Preventative and General Dentistry FAQ

How often should I see the dentist?

You should get your teeth cleaned by a hygienist at least twice a year. This can be different for each individual due to many factors. Home care, diet and genetics all play a role in determining how often you will benefit from maintaining health in you mouth. The early detection of problems associated with your teeth, gums and bone is key in continuing care of your mouth and overall health. The dentist will want to take a look around and make sure everything is doing okay at each visit to make sure we are all staying on top of things and not allowing disease to take hold. X-rays are recommended yearly to help the dentist in making a thorough exam due to some areas of the teeth are unseen upon a visual exam.

Why do I need to get it fixed when it does not hurt?

Tooth decay starts off small and gets deeper within the tooth. Once deep enough it gets closer and closer to the nerve that lives within each of our teeth. The closer decay or cracks get to the nerve the more pain associated with the situation. Early prevention and diagnosis can prevent pain from coming and needing more extensive treatment like root canals and crowns. Our goal is to maintain health and reduce stress in your life, by early detection we can do this together.

Why do I need to floss?

Flossing combined with tooth brushing is the most effective way to clean our teeth. Tooth brushing gets the outer most surfaces of the teeth clean. However, the surfaces between the teeth that are susceptible to getting decay need to be cleaned as well. If you have ever gone to wash your car and only used the water spray you will appreciate why flossing is necessary. Just as a smear layer forms on teeth that is difficult to remove so it does the same on your car. If you have ever used the spray and then wiped your hand across the surface and still it was dirty that is the same as it is with your teeth. They require mechanical stimulation to completely clean the surfaces. Bristles of our toothbrushes just do not get in between the teeth, that is why flossing in addition to brushing is so beneficial.

Why do my gums bleed when I floss?

The mouth is no different than any other part of the body. When bacteria accumulate somewhere they can cause inflammation and subsequent bleeding. The gums when not cared for properly accumulate bacteria along their surfaces and when brushed or flossed on an irregular schedule can bleed. The goal is to brush and floss regularly and this inflammation will never take hold. Try taking a two week challenge. Make an effort to brush twice a day for two minutes and floss at night before bedtime and see if the bleeding subsides by the two week mark.

What are the parameters for brushing teeth?

You should brush your teeth at least for 2 minutes 2 times a day. It should be the last thing you do before you go to bed. Small circular brush motions combined with soft bristles is the way to go when it comes to brushing. Using a hard toothbrush can actually brush away healthy tooth structure along the gum line and can cause gum recession. Gum recession exposes a more sensitive/softer part of the tooth that can progressively be worn away by the abrasive in your toothpaste.

How much and how often should I brush my teeth?

2 times a day for 2 minutes each time followed by flossing at night before betime.

What is fluoride?

Fluoride is a natural ion found in nature. In small concentrations it can help change the crystalline make up of a tooth making it harder and less susceptible to be eaten up by the bacteria that cause decay (cavities).

What is a tooth made of?

Hydroxyappetite. This compound is a crystalline structure that combines with other inorganic and organic compounds to form a tooth. Each tooth has 3 layers; the enamel is the hard outer coating, the dentin is the material found between the enamel and the pulp or nerve of the tooth. It takes decay longer to get through the enamel but once it reaches the dentin spreads quicker and is more of a threat to tooth health and longevity.

What is a cavity?

Tooth decay is the term given to the softening of a tooth by a process known as demineralization. Once this process has progressed to the point where the surface breaks in then it is known as a cavity.

How does tooth decay form?

A cavity is a location on a tooth where enough of its mineral content has been lost that a hole starts to form. The process by which this occurs is called demineralization and it takes place because of the presence of acids on a tooth’s surface. When the ph of the mouth becomes acidic, tooth decay moves more rapidly and can cause further damage to the teeth and supporting structures.

Where do the acids that cause tooth decay come from?

The acids that cause tooth demineralization (cavity formation) are produced by specific types of bacteria (mutans streptococci and lactobacilli) that live in dental plaque. Dental plaque is the layer of food mixed with bacteria that act as a sort of smear layer that is to removed for maximal oral health and maintenance.

These bacteria are living organisms just like we are. When we consume foods and beverages, we create waste products. Bacteria do the same thing. The bacteria that cause tooth decay utilize sugars (glucose, sucrose, fructose, lactose, or cooked starches) as their food source. The waste products created from digesting these sugars are the acids (especially lactic acid) that cause the demineralization of tooth enamel and dentin.

Since the bacteria that live in our mouth eat when we do, as we ingest foods that contain sugars (such as soda, candy, milk, and even fruits and vegetables) these bacteria get a meal too. And within minutes they start producing the acids that cause tooth decay. 

When is it referred to as a cavity?

Once this demineralization process proceeds long enough the outer layer of tooth structure breaks in (cavitates) forming a hole or cavity. A cavity is a process of on and off again demineralization and remineralization. This tug of war can take months to even years of back and forth before an actual cavity can form. Once the demineralization processes win out a hole will form at which time a filling or restoration will be needed to correct and stop this process.

If a restoration is not completed and the decayed portion of tooth structure not removed the process will keep eating up the tooth until getting closer to the nerve causing pain. The earlier we can get to this process the better.

What is a filling (restoration)?

 A filling is the term given to a process of correcting the cavity or decay process of a tooth. Once the demineralization of the tooth cavitates in a filling will need to be placed to stop the ongoing process. This filling includes removing all the harmful, soft, decayed portion of tooth structure and replacing it with material which restores to tooth back to health and its original form and function. 

What different types of filling materials are there for cavities?

 A tooth can be restored with any number of materials all of which can do the job while some do it better depending upon the desired outcome and cost. The most common way is with a tooth colored composite material. Different shades of composite can be bonded to a tooth to directly fill in the space left from removing the decay portion of tooth structure.

Other materials such as porcelain and gold can be used to fill in the spaces, which will give a more homogenous strong matrix. Dental amalgam has fallen out of favor due to the mercury content and possible minute exposure to this substance. 

Why does my tooth start to hurt?

 If a cavity is not detected in its earliest stages it will destroy more tooth structure and get deeper within a tooth and closer proximity to the nerve. The nerve or pulp of a tooth is where the blood supply and nerve live. Each tooth has a pulp area and when decay gets deep enough it will start to become sensitive to cold and hot and also sensitive to chewing on it.

The goal is to detect the decay before it gets to this point, in doing so will save more of the tooth and ultimately prevent further more in depth treatment such as root canals and crowns.  Once a tooth starts to hurt and if the nerve is irreversibly affected by the decay process, then a root canal will be required to keep the tooth.  If the decay progresses into the bone or destroys the tooth beyond repair, then often times the tooth will have to be removed and a suitable replacement fabricated to maximize chewing and standard/quality of life. 

What is a root canal?

 A root canal is the process by which we remove the nerve of the tooth.  Generally this is done to stop and infection due to decay getting to the nerve of the tooth.  By completing this process the tooth is no longer vital but can still be utilized in your mouth.  Most often antibiotics are needed and a crown will be place over the top of the tooth to help strengthen the tooth due to structural weakness. 

Do I need a night guard?

 A night guard is an appliance aimed at protecting your natural tooth structure from wear, usually from grinding your teeth. This grinding usually takes place at nighttime and can cause severe wear of your teeth. A night guard can be worn to slow this progression by grinding on the hard acrylic that it is made of rather than your own teeth.  Muscles will always win this battle and your teeth get in the way.  A night time splint can also reduce the pressures that grinding can put on your TMJ disc and supporting musculature. 

What is TMD?

 Temporomandibular disorder is a term used to describe problems and symptoms associated with disorders and problems with the temporomandibular disc and joint. This disc is the piece of tissue between your skull and jawbone or mandible. It supports and maintains movement of the lower jaw during mastication or chewing. TMD can range from a simple pop or click to pain on opening and even limited opening causing malnutrition and severe headaches and discomfort. There are non-surgical and surgical approaches to treating TMD. Usually it is recommended to exhaust the non-surgical approaches before proceeding with the surgical ones.

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