Here are some frequent questions we hear from our patients about various treatments and topics in dentistry. If you have a question that is not listed here that you would like answered, please email us or talk to one of your doctors and we will be glad to discuss it with you and possibly post it here for others to read!


How often should I brush and floss?
What is plaque and calculus (tartar)?
How often should I have dental exams and hygiene visits (cleanings)?
What causes bad breath (halitosis) and what can I do to treat halitosis?
What are dental implants?
Do I have to go to more than one doctor to get dental implants?
What are the benefits of implants?
Who is a candidate for dental implants?
What does the dental implant procedure involve?
How long does an implant last?
How much does an implant cost as compared to other forms of dentistry?
Do implants require any special care?
Is there any chance of rejection of the dental implant?
What will happen without treatment?
Do I have to get my teeth capped to get rid of spaces between my front teeth?
Is tooth whitening safe?
Is gum surgery essential if I have periodontal (gum) disease?
If periodontal disease is such a problem, why doesn't it hurt?

Q. How often should I brush and floss?

A. We recommend brushing at least twice a day (morning and before bedtime) and flossing everyday. Brush for at least 2 minutes devoting 30 seconds to the "4 Quadrants" of your mouth: Upper Right, Lower Right, Lower Left, Upper Left. We also recommend the Sonicare toothbrush for optimal results with homecare. Please visit www.sonicare.com for more information.

Flossing should be done daily to help remove food and plaque debris from in between the teeth and gums. Food left between the teeth is the major causative factor for cavities that occur between teeth. When you have a preventive care appointment with one of our hygienist, they will review the different techniques for brushing and flossing to help keep your smile healthy!

Q. What is plaque and calculus (tartar)?

A. Plaque is a combination of saliva, food debris, and bacteria and bacterial by-products. Bacterial colonies have the means to actually stick and adhere to tooth structure. The intial layers of plaque usually start to form within 24 hours of brushing, which is why it is so important to brush twice daily to keep plaque from accumulating. Calculus is plaque that has not been mechanically removed by brushing and is calcified from the minerals in our saliva. Calculus is extremely difficult to remove with any toothbrush and has to be removed with professional hygiene instruments at a dental office.

Q. How often should I have dental exams and hygiene visits (cleanings)?

A. Depending on your level of plaque, homecare habits and general health, many people are advised to visit the dentist every 6 months for routine preventive care and exams. We recommend check-ups every 3-4 months for some patients with different dental conditions such as periodontal disease.

Seeing the denist regularly is vital in maintaing optimal health and preventing major dental problems from occuring in the future. At the exam and/or hygiene visit, we will:

• Review your medical and dental history including medications/allergies/and past surgical history
• Take diagnositic radiographs (x-rays) to help give us a complete picture of your current dental status. Radiographs can also help us detect bone loss and any changes that may be indicative of benign or malignant neoplasms or growths
• Full head and neck exam to check for muscle pain, joint function, skin changes, oral cancer screenings and overall oral health
• Gum and bone evalution to check for the presence of gingivitis or periodontitis
• Review and evalutaion of current dental restorations and evaluation for dental cavities
• Smile evalution to assess your satisfaction with your current smile
• Oral hygiene instruction for homecare
• Thorough prophylaxis (cleaning) to remove all plaque and calculus
• Review of proposed treatment and discussion of treatment plan

We feel it is so important to include you, the patient, in the treatment planning and decision making process. It is our goal to provide you with the best possible dental care and staying current with your regular preventive care visits will help us in acheiving that goal.

Q. What causes bad breath (halitosis) and what can I do to treat halitosis?

A. There are many causes for halitosis. Here are a few known causes:

• Poor hygiene habits- food and plaque left behing after cleanin that promotes bacterial growth
• Foods-many foods that contain strong odor-compounds are exhaled through the lungs after they enter the bloodstream
• Periodontal disease-inflamed gum tissue due to the chronic presence of calculus
• Dry mouth (xerostomia)-many medications are notorious for causing this side effect
• Tobacco products
• Certain medical conditions and illness
• Dieting-"no carb" diets release compounds called ketones which have an odor
• Dehydration-water consumption helps increase saliva flow which can help counter-act bad breath
• Cavities and non-hygienic dental prosthesis-partial or complete dentures that are not cleaned properly

One of the main ways to combat halitosis is to practice good oral hygiene, including brushing and scraping your tongue. The tongue is a major source of the more than 500 species of bacteria that is found in our oral cavities. Brushing and scraping away the film of bacteria that is found on our tongues can help reduce halitosis. Stay hydrated and stay away from tobacco products!

For patients taking medications or who are going through radiation therapy for head/neck cancer, there are certain saliva analogues and medications that we can prescribe to help regain some salivary function and keep the mouth lubricated.

Q. What are dental implants?

A. People often refer to a dental implant as a replacement tooth, but it is actually a metal post (usually titanium) or appliance that replaces the patient's tooth root or roots. Once the implant is placed in the bone, the crown is placed on top by either a screw or cement and is anchored firmly to the bone by the implant. The patient's new teeth look, feel and work just like natural teeth. There are several types of dental implants suited to various dental conditions.

Q. Do I have to go to more than one doctor to get dental implants?

A. Many times patients are referred to and Oral Surgeon or Periodontist for the acutal placement of the implant itself. The procedure is almost always done under local anesthesia which is used when a patient has common dental procedures such as fillings or crowns. The referring dentist will then finish the treatment by fabricating the crown that attaches to the implant thus restoring the look and feel of a natural tooth.

Q. What are the benefits of implants?

A. Dental implants have really become the standard of care for replacing missing teeth. Dental implants will allow a patient to function in such a way that they can chew, talk, and clean the implant in the same way as a natural tooth. Implants also offer exceptional esthetic results.

Q. Who is a candidate for dental implants?

A. Because of recent advances in implant technology, more and more people are implant candidates - although many people may be told they are not. The only way to know for certain is to be evaluated by a practitioner who has received advanced training in implant dentistry. Typically, if a patient is healthy enough to undergo fixed bridgework procedures or routine extractions, he or she can also undergo dental implant procedures. Here are a few cases where implants would be a viable treatment modality:

• The patient who cannot function comfortably with conventional dentures.
• The patient who has lost teeth and wants to avoid removable partial dentures.
• The patient who needs a crown or fixed bridge but doesn't want to damage his or her adjacent healthy teeth by removing tooth structure.
• The person who wants to have the dental solution that is the closest to what Mother Nature created.

Q. What does the dental implant procedure involve?

A. Most implants can be placed by a trained dentist or specialist in one or two office visits. Further visits will also be needed to fit the replacement teeth, which fasten to the implants. In addition, it is possible that some bone structure will have to be added to the patient's jaw or that other adjustments may have to be made. Tested methodologies now exist that can effectively and safely add bone where needed. This process can delay the placement of the implant for a period of months. Most insertions can be performed under the same local anesthesia used for routine fillings. Medication so the patient can sleep during the procedure is available with oral conscious sedation or IV sedation. Temporary teeth are sometimes placed until permanent replacement teeth are made so that a patient's esthetics and function are not compromised during the interim.

Q. How long does an implant last?

A. Implants are currently the longest lasting fixed dental prosthesis that we can offer with today's treatment technology. Most implant cases have long term (over 10 years) success rates in the mid to upper 90th percentile. We recommend a preventive maintenance program to help insure the long-term success of your implants and teeth.

Q. How much does an implant cost as compared to other forms of dentistry?

A. The cost of implant dentistry is comparable to that of fixed bridgework or other advanced dental procedures in most cases. The advantage of dental implants compared to other fixed prosthesis is that many crowns/bridges need to be replaced at some point whereas implants have much higher long-term success rates. The cost of replacing previous treatment will many times exceed the cost of a one-time implant procedure fee.

Q. Do implants require any special care?

A. Dental implants and accompanying replacement teeth should be cared for in the same way as natural teeth. Although they cannot get decay, they are still subject to gum disease and bone loss in the same way natural teeth are.

Q. Is there any chance of rejection of the dental implant?

A. The body doesn't reject a dental implant as it might a soft tissue implant such as a lung, heart or kidney. Dental implants are most often made of titanium, which is a very biocompatible material. Certain medical conditions such as severe diabetes and autoimmune disorders may lower the success rates of dental implants. Smoking has been linked to a decrease in implant success rates as well.

Q. What will happen without treatment?

A. When you lose your teeth, you gradually lose the bone that supports the teeth. As this bone shrinks, problems with a lack of support lead to increased discomfort, mobility, lack of retention of dentures, and sharp, painful ridges, movable gums and sore spots. The tongue also enlarges to accommodate the space. With tooth loss, a five-fold decrease in function occurs and the diet shifts to softer foods. When bone is lost, the incidence of numbness to the lower lip or even fracture of the jaw increases. In addition, this progression will affect our ability to provide the treatment we could have before so much bone loss. It could require more implants or more extensive treatment. Or, it may be possible that we will not be able to provide the same treatment we recommend now. At its worst, the bone loss could be so severe that the only way for the person to have teeth of any kind would require a hip graft (taking bone from the patient's hip).

Q. Do I have to get my teeth capped to get rid of spaces between my front teeth?

A. In most cases capping to correct spaces isn't necessary. Today with beautiful, natural looking porcelain veneers we can easily make dramatic cosmetic changes to remove spaces, fix cracked teeth, do minor tooth straightening, and change the color of your teeth. In many instances, little or no tooth structure needs to be removed to create the smile of your dreams. Another option for spacing and misalignment is orthodontics which will often provide long term correction without the need for prosthetic treatment.

Q. Is tooth whitening safe?

A. Whitening procedures are safe and approved by the American Dental Association. Bleaching does not wear away any tooth structure or make a tooth more susceptible to staining.

Q. Is gum surgery essential if I have periodontal (gum) disease?

A. We have found, many times, surgery is not necessary following a conservative course of periodontal treatment. This type of care typically includes a series of nonsurgical gum treatments. Even when surgery is required, it often is needed only in a few areas of the mouth and results can be greatly enhanced by nonsurgical preparation.

Q. If periodontal disease is such a problem, why doesn't it hurt?

A. Periodontal problems can become quite serious and extremely advanced without any pain whatsoever. That is why it is so important to be attentive to the warning signs - bleeding gums when brushing and flossing, swollen gums, receded gums, teeth changing position, pus or swelling around gums - to name a few.