FAQ's
When
should my Child's
First Visit be?
Should
my children get Fluoride?
Do
my children need Sealants?
What
is Amalgam?
Are X-rays safe?
Will
White Fillings last?
Do
CEREC single visit all Porcelain Crowns look better?
What
is Air Abrasion?
Can
I have Whiter Teeth?
What
can I do about bad breath? (Halitosis)
What
is Periodontal
Disease and how is it treated?
My
Child's First Visit:
We
recommend children have their first visit between ages 2 1/2 and 3 1/2 yrs. This
visit can be in conjunction with your own cleaning appointment. We will do a simple
visual exam for your child, possibly using the intraoral camera. We want your
child's experience to pleasant and will explain to you and your child what we
are doing every step of the way.
We
will most likely not clean your child's teeth at their first visit. We want this
appointment to be brief and non-threatening. At their next visit we will clean
their teeth, apply topical fluoride, and possibly take x-rays. It will be helpful
for all of us to present this appointment to your child in a relaxed, (no big
deal), manner.
Regular
recall cleanings should begin at age 3 1/2 - 4 yrs. Please be assured we will
make every effort to have your child's visit a positive experience.
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Amalgam:
Dental
amalgam is the end result of mixing approximately equal parts of mercury (43 to
54 percent) and an alloy powder (57 to 46 percent) composed of silver, tin, copper,
and sometimes smaller amounts of zinc, palladium, or indium. As a Dental Amalgam
sets it expands. This gives the amalgam a tremendously tight fit
in the tooth.
It also creates stress within the tooth. This stress is compounded by a property,
known as "Flow", present in all metals. Simple stated, a metal bends
and flows as forces are applied to it. Consequently, after a dental amalgam has
been placed, chewing forces will cause the amalgam to wedge more tightly into
the tooth. It has been shown, due to these increases in the internal forces, that
large amalgams actually increase the likelihood a tooth will fracture. The use
of dental amalgam began to decrease in the 1970s.
There were several reasons
for this.
1)
Having mercury included in a filling material became a concern to many people.
2)
There were fewer cavities being seen in children. Largely the result of topical
and systematic fluoride, sealant use, and improved oral hygiene practices.
3)
The improvement in composite filling materials. Composites, "White Fillings",
are continuing to improve at a remarkable pace.
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Fluoride:
At
what age should professionally-applied topical fluorides first be administered?
Topical
fluorides should begin at age three. Newly erupted primary teeth are very porous,
receiving even greater anticariogenic benefits from fluoride than do permanent
teeth.
In addition to office fluoride application, what other therapies should be used?
The
most effective method is water fluoridation or dietary supplementation. If you
live in an area that has fluoridated water you won't need dietary supplement.
Check with your water company to see if your water has fluoride in it.
Dentifrice
(toothpastes), mouth rinses and home fluoride gels offer frequent low concentrations
of fluoride which enhance the remineralization process of the tooth enamel.
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What
is remineralization and how does it work?
The
process of tooth decay causes demineralization or loss of minerals. With the aid
of fluorides, minerals can be incorporated back into the lesion through remineralization.
These processes are always occurring, back and forth.
It
is usually not until the lesion has spread into the dentin, the second layer of
tooth structure past the outermost enamel, that demineralization becomes radiographicly
detectable. At the point where a lesion becomes barely detectable, scientists
estimate that it has been developing for approximately 36 months.
Should dental professionals recommend fluoride therapy for adults?
Topical
fluorides can provide significant benefits for adults. Adults with undetectable
subsurface or "white spot" lesions can benefit from the increased remineralization
potential of continuous low fluoride levels. Also, the growing incidence of adult
root caries could be reduced through utilization of office and home fluoride regimens.
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Can
fluorides benefit xerostomic (dry mouth) patients?
When
salivary flow is absent or minimal, caries destruction is rapid and rampant. Patients
experiencing drug or radiation-induced xerostomia (dry mouth) should be treated
with professionally-applied fluorides, home fluorides, and a strict program of
oral hygiene.
Temporary
dry mouth commonly occurs as a side effect of many drugs including: antihistamines,
diuretics, antihypertensives, anticholinergic, antidepressants, antipsychotics,
and decongestants.
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Does
fluoride possess anti-plaque properties?
In
addition to decreasing enamel solubility and enhancing the remineralization process,
fluoride has been shown to affect the metabolism and quantity of plaque bacteria.
Both high and low concentrations of fluoride could be useful as an adjunct to
traditional mechanical plaque control therapy. Most of the research in this area
has used stannous fluoride which has demonstrated the ability to metabolically
disrupt plaque bacteria, specifically, Streptococcus mutans.
What
are the differences between the types of fluorides used?
Stannous
fluoride, sodium fluoride, and acidulated phosphate fluoride (APF) appear to be
equally effective at preventing cavities. However, they differ in terms of application
frequency, taste, cost, stability, gingival tissue acceptance, and staining tendency.
Many stannous fluoride products have a bitter taste and some have been shown to
cause tooth staining. Stannous fluoride may occasionally contribute to gingival
irritation. On the basis of available research, stannous fluoride appears to be
the most effective type from a bacteriostatic standpoint.
Sodium
fluoride has an acceptable taste and does not cause staining or gingival irritation.
Its primary drawback is that it requires more office applications than APF. Acidulated
phosphate fluoride (APF) is usually applied biannually making it more convenient
than sodium fluoride office topicals. APF is stable in plastic containers and
is usually flavored for an acceptable taste. Use of a thixotropic APF gel can
help preclude inadvertent ingestion.
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Which
is more effective-daily or weekly fluoride rinses?
Daily
rinses (0.05odium fluoride) and weekly rinses (0.2odium fluoride) have been shown
to be equally effective. Daily rinses are available over-the-counter and weekly
rinses require a prescription or office dispensing. The benefits to the primary
dentition (baby teeth) from fluoride rinsing are less than those generally obtained
for the permanent dentition (permanent adult teeth).
Can
topical fluoride applications produce tooth mottling (pitting and discoloration)?
Tooth
mottling is caused by excessive systemic use of fluorides during the
period
of tooth development, not by topical use.
How
much fluoride dentifrice (toothpaste) should be placed on a child's toothbrush?
Preschoolers
should have only the tips of their brush wetted with a fluoride-containing toothpaste
(no more than a pea-sized dot). Most fluoride dentifrices contain 1,000 ppm of
fluoride. Younger children can ingest up to .30 mg of fluoride during a single
brushing. Consistent ingestion of large quantities during tooth development may
result in mild enamel fluorosis. Parents should monitor their child's brushing
and instruct them not to swallow.
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Sealants:
Sealants
are a composite material bonded to the tooth, filling any pits or grooves which
otherwise would be highly susceptible to decay if left untreated. Dental sealants
have been available for over 20 years and their value is well documented. Recently
there have been significant advancements in the quality of bonding agents and
sealant materials.
We
have found using a flowable permanent composite to be stronger and more successful
than using normal sealant composite. The flowable permanent composite is the same
material we use for permanent fillings. Permanent composites are placed in three
steps.
1)
Preparation of the tooth, "Cleaning & Etching"
2) Application
and curing of the "Bonding Agent"
3) Placing and curing the "Flowable
Composite"
In
traditional sealants the bonding agent is included in the flowable sealant. Having
steps 2 & 3 combined does save some time but sacrifices quality. Step 2 is
crucial in maximizing bonding. Having the "Bonding Agent" in a separate
step allows us to take full advantage of its thorough wetting properties. The
"Bonding Agent" can now reach the very bottom of each pit or groove,
as well as the etched prepared tooth structure.
This
3 step process gives our patients a Far Superior Sealant.
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All
Porcelain Crowns: (CEREC single visit crowns)
Without
question, all porcelain crowns offer the best esthetic solution. They maintain
a natural translucency not found in any other restorative material. The development
of this material and the improvements in bonding agents have made it possible
for dentistry to achieve dramatic results.
We
are pleased to now be able to offer our patients the latest in aesthetic bonded
restorations, "CEREC single visit crowns".
Traditional
porcelain comes in three forms;
1)
All ceramic fired in layers in a dental laboratory
2)
A pressed ceramic filled resin created in a dental laboratory using a lost wax
technique
3)
A ceramic fired in a dental laboratory to a metal foundation
All
three of these processes share a common concern. By being fabricated in a dental
laboratory they are exposed to the room conditions during fabrication. This leads
to contamination of the materials and a weakened final restoration when compared
to the "CEREC" crowns..
The
"CEREC" material if fabricated in a industrial clean vacuum, thereby
avoiding contamination and internal bubbles, as can be found in restorations fabricated
in a dental laboratory. The CEREC ingot is then precisely milled into a crown
for our patient using the CEREC 3D Imaging unit. The crown is then bonded to the
tooth.
"CEREC"
crowns are 40% stronger than the crowns obtained from a dental laboratory They
look like natural teeth and are compatible with natural chewing forces.
The
"CEREC" restoration can also be used for inlay and onlay fillings. Studies
have shown that a tooth restored with a "CEREC" inlay
is as strong as a natural undecayed tooth. No other material has been able to
show test results equal to "CEREC".
Our
patients have been elated with their all porcelain, "CEREC" single visit
crowns.
(More
info on CEREC)
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Whiter
Teeth:
There
are several ways to have whiter teeth.
Whitening
you natural teeth can be done in the office in one hour. This is done with a concentrated
solution while extra care is taken to protect your gum tissue.
Whitening
at home by having custom trays made and wearing these trays 30-60 min. per day
for 1-3 weeks. A less concentrated solution is placed in the trays. Home whitening
will give you the whitest teeth.
A
combination of the two has become increasingly popular. This takes advantage of
the immediate results obtained in the office and gives you the additional benefit
of having the means to maintain your whitened smile. Using your home kit when
needed to remove excess coffee and tea stains as they might develop over the years.
Finally
there are all porcelain crowns. These can be used to whiten teeth and/or change
the shape of broken or miss shaped teeth, dramatically improving your smile.
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Air
Abrasion:
Air
abrasion is the use of surgical grade silica particles in a stream of compressed
nitrogen to remove tooth decay, often avoiding the need for an anesthetic.
This
process allows us to restore teeth with minimal post-op irritation. We can now
make our fillings extremely conservative by using a flowable composite bonded
directly to the tooth. The resulting filling is virtually
undetectable.
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White
Fillings:
White
fillings are of two types;
1)
Indirect inays and onlays
In
our office this can be done two different ways. We can prepare the tooth and have
a lab fabricate the restoration or use the "CEREC" single visit system.
(More info on CEREC)
The
"CEREC" material if fabricated in a industrial clean vacuum, thereby
avoiding contamination and internal bubbles, as can be found in direct restorations.
The CEREC ingot is then precisely milled into an inlay or onlay, while you wait,
and then bonded to the tooth.
Studies
have shown that a tooth restored with a "CEREC" inlay
is as strong as a natural undecayed tooth. No other material has been able to
show test results equal to "CEREC".
2)
A directly placed composite
Composites
are light cured, filled, resins. They come in several shades which allows us to
ensure a pleasing result. No longer do patients need to settle for discolored
unnatural fillings in their teeth.
White
fillings are the restorations of choice in maintaining your natural smile.
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Treating
Periodontal Disease:
Periodontal
disease is an infection of the gums and bone that surround the teeth. It is caused
by specific bacteria that live in the deepening space between the teeth and gums,
called a pocket. The bacteria that cause periodontal disease trigger the body’s
immune system to produce enzymes. It is these enzymes that actually cause bone
to be lost. Periodontal disease is the number one cause of adult tooth loss.
The traditional treatment for periodontal disease has always included a series
of steps, starting with the removal of plaque and tartar from the root surfaces;
this is called scaling and root planing. After healing, the areas are reevaluated,
home care techniques are modified, and in severe cases, surgery is recommended.
Recent breakthroughs have led to the development of another effective tool in
the in the ongoing fight against periodontal disease. This new development is
a systemic medication called Periostat.
It is not taken for its antibiotic effect, but for its ability to inhibit the
bone destroying enzymes released by the body in response to periodontal disease.
We usually prescribe Periostat for several months, at minimum. It is taken twice
daily, one capsule in the morning and one in the evening, about an hour before
meals.
When used in combination with scaling and root planing, Periostat suppresses the
level of destructive enzymes that cause bone loss. In turn, this will help to
reduce the depth of pockets and promote a healthy attachment of the gums to the
teeth.
We won’t prescribe Periostat if you’re allergic to Tetracyclines, or
if you're pregnant or nursing.
Periostat is an important advancement in the treatment of adult periodontitis.
We recommend Periostat in combination with scaling, root planing and improved
home care techniques to help stop the ongoing damage caused by periodontal disease.
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Halitosis:
No
one wants bad breath, but everyone gets it - or at least worries about it - at
one time or another. Here are some things you can do to keep bad breath to a minimum:
Eliminate the bacteria and food particles that can cause bad breath; floss, then
brush your teeth, gums and tongue after each meal. Make this easier by keeping
floss, toothpaste and a toothbrush in your desk, your purse and your car.
If
you can’t brush and floss, rinse your mouth with water after eating to dislodge
food and moisten your mouth.
Have
your teeth cleaned and examined by a dental professional twice a year.
Learn the proper way to brush, and practice what you learn. Drink lots of liquids,
preferably water, to keep your mouth moist.
If
your mouth feels dry, chew sugarless gum to stimulate production of saliva. You
can also chew on raw parsley; it’s a natural breath freshener. Baking soda
is an effective odor eliminator; if you can handle the taste, try brushing with
a mixture of baking soda and water. Or try a toothpaste that contains baking soda.
Try
rinsing your mouth for one minute with a 50-50 mixture of hydrogen peroxide and
warm water to kill odor-causing bacteria.
Avoid
mouthwashes that contain alcohol; read the label! Instead, try a mouthwash that
contains chlorine dioxide. This compound doesn't just mask odor, it actually
eliminates it at the source by attacking the odor-causing volatile sulfur compounds
(VSC’s).
Snack
on raw vegetables such as carrots, celery and red peppers. This stimulates the
production of saliva.
Use an oral irrigation device such as a Water Pik
to remove particles of food wedged between your teeth; portable models are available.
If
your wear dentures or a retainer, clean them frequently, and periodically soak
them in an antiseptic solution.
Bad breath that’s resistant to these remedies, or that continues for an extended
period of time, should be evaluated by your dentist.
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Are X-rays safe? **We use Digital X-rays in our office**
Yes, when the proper precautions are taken.
This involves a lead apron placed over the patient as a protective barrier, the use of minimal radiation, and not taking unnecessary films.
We avoid taking X-rays on women who are pregnant or people who have had recent exposure to high amounts of radiation.
The advances in digital X-rays allow us to use less radiation than ever before. There is as much as an 80% decrease in the exposure to the patient with digital X-rays over conventional dental X-ray film.
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