frequently asked dental questions
To assist in answering questions that you may have, we have
compiled several frequently asked questions, listed below.
Please select a topic that you are interested in.
Cosmetic Dentistry:
How can I find a good cosmetic dentist?
The American Academy of Esthetic Dentistry is a prime
source (312-981-6770) of notable specialists and teachers
in all fields of dentistry. Or call local or state dental societies
or state dental schools, dental specialists, (i.e., orthodontists,
oral surgeons, etc.) Specialists and professionals in other
fields, (i.e., plastic surgeons, cosmetologists, models, actors
and/or agencies) often refer patients. Ask friends for a recommendation.
Is it possible for me to picture how I would
look after cosmetic dental treatment?
Yes. Many dental offices can use the latest
technology to offer you computer imaging, giving you a good
idea of what you can look like after cosmetic dental improvements.
Is there a good book about cosmetic dentistry
that I can buy?
Yes, Change Your Smile (Quintessence Publishing Company,
800/621-0387) is an excellent source of consumer information
on every phase of cosmetic dentistry.
back ^
Whitening:
How can I get the yellow out of my teeth?
The first step is to get a cleaning using a "prophy jet",
with a baking soda spray, for tooth polishing to remove
superficial stains as the last step. This will help your dentist
evaluate the type and amount of “real” discoloration
present in your teeth. Then, a two-step, in-office bleaching
technique using heat/lamp or the new laser approach, is combined
with the usual "matrix home bleach" for the safest,
quickest way to whiter teeth. Subsequent follow-up is recommended
to maintain your new tooth color.
I have dark stains; what can be done?
A good cleaning in the dental office with the "prophy
jet" using baking soda spray is a good start. In-office
bleaching using heat/lamp or the new laser technique, especially
when combined with matrix home bleaching can also help. If
your teeth are very dark it may take several treatments in-office, plus up to three months at home. You may also want
to consider replacing old fillings with tooth colored bonded
restorations and/or porcelain laminate veneers. If the stains
are bright orange, they may be caused by chromogenic bacteria
and may need polishing and/or antibiotics to correct the condition.
Another technique called mircoabrasion, which involves polishing
the stains with a mild acid in combination with bleaching,
may be useful, especially for white stains. The most important
thing is for you to have a consultation with your dentist,
who will help you make the correct decision and avoid problems.
My old fillings in the front have turned dark. Can
they be bleached?
Bonding and composite resin fillings do not bleach. Usually,
polishing may help, but if not, you can have the surface of
the fillings redone. Otherwise, it's time to replace with
newer bonding or porcelain laminates for longer lasting results.
Remember, only replace these fillings after bleaching in order
to match the new, improved color of your own natural tooth.
How long does bleaching last?
Each person is different. It depends on many factors including
your diet, the original color of your teeth, and each individual
tooth's ability to absorb the bleaching products.
Is there more than one way to bleach?
Yes. The in-office option is an external light source or
new laser techniques. An at-home matrix or nightguard used
with a carbamide peroxide gel will also bleach teeth, but
not as quickly. The combination of in-office followed by at-home
seems to provide the best results.
I have one dark tooth in the front. Will regular
at-home bleaching make it lighter?
External bleaching may not help. Internal bleaching may be
the solution if the tooth has had the nerve removed (root
canal treatment). If not, consider bonding, porcelain veneering,
or capping the tooth to mask the darkness.
I have been smoking for years -- can my teeth be
whiter?
Yes. Our external bleaching may or may not help. If not, the
teeth can be covered with a light composite resin bonding
or beautiful "stick on" porcelain laminates. However,
continued heavy smoking will unfortunately shorten the longevity
of any treatment result.
Does a special whitening toothpaste really lighten
teeth?
Most "whitening toothpastes" remove some surface
stains, but they will not bleach the teeth as effectively
as bleaching gels or solutions that contain the bleaching
agent carbamide peroxide. Even if the toothpaste does contain
some bleaching chemicals, the length of time in which the
paste is in contact with the teeth is insignificant compared
with using a bleaching solution and a form-fitted matrix, or
especially an in-office treatment. Also, these toothpastes
may have harmful abrasives that can wear away tooth structure
over time.
back ^
Perio:
I have a "gummy" smile . . . can anything
be done?
Yes! Cosmetic gum raising and/or tissue sculpting is an excellent
choice. Sometimes orthodontics can help, as well as orthognathic
surgery. You need to get a consultation with a good cosmetically-trained
restorative dentist, periodontist, surgeon and an orthodontist.
Your best bet is to visit a dental office that have all these
specialists working together in the same facility.
My gums have shrunk, making my teeth look larger;
what can be done?
Sometimes a gum graft can be done to cover sensitive roots
and stop the downward progression of your gums. New techniques
with little discomfort and great results are available. You
may also need bonding, or other restorative treatment, as
part of the treatment plan.
There is a dark line on my tooth at the gum line
-- what causes that?
Usually a metal margin on a crown or a dark root. Look for
a dentist who makes crowns with "porcelain margins or
all ceramic crowns." Visit the dentist to determine the
exact cause and best solution.
My gums bleed when I brush or floss. Is this normal?
No! A thorough soft tissue evaluation including x-rays, with
a prophylaxis (cleaning) and good homecare instructions are
an essential beginning. Usually bleeding is a beginning symptom
of gingivitis or periodontal disease, and may require conventional
gum surgery if necessary. Seek a dentist who can do different
forms of treatment from simple cleaning of the teeth to antibiotic
therapy, and, as a last resort, surgery.
How often should I have my teeth cleaned?
Each person is different...twice a year is based on most insurance
coverage, but most patients need to have a professional dental
cleaning every 3 to 4 months. Decay and gum disease are caused
by bacteria in a colony that takes about 8-10 weeks to become
destructive, or must be removed or broken up within this base
period.
Why do I need to have x-rays? Won't they cause cancer?
X-rays show a variety of things not seen by a visual exam,
including bone loss, tooth decay, impacted teeth, some tumors,
and cysts. Most dental x-ray machines today are low dosage.
For the very concerned patient, a new technology called radiovisiography
uses the lowest amount of radiation. For instance, an entire
set of complete x-rays is equal to one conventional x-ray
using 90% less radiation.
My son chews tobacco -- will it cause cancer?
It sure can! Chewing tobacco has an even higher risk than
cigarettes because of the concentration of tobacco. Chewing
tobacco is a high-risk cancer producer.
back ^
Restorative:
My crown in the front doesn't match my teeth -- it
looks fake. What can be done?
This is the hardest thing to do in dentistry-match a single
front tooth. Look for an excellent cosmetic dentist who works
with a "master ceramist" in his or her office. Sometimes
it is necessary to do more than one tooth. In that case, bonding
or porcelain laminates might be the answer. Remember, it takes
a great deal of artistry involved on the part of the dentist
and ceramist.
What's a cap? What's a crown?
A cap and a crown are the same thing. The entire tooth surface
is reduced and usually replaced with artificial material such
as porcelain or porcelain bonded to metal.
I've lost a tooth. What can be done?
Today’s dentistry offers many options.
1. Tooth bonded back in place
2. A removable appliance
3. A fixed bridge
4. An implant and crown
What's the difference between bonding and porcelain
laminate veneers?
Bonding is a tooth-colored plastic (composite) resin material
and is done in one visit (little tooth reduction, no anesthesia
required). Porcelain laminate veneers can mask dark stains
better with less long-term chipping than bonding. They are
made by a ceramist and do not stain, offering greater choice
in color, shape, and vitality. They require only two office
visits.
What's the difference in cost between bonding and
veneers?
Generally bonding is 1/2 to 1/3 of the cost of veneers or
crowns. Your best bet is to review the fee range and advantages/disadvantages
for all procedures in Change Your Smile (Quintessence
Publishing Company).
How long does a bonding/veneer last?
On the average, bonding last three to eight years. Porcelain
laminate veneers lasts four to twelve years or more.
Why should I spend a lot of money on a root canal?
Why not just pull the tooth?
Losing a tooth can be the beginning of many more lost teeth.
Saving the tooth maintains space, keeps other teeth from shifting,
and eliminates the need and cost of a bridge or implant and
crown. Although seemingly expensive, it is actually quite
cost-effective.
I have so many dental problems; sometimes I think
I should just pull out all my teeth and get dentures.
To be able to wear a denture comfortably requires sufficient
retention. Bone is invariably lost when teeth are pulled and
then continues to reabsorb and shrink back, resulting in poor-fitting
loose dentures. These consistently require remaking and never
function as natural teeth. Eating, speech and overall functions
are severely compromised. Most times, even if the root can
be saved, a good dentist can give a patient good functioning
and esthetically-pleasing, long-lasting teeth. Today, dental
implants, used to anchor a denture, add stability and are an
ideal choice for most denture patients.
I have a space between my two front teeth. How can
it be closed?
There are several ways in which this can be corrected:
1. Orthodontics is the best way (multiple visits)
2. Bonding (one visit)
3. Porcelain laminate veneers (two visits)
4. Crowns (two visits)
My teeth are too small -- can I have bigger teeth?
Yes. it's possible either with composite resin bonding, porcelain
laminate veneers or full crowns if they break or are already
broken. Have a consultation which will include esthetic computer
imaging to see how you can look with long or perhaps wide
teeth.
My "canine" teeth are too pointed. Help! I
look like a vampire!
Cosmetic contouring or reshaping your natural teeth would
be the best possible procedure for this. It only takes one
quick, painless appointment to improve your look.
My teeth are uneven, what can I do?
Cosmetic contouring, porcelain laminate veneers, orthodontics,
bonding, or crowns can be used to correct this.
I was hit in the mouth and my teeth are broken, chipped,
and cracked. What can I do?
Translumination or an intraoral camera can be used to determine
the extent of the cracks. Your possible choices to correct
the problem would be:
1. Bonding
2. Porcelain laminate veneers
3. Porcelain crowns
I have big dark silver fillings . . . can they be
made tooth-colored?
Yes. Possible tooth colored replacement choices include:
1. Composite (plastic) resin
2. Porcelain inlay/onlay
3. Porcelain crowns
My teeth stick out in the front. Are braces my only
option?
No. Many times a compromise can be suggested after a cosmetic
consultation.
Possible options include:
1. Cosmetic contouring
2. Bonding
3. Porcelain laminate veneers
4. Crowns
Keep in mind that orthodontics is usually the best choice
for these situations.
My teeth don't show when I smile.
1. Orthodontics is your best bet -- the teeth can usually
be brought down enough to show. However, at times orthognathic
surgery may be suggested as well.
2. Bonding or porcelain laminate veneers or full crowns are
a possible compromise.
back ^
Halitosis:
What can I do about bad breath?
It may be coming from your teeth or gums, but usually it's
from bacteria colonizing on the back of the tongue. A comprehensive
breath evaluation and bacterial culture can determine the
best form of treatment. See a dentist who uses a new diagnostic
device called the Halimeter with bag culturing to help diagnose
the extent of your problem. There are remedies available today
to combat this problem. Mouth rinses (chlorine dioxide) and
tongue scrapers help get rid of the bacteria that cause these
odors.
back ^
Orthodontics:
I'm in my 50's. Am I too old for braces?
No. Many adults are choosing tooth-colored ceramic braces,
which hardly show. A removable appliance may even work with
certain patient problems. Orthodontics is usually the most
cost-effective treatment because it means eliminating
the cosmetic problem while retaining your natural teeth. Restorative
treatment always has a limited "life expectancy" on any
restorations, meaning you will have to continually pursue
whatever treatment you choose.
My chin recedes. Is there anything that can make
me look normal, besides a chin implant?
1. Orthodontics is a good place to start, but most
times the treatment will have to be coordinated with an orthognathically-trained
oral surgeon.
2. Orthognathic surgery (jaw advancement)
3. Work with a team -- orthodontist, oral surgeon, and restorative
dentist.
My teeth are loose.
Have a teeth cleaning (prophylaxis), full mouth x-rays,
and periodontal probing to determine why they are loose. Chances
are you will want to have a consultation with a periodontist
to help determine the cause and develop a plan to treat the
condition.
My denture makes me look old and it doesn't fit well.
Is there anything that can be done?
The first step is to arrange for a cosmetic evaluation
as your lipline (smileline) can be evaluated and proposed
correction can be shown to you using computer imaging. This
way you can be certain you will like the look of the new dentures.
I've heard about dental implants; what are they?
They are an excellent means of replacing missing
teeth. The titanium implant, osseointegrates, (biologically
binds) to the bone, and a full crown goes on top. The result
is a natural-looking, secure tooth replacement.
My dentist told me I've lost bone in my jaw. . .
can it be re-grown?
Often the lost bone can be restored -- bony ridges
can be augmented and even places where there is no bone can
be improved considerably. These procedures are called “guided
bone regeneration,” or "bone grafts". Ask
your dentist if you are a candidate.
How do I know if I am a good candidate for implants?
An evaluation with diagnostic records and a CT-Scan
which is a 3-dimensional type x-ray that accurately measures
the amount of bone remaining to anchor the implants.
How long do implants last?
Statistics indicate that they may last in excess
of 35 years. Once successfully integrated with the surrounding
bone, implants have a long-term potential as natural teeth,
if properly taken care of.
How long have implants been around?
The current cylinder type of titanium has been used
in excess of 30 years. Implants were invented in 1957 in Stockholm,
Sweden. They were then tested in the 1960's and introduced
in Europe and the U.S. in the 1970's and early 1980's. Implants
are safe and provide for an excellent option for people with
missing teeth.
What is the success rate of implants?
Highly successful. Implants boast low infection potential,
no rejection by the body, ninety-five to ninety-eight percent
success rate for the lower jaw, and eighty-six to ninety-two
percent success rate for the upper jaw. However, implants
must be maintained by the patient with proper oral hygiene
and frequent dental exams and cleanings.
back ^
Other Treatments:
My jaw looks like Jay Leno's jaw. . . . Can anything
be done for me?
Yes. Orthognathic surgery can be quite effective in correcting
this condition. Esthetic imaging can show you how you will
look with your new chin.
My jaw locks, pops, creaks or clicks.
This requires a visit to a dentist or oral surgeon who treats
temporomandibular problems. Sometimes these problems require
no treatment.
I need a face lift and some dental work . . . which
should I do first?
Do the dental treatment first and optimize your smile. That
way, you will not have someone tugging on your lip or cheeks.
My smile is crooked.
No problem. Although orthodontics is the ideal way to correct
this condition, sometimes an alternative method using restorative
treatment with bonding, laminating, or full crowns can make
a pleasing result.
back ^
Tips:
Do you have any general advice for me before I seek
treatment?
- Before intended cosmetic dental treatment, insist on having
your smile computerized to make certain you will like the
result.
- Make certain you understand the realistic life expectancy
of each potential solution to your problem.
- Try to match your need for esthetic perfection with both
the dentist and laboratory technician's ability to deliver
for you.
Tips for Getting the Smile You Want!
1. Don’t perpetuate an unattractive smile. Some people go from dentist to dentist looking for that ideal smile, but settling for a “one-tooth-at-a-time” strategy—a new filling here, replacing a crown there, or bonding a chipped tooth. The wiser choice is to approach the mouth holistically, starting with a detailed face and smile analysis, and then developing a plan.
2. Don’t take your first steps in looking younger by beginning with skin resurfacing or a face lift. A smile makeover should be the first step in making the face look younger. Recreating the silhouette and shape of the teeth, straightening their alignment, and whitening the color—these are the three aspects of cosmetic smile rejuvenation that are essential to youthful appearance.
3. Discuss with your dentist how “conservative” you want the teeth preparations to be. Be specific beforehand since some dental techniques, such as crowning, call for almost complete tooth enamel removal. And even the more conservative porcelain laminate can be a disaster for you if the dentist’s technique calls for almost TOTAL enamel reduction. So there are different techniques and you need to have a clear picture about what will and will not be done to you.
4. Educate yourself as to the advantages and disadvantages of each type of restoration, as well as their predicted “life spans.” Your present dentist may or may not be the best person to change your smile. Read this and more in the consumer guide to cosmetic dentistry, Change Your Smile (Quintessence Publishing).
5. You need to match your need for the best results with the best referral. Sources are the American Academy of Esthetic Dentistry and the American Academy of Cosmetic Dentistry, as well as the dental schools in your state. Unfortunately, most local dental associations refer on a rotating basis to members and many search engines list those dentists who pay for the placement of their listing.
6. Make sure the dentist you select uses high-tech diagnostic devices to help make a thorough, functional, as well as cosmetic, evaluation before giving you a plan of treatment. For instance, a tiny intra-oral camera can show an enlarged image of your teeth by 20X so both you and the dentist should be able to see any tooth defects you have. This can help prevent accidental tooth fractures and/or tooth loss. Digital X-rays can be enlarged to the size of a TV monitor, aiding the dentist in diagnosing potential problems in the early stages. Another essential diagnostic tool is laser detection technology that helps find and predict cavities that cannot usually be seen by just examining your teeth even with magnifying glasses.
7. No doubt you have read advertisements for products that did not measure up to their claims. Well, dental ads are no different. Most are written by advertising agencies that are paid well for creating clever phrases and images. Real credentials are difficult to evaluate. Don’t be fooled by those that have founded their own “learning institute” and listed themselves as members. More reliable are dentists that list academic dental school professorships. Authors of dental textbooks, dentists who teach at recognized dental schools and those who have advanced specialty degrees may have the qualifications you are looking for.
8. Check the Better Business Bureau in the city where you live to make sure the dentists you are considering to do your smile makeover have a good record of pleasing patients. They will have a record of complaints filed against dentists.
9. You want no surprises. Everything should be clear in advance, including details of the treatment plan, the extent of tooth reduction, any surgery required, options and any compromises possible, as well as the fees. Will the dentist you consult with be doing all the treatment or just part of it? Don’t be afraid to ask questions.
10. NEVER hesitate to get a second or even third opinion. This will allow you to visit other offices and see what they have to offer. It will also provide you with a different analysis of the treatment plan given to you by the first or second dentist. Don’t give up until you have the smile that you always wanted!
back ^
|
