Park Dental - Offering a gentle and caring place for your family dentistry needs

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Asking questions and getting answers is a part of good oral health care. To help you find those answers, Park Dental Associattes has prepared responses to frequently asked questions (FAQ's) posed by the public. To read the answers just click on the questions and it will appear below.

If your question is not answered here, feel free to contact Park Dental Associates by clicking on the Contact tab found at the top of the page.

Why Do I Need Anesthesia at the Dental Office?
To make your dental visit as comfortable as possible, your dentist may suggest anesthesia to reduce or eliminate any pain or anxiety that may be related to your dental treatment. The type of anesthesia required for any dental procedure depends on the needs or preferences of the patient. Return to top
How do I know if I'm a candidate for dental anesthesia?
You and your dentist will decide what level of anesthesia is right for you. Some patients prefer a higher level of anesthesia than others. Children, people with special needs, such as those with mental retardation, and those with a condition such as a dental phobia may require a higher level of anesthesia. The type of anesthesia administered by your dentist is more dependent on individual patient preferences than specific dental procedures. Return to top
What are the levels of dental anesthesia?
Local anesthesia is produced by the application or injection of a drug to eliminate pain in a specific area in the mouth. Topical anesthetics are frequently used by your dentist to numb an area in preparation for administering an injectable local anesthetic. Injectable local anesthetics, such as lidocaine, numb mouth tissues in a specific area for a short period of time. Your dentist will probably inject a local anesthetic before filling cavities, preparing your teeth for crowns or for any surgical procedure. Local anesthesia is the most commonly used form of anesthesia in the dental office. Conscious sedation can be used to help you relax during a dental procedure. Your dentist may administer an antianxiety agent, such as nitrous oxide, or a sedative, in combination with a local anesthetic for pain. During conscious sedation, you will remain calm during treatment, yet rational and responsive to speech and touch. Antianxiety agents and sedatives can be administered by mouth, inhalation or injection. Deep sedation and general anesthesia are used for complex procedures and for patients who have trouble controlling their movements or need a deeper level of anesthesia during treatment. During deep sedation you will be unable to respond appropriately to verbal commands. During general anesthesia you will be unconscious. Return to top
What should I tell my dentist before receiving anesthesia?
Your dentist needs to know about all the medications that you are taking, any allergic reactions you've had to medicines in the past, and your past and present health conditions. It's important that you answer your dentist's questions completely and ask about your concerns. This way your dentist will be sure to tell you everything you need to know before receiving treatment. For example, in some cases, your anesthesia treatment may require that you suspend certain medications or abstain from eating or drinking for a period of time before the treatment. Return to top
Is anesthesia in the dental office safe?
Although taking any medication involves a certain amount of risk, the drugs that produce anesthesia are entirely safe when administered by a trained anesthesia provider. The best thing to do is ask questions about any procedure with which you are not familiar. Ask about alternatives, training, the doctor's commitment to continuing education and the credentials of other personnel in the dental office who might be assisting with your treatment. Good communication between the dentist and the patient is the best way of insuring safety. Return to top
How Can I Brighten My Smile?
Your wedding is coming up, and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for movie stars, and it isn't just for one day. Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth bleaching safely lightens the color of the teeth, lasting for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised. Return to top
Is bleaching for you?
Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond better to bleaching. Gray stains caused by fluorosis, smoking or tetracycline use can be lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal (gum) disease or teeth with worn enamel, your dentist may discourage bleaching. Return to top
What's involved?
First, the dentist will determine whether you are a candidate for tooth bleaching and what type of bleaching system would provide the best results. If you're in a hurry for whiter teeth, you may decide to have your teeth lightened immediately. Your dentist will use either an in-office bleaching system or laser bleaching while you sit in the dental chair. Some patients choose dentist-supervised at-home bleaching, which is more economical and provides similar results. If you don't choose laser bleaching, at your next appointment your dentist or hygienist will make impressions of your teeth to create a mouthguard appliance. The mouthguard is custom-made for your mouth and is lightweight so that it can be worn comfortably while you are awake or sleeping. The mouthguard is so thin that you should even be able to talk and work while wearing it. Along with the mouthguard, you'll receive the bleaching materials. You'll be given instructions on how to wear the mouthguard. Some bleaching systems recommend bleaching your teeth for several hours a day. Generally this type of system requires two to four weeks to complete. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10 to 14 days to complete. Over-the-counter bleaching systems are also available and are generally safe and effective, although it is best to check with your dentist before using these products. These systems, which come in the form of strips and gels, usually contain a lower strength of bleaching agent than products used in the dentist's office. For this reason, they must be used longer to achieve a desired effect, but they are also cheaper. Return to top
How long does it last?
Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee and tea. At this point you may choose to get a touch-up. The retreatment time is much shorter than the original treatment time. Return to top
How does it work?
The active ingredient in most of whitening agents is carbamide peroxide; when water comes into contact with this white crystal, the release of hydrogen peroxide lightens the teeth. Return to top
Is it safe? Any side effects?
Several studies have proven bleaching to be safe and effective. The American Dental Association has granted its seal of approval to some tooth bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends. Return to top
What are realistic expectations?
No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two-shade improvement as seen on a dentist's shade guide. The success rate depends upon the type of stain involved, the type of bleaching procedure and your compliance. Bleaching can only provide a shift in color from gray to a lighter shade of gray, for example. Bleaching does not lighten artificial materials such as bonding or veneers. Return to top
What is Bruxism?
Bruxism is the technical term for grinding and clenching of the teeth that may cause facial pain. People who grind and clench their teeth, called bruxers, unintentionally bite down too hard at inappropriate times, such as in their sleep. In addition to grinding teeth, bruxers also may bite their fingernails, pencils and chew the inside of their cheek. People usually aren't diagnosed with bruxism until it is too late, as many people don't realize they have the habit. Others mistakenly believe that their teeth must touch at all times. About one in three people suffer from bruxism, which can easily be treated by a dentist. Return to top
Can bruxism cause harm?
People who have otherwise healthy teeth and gums can clench so often and so hard that over time their teeth become sensitive. They experience jaw pain, tense muscles and headaches along with excessive wear on their teeth. Forceful biting when not eating may cause the jaw to move out of proper balance. Return to top
What are the signs?
When a person has bruxism, the tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth, which is called dentin. When exposed, dentin may cause the tooth to become sensitive. Bruxers may experience pain in their temporomandibular joint (TMJ), which may manifest as popping and clicking of the jaw. Tongue indentations are another sign of clenching. Stress and certain personality types are at the root of bruxism. Anger, pain, nervousness and frustration can trigger bruxing. People who are aggressive, competitive and hurried also may be at a greater risk for bruxism. Return to top
What can be done about it?
During regular dental visits, the dentist automatically checks for physical signs of bruxism. If the dentist or patient notices signs of bruxism, the condition may be observed over several visits to be sure of the problem before recommending and starting therapy. The objective of therapy is to get the bruxer to change behavior by learning how to rest the tongue, teeth and lips properly. When some people become aware of their problem, simply advising them to rest their tongue upward with teeth apart and lips shut may be enough to change their behavior and relieve discomfort. However, the dentist can make a plastic mouth appliance, such as a night guard, that's worn to absorb the force of biting. This appliance can prevent future damage to the teeth and helps change the patient's destructive behavior. If teeth grinding is due to stress, a bruxer may be able to prevent the problem with counseling or strategies that promote relaxation, such as exercise and meditation. Biofeedback is used to treat daytime clenchers by using an electronic device to measure muscle activity and to teach patients how to reduce muscle activity when the biting force becomes too great. Return to top
What is Tooth Decay?
Tooth decay is the disease known as caries or cavities. Unlike other diseases, however, caries is not life-threatening and is highly preventable, though it affects most people to some degree during their lifetime. Return to top
What causes tooth decay?
Tooth decay occurs when your teeth are frequently exposed to foods containing carbohydrates (starches and sugars) like soda pop, candy, ice cream, milk, cakes and even fruits, vegetables and juices. Natural bacteria live in your mouth and form plaque. The plaque interacts with deposits left on your teeth from sugary and starchy foods to produce acids. These acids damage tooth enamel over time by dissolving, or demineralizing, the mineral structure of teeth, producing tooth decay and weakening the teeth. Return to top
How are cavities prevented?
The acids formed by plaque can be counteracted simply by saliva in your mouth, which acts as a buffer and remineralizing agent. Dentists often recommend chewing sugarless gum to stimulate your flow of saliva. However, though it is the body's natural defense against cavities, saliva alone is not sufficient to combat tooth decay. The best way to prevent cavities is to brush and floss regularly. To rebuild the early damage caused by plaque bacteria, we use fluoride, a natural substance that helps to remineralize the tooth structure. Fluoride is added to toothpaste to fight cavities. The most common source of fluoride is in the water we drink. Fluoride is added to most community water supplies and to many bottled and canned beverages. If you are at medium- to high-risk for cavities, your dentist may recommend special high-concentration fluoride gels, mouthrinses or dietary fluoride supplements. Your dentist may also use professional strength anti-cavity varnish, or sealants – thin, plastic coatings that provide an extra barrier against food and debris. Return to top
Who is at risk for cavities?
Because we all carry bacteria in our mouths, everyone is at risk for cavities. Those with a diet high in carbohydrates and sugary foods and those who live in communities without fluoridated water are likely candidates for cavities. And because the area around a restored portion of a tooth is a good breeding ground for bacteria, those with a lot of fillings have a higher chance of developing tooth decay. Children and senior citizens are the two groups at highest risk for cavities. The objective of therapy is to get the bruxer to change behavior by learning how to rest the tongue, teeth and lips properly. When some people become aware of their problem, simply advising them to rest their tongue upward with teeth apart and lips shut may be enough to change their behavior and relieve discomfort. However, the dentist can make a plastic mouth appliance, such as a night guard, that's worn to absorb the force of biting. This appliance can prevent future damage to the teeth and helps change the patient's destructive behavior. If teeth grinding is due to stress, a bruxer may be able to prevent the problem with counseling or strategies that promote relaxation, such as exercise and meditation. Biofeedback is used to treat daytime clenchers by using an electronic device to measure muscle activity and to teach patients how to reduce muscle activity when the biting force becomes too great. Return to top
What can I do to protect my teeth?
The best way to combat cavities is to follow three simple steps: Cut down on sweets and between-meal snacks. Remember, it's these sugary and starchy treats that put your teeth at extra risk. Some research says certain foods, such as peanuts or sugar-free chewing gum, may be "friendly" to teeth. Eating these foods along with or after foods that contain carbohydrates may help to counter the effects of acids produced by bacteria. Drinking plenty of water can help wash away food particles. Of course, dentists encourage their patients to eschew these sugary snacks in favor of healthy alternatives. Brush after every meal and floss daily. Cavities most often begin in hard-to-clean areas between teeth and in the fissures and pits – the edges in the tooth crown and gaps between teeth. Hold the toothbrush at a 45-degree angle and brush inside, outside and between your teeth and on the top of your tongue. Be sure the bristles are firm, not bent, and replace the toothbrush after a few weeks to safeguard against re-infecting your mouth with old bacteria than can collect on the brush. Only buy toothpastes and rinses that contain fluoride (antiseptic rinses also help remove plaque) and that bear the American Dental Association seal on the package. Children under age 6 should only use a small pea-sized dab of toothpaste on the brush and should spit out as much as possible, because a child's developing teeth are sensitive to higher fluoride levels. Finally, because caries is a transmittable disease, toothbrushes should never be shared, especially with your children. See your dentist at least every six months for checkups and professional cleanings. Because cavities can be difficult to detect, a thorough dental examination is very important. If you get a painful toothache, if your teeth are very sensitive to hot or cold foods or if you notice signs of decay like white spots, tooth discolorations or cavities, make an appointment right away. The longer you wait to treat infected teeth, the more intensive and lengthy the treatment will be. Left neglected, cavities can lead to root canal infection, permanent deterioration of decayed tooth substance and even loss of the tooth itself. Return to top
What is Fluoride?
Fluoride is a compound of the element fluorine, which is found universally throughout nature in water, soil, air and food. Existing abundantly in living tissue as an ion, fluoride is absorbed easily into tooth enamel, especially in children's growing teeth. Once teeth are developed, fluoride makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before the damage is even visible. Two forms of fluoride protect the teeth: systemic fluoride and topical fluoride. Return to top
What is systemic fluoride?
Systemic fluoride is ingested into the body when added to public and private water supplies, soft drinks and teas and is available in dietary supplement form. Once systemic fluoride is absorbed via the gastrointestinal tract, the blood supply distributes it throughout the entire body. Most fluoride not excreted is deposited in bones and hard tissues like teeth. Return to top
What's topical fluoride, and when should I use it?
Topical fluoride is applied directly to the teeth. It is found in products containing strong concentrations of fluoride to fight tooth decay, such as toothpastes and mouth rinses. These products are then expectorated or rinsed from the mouth without swallowing. Dentists recommend brushing with a fluoride toothpaste at least twice a day or after every meal, combined with a regimen of flossing and regular dental checkups. Professionally administered topical fluorides such as gels or varnishes are applied by a dentist and left on for about four minutes, usually during a cleaning treatment. For patients with a high risk of cavities, the dentist may prescribe a special gel for daily home use, to be applied with or without a mouth tray for up to six weeks. Return to top
Why is most of the water we drink fluoridated?
Fluoridated water protects against cavities and root caries – a progressive erosion of adult root surfaces caused by gum recession – and helps remineralize early carious lesions. Thanks to these preventive benefits, public water fluoridation is considered the most efficient and cost-effective cavity prevention measure available. More than 144 million United States residents in more than 10,000 communities drink fluoridated water, most from public water supplies with artificially added fluoride. A small percentage get water from private wells with naturally fluoridated water. The Environmental Protection Agency (EPA) has determined that the accepted "optimal" range of fluoride in water lies between 0.7 and 1.2 parts per million (ppm) or milligram per liter. The limit allowed by the EPA in public water is 4 ppm. Backed by results from more than 140 documented studies undertaken in 20 different countries over the past several decades, fluoridated water adhering to these standards has been scientifically established as safe for drinking. Water fluoridation is endorsed by nearly every major health and safety-related organization. Fluoridation of community water supplies is the single most effective public-health measure to prevent tooth decay and to improve oral health for a lifetime. Return to top
Are children more sensitive to fluoride?
Developing teeth are sensitive to higher fluoride levels. In young children, excess fluoride intake can cause dental fluorosis, a harmless cosmetic discoloring or mottling of the enamel, visible as chalky white specks and lines or pitted and brown stained enamel on developing teeth. They are at greater risk if they swallow or use too much toothpaste and fluoride supplements or regularly drink water containing excessive fluoride levels. Parents should monitor the use of toothpaste, mouth rinses or other topical fluoride supplements in young children, checking with a dentist on proper dosage. If you are concerned about the fluoride levels in your drinking water, call the local public water department or your water supplier. If the source is a private well, request a fluoride content analysis taken via a water sample through your local or county health department. Return to top
What is Baby Tooth Decay?
Baby bottle tooth decay is caused by the frequent and long-term exposure of a child's teeth to liquids containing sugars. Among these liquids are milk, formula, fruit juice, sodas and other sweetened drinks. The sugars in these liquids pool around the infant's teeth and gums, feeding the bacteria in plaque. Every time a child consumes a sugary liquid, acid produced by these bacteria attack the teeth and gums. After numerous attacks, tooth decay can begin. The condition also is associated with breast-fed infants who have prolonged feeding habits or with children whose pacifiers are frequently dipped in honey, sugar or syrup. The sweet fluids left in the mouth while the infant is sleeping increase the chances of cavities. Return to top
Why should I be worried about baby bottle tooth decay?
Giving an infant a sugary drink at nap or nighttime is harmful because during sleep, the flow of saliva decreases, allowing the sugary liquids to linger on the child's teeth for an extended period of time. If left untreated, decay can result, which can cause pain and infection. Severely decayed teeth may need to be extracted. If teeth are infected or lost too early due to baby bottle tooth decay, your child may develop poor eating habits, speech problems, crooked teeth and damaged adult teeth. Healthy baby teeth will usually result in healthy permanent teeth. Return to top
How can I prevent baby bottle tooth decay?
Never allow a child to fall asleep with a bottle containing milk, formula, juice or other sweetened liquids. Clean and massage the baby's gums to help establish healthy teeth and to aid in teething. Wrap a moistened gauze square or washcloth around the finger and gently massage the gums and gingival tissues. This should be done after every feeding. Plaque removal activities should begin upon eruption of the first baby tooth. When brushing a child's teeth, use a soft toothbrush and water. If you are considering using toothpaste before your child’s second birthday, ask your dentist first. Parents should first bring their child to the dentist when the child is between 6 and 12 months old. Return to top
Will changes in my child's diet help prevent baby bottle tooth decay?
A series of small changes over a period of time is usually easier and eventually leads to better oral health.

To incorporate these changes:
Gradually dilute the bottle contents with water over a period of two to three weeks.
Once that period is over, if you give a child a bottle, fill it with water or give the child a clean pacifier recommended by a dentist. The only safe liquid to put in a bottle to prevent baby bottle tooth decay is water.
Decrease consumption of sugar, especially between meals.
Children should be weaned from the bottle as soon as they can drink from a cup, usually by their first birthday, but the bottle should not be taken away too soon, since the sucking motion aids in the development of facial muscles, as well as the tongue.

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What are Crowns?
A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to restore a tooth when there isn't enough of the tooth remaining to provide support for a large filling, attach a bridge, protect weak teeth from fracturing, restore fractured teeth or cover badly shaped or discolored teeth. Return to top
How is a crown placed?
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth. Return to top
Will it look natural?
Yes. The dentist's main goal is to create a crown that looks like a natural tooth. That is why your dentist takes an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape and length of your natural teeth. Any one of these factors alone can affect your appearance. If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive. Return to top
Why crowns and not veneers?
Yes. The dentist's main goal is to create a crown that looks like a natural tooth. That is why your dentist takes an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape and length of your natural teeth. Any one of these factors alone can affect your appearance. If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive. Return to top
What is the difference between a cap and a crown?
There is no difference between a cap and a crown. Return to top
How long do crowns last?
Crowns should last approximately five to eight years. However, with good oral hygiene and supervision, most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice or fingernail biting may cause this period of time to decrease significantly. Return to top
How should I take care of my crown?
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth. Return to top
What are Veneers?
Veneers are ultra-thin shells of ceramic (porcelain) or a composite resin material, which are bonded to the front of teeth. This procedure requires little or no anesthesia and can be the ideal choice for improving the appearance of the front teeth. Veneers are placed to mask discolorations, to brighten teeth and to improve a smile. Return to top
Why a veneer?
Veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's color, size or shape. Veneers can mask undesirable defects, such as teeth stained by tetracycline and damage due to an injury or as a result of a root-canal procedure. They are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed. Return to top
What happens during this procedure?
Patients may need up to three appointments for the entire procedure: diagnosis and treatment planning, preparation and bonding. It's critical that you take an active role in the smile design. Spend time in the planning of the smile. Understand the corrective limitations of the procedure. Have more than one consultation, if necessary, to feel comfortable that your dentist understands your objectives. To prepare the teeth for the veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about half a millimeter of the tooth is removed, which may require a local anesthetic. Composite resin veneers are generally done in one appointment. After the tooth is prepared, the dentist carefully bonds and sculpts the composite material onto your teeth. For ceramic veneers, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This may take several days. If the teeth are too unsightly, a temporary veneer can be placed, at an additional cost. When your ceramic veneers are ready, the dentist places each veneer on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the results, and pay particular attention to the color. At this point, the color of the veneers can still be adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a light beam hardens the cement. Return to top
How about maintenance?
For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have changed in size and shape. Brush and floss daily. After one or two weeks, your dentist will ask you to return for a follow-up appointment. Return to top
What are realistic expectations?
Veneers are reasonable facsimiles of natural teeth, not perfect replacements. It's not uncommon to see slight variations in the color of veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance your smile and can heighten self-esteem. Return to top
What are Cold Sores?
Cold sores, also known as fever blisters, are tiny, clear, fluid-filled blisters that form around the mouth and are caused by the herpes simplex virus (usually type 1, or HSV-1) living inside your nerve tissue. Cold sores usually do not last longer than two weeks. However, the sores are highly contagious and tend to recur when the virus is reactivated by a trigger such as stress, sunlight, fever or illness. Return to top
What is the difference between a cold sore and a canker sore?
Like cold sores, canker sores – also known as aphthous ulcers – can be quite painful and often recur. While cold sores are caused by a virus, the formation of a canker sore may be triggered by multiple factors such as stress, food allergies or a weakened immune system. A canker sore forms in the soft tissues of your mouth and is not contagious, whereas a cold sore usually appears around the lip area outside the mouth and is highly contagious. If a cold sore appears inside the mouth, usually it appears on the non-movable parts such as the roof, rather than the tongue or soft palate. Return to top
What happens when you are first exposed to HSV-1?
Most people get HSV-1 infections during infancy or childhood and usually catch the virus from an infected family member or friend. Only an estimated 30 percent of those infected actually develop the characteristic blisters. If sores do develop, they can appear anywhere from two to 12 days after exposure to an infected person. Other persons with a primary infection may have flu-like symptoms such as a high fever, sore throat, swollen neck glands and mouth soreness. Return to top
What are the stages of a cold sore?
Day 1: Prodrome (tingle) stage - Before a cold sore has formed, you may feel a tingling, itching or burning sensation beneath the skin, usually around the mouth or the base of the nose. Applying antiviral medications during this stage can help alleviate cold-sore symptoms. Days 2 to 3: Blister stage - An outbreak of fluid-filled blisters is the first visible sign of cold-sore formation. Day 4: Ulcer or weeping stage - Typically, the most contagious and painful stage of cold sores is when blisters rupture, leaving a shallow, reddish, open sore. Days 5 to 8: Crusting stage - After a few days, the blisters dry up and form a yellow or brownish crust, which eventually falls off. During this stage, it is important to care for the scab, which can crack or break. Days 9 to 12: Healing stage - Usually a series of scabs will form on the lesion, which eventually flake off. Each new scab will be smaller than the previous one, until the cold sore heals completely, usually without scarring. Return to top
What triggers a cold sore?
There may be long periods when the herpes virus remains inactive. The following factors can trigger cold sores: Illness, such as cold or flu Dental treatment Physical stress or fatigue Menstruation or pregnancy Mouth trauma An immune-system deficiency Sunlight exposure or ultraviolet lamps Food allergies Return to top
How are cold sores treated?
Most cold sores are mild and do not require treatment. Antiviral medications can reduce the frequency, duration and severity of outbreaks. Medications with a numbing agent, such as benzyl alcohol, can help alleviate a cold sore's burning, itching and pain. Emollients can reduce cracking and soften scabs. Applying aloe vera balm three times a day to the cold sore also can help fight the infection and enhance healing. If over-the-counter remedies don't help, ask your dentist for a prescription. A dentist also can accurately diagnose cold sores and base treatment on important factors such as your age, overall health, medical history and tolerance for specific medications. Return to top
What precautions should be taken?
To prevent transmission of the virus to another person, avoid: Intimate physical contact with others Sharing eating utensils, toothbrushes, towels and razors Touching the blisters (always wash your hands after applying medication) Return to top
What can I do to minimize frequent outbreaks?
Eat foods high in lysine (an amino acid found in red meats, fish and dairy products) or take supplements Apply sunscreen to the face and lips before going outdoors Shave with a disposable razor during an outbreak Replace your toothbrush Engage in relaxing activities to reduce stress Return to top
Canker or Cold Sore?
In or out? That's the first question to ask when you're trying to figure out whether you have a canker sore or a cold sore. If it's inside your mouth, it's most likely a canker sore; outside, probably a cold sore. The two may seem similar, but the similarity ends with the fact that both are connected with the mouth and both cause pain and discomfort. So knowing which one you have is the first step to knowing how it's caused and how to treat it. Canker sores (or mouth ulcers) generally occur inside the mouth. They often are triggered by trauma such as biting your cheek, jabbing your gum with your toothbrush or even overzealous tooth cleaning. Cold sores are tiny, clear, fluid-filled blisters that form around the mouth and are caused by the herpes simplex virus living inside your nerve tissue. (It is usually not the same virus that causes genital herpes.) Diligence is key when dealing with your oral health, says Academy of General Dentistry spokesperson Eric Z. Shapira, DDS, MAGD. "You need to be aware of any kind of lesion in the mouth or around the mouth, then report it to your dentist so he or she can play 'detective," says Dr. Shapira. "It is important to know what it is and what caused it before it can be treated properly." Question Cold Sore Canker Sore 1. Where does it strike? Outside the mouth Inside the mouth 2. What does it look like? Tiny, clear blisters usually on the lips or under the nose Small ulcer with a white or gray base and red border 3. What triggers it? Flare-up of herpes simplex virus Trauma, such as biting your cheek or jabbing your gum with a toothbrush 4. How long does it last? About a week One or two weeks 5. Is it contagious? Yes No 6. How do I treat it? Aloe vera or over-the-counter topical anesthetics to ease pain and discomfort Over-the-counter medications or, if needed, prescription antiviral drugs to prevent outbreaks Rinse with antimicrobial mouthwash or warm water and salt Over-the-counter oral anesthetics Antibiotics and steroids, in severe cases Return to top
What is a Denture?
A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position. Complete dentures are either "conventional" or "immediate." A conventional denture is placed in the mouth about a month after all the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback behind an immediate denture is that it may require more adjustments after the healing has taken place. Return to top
Who needs a denture?
Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech and provides support for facial muscles. It will greatly enhance the facial appearance and smile. Return to top
What happens when you get a denture?
A dentist can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient's final denture is placed, following any minor adjustments. New denture wearers need time to get accustomed to their new "teeth," because even the best-fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days to a few weeks. To get accustomed to chewing with a new denture, start with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change in facial appearance, increased salivary flow or minor irritation or discomfort. Return to top
How do you care for a denture?
A denture is fragile, so it is important to handle it with care. Remove and brush the denture daily, preferably with a brush designed specifically for cleaning dentures, using either a denture cleanser or toothpaste. Never use harsh, abrasive cleansers, including abrasive toothpastes, because they may scratch the surface of the denture. Don't soak your denture in boiling water because it will cause it to become warped. If you wear a partial denture, be sure to remove it before brushing your natural teeth. When not in use, soak it in a cleanser solution or in water. Get in the habit of keeping the denture in the same safe and handy place to reduce the likelihood of misplacement. Return to top
Should a denture be worn at night?
While you may be advised to wear your denture almost constantly during the first two weeks – even while you sleep – under normal circumstances it is considered best to remove it at night and soak the denture in cleansing solution or water. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums. Return to top
Continue seeing your dentist regularly
It is important to continue having regular dental checkups so that your dentist can examine oral tissues for signs of disease or cancer. With age, your mouth will continue to change as the bone under your denture shrinks or recedes. To maintain a proper fit over time, it may be necessary to adjust your denture or possibly remake your denture. Never attempt to adjust a denture yourself, and do not use denture adhesives for a prolonged period because this can contribute to bone loss. When in doubt, consult your dentist. Return to top
Are there any alternatives to dentures?
Dentures are no longer the only way to restore a mouth that has little or no non-restorable teeth. Strategically placed support, or implants, can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble the "feel" of real teeth. Dental implants are becoming the alternative of choice to dentures, but not everyone is a candidate for implants. Speak with your dentist for advice. Return to top
How Does Diabetes Affect Oral Health?
It is estimated that up to 20 million people have diabetes, but only two-thirds of these individuals are diagnosed. Studies have shown that diabetics are more susceptible to the development of oral infections and periodontal (gum) disease than those who do not have diabetes. Oral infections tend to be more severe in diabetic patients than non-diabetic patients. And, diabetics who do not have good control over their blood sugar levels tend to have more oral health problems. These infections occur more often after puberty and in aging patients. Return to top
How are gum disease and diabetes related?
Because diabetes reduces the body’s resistance to infection, the gums are at risk for gingivitis, an inflammation usually caused by the presence of bacteria in plaque. Plaque is the sticky film that accumulates on teeth both above and below the gum line. Without regular dental check-ups, gum disease may result if gingivitis is left untreated. It also can cause inflammation and destruction of tissues surrounding and supporting teeth, gums, bone and fibers that hold the gums to the teeth. Return to top
What other types of problems could I experience?
Diabetics may experience burning mouth syndrome and fungal infections, such as thrush and oral candidiasis. Dry mouth (xerostomia) also may develop, causing an increased incidence of decay. To prevent problems with bacterial infections in the mouth, your dentist may prescribe antibiotics, medicated mouth rinses and more frequent cleanings. Return to top
How can I stay healthy?
Make sure to take extra good care of your mouth and have dental infections treated immediately. Diabetics who receive good dental care and have good insulin control typically have a better chance at avoiding gum disease. Diet and exercise may be the most important changes that diabetics can make to improve their quality of life and their oral health. Diabetic patients should be sure both their medical and dental care providers are aware of their medical history and periodontal status. To keep teeth and gums strong, diabetic patients should be aware of their blood sugar levels in addition to having their triglycerides and cholesterol levels checked on a regular basis. These may have a direct correlation on your chances of avoiding gum disease. Return to top
What is the best time to receive dental care?
If your blood sugar is not under control, talk with both your dentist and physician about receiving elective dental care. Dental procedures should be as short and as stress free as possible. Also make morning appointments because blood glucose levels tend to be under better control at this time of day. If you have a scheduled appointment, eat and take your medications as directed. See your dentist on a regular basis, keep him or her informed of your health status and keep your mouth in good health. Return to top
What is Dry Mouth?
Dry mouth (xerostomia) is caused by a decrease in the amount of saliva in the mouth when the salivary glands do not work properly. The salivary glands help keep your mouth moist, which helps prevent tooth decay and other oral health problems. Prescription and over-the-counter medications are the most common cause of dry mouth. In fact, more than 400 medications can contribute to mouth dryness. The most common troublemakers are antihypertensives, antidepressants, painkillers, tranquilizers, diuretics and antihistamines. Dry mouth may be a sign of a serious health condition or may occur when a person is upset or experiences stress. It also can be caused by radiation therapy and chemotherapy hormonal alterations or diseases such as AIDS, diabetes or Sjögren's syndrome. Patients with Alzheimer's disease or those who suffer a stroke may experience dry mouth. Approximately 30 percent of persons over the age of 65 are affected by dry mouth. Return to top
Can dry mouth cause health problems?
Yes. You want to prevent dry mouth if possible, because it can cause difficulty in tasting, chewing or swallowing. It also allows plaque to build up on your teeth faster, leading to a higher risk of cavities. In certain cases, a lack of moisture can make your tongue become very sensitive, causing a condition called burning mouth syndrome. Dry mouth can also lead to bad breath, ulceration or soreness of the mouth, gum disease and difficulty in wearing dentures. Return to top
Why is saliva important?
Saliva helps wash away cavity-causing bacteria, provides enzymes to help digest food, protects teeth from decay by neutralizing harmful acids and keeps oral tissues healthy. Without saliva, you would lose your teeth much faster. Return to top
What is Sjögren's syndrome?
Sjögren's syndrome is an autoimmune disease that causes the body to attack its own moisture-producing glands. Approximately 1-4 million Americans have this condition. The majority of sufferers are women who are in their late 40s at the time of diagnosis. Sjögren's syndrome is difficult to diagnose because symptoms vary greatly. Patients may experience dryness in the eyes and mouth, fatigue or joint pain, and it also mimics the natural signs of aging. Return to top
How can my dentist help?
Your dentist will want to know if you have difficulty swallowing or speaking, oral soreness or a dry throat. Help your dentist to diagnose the problem by paying close attention to the symptoms associated with dry mouth. If you have any questions about this condition, ask your dentist. There are many treatments that can help ease the symptoms of dry mouth, including over-the-counter saliva substitutes. To ease discomfort, your dentist may also recommend the following: Brush and floss twice a day Chew sugarless gum Avoid alcohol and caffeine Avoid smoking Avoid citrus juices (tomato, orange, grapefruit) Avoid dry foods, such as toast or crackers Avoid overly salty foods Drink plenty of water Regular dentist visits Return to top
Should I Floss?
Plaque is a sticky layer of material containing bacteria that accumulates on teeth, including places where toothbrushes can't reach. This can lead to gum disease. The best way to get rid of plaque is to brush and floss your teeth carefully every day. A toothbrush cleans the tops and sides of your teeth. Dental floss cleans between them. Some people use waterpicks, but floss is the best choice. Return to top
Why should I floss?
Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces and controls bad breath. By flossing your teeth daily, you increase the chances of keeping your teeth a lifetime and decrease your chance of having periodontal (gum) disease and tooth decay. Flossing is the single most important weapon against plaque, perhaps more important than the toothbrush. Many people just don't spend enough time flossing and many have never been taught to floss properly. When you visit your dentist or hygienist, ask to be shown. Return to top
Which type of floss should I use?
Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridge work. Tapes are usually recommended when the spaces between teeth are wide. They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss but does tear more than waxed floss. Return to top
How should I floss?
There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don't cut off your finger's circulation!) Wind the rest of the floss similarly around the same finger of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don't pull it down hard against your gums or you will hurt them. Don't rub it side to side as if you're shining shoes. Bring the floss up and down several times, forming a "C" shape around the tooth and being sure to go below the gumline. The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gumline and forming a "C" on the side of the tooth. Return to top
How often should I floss?
At least once a day. To give your teeth a good flossing, spend at least two or three minutes. Return to top
What are floss holders?
You may prefer a prethreaded flosser or floss holder, which often looks like a little hacksaw. Flossers are handy for people with limited dexterity, for those who are just beginning to floss or for caretakers who are flossing someone else's teeth. Return to top
Is it safe to use toothpicks?
In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. When you use a toothpick, don't press too hard, as you can break off the end and lodge it in your gums. Return to top
Do I need a waterpick (irrigating device)?
Don't use waterpicks as a substitute for brushing and flossing. But they are effective around orthodontic braces, which retain food in areas where a toothbrush cannot reach. However, they do not remove plaque. Waterpicks are frequently recommended by dentists for persons with gum disease; solutions containing antibacterial agents like chlorhexidine or tetracycline, available through a dentist's prescription, can be added to the reservoir in these cases. Return to top
What is Gum Disease?
Gum disease, or periodontal disease is a chronic inflammation and infection of the gums and surrounding tissue. It is the major cause of about 70 percent of adult tooth loss, affecting three out of four persons at some point in their life. Periodontal diseases include gingivitis and periodontitis. Return to top
What causes gum disease?
Bacterial plaque – a sticky, colorless film that constantly forms on the teeth – is recognized as the primary cause of gum disease. If plaque isn't removed each day by brushing and flossing, it hardens into a rough, porous substance called calculus (also known as tartar).Toxins produced and released by bacteria in plaque irritate the gums. These toxins cause the breakdown of the fibers that hold the gums tightly to the teeth, creating periodontal pockets that fill with even more toxins and bacteria. As the disease progresses, pockets extend deeper, and the bacteria moves down until the bone that holds the tooth in place is destroyed. The tooth eventually will fall out or require extraction. Return to top
Are there other factors?
Yes. Genetics is also a factor, as are lifestyle choices. A diet low in nutrients can diminish the body's ability to fight infection. Smokers and spit tobacco users have more irritation to gum tissues than non-tobacco users, while stress can also affect the ability to ward off disease. Diseases that interfere with the body's immune system, such as leukemia and AIDS, may worsen the condition of the gums. In patients with uncontrolled diabetes, where the body is more prone to infection, gum disease is more severe or harder to control. Pregnant women experience elevated levels of hormones that cause the gums to react differently to the bacteria found in plaque, and in many cases can cause a condition known as “pregnancy gingivitis.” Return to top
What are the warning signs of gum disease?
Signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, loose or separating teeth, pus between the gum and tooth, persistent bad breath, a change in the way teeth fit together when the patient bites and a change in the fit of dentures. While patients are advised to check for the warning signs, there might not be any discomfort until the disease has spread to a point where the tooth is unsalvageable. That's why patients are advised to get frequent dental exams. Return to top
What does periodontal treatment involve?
In the early stages of gum disease, most treatment involves a special cleaning called scaling and root planning, which removes plaque and tartar around the tooth and smoothing the root surfaces. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, called gingivitis, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums – sometimes with the assistance of a laser – and removing the hardened plaque build-up and recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean. Return to top
How do I prevent gum disease?
Removing plaque through daily brushing, flossing and professional cleaning is the best way to minimize your risk. Your dentist can design a personalized program of home oral care to meet your needs. Return to top
What is the role of a general dentist?
The general dentist usually detects gum disease and treats it in the early stages. Some general dentists have acquired additional expertise to treat more advanced conditions of the disease. If the general dentist believes that the gum disease requires treatment by a specialist, the patient will be referred to a periodontist. The dentist and periodontist will work together to formulate a treatment plan for the patient. Return to top
Is maintenance important?
Sticking to a regular oral hygiene regimen is crucial for patients who want to sustain the results of periodontal therapy. Patients should visit the dentist every three to four months (or more, depending on the patient) for spot scaling and root planing and an overall exam. In between visits, they should brush at least twice a day, floss daily and brush their tongue. Manual soft nylon bristle brushes are the most dependable and least expensive. Electric brushes are also a good option, but don't reach any further into the pocket than manual brushes. Proxy brushes (small, narrow brushes) and other interdental cleaners are the best way to clean between the recesses in the teeth and should be used once a day. Wooden toothpicks and rubber tips should only be used if recommended by your dentist. Return to top
What is a Dental Implants?
A dental implant is an artificial tooth root that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don't rely on neighboring teeth for support and they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth. Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: the first is placed directly into the jaw bone, like natural tooth roots; the second is used when the jaw structure is limited, therefore, a custom-made metal framework fits directly on the existing bone. Return to top
How do they work?
Strategically placed, implants can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble real teeth. Return to top
Can anyone receive dental implants?
Talk with your dentist about whether you are an implant candidate. You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates. Return to top
What can I expect during this procedure?
The dentist must perform surgery to anchor the "artificial root" into or on your jaw bone. The procedure is done in the dental office with local anesthesia. The gum is then secured over the implant, which will remain covered until it fuses with the bone. The dentist then uncovers the implant and attaches an extension, or post, to the implant. With some implants, the implant and post are a single unit placed in the mouth during the initial surgery. Finally, the dentist makes an artificial tooth, or crown, that is attached to the implant post. Return to top
How long does this process take?
The process can take up to nine months to complete. Each patient heals differently, so times will vary. After the implant and posts are placed surgically, the healing process can take up to six months and the fitting of replacement teeth no more than two months. Sometimes, if a patient has good bone quality, posts can be placed and replacement teeth fitted in one appointment. Return to top
What is the success rate of the implants?
The success rate for implants depends on the tooth's purpose and location in the mouth, as well as a patient’s overall health. Return to top
How do I care for dental implants?
Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the fixtures at least twice a day. Your dentist will give you specific instructions on how to care for your new implants. Additional cleanings of up to four times per year may be necessary to ensure that you retain healthy gums. Return to top
What is the cost of dental implants?
Since implants involve surgery and are more involved, they cost more than traditional bridgework. However, some dental procedures and portions of the restoration may be covered by dental and medical insurance policies. Your dentist can help you with this process. Return to top
What is a Mouthguard?
A mouthguard is a flexible appliance that is worn in athletic and recreational activities to protect teeth from trauma. The dental profession unanimously supports the use of mouthguards in a variety of sports activities. Return to top
Why should I wear a mouthguard?
A mouthguard can prevent serious injuries such as broken teeth, jaw fractures, cerebral hemorrhage and neck injuries by helping to avoid situations where the lower jaw gets jammed into the upper jaw. Mouthguards are effective in moving soft tissue in the oral cavity away from the teeth, preventing laceration and bruising of the lips and cheeks, especially for those who wear orthodontic appliances. They may also reduce the severity and incidence of concussions. Return to top
In what sports should I wear a mouthguard?
Anytime there is a strong chance for contact with other participants or hard surfaces, it is advisable to wear a mouthguard. Players who participate in basketball, softball, football, wrestling, soccer, lacrosse, rugby, in-line skating and martial arts, as well as recreational sports such as skateboarding and bicycling, should wear mouthguards while competing. Return to top
Why don't kids wear mouthguards?
Parents are sometimes uninformed about the level of contact and potential for serious dental injuries involved with sports in which the child participates. Some, though not all, schools reinforce the health advantage of mouthguards for their contact sports. Cost may be another consideration, although mouthguards come in a variety of price ranges. Return to top
What are the different types of mouthguards?
Stock mouthguard: The lowest cost option is a ready-made, stock item, which offers the least protection because the fit adjustment is limited. It may interfere with speech and breathing because this mouthguard requires that the jaw be closed to hold it in place. A stock mouthguard is not considered acceptable as a facial protective device. Mouth-formed mouthguard: There are two types of mouth-formed mouthguards. The first is a shell-liner mouthguard that is made with an acrylic material that is poured into an outer shell, where it forms a lining. When placed in an athlete's mouth, the protector's lining material molds to the teeth and is allowed to set. Another type is a thermoplastic, or “boil-and-bite,” mouthguard. This mouthguard is softened in hot water and then placed in the mouth and shaped around the teeth by using finger, tongue and sometimes biting pressure. Custom-made mouthguard: The best choice is a mouthguard custom-made by your dentist. It offers the best protection, fit and comfort level because it is made from a cast to fit your teeth. Return to top
How should I care for a mouthguard?
Clean your mouthguard by washing it with soap and cool (not hot) water. Before storing, soak your mouthguard in mouthwash. Keep your mouthguard in a well-ventilated, plastic storage box when not in use. Make sure the box has several holes so the mouthguard will dry. Heat is bad for a mouthguard, so don't leave it in direct sunlight or in a closed automobile. Don't bend your mouthguard when storing. Don't handle or wear someone else's mouthguard. Call your dentist if there are any problems. Return to top
How Can Gum Disease Affect My Cardiovascular Health?
Researchers are finding possible links between periodontal (gum) infections and other diseases throughout the body. Current studies suggest that there may be a link between gum disease and cardiovascular disease. In fact, some research suggests that gum disease may be a more serious risk factor for heart disease than high blood pressure (hypertension), smoking, high cholesterol, gender and age. Studies suggest that people who have gum disease seem to be at a higher risk for heart attacks, although no one is certain how this relationship works. Your oral health affects your overall health, but studies that will find exactly why these problems are linked are still underway. Return to top
How does gum disease affect my cardiovascular health?
The current theory is that bacteria present in infected gums can come loose and move throughout the body. The same bacteria that cause gum disease and irritate your gums might travel to your arteries. Researchers are unsure what causes the bacteria to become mobile, but it has been suggested that bacteria can be dislodged and enter the bloodstream during tasks as simple as brushing, flossing or even chewing. Research shows that your risk of developing cardiovascular disease varies according to the severity of gum infection. The worse the infection, the more likely the bacteria are to become blood-borne. Infected gums bleed, making it easier for bacteria to enter your bloodstream. If bacteria become dislodged, the bacteria can enter through cuts or sores in your mouth and can travel to other parts of the body through your bloodstream. If bacteria reach the arteries, they can irritate them in the same way that they irritate gum tissue. This could cause arterial plaque to accumulate, which can cause hardening of the arteries and decreased or blocked bloodflow. Compromised bloodflow to your heart can cause a heart attack. Also, arterial plaque can come loose and travel to other parts of the body. If a blockage occurs in the brain, it can cause a stroke. Return to top
What should I do to protect my heart and arteries?
Keep your mouth healthy! Gum disease is a serious gum infection that should always be taken seriously. Although gum disease can often show few or no symptoms at all, watch for gums that are red and irritated or bleed easily. There are many new treatments available to control and help reverse gum disease. Remember, gum disease is caused by plaque buildup. Brush and floss regularly to remove plaque that you can't see below the gumline, and remember to schedule regular checkups. If you remove the plaque, you minimize the chance for getting gum disease. If you have any questions about your oral health, ask your dentist. Return to top
What Causes a Toothache?
While decay often is cited as the primary cause of a toothache, it's important for you to have a complete oral examination to determine the cause. Other dental causes of a toothache include: infection, gum disease, grinding teeth (bruxism), tooth trauma and an abnormal bite. Tooth eruption may be the cause of tooth or jaw pain in babies and school-age children. TMJ, sinus or ear infections and tension in the facial muscles can cause discomfort that resembles a toothache, but often these health problems are accompanied by a headache. Pain around the teeth and the jaws can be symptoms of heart disease such as angina. If your dentist suspects a medical illness could be the cause of your toothache, he or she may refer you to a physician. Return to top
Why does my toothache?
You may have a dental cavity or advanced gum disease. The first sign of decay may be the pain you feel when you eat something sweet, very cold or very hot. If the pulp – the inside of the tooth that has tissue and nerves – has become irritated, this can cause pain in your tooth. Return to top
What are the symptoms of a toothache?
Because the symptoms of a toothache may resemble other medical conditions or dental problems, it can be difficult to diagnose the cause without a complete evaluation by your dentist. If you notice pus near the source of the pain, your tooth may have become abscessed, causing the surrounding bone to become infected. Or the pus could indicate gum disease, which usually is characterized by inflammation of the soft tissue and abnormal loss of bone surrounding the teeth. Contact your dentist immediately if you have any of the following symptoms: Fever Difficulty breathing or swallowing Swelling around the tooth area Pain when you bite A foul-tasting discharge Return to top
How do I alleviate the pain if I cannot see my dentist right away?
Anyone with a toothache should see a dentist at once for diagnosis and treatment because, if left untreated, your condition can worsen. However, if you are unable to schedule an emergency appointment, a self-care treatment can temporarily alleviate pain and inflammation from a toothache: Rinse with warm salt water. Gently floss teeth to dislodge any food particles trapped between teeth. Take an over-the-counter pain reliever such as aspirin, ibuprofen or acetaminophen to relieve pain. If your child has a toothache, use acetaminophen. Never put aspirin or any other painkiller against the gums near the aching tooth, as it may burn the gum tissue. Apply an over-the-counter antiseptic containing benzocaine directly to the irritated tooth and gum to temporarily relieve pain. Direct application of oil of cloves (eugenol) may also help to numb the gums. The oil may be rubbed directly on the sore area or soak a small piece of cotton and apply it to the sore tooth. If there has been some trauma to the tooth, a cold compress may be applied on the outside cheek to relieve pain or swelling. If your tooth has been knocked out, forced out of position, loosened or fractured, visit the dentist's office or a hospital emergency room immediately. Return to top
How can my dentist help?
Your dentist will conduct a complete oral examination to determine the location and cause of the toothache, looking for signs of swelling, redness and obvious tooth damage. He or she may also take X-rays looking for evidence of tooth decay between teeth, a cracked or impacted tooth or a disorder of the underlying bone – problems that the dentist may not be able to find through a routine exam. Your dentist also may prescribe pain medication or antibiotics to speed the healing of your toothache. If, by the time you see your dentist, your tooth has become infected, then treatment could require removal of the tooth or a root canal procedure, which involves removing the damaged nerve tissue from the middle of a tooth. Return to top
Is there a way to prevent toothache?
The key to preventing toothaches is establishing a regular oral hygiene routine and sticking to it. For example, failure to brush and floss regularly after meals can significantly increase your risk of developing cavities. After you eat, bacteria in your mouth feed on sugar and starch and produce acid that can "eat" a hole (or cavity) in your tooth's enamel. If the cavity is not filled, it can cause considerable pain and potentially destroy the dentin, pulp and the tooth's nerve. Here are a few tips to help reduce your risk for developing a toothache: Brush at least twice a day, preferably after every meal and snack. Floss once a day to prevent gum disease. Visit your dentist twice a year for oral examinations and a professional cleaning. Return to top
How Does Pregnancy Affect My Oral Health?
It's a myth that calcium is lost from a mother's teeth and "one tooth is lost with every pregnancy." But you may experience some changes in your oral health during pregnancy. The primary changes are due to a surge in hormones – particularly an increase in estrogen and progesterone –- can exaggerate the way gum tissues react to plaque. Return to top
How does a build-up of plaque affect me?
If the plaque isn't removed, it can cause gingivitis – red, swollen, tender gums that are more likely to bleed. So-called "pregnancy gingivitis" affects most pregnant women to some degree, and generally begins to surface as early as the second month. If you already have gingivitis, the condition is likely to worsen during pregnancy. If untreated, gingivitis can lead to periodontitis, a more serious form of gum disease. Pregnant women are also at risk for developing pregnancy tumors, inflammatory, non-cancerous growths that develop when swollen gums become irritated. Normally, the tumors are left alone and will usually shrink on their own after the baby’s birth. But if a tumor is uncomfortable and interferes with chewing, brushing or other oral hygiene procedures, the dentist may decide to remove it. Return to top
How can I prevent these problems?
You can prevent gingivitis by keeping your teeth clean, especially near the gumline. You should brush with fluoride toothpaste at least twice a day and after each meal when possible. You should also floss thoroughly each day. If brushing causes morning sickness, rinse your mouth with water or with antiplaque and fluoride mouthwashes. Good nutrition – particularly plenty of vitamin C and B12 – help keep the oral cavity healthy and strong. More frequent cleanings from the dentist will help control plaque and prevent gingivitis. Controlling plaque also will reduce gum irritation and decrease the likelihood of pregnancy tumors. Return to top
Could gingivitis affect my baby's health?
Research suggests a link between preterm, low-birthweight babies and gingivitis. Excessive bacteria can enter the bloodstream through your gums. If this happens, the bacteria can travel to the uterus, triggering the production of chemicals called prostaglandins, which are suspected to induce premature labor. Return to top
When should I see my dentist?
If you're planning to become pregnant or suspect you're pregnant, you should see a dentist right away. Otherwise, you should schedule a checkup in your first trimester for a cleaning. Your dentist will assess your oral condition and map out a dental plan for the rest of your pregnancy. A visit to the dentist also is recommended in the second trimester for a cleaning, to monitor changes and to gauge the effectiveness of your oral hygiene. Depending on the patient, another appointment may be scheduled early in the third trimester, but these appointments should be kept as brief as possible. Return to top
Are there any dental procedures I should avoid?
Non-emergency procedures generally can be performed throughout pregnancy, but the best time for any dental treatment is the fourth through six month. Women with dental emergencies that create severe pain can be treated during any trimester, but your obstetrician should be consulted during emergencies that require anesthesia or when medication is being prescribed. Only X-rays that are needed for emergencies should be taken during pregnancy. Lastly, elective procedures that can be postponed should be delayed until after the baby's birth. Return to top
What is a Root Canal?
Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the pulp, which carries the tooth's nerves, blood vessels and connective tissue. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but no more than four root canals. Return to top
Why do I feel pain?
When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow and cellular activity, and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks. Return to top
Why do I need root canal therapy?
Root canal therapy is necessary because the tooth will not heal by itself. Without treatment, the infection will spread, bone around the tooth will begin to degenerate and the tooth may fall out. Pain usually worsens until one is forced to seek emergency dental attention. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift crookedly, resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal therapy. If you have the choice, it's always best to keep your original teeth. Return to top
What is a root canal procedure?
A root canal is a procedure done to save the damaged or dead pulp in the root canal of the tooth by cleaning out the diseased pulp and reshaping the canal. The canal is filled with a rubberlike substance called gutta–percha or another material to prevent recontamination of the tooth. The tooth is then permanently sealed, with possibly a post and/or a crown made of porcelain or metal alloy. This enables patients to keep the original tooth. Return to top
What is involved in root canal therapy?
Once your general dentist performs tests on the tooth and recommends therapy, he or she can perform the treatment or refer you to an endodontist (a pulp specialist). Treatment usually involves one to three appointments. First, you will probably be given a local anesthetic to numb the area. A rubber sheet is then placed around the tooth to isolate it. Next, an opening is drilled from the crown into the pulp chamber, which, along with the root canal, is cleaned of all diseased pulp and reshaped. Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, the tooth may be left open to drain or the dentist may go right ahead and fill the canals. If you're given a temporary filling, usually on the next visit it's removed and the pulp chamber and canal(s) are filled with gutta percha or another material to prevent recontamination. If the tooth is still weak, a metal post may be inserted above the canal filling to reinforce the tooth. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve appearance. Return to top
What are the risks and complications?
More than 95 percent of root canal treatments are successful. However, sometimes a procedure needs to be redone due to diseased canal offshoots that went unnoticed or the fracture of a filing instrument, both of which rarely occur. Occasionally, a root canal therapy will fail altogether, marked by a return of pain. Return to top
What happens after treatment?
Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic. A follow-up exam can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods with the treated tooth, and see your dentist regularly. Return to top
What is a Sealant?
A dental sealant is a thin plastic film painted on the chewing surfaces of teeth to prevent cavities. Return to top
How effective are sealants?
Studies have proven that properly applied sealants are 100-percent effective in protecting the tooth surfaces from cavities. As long as the sealant remains intact, small food particles and bacteria that cause cavities cannot penetrate through or around a sealant. Sealant protection is reduced or lost when part or all of the bond between the tooth and sealant is broken. However, clinical studies have shown that teeth that have lost sealants are no more susceptible to tooth decay than teeth that were never sealed. Return to top
How are sealants applied?
A cleaning solution is applied to the surface of the tooth, including the pits and grooves. After 15 seconds, the solution is thoroughly rinsed away with water. After the site is dried, the sealant material is applied and allowed to harden, sometimes by using a special curing light. Sealant treatment is painless and takes anywhere from five to 45 minutes to apply, depending on how many teeth need to be sealed. Sealants must be applied properly for good retention. Return to top
How long will a sealant last?
Sealants should last five years, but can last as long as 10 years. One study reported that seven years after application, an impressive 49 percent of treated teeth were still completely covered. Sealants should not be considered permanent. Regular dental checkups are necessary to monitor the sealants' bond to the tooth. Return to top
Who should receive sealant treatment?
Children, because they have newly erupted, permanent teeth, receive the greatest benefit from sealants. The chewing surfaces of a child's teeth are most susceptible to cavities. Surveys show that the majority of all cavities occur in the narrow pits and grooves of a child's newly erupted teeth because food particles and bacteria cannot be cleaned out. Other patients also can benefit from sealant placement, such as those who have existing pits and grooves susceptible to decay. Research has shown that almost everybody has a 95-percent chance of eventually experiencing cavities in the pits and grooves of their teeth. Return to top
Are sealants covered by insurance?
Insurance benefits for sealant procedures have increased considerably, especially as companies start to realize that sealants are a proven preventive technique. This preventive measure can help reduce future dental expenses and protect the teeth from more aggressive forms of treatment. Return to top
Why Are My Teeth Sensitive?
Tooth sensitivity is caused by the movement of fluid within tiny tubes located in the dentin (the layer of tissue found beneath the hard enamel that contains the inner pulp), which results in nerve irritation. When the hard enamel is worn down or gums have receded, causing the tiny tube surfaces to be exposed, pain can be caused by eating or drinking food and hot or cold beverages; touching your teeth or exposing them to cold air. Exposed areas of the tooth can cause pain and even affect or change your eating, drinking and breathing habits. Taking a spoonful of ice cream, for example, can be a painful experience for people with sensitive teeth. The excessive consumption of acid-containing foods and beverages such as citrus juices and fruits and soft drinks can also put you at risk for tooth sensitivity. Bulimia and acid reflux can also result in erosion of the hard enamel and sensitivity due to acid in the mouth. Return to top
Is tooth sensitivity a common condition?
Tooth sensitivity is one of the most common complaints among dental patients. At least 40 million adults in the United States suffer at some time from sensitive teeth. Return to top
How can I avoid sensitivity?
Some toothpastes contain abrasive ingredients that may be too harsh for people who have sensitive teeth. Ingredients found in some whitening toothpastes that lighten and/or remove certain stains from enamel, and sodium pyrophosphate, the key ingredient in tartar-control toothpastes, may increase tooth sensitivity. Return to top
What can I do about sensitive teeth?
Tooth sensitivity can be reduced by using a desensitizing toothpaste, applying sealants and other desensitizing and filling materials, including fluoride, by your dentist and decreasing the intake of acid-containing foods. Tartar-control toothpastes will sometimes cause teeth to be sensitive as well as drinking soft drinks throughout the day, so these habits should be avoided. Avoid using hard-bristled toothbrushes and brushing your teeth too hard, which can wear down the tooth's surface and expose sensitive spots. The way to find out if you're brushing your teeth too hard is to take a good look at your toothbrush. If the bristles are pointing in multiple directions, you're brushing too hard. Return to top
How do I know when it's time to see a dentist?
If a tooth is highly sensitive for more than three or four days and reacts to hot and cold temperatures, it's best to get a diagnostic evaluation from your dentist to determine the extent of the problem. Before taking the situation into your own hands, an accurate diagnosis of tooth sensitivity is essential for effective treatment to eliminate pain. Because pain symptoms can be similar, some people might think that a tooth is sensitive, when instead, they actually have a cavity or abscess that's not yet visible. Return to top
How do I describe my symptoms to my dentist?
Sensitivity may be defined as a short, sharp pain, which is usually initiated by eating hot or cold foods or exposure to cold air. Aching often follows. Because sensitivity may mean different things to a patient and dental professional, be sure to clarify exactly what you feel when you discuss the condition with your dentist. Be sure to tell the dentist when the pain started and if there is anything, such as the application of a warm compress, that helps eliminate the pain. Return to top
Do some products help decrease sensitivity?
Toothpastes for sensitive teeth usually contain a desensitizing agent that protects the exposed dentin by blocking the tubes in the teeth that are connected to nerves. In most cases, these products must be used on a regular basis for at least a month before any therapeutic benefits may be noticed. Return to top
What can the dentist do for my sensitive teeth?
Dentists have a variety of regimens to manage tooth hypersensitivity, including both in-office treatments and patient-applied products for home use. If you are diagnosed with dentin hypersensitivity, your dentist may apply a desensitizing agent or a protective coating. You may be prescribed a stannous fluoride gel or an over-the-counter desensitizing toothpaste containing fluoride and either potassium nitrate or strontium chloride. These ingredients help block transmission of sensation from the tooth to the nerve. It also might help to massage the special paste onto your gums with your finger after brushing. Return to top
What should I do after the dentist has applied a desensitizing agent?
Listen closely to your dentist's instructions. He or she may advise you not to eat or drink for a short period of time, to eliminate all sources of irritation, such as acidic foods or medication or flavored toothpastes. You may also be instructed to change oral hygiene habits that are likely to cause abrasion or use a daily fluoride application (a rinse or brush-on gel). Return to top
What is Temporomandibular Joint Disorder?
Temporomandibular joint disorder (TMD) describes a variety of conditions that affect jaw muscles, temporomandibular joints and nerves associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or develop after an injury. TMD affects more than twice as many women than men. Return to top
What is the temporomandibular joint?
The temporomandibular joint (TMJ) is a joint that slides and rotates just in front of your ear, consisting of the temporal bone (side of the skull) and the mandible (lower jaw). Chewing muscles connect the lower jaw to the skull, allowing you to move your jaw forward, sideways and open and close. The joint works properly when the lower jaw and its joint (both the right and left) are synchronized during movement. TMD may occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing. Return to top
What causes TMD?
Trauma to the jaw or jaw joint sometimes plays a role in TMD, but in most cases the cause of the disorder is unknown. Most experts suggest that certain tasks, either mental or physical, may cause or aggravate TMD, such as stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism). These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain. Return to top
What TMD symptoms can I experience?
Jaw pain or soreness that is more prevalent in the morning or late afternoon Jaw pain when you chew, bite or yawn Clicking when opening and closing your mouth Difficulty opening and closing your mouth Locked or stiff jaw when you talk, yawn or eat Sensitive teeth when no dental problems can be found An earache without an infection Return to top
What can I do to treat TMD?
The majority of cases can be treated by unloading (resting) the joint, taking a non-