Ask Dr. Pak

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Why should I go to the dentist regularly? (Crisis treatment vs. preventive treatment)

Many people do not see a dentist on a regular basis. They go only when they have a problem. We call this “crisis treatment” as opposed to “preventive treatment.” While these patients may feel they are saving money, it usually ends up costing much more in both dollars and time. The reason for this is that most dental problems do not have any symptoms until they reach the advanced stages of the disease process. A simple example is tooth decay. We often hear, “Nothing hurts…I don’t have any problems.”

But tooth decay does not hurt! Until, that is, it gets close to the nerve of the tooth. By that time, root canal treatment followed by a post, buildup, and crown are often necessary, instead of the filling which could have been placed several years earlier when the cavity was just beginning to form. Your dentist can usually detect a cavity 3-4 years before it develops any symptoms. It is not uncommon to see a patient with a huge cavity and who has never felt a thing! This is why regular checkups are important – so why not schedule yours today?

Why should I floss, isn’t brushing enough?

You should floss to reduce the number of bacteria in your mouth. There are millions of these microscopic creatures feeding on food particles left on your teeth. This bacteria lives in plaque which can be removed by flossing. Brushing your teeth gets rid of some of the bacteria in your mouth. Flossing gets rid of the bacteria your toothbrush can’t get to. That’s the bacteria hiding in the tiny spaces between your teeth. Brushing without flossing is like washing only half your face. The other half remains dirty.

If you do not floss, you allow plaque to remain between your teeth. Eventually it hardens into tartar. Plaque can be removed by brushing. Only your dentist can remove tartar.

Ask your dentist to show you the proper way to floss. You will both notice the difference at your next cleaning appointment.

How can I get my kids to brush their teeth?

Make it fun! If you are enthusiastic about brushing your teeth, your children will also be enthusiastic. Children want to do the things their parents do. If your children see you brushing your teeth and displaying good dental habits, they will follow.

Checking Plaque Removal – To see if any plaque has been missed, you can use a disclosing (staining) tablet or solution. These products are made of harmless vegetable dyes that stain the plaque a bright color, so that you can see where the plaque is.

Begin to take your children to the dentist at an early age. All children should be seen by their 1st birthday or 6 months after the eruption of the first tooth. Ask your dentist for other creative ways to get children to brush their teeth.

How can I prevent cavities?

You can certainly minimize the number of cavities you get. Always spend two to three minutes brushing your teeth. It takes that long to get rid of the bacteria which destroy tooth enamel. Do not brush too hard. It takes very little pressure to remove bacteria and plaque. Floss at least once a day. It is the only way to get bacteria from between your teeth.

Watch the sugar you eat. There is sugar in candy, fruits, crackers and chips. These are the foods that the bacteria in your mouth like best. Be mindful of foods like raisins and peanut butter that stick to your teeth. They can provide a constant supply for the bacteria eating into your teeth. Try to minimize the times during the day when sweet items are eaten and clean your teeth afterwards.

If you cannot brush after a meal, rinse your mouth with water—which can help to remove food from your teeth. Chewing sugarless gum after a meal can also help. Chewing stimulates the flow of saliva which acts as a natural plaque-fighting substance.

Do not forget your regular dental visits. Good dental habits will go a long way toward a no-cavity visit.

How safe are dental X-rays?

Exposure to all sources of radiation — including the sun, minerals in the soil, appliances in your home, and dental X-rays — can damage the body’s tissues and cells and lead to the development of cancer. Fortunately, the dose of radiation you are exposed to during the taking of X-rays is extremely small.

Advances in dentistry over the years have lead to the low radiation levels emitted by dental X-rays. Some of the improvements are new digital X-ray machines that limit the radiation beam to the small area being X-rayed, higher speed X-ray films that require shorter exposure time compared with older film speeds to get the same results, and the use of film holders that keep the film in place in the mouth (which prevents the film from slipping and the need for repeat X-rays and additional radiation exposure). Also, the use of lead-lined, full-body aprons protects the body from stray radiation (though this is almost nonexistent with the modern dental X-ray machines.) In addition, federal law requires that X-ray machines be checked for accuracy and safety every two years, with some states requiring more frequent checks.

What's the latest word on the safety of amalgam-type fillings?

Over the past several years, concerns have been raised about silver-colored fillings, otherwise called amalgams. Because amalgams contain the toxic substance mercury, some people think that they are responsible for causing a number of diseases, including autism, Alzheimer’s disease, and multiple sclerosis.

The American Dental Association (ADA), the FDA, and numerous public health agencies say amalgams are safe, and that any link between mercury-based fillings and disease is unfounded. The cause of autism, Alzheimer’s disease, and multiple sclerosis remains unknown. Additionally, there is no solid, scientific evidence to back up the claim that if a person has amalgam fillings removed, he or she will be cured of these or any other diseases.

In March of 2002, the FDA reconfirmed the safety of amalgams. Although amalgams do contain mercury, when they are mixed with other metals, such as silver, copper, tin, and zinc, they form a stable alloy that dentists have used for more than 100 years to fill and preserve hundreds of millions of decayed teeth. The National Institutes of Health conducted several large-scale studies that concluded in 2006 that amalgam fillings were safe.

In addition, there has been concern over the release of a small amount of mercury vapor from these fillings, but according to the ADA, there is no scientific evidence that this small amount results in adverse health effects.

How do whitening toothpastes work and how effective are they?

All toothpastes help remove surface stains through the action of mild abrasives. Some whitening toothpastes contain gentle polishing or chemical agents that provide additional stain removal. Whitening toothpastes can help remove surface stains only and do not contain bleach; over-the-counter and professional whitening products contain hydrogen peroxide (a bleaching substance) that helps remove stains on the tooth surface as well as stains deep in the tooth. None of the home use whitening toothpastes can come even close to producing the bleaching effect you get from your dentist’s office through chair-side bleaching or power bleaching. Whitening toothpastes can lighten your tooth’s color by about one shade. In contrast, light-activated whitening conducted in your dentist’s office can make your teeth three to eight shades lighter.

There are so many toothpastes to choose from; how do I know which one to use?

First, when purchasing a toothpaste for you or your child, select one that contains fluoride. Fluoride-containing toothpastes have been shown to prevent cavities. However, one word of caution:Use only a very small amount for children under age 6 (the size of their fingernail). This is because young children swallow toothpaste, and swallowing too much fluoride can lead to tooth discoloration in permanent teeth.

It is also wise to select a product approved by the American Dental Association. The ADA’s Seal of Acceptance means that the product has met ADA criteria for safety and effectiveness and that packaging and advertising claims are scientifically supported. Some manufacturers choose not to seek the ADA’s Seal of Acceptance. Although these products may be safe and effective, these products’ performance have not been evaluated or endorsed by the ADA.

Next, when considering other properties of toothpaste — such as whitening toothpastes, tartar-control, gum care, desensitizing, etc. — the best advice for selecting among these products may be to simply ask your dental hygienist or dentist what the greatest concerns are for your mouth at this time. After consulting with your dentist or hygienist about your oral health’s greatest needs, look for products within that category (for example, within the tartar control brands or within the desensitizing toothpaste brands) that have received the ADA Seal of Acceptance.

Finally, some degree of personal preference comes into play. Choose the toothpaste that tastes and feels best. Gel or paste, wintergreen or spearmint all work alike. If you find that certain ingredients are irritating to your teeth, cheeks or lips, or if your teeth have become more sensitive, or if your mouth is irritated after brushing, try changing toothpastes. If the problem continues, see your dentist.

What are the dangers of oral piercing?

The American Dental Association recognizes that piercing is a widely accepted form of self-expression, and that includes piercings in the mouth. However, the potential problems are numerous. Some symptoms after a piercing include pain, swelling, infection, drooling, taste loss, scarring, chipped teeth, tooth loss, and an increased flow of saliva, none of which are particularly pleasant. Tongue piercing can also cause excessive bleeding.

Most piercings require some sort of manipulation – putting your or somebody else’s hands in your mouth. Difficulty talking and damage to your teeth are distinct possibilities. So if you’re thinking of some sort of piercing in or around your mouth, talk to your dentist first.

If you already have piercings and are having problems, see your dentist right away.

I knocked out a tooth, can it be saved?

Oral injuries are often painful, and should be treated by a dentist as soon as possible.

Attempt to find the tooth
Rinse, do not scrub, the tooth to remove dirt or debris.
Place the clean tooth in your mouth between your cheek and gum or under your tongue
Do not attempt to replace the tooth into the socket as this could cause further damage.
Get to the dentist. Successful re-implantation is possible only when treatment is performed promptly

If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse it in milk.

What causes morning breath?

When you are asleep, saliva production in your mouth decreases. Since saliva is the mouth’s natural mouthwash, most people experience morning breath. Bacteria found on teeth, in the crevices and on the taste buds of the tongue, break down the food particles, which produce sulfur compounds. It is actually these sulfur compounds which give our breath a bad odor. During waking hours, saliva helps to wash away bacteria and food particles. Saliva also helps to dissolve the foul smelling sulfur compounds.

Chronic, long-term mouth odor can be a sign of more serious illness. See your dentist if this is a concern.

What can I do about sensitive teeth?

Sensitivity toothpaste, which contains strontium chloride or potassium nitrate are very effective in treating sensitive teeth. After a few weeks of use you may notice a decrease in sensitivity. Highly acidic foods such as oranges, grapefruits and lemons, as well as tea and soda can increase tooth sensitivity, and work against any sensitivity toothpaste. If you do not get relief by brushing gently and using a desensitizing toothpaste, see your dentist. There are special compounds that can be applied in office to the roots of your tooth to reduce—if not eliminate—the sensitivity. High-fluoride containing home care products can also be recommended to help reduce tooth sensitivity.

Ask the friendly staff at Mountain Dental for more information on sensitive teeth.

What is periodontal disease?

Periodontal disease is inflammation and infection of the gums and supporting bone structure, which if left untreated, can cause permanent jaw bone destruction and possible tooth loss. Untreated periodontal disease has been linked to increased risk for conditions such as heart disease, stroke, low birth weight babies and pre-term delivery, respiratory disease, and prostate cancer. An advanced stage of periodontal disease exhibits inflamed gums pulling away from your bone and teeth. Other signs of periodontal disease include:

Bad breath
Red or swollen gums
Loose teeth or teeth that have moved
Sensitive teeth
Pus coming from around the teeth
Pain on chewing
Tender gums
Bleeding gums

Treatment of early periodontal disease can be performed in-office. However, advanced stages may require surgery. Periodontal disease can be prevented and treated successfully by seeing your dentist and dental hygienist regularly and following recommended care plans.

What should I do about bleeding gums?

People often respond to bleeding gums with the wrong method of treatment. Usually, gums that bleed are a symptom of the onset of periodontal disease or gingivitis. But often, people stop brushing frequently and effectively because it may be painful or it may cause the gums to bleed again. Instead, when gums are inflamed, brushing often and effectively is imperative. More importantly, you should see your dentist to have a periodontal screening and recording performed in order to determine the level of disease present and the best treatment course to pursue.

It is also worth noting that chronic dental pain and discomfort are obvious signs of a problem. Over-the-counter drugs may provide some temporary relief. These medications usually only mask the existence of a problem and should be taken on a temporary basis.

It is important to see your dentist as soon as possible if your gums begin to bleed.

Why should I use a mouthguard?

A mouthguard can prevent injuries to your face and teeth. Most people benefit from wearing a mouthguard when playing any sport. You should wear one whether you are playing professionally or just on weekends. Do what you can to preserve your smile and your health. The best mouthguards are custom-fitted by your dentist. This is especially important if you wear braces or fixed bridgework.

Commercial, ready-made mouthguards can be purchased at most sporting goods stores. They are relatively inexpensive but they are also less effective. In either case, rinse your mouthguard with water or mouthwash after each use. With proper care, it should last for several months.

Ask your dentist which kind of mouthguard you should use.

I have dentures. Is it necessary for me to still see my dentist?

Visits to the Dentist include more than just “checking teeth”. While those patients who wear dentures no longer have to worry about dental decay, they may have concerns with ill fitting appliances or mouth sores to name a few. Annual visits to the Dentist (or sooner if soreness is present) is recommended. During these visits an oral cancer screening and head and neck exam will be performed as well as an evaluation of the fit or need for replacement of the existing appliances. Regular visits can help you to avoid more complicated problems down the road even with a denture.

I just found out I am pregnant , how can this affect my mouth?

About half of women who are pregnant experience a condition called pregnancy gingivitis. This condition can be uncomfortable and cause swelling, bleeding, redness or tenderness in the gum tissue. A more advanced oral health condition called periodontal disease (a serious gum infection that destroys attachment fibers and supporting bone that hold teeth in the mouth) may affect the health of your baby. Studies have shown a relationship between periodontal disease and preterm, low birth-weight babies. In fact, pregnant women with periodontal disease may be seven times more likely to have a baby that’s born too early and too small. The likely culprit is a labor-inducing chemical found in oral bacteria called prostaglandin. Very high levels of prostaglandin are found in women with severe cases of periodontal disease.