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FAQ’s

FAQ’s

This is a question I am asked pretty much every time I encounter a new patient with amalgam or silver fillings. There are many controversies surrounding silver fillings and the fact that they contain mercury. My own opinion is that I wouldn't want them in my mouth so I am certainly not placing them in my patients' mouth! That being said this does not mean that all silver filling need to be removed immediately. Here is the good news! Amalgam fillings are never used in our practice. In fact they are pretty much obsolete throughout the profession. Most silver fillings have a lifespan of about ten years in the mouth. The determination to remove them is made if there is evidence that leakage is occurring or there is a fracture in the material. To determine if leakage is occurring we use digital x-ray to help us see if there is recurrent decay under the filling. However, decay is not always visible with an x-ray alone due to the silver filling masking the decay when viewed on the x-ray. A clinical determination is also necessary. We look at the filling at the interface where the filling meets the natural tooth, if the filling is leaking you will see a dark line or a grayish hue on the tooth. Here is the bad news! Leaking fillings don't cause pain until it is often too late! This means that early detection and maintenance of your mouth is critical to prevent the need for root canals and extensive dentistry.
It is possible that the particular tooth may have a cavity. If the sensitivity is severe and lasts a prolonged period of time it is possible that root canal therapy may be necessary. If there is an existing filling in the tooth the sensitivity may be caused by a leaking filling. In this case, often replacement of the filling is all that is needed.
It is possible that the particular tooth may have a cavity. If the sensitivity is severe and lasts a prolonged period of time it is possible that root canal therapy may be necessary. If there is an existing filling in the tooth the sensitivity may be caused by a leaking filling. If it is determined that it is a leaking filling, often replacing the filling is all that is necessary.
Typically the determination of weather a patient should have veneers or crowns is based on what the patient and dentist are looking to achieve. While both procedures can be highly aesthetic the two treatments have different uses. Typically veneers are used when a patient would like to improve the shape and color of their teeth. Crowding and excess space issues can also be alleviated. Veneers are thin (approximately finger nail thickness) beautifully shaped porcelain that is customized for each individual patient based on the desired aesthetic or functional need. Frequently crowns are used in cases in which there is less tooth structure due to tooth decay or in cases in which a tooth has undergone root canal therapy or trauma. Crowns can achieve all of the aesthetic advantages of veneers and should only be used when necessary.
The placement of veneers should not be painful. During the procedure, typically the patient is anesthetized and in some cases patients may request nitrous oxide. While the teeth are being prepared for veneers there should be no pain or discomfort at all. Shortly after the procedure patients are given a non-steroid anti-inflammatory (NSAID) such as Advil. This is all that should be needed to prevent the breakthrough of any pain associated with the preparation for veneers. The next part of the procedure involves the cementation of the veneers. Again the patient is anesthetized. Anesthetic is need here because the temporaries are removed and the teeth may be sensitive due to the exposure of the teeth after the removal of the temporaries. After the veneers have been cemented teeth are sometimes sensitive due to the procedure. Again Advil or another NSAID is used to prevent the breakthrough of pain. Plenty of water is needed to keep teeth cool during the procedure. Teeth need to be properly disinfected to ensure longevity and health of the restorations. Veneers will enable you to Smile Smile Smile and should be a comfortable painless experience...
Horizontal grayish lines are often from antibiotic use while teeth are developing and as such are what is referred to as internal or inherent stains. Other internal staining may be a result of anomalies in genes or illness during the development of teeth. These stains often present a challenge for any of the whitening products and procedures. However results are seen with in-office whitening products such as zoom whitening or GC Ion followed by a home regiment with at-home whitening products such as Night White in custom trays. If you are unable to acquire the results you desire from in office whitening, veneers will certainly get you the results you are looking for. Veneers are thin, beautifully shaped ceramic shells that are placed over teeth and will mask the horizontal lines or any other internal stains. As an added benefit the shape of teeth can be enhanced and customized based on a patient's desires and functional needs.
Flossing helps to clean plaque in hard to reach places on the tooth surface, specifically in between the teeth where the toothbrush can not reach. Accumulation of plaque left on the tooth surface can lead to the formation of tartar which is a hard structure that contains bacteria. Tartar can only be removed professionally by your dentist or hygienist. Build up of tartar can lead to inflammation of the gums also called gingivitis. Regular flossing coupled with good oral hygiene can help to prevent gum disease.
There may be recession over the tooth exposing the root surface. Often root surfaces tend to be sensitive when they become exposed. Sometimes when a root surface is exposed aggressive tooth brushing can wear away at the root and cause increased sensitivity. An appointment with your dentist can pinpoint the cause of the sensitivity and often there is a simple solution.
Mouthwash or specifically antibacterial mouthwash helps to reduce the amount of bacteria in the mouth. This is important because these bacteria produce sulfur compounds which are the actual cause of bad breath or halitosis. Other mouth washes contain fluoride which helps to harden the outer surface of tooth structure and prevent bacteria build up and tooth decay.
Based on clinical studies tooth whitening products are not harmful when used as directed. These studies demonstrate that there is no concern about harm to the dental enamel or any tooth structure.
Every individual patient will have different whitening results. Additionally each individual has their own saturation point or point in which their teeth will longer whiten. This is why it is important to use these products under the supervision of your dentist. The dentist can identify this saturation point and determine if additional whitening is necessary and will be effective.
One wonderful characteristic about porcelain veneers is their resistance to staining. However they are not completely impervious to stain. We often see staining with patients who frequent coffee, red wines, or food with high chromatic value. Daily maintenance should include brushing with a soft bristle toothbrush and non- abrasive toothpaste (ie. Non-whitening) and flossing. If the staining progresses and cannot be handled with daily maintenance, in-office whitening can be used to help eliminate some stain. In some cases recession occurs around the veneer and may appear as stain. In this case the veneers can be replaced or a gum tissue graft can be done to cover the recession. Lastly if the staining is more than whitening can handle the veneers can be replaced in the same manner they were placed the first time.
Sometimes teeth do shift. If that is the case you should see your dentist to determine if Invisalign, a simple aligner or traditional braces is right for you. Shifting teeth can cause other problems in the mouth, it is best to catch tooth shifting early. Often when it is caught early shifting of teeth requires very little to get the teeth back into alignment. This will avoid the possibility of bite problems down the line.
Invisalign is a series of aligners that incrementally moves teeth as prescribed by the dentist based on the required results of the patient and dentist. The aligners are replaced every two weeks. Each aligner moves the teeth a little more towards the goal of straightening the teeth. Once all the information is gathered patients can view the final results of their alignment on the computer imaging program before committing to treatment. This enables the patient to preview the results and be a part of the treatment planning.
This can be a result of hypo or hyper calcifications. It could also be a result of antibiotic therapy with tetracycline while the teeth were still in development.
In office whitening or professional whitening is the most predictable and effective way to whiten your teeth when followed by an at-home whitener for 7-14 days. The whitening results from the in-office procedure needs to be stabilized by an at-home technique. The in-office whitening procedure starts with the isolation and protection of the gum tissue and lips. The whitening material is applied to the teeth, after which a high intensity light is focused on the teeth. Typically 3 passes are done to achieve the greatest whitening results, and with each pass new whitening material is placed. The doctor can control the concentration of the material as well as how long the material is applied to achieve the most effective whitening results. At-home whitening uses custom trays that are made from molds of our patients' teeth. Whitening material is placed in the trays to apply the material to the teeth. The trays are worn for only 1 to 2 hours at a time to reduce any patient sensitivity. With these procedures an improvement of anywhere from 4 to 8 shades can be expected depending on various factors including the starting shade and extrinsic staining from foods that have a high "chromogenic" index, i.e. stains caused by foods such as soy sauce, tea, coffee, red wine or cigarette smoking.
The outer surfaces of our teeth are made of enamel rods which are porous. These tiny pores have a tendency to collect non-harmful stains that brushing alone can not reach. Whitening products and procedures use either carbamide peroxide or hydrogen peroxide to breakdown stains and internal colors from within the enamel pores. The chemical reaction is an oxidation process in which stain is broken down. High intensity light is used in in-office procedures and serves to accelerate the oxidation reaction.
The most important difference and advantage of in-office or professional whitening is the ability to have your dentist determine if in fact you are a good candidate for the procedure. In addition it is important that the teeth and gums are healthy, free from tooth decay and the teeth are clean. In office procedures can be monitored by the dentist, gum tissue and lips can be isolated and the proper concentration and length of treatment can be determined. Also the concentration of peroxide is greatest when administered by the dentist.
This depends on the starting shade of the tooth, since some shades are more difficult to whiten. For difficult shades, the tray and gel system fabricated by the dentist is highly effective. The tray and gel systems use carbamide peroxide. This system should be monitored carefully by the patient and dentist and if sensitivity arises a shortened cycle may be necessary.
Both treatments involve full or partial facings of teeth that when properly done can enhance the beauty of your smile. Today's composite materials can provide a life like beautiful appearance that is conservative of tooth structure and can last for a long time. Veneer therapy is used in cases in which more is needed to be done to accomplish natural esthetics. Veneers can be used in more severe tooth misalignment, tooth form, tooth color and spacing issues. With composite veneers the resin is applied in layers to the tooth and sculpted directly in the mouth to achieve the desired esthetic the patient is looking for. Composite veneers are used in situations in which there is chipping or discoloration of natural teeth. They are also used where there are minor misalignments of teeth to give teeth the appearance of more aligned teeth. The greatest advantage of composite veneers is that it is an additive process that is reversible and can be removed and replaced as needed. Beautiful natural aesthetics can be achieved in the right hands. Composite veneer therapy is an art. Aesthetic dentistry is not for all dentists and involves extreme attention to detail. When accomplished properly no one should know you had the treatment. Porcelain veneer therapy involves removal of a thin approximately finger nail thickness layer of the tooth's enamel followed by the bonding of a thin sculpted porcelain veneer. This procedure is used when there is more severe discoloration, malformation or misalignment of teeth. Advantages of porcelain veneers are their extreme resistance to stain and chipping as compared to composite veneers. They are even more resistant to stain than natural teeth. In general both procedures can produce beautiful natural aesthetic results. Your doctor can help you decide which procedure or combination of procedures is right for you.
Sensitivity is sometimes a result of either in-office or at-home whitening systems. The sensitivity ranges from no sensitivity at all, to very sensitive. Typically sensitivity does not last longer than 24 to 48 hours. If sensitivity persists past that time there could have been underlying conditions that may have been triggered and it is recommended that you discuss this with your dentist. The best remedy is an NSAID (non-steroidal anti-inflammatory drug) such as Advil or Aleve. Typically our patients are given an NSAID before they leave and are instructed to take it at the end of the procedure and before bed time. If symptoms do occur they typically do not occur directly after the procedure. Rather they occur multiple hours after the procedure. Taking the NSAID ahead of time may prevent the sensitivity from surfacing. In addition different pastes containing high concentrations of fluoride can be placed on the teeth that are administered by the dentist or given to the patient to apply to the teeth that help to alleviate the symptoms.
There are many treatment alternatives to dentures. The most frequent complaint about dentures is the retention and stability of the lower denture. Treatments can range from as little as two implants to support the lower denture to a full mouth of implants to replace each individual tooth. Typically implants are strategically placed so that bridges can be placed to replace the missing teeth.
It is possible that you are clenching grinding or brushing your teeth while you sleep. The best thing to do is to schedule an appointment with your dentist to determine if there is a TMJ. If this is the case your dentist can determine the extent of the problem. Often a night guard helps alleviate the symptoms and your dentist can fit you with the proper night guard for the specific TMJ issue. This type of pain is not something that should be ignored if caught early it can be treated and damage to the TMJ can be prevented.
The bleeding gums could be caused from too aggressive brushing. It may also be that plaque and tartar accumulation on the teeth is irritating the gums and the brushing is further irritating the gum and causing them to bleed. In any case gums should not bleed from brushing alone. A visit to the dentist is most probably in order to see if a cleaning or a deep cleaning is necessary to bring back the health of the gums or to determine any other underlying cause.
A canker sore, also know as an aphthous ulcer presents as a painful sore inside of the mouth. They can be white, yellow, grey and often have a small red border surrounding them. Canker sores are one of the most common oral conditions. It is estimated that 10% of the population gets canker sores. Canker sores are not contagious and should resolve within 7-10 days. If canker sores persist longer than two weeks you should see your dentist.
During pregnancy oral health is more important than ever. Pregnancy cause hormonal change that increase the risk of gum disease or periodontal problems. If you are planning to be pregnant you should see your dentist prior to getting pregnant for a through cleaning, dental exam and examination of your gums. This will ensure that any necessary treatment is done before you are pregnant to reduce any risk to your developing baby.
To be on the safe side, treatment during the first trimester and the second half of the third trimester should be avoided. These are critical development times for your baby and any undue stress on the body should be avoided if possible. Any routine dental treatment can be done in the second trimester but elective dentistry should be done after birth of the child. If possible avoid all dental X-rays during pregnancy except in an emergency. If it is completely necessary you can take X-rays but your dentist should take extra precautions to help protect you and your developing baby. Dr. Sellinger uses digital X-rays and the dose of radiation is substantially reduced than traditional X-rays. Do not avoid regular dental visits while you are pregnant. Cleanings are extremely important during pregnancy. Pregnancy hormones effect the gums and professional cleanings along with monitoring your gum health by your dentist is necessary to avoid more serious gum problems. Dental plaque is a sticky, colorless film that continually forms in between and on the surface of the teeth. Dental plaque is a biofilm that is made up of microorganisms such as streptococcus mutans and other bacteria. It can develop on teeth above the gum line (supragingival), below the gum line on the roots of teeth (subgingival) and along the gum line (gingival).
Dental Plaque is a colorless and sticky film that forms on teeth, and in between teeth from everyday eating and drinking. It is made up of microorganisms including streptococcus mutans and various other bacteria found in the mouth. It is removed with regular brushing and flossing. If left on the teeth it can harden, this hardening of plaque is referred to as calculus or tarter. Dental calculus also known as tarter, forms by the hardening of dental plaque on teeth if it is not removed. Dental plaque can be removed by regular home care including brushing and flossing. Dental calculus can only be removed during a professional cleaning. If dental calculus forms below the gum line it can irritate the gums leading to inflammation and infection. This inflammation coupled with infection can lead to gum disease if untreated. This is why it is so important to keep a regular schedule with your hygienist and dentist to monitor your oral health.

FAQ’s