avoiding fights
  • Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.
What is Air Abrasion

Air Abrasion Tooth Cutting

Usually, dentists remove decay from teeth or reshape teeth to receive crowns by using air-rotor hand pieces and rotating abrasive instruments.  These high-speed devices provide excellent, easy, non-traumatic removal of diseased tooth structure usually requires anaesthesia and produces a characteristic high-pitched sound, which is objectionable to some people, as well as a peculiar odour.

Small areas of tooth decay can be removed with microscopic abrasive particles forcefully blown onto the affected tooth using compressed air.  The resultant removal of decay has the following advantages.

1. Local anaesthetic may not be required

2. There is no odour involved with the decay removal.

3. The technique has no vibration and very little noise

4. The cuts made on the tooth are not traumatic to the tooth, and they are very small.

The only disadvantages to air abrasion tooth cutting are:

1. Occasionally, the procedure requires local anaesthetic.

2. The abrasive particles are messy.

3. It may take more time than using the air-rotor hand piece.

4. Only small areas of decay can be removed.

Air abrasion tooth cutting is very useful when the affected teeth have small and undermined areas of decay.  Most patients find the technique to be very acceptable.

What is Bottle Mouth?

Bottle Mouth – A Preventable Condition

Babies have a natural tendency to suck whatever is placed into their mouths.  Objects range from thumbs, fingers, pacifiers, liquid-filled bottles, and various other objects.

A commonly occurring problem in infancy is that because sucking the baby bottle calms the child, and sweet fluids further pacify the child, caregivers are often influenced to let the child suck a baby bottle with sugar-containing liquids in it such as fruit juice, baby formula or milk. The result of prolonged and unrestricted sucking of a baby bottle with sugar-containing liquid is it is often rampant, uncontrollable dental decay – also called “baby bottle syndrome.”

It is suggested that caregivers provide non-sugar containing liquids for babies until the child is capable of using a cup.  Avoid training cups that have no-spill valves in them, which are very similar to baby bottles and require sucking.  Instead of using no-spill cups, cups with a weighted base to reduce spills are more appropriate.  Limit use of sugar-containing liquids to mealtimes.

“Baby bottle syndrome” is a serious condition that can have long-term consequences.  Avoid it by using the preceding simple suggestions.

What is Cracked-Tooth Syndrome?

Cracked-Tooth Syndrome

Often, teeth may crack when subjected to the stress of chewing hard foods, ice, or hard objects, or just from normal chewing.  Teeth with or without restorations (fillings) may exhibit this problem, but teeth restored with typical silver alloy or tooth-coloured restorations are most susceptible.  Older persons have more cracked teeth than younger people.


1. Pain on chewing

2. Pain on cold-air application

3. Pain when eating sweets

4. X-ray evidence of the problem is not present

5. Dental decay is not present

6. Easy verification of the crack by the dentist when the tooth is prepared for restoration.


1.Simple crack: The majority of cracked teeth (about 9 out of 10) can be treated by placement of a simple crown (cap) on the tooth.  When the tooth is prepared for the crown and a temporary restoration is placed, the pain usually leaves within a few days.  If this is the case with your tooth, we will place the final crown without a problem on your next appointment.  The condition should then be solved.

2. Complex Crack:  Occasionally, (about 1 in 10) the tooth cracks into the pulp (nerve) of the tooth.  If pain persists after placement of the temporary crown, you may have a crack into the pulp of the affected tooth.  Please call us.  This tooth may require endodontics (root canal therapy) before the crown is placed.  This procedure requires about two additional appointments before the crown is placed.

3. Tooth Cracked in Half:  Occasionally, a tooth  cracks into two separate pieces, requiring removal of the entire tooth, or removal of one of the pieces, root canal therapy, and a crown on the remaining pieces.

Thank you for your co-operation

Dental Radiographs (X-Rays)?

Dental Radiographs (X-Rays)

Small amounts of radiation are used to make pictures of teeth (radiographs)

These black and white images show various shades of grey because some portions of teeth or dental restorations let more or less of the radiation pass through  The result is a picture that shows the presence of dental decay.  It is nearly impossible to diagnose the presence of decay between the teeth without using dental radiographs

There are two types of dental radiographs, conventional and digital.  The newer form of radiographs are digital, which allow faster observation of the images with lower radiation.  Some people are worried about the radiation used in dentistry.  Dental radiographs use a very small amount of radiation and it is directed exactly to the site where it is needed.  The amount of radiation required for one dental radiograph (bitewing or periapical) is about the same amount of radiations you receive by standing in a parking lot in the sun for a few minutes, or riding in an airplane for a few minutes.  The fear of dental radiographs, which are used with caution and good judgment, it totally unfounded.  The extremely minimal amount of radiation present in dental radiographs is far outweighed by the diagnostic advantage provided by the radiographs.

What are Sealants?

Why Seal Teeth? Over the past many years, numerous materials and techniques have been developed to seal the chewing (occlusal) surfaces of teeth. Sealants are necessary because some teeth have defective occlusal surfaces when they erupt into the mouth, and food debris and micro organisms penetrate into the grooves on the teeth during eating. Patients cannot clean these areas effectively, and dental decay (caries) occurs frequently.


Do All Teeth Need to Be Sealed? Usually only the back (posterior) teeth require sealing. It is difficult to tell which teeth require sealing because incomplete fusion of the teeth often leaves a microscopic entry from the enamel outside the tooth into the softer dentin inside. Therefore, we suggest that all suspect posterior teeth and selected anterior teeth be sealed. An electronic device (DiagnoDent) may be used to assist the dentist in determining if dental decay is present.


Will All Decay Be Prevented? Sealants placed as close to the eruption time of the teeth as possible prevent the majority of decay on the chewing (occlusal) surfaces of the teeth. However, flossing, brushing, and routine fluoride therapy are required to prevent decay on the other surfaces of the teeth. In the presence of poor oral hygiene, decay may begin between the teeth, since sealants cannot be placed on these surfaces.


Cost? The cost for sealing a tooth with plastic is about one-fourth to one-third the cost of filling (restoring) the tooth in the event of decay. Sealants do not require aesthetic or cutting away tooth structure.


How Long Do Sealants Last? Studies show sealants last many years. However, occasional resealing may be required.

Thank you.

Tongue Pierceing and Its Dental Effects?

Body piercing is popular among adolescents and young adults. Included in this phenomenon is piercing of the tongue and placement of a metal bar or ring through the tongue. This ornament rests in the mouth at all times and unavoidably moves as the person eats or talks.


If you have a metal bar or ring in your tongue, you should be very careful to avoid having the metal hit your teeth as you move your tongue. Letting the metal object move as the tongue makes its normal eating and speaking movements may cause cracks in teeth or even break off pieces of enamel.


Micro cracks are created in teeth by hitting them with the metal. The result of the micro cracks will be future fractures of tooth enamel, necessitating extensive and expensive dental crowns.


Tongue piercing may cause mild to severe infection upon placement or throughout the life of the piercing. Consult your dentist as soon as any soreness, redness, or draining occurs.


The best tongue piercing is none at all, but if you must have it done, be very gentle with the movements of your tongue or dental damage is inevitable.

What Materials are Used for Tooth Restorations?

This information is provided to help you make decisions about selection of materials as tooth restorations in your mouth. Many types of metals are used in dentistry for the replacement and rehabilitation of oral structures. Most of these metals are considered to be inert when placed in the body, while others have been criticized as potential toxins or allergens. Plastics and ceramics are used commonly as tooth restoratives, and although controversial, these have not been shown to have adverse biologic responses. The following information will help you to make decisions about the type of tooth restorations you prefer to be placed in your mouth:



Silver amalgam has been used since the 1800s for tooth restoration. This alloy contains silver, tin, copper, zinc, and about 50 percent mercury. It has been highly successful, but unsightly. Use of mercury in the body has been criticized since its inception, but amalgam use is still supported by the American Dental Association and other health groups worldwide. A few people in the overall population may be allergic to the elements in silver amalgam. You have several other options for restorations (fillings).




A. Silver amalgam. Average longevity about 15 years, silver coloured, low-moderate initial cost. Best used in small-to medium-sized restorations of posterior teeth (premolars and molars).

B. Gold inlays and onlays. Average longevity 20 years or longer, gold coloured, moderate to high initial cost. May be used in most locations where metal is not displayed to an objectionable level.

C. Resin/Plastic (may be called composite) – (one- or two-day appointment placement*). Average longevity 10-15 years, tooth coloured, moderate to high cost. Best used in small-to medium-sized restorations for front or back teeth. Considered at this time to be comparable to silver amalgam’s service potential.

D. Ceramic (one- or two-day appointment placement*). Average longevity 10-15 years, tooth coloured, moderate to high initial cost. Best used in moderate- to large-size restorations for front or back teeth.




a. Metal alone. High-noble, noble, or base metal. Average longevity 20 years to life, gold or “silver” color, moderate to high initial cost. May be used in any area where metal display is not objectionable.

b. Porcelain fused-to-metal. Average longevity 10-20 years, tooth coloured, moderate to high initial cost.  May be used in any area where extreme biting stress is not present, and patient does not have severe tooth grinding habit.

c. All-Ceramic. These restorations are constructed from ceramic alone. Average longevity is under study, moderate to high initial cost. All-ceramic fixed prostheses may be used in many clinical situations.  These materials are being improved constantly, and it is expected that they will eventually replace metal-containing restorations.

d. Resin/Plastic. These restorations may be used for single crowns or some bridges.

Average longevity is several years. Success has been reported up to 5 years.

We will inform you about the best type of tooth restoration for your mouth, and we welcome your questions. Thanks for helping us to make these important decisions.

How to try and stop Thumb Sucking?

Your child is involved with a natural and commonly occurring reflex, thumb-sucking. It is nearly impossible to restrict or limit the natural act in infancy, but it usually stops somewhere between two and four years of age. If thumb-sucking continues beyond age four, it should be discouraged.


What can you do if your child keeps thumb-sucking past age four? Several suggestions follow:

• Reason with the child about the potential harmful effects of long-term thumb-sucking, including development of cracked teeth and a poor bite. This approach works on some children.

• Reward the child when thumb-sucking is reduced.

• Make sure the child knows that he or she is loved and is in a secure situation. Less anxiety and fear leads to less thumb-sucking.

• Often, placing a sock, glove, or bandage on the hand to remind the child not to suck his/her thumb is successful. However, some children pull the reminder off and continue to suck.

• Placing a spicy or unpleasant-tasting solution on the thumbnail sometimes prevents the child from sucking his/her thumb.

• As a last resort, your dentist can make an appliance to place in the mouth that will discourage and potentially eliminate thumb-sucking.

Fluoride as Preventative Therapy?

1. Use of small amounts of fluoride (one part per million) in community water supplies has been shown to significantly reduce dental decay. Your water supply may contain fluoride. If you do not know, ask your dentist or dental hygienist.

2. Where fluoride in water supplies is not available, addition of fluoride to the diet of children has been shown to similarly reduce the development of dental decay. About 1mg per day is the optimal dosage; with lesser amounts for young children (we will advise you of the amount for your child).

3. Application of fluoride on the tooth-cleaning appointment has a slight decay-reducing influence.

4. Application of resin containing fluoride to teeth by your dentist or dental hygienist is well-known to significantly reduce the possibility for dental decay.

5. Placement of fluoride on teeth in the form of rinses can reduce new dental decay, depending on the concentration of fluoride.

6. Strong fluorides are used for patients who have high decay potential, such as those receiving chemotherapy or radiation therapy, or those in orthodontic


As a group, dentists and physicians, as well as global health organizations favour use of fluoride in all of the previously described methods. Fluoride for reduction of dental decay has had more legitimate worldwide research than any other health related subject. Nevertheless, there are some groups that oppose fluoride use for various political and alleged health reasons.

The decision to use fluoride for you and your family is up to you. For almost all dentists and physicians, “anti-fluoride” arguments make no sense at all.

Why do I need a Bite Guard for Bruxism and/or Clenching?

1. Reasons for Occlusal Splints: The purpose of splint therapy is to allow your lower and upper jaw to come together without tooth contact, thereby reducing muscle pain and tooth wear. Many situations cause the malfunction of your lower jaw. Examples are accidents, surgery, developmental defects, peculiar oral habits, many fillings placed over numerous years, naturally occurring malocclusion (poor bite), orthodontics, psychological stress, clenching or bruxing (grinding teeth), and other conditions.


2. What Does an Occlusal Splint Accomplish? This treatment has been used for many years to keep the teeth from contacting during chewing and to allow the lower jaw to return to a comfortable hinge position without interference and guidance from the teeth. When the splint has been worn for a few days the jaw functions freely. Occlusal splints assist in establishing normal jaw function.


3. Types of Splints:

• Full Arch: Some splints fit on your upper or lower jaw and covers all of the teeth on that arch.

• NTI-TSS: These small splints fit only in the front of your mouth and are used on a part-time basis.


4. When Are Splints Worn?

• If you have a Temporomandibular Disorder – (TMD): You will probably receive a full-arch splint. You should wear the splint at all times including while eating, unless directed otherwise. If you remove the splint to eat, your treatment will not be as effective. Many fillings placed in your mouth over the years or other conditions have caused your teeth to meet in a position your jaws cannot tolerate. The splint eliminates tooth-to-tooth contact. Your symptoms will gradually disappear while you are wearing the splint; and your natural teeth, bridges, and/or fillings will be adjusted to the new bite by us. This procedure is called occlusal equilibration. After equilibration, you may be asked to wear your splint only at night. After a period of time, you will not wear the splint at all. The described treatment usually requires a few weeks to several months.

• If You Grind Your Teeth Excessively: You should wear your splint at night when you cannot control your jaw movements or during times of psychological stress. During the daytime, make sure your splint is placed in water to avoid warping.


5. Cleaning the Splint and Teeth: Food accumulates around and under splints. At least one time each day, brush and floss your teeth very thoroughly. Brush and rinse the inside and outside of the splint, and then return it to your mouth. Dental decay will progress in the teeth under the splint in accelerated levels if you are not careful about cleanliness of your mouth and splint. If you have a high dental decay potential, fluoride-containing rinses or gels may be suggested to be placed into your splint once per day.


6. When the Splint Is Out of the Mouth: Your teeth may not meet in harmony. This situation is to be expected because of muscle and jaw relaxation while you were wearing the splint. Occlusal equilibration may be requested to eliminate this improper meeting of the teeth (malocclusion). If the splint is out of your mouth, place it in a container of water to prevent it from warping. You may desire to soak it occasionally in a commercially available denture cleanser. As an alternative, you may soak it in a solution made by adding a few drops of Clorox to a cup of water.  Please call if you have any questions. Thank you.

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