Ask The Dentist

Common Dental Questions

Welcome to our “Ask the Dentist” section. We have collected several frequently asked questions from people about dental care. Please feel free to email us with a dental question. We will answer it online here for everyone.

Q. I’d like to have a tooth colored filling. I know that they’re more expensive than amalgam silver, but does the better quality warrant their cost over silver?

A. Silver had been the standard filling of choice in America for about 115 years. The Chinese were the first people to use silver fillings about 3000 years ago. “Amalgam” as we refer to silver, has advantages as a dental restoration. Its ease of use, durability and low cost made it a good choice for filling cavities. However, modern technology has brought materials into the dental industry that eliminates many of the problems with silver fillings.

1) Independent research has conducted experiments that indicate Amalgam fillings may leak harmful mercury into the body.

2) X-rays. Your dentist is not able to x-ray through a tooth that has a silver filling. The reason why this is a problem is that if you have tooth decay underneath your filling your dentist may not be able to detect it. The first sign that there is a problem may be when you have a toothache and by then saving the tooth can become very expensive.

3) Micro leakage. When a filling is placed inside a cavity small amounts of bacteria may leak in between the silver and your tooth which may lead to further tooth decay.

4) Appearance. A tooth colored filling will blend in with your natural teeth.

Composite (tooth colored) fillings on the other hand are bonded to the inside walls of your teeth leaving very little opportunity for micro leakage. All in all I would say that in most cases a composite filling would be the filling of choice.

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Q. Are drills really becoming obsolete? I’ve now heard on several occasions about lasers and sand blasters to remove decay. Do these really work?

A. Well, by no means has the drill become obsolete. I’m sure that we all look forward to the day when dentists no longer need to use rotary instruments, such as the drill, to remove decay, mostly due to that screeching sound. However, modern technology is racing through the dental industry and this does include the use of both lasers and sandblasters to remove tooth decay. Although these technics are very effective, they are limited to very small cavities. This works well on small children and often times eliminates the need for an anesthetic injection.

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Q. My 10 year old child brushes his teeth regularly and he doesn’t eat a bunch of candy, yet it still seems that at his six month checkup, he will have developed new cavities. What do you think could be our problem?

A. Well you’re not alone and I see this more often than I’d like. The main reason that children are more likely to have new cavities is because their teeth are still developing and are therefore less mineralized (or softer) than adult teeth. Your child’s teeth will not be fully developed until their late teenage years. During this period of time you should do the following: Observe your child’s brushing making certain that the area where the teeth meet the gums is being brushed well enough to remove all pasty particles. This will prevent decay from forming at the gum line and maintain healthy gums. Having your child floss during his favorite TV program is an excellent way to begin this essential habit. Sealants can be applied to all the adult back teeth and will help prevent cavities on the chewing surface. And last, but not least, you should discuss a regular fluoride program with your dentist. Both in office and at home treatments are available.

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Q. I was told that I should get sealants on my child’s teeth. What are they and are they really necessary?

A. Sealants are a polymer resin that is brushed on the chewing surface of your child’s adult teeth. This polymer resin is bonded to the surface of the teeth with an ultra violet light. This is an excellent procedure for the purpose of preventive dentistry. Your child’s teeth have many grooves on the chewing surface. We refer to these grooves as pits and fissures. When sealants are not used, food particles will accumulate in these grooves and begin to decay. The by-product of this decay is lactic acid which destroys tooth enamel, leaving a cavity that needs to be filled. The sealants act as a protective coating between the lactic acids and the tooth enamel. This procedure is relatively inexpensive and considerably less expensive than filling a cavity.

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Q. My dentist said that I will require root canal work. Wouldn’t it just be a lot easier to have him extract the bad tooth?

A. Most people cringe at the mere mention of a root canal. Well, I have to tell you that maybe 25 years ago the “cringe” was justified, but with the quality of today’s anesthetics and technics the procedure should be virtually pain free. The first thing we should cover is why some teeth need root canal therapy (RCT). Inside the tooth there is living tissue. When a tooth receives trauma, such as a sports injury, or in most cases, tooth decay, the living tissue begins to die. As this tissue dies it decays and becomes infected. If left untreated this infection can travel into the jaw bone. An extraction could be an immediate solution, however; there are many clinical reasons why one tooth extraction can lead to a domino effect of tooth loss in the future. What Root Canal Therapy does is that it allows the dentist to remove the dying tissue by creating an access hole through the top of the tooth. Once the inner tissue is removed the canal is filled, and the tooth will remain functional for many years to come.

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Q. I just can’t afford insurance, so unfortunately I have been unable to make an appointment with a dentist for a few years. My teeth are not hurting so is a checkup really needed?

A. Absolutely! Not having insurance means that preventive maintenance and regular cleanings are a must for you. Due to the expense of operative dentistry, getting your teeth cleaned twice a year and having small cavities filled is far less expensive than waiting for a tooth ache to come along, which may require a root canal or a crown (cap). Visiting your dentist on a regular basis for check-ups and cleanings allows you to maintain a healthier mouth. Small cavities can be filled before they become too deep and require major operative dentistry. Note these comparisons: Regular 6 month cleanings over a four year period may cost you about $360. About $90 per year. On the other hand, the person who has a small cavity that goes unnoticed, since there is usually no pain associated with a small cavity, runs the risk of the cavity traveling all the way to the nerve inside the tooth, which would then require a root canal and crown at a cost of approximately $950. Case studies have shown that in the long run people who visit their dentist on a regular basis spend far less money than those who wait for something to start hurting before making a dental appointment.

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Q. I’m wearing full upper dentures right now. The remaining six bottom teeth I have are in pretty bad shape. I’d rather not have them pulled since I’ve heard that lower dentures don’t fit very good. Other than dental implants, what options do I have?

A. This is a very common scenario and you’ve heard right, lower dentures typically do not fit as well as upper dentures. However, a rather simple technique does exist that can make your lower denture actually fit, as good, if not better, than your existing upper denture. What your dentist can do is extract all but the two healthiest teeth from your lower jaw. Next, those two teeth are shaved down to the gum line, so that the roots are still solid in the jaw bone, but you no longer see the portion of the tooth that used to rise above the gums. The dentist then places a precision attachment to the top of the root. A precision attachment is very similar to the snaps used on clothing. The concept is very simple: You put half of the snap on top of the root and the other half in the denture. The end result is a very secure lower denture.

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Q. I’m considering having my teeth bleached. Does bleaching actually work? Also, do those bleaching kits from drug stores perform as well as the custom ones your dentist makes for you?

A. Yes, bleaching does really work, although results do vary from patient to patient. Just as your skin contains millions of pores your teeth contain millions of what are referred to as tubules. These tubules will eventually absorb particles that will in time cause your teeth to discolor. Smoking and coffee drinking will accelerate this process. When a bleaching solution is applied to your teeth the chemical is absorbed into these tubules, bleaching out the discoloration and whitening your teeth. There’s a few good reasons why a custom fit bleaching system from your dentist is more effective than the over the counter products. The over the counter trays are designed to fit in your mouth but are not custom fit to your teeth. Therefore, there is little control over where the bleaching solution goes. Since the chemical is an irritant to the gums, these over the counter solutions have to be made considerably weaker, therefore less effective. The trays made by your dentist are custom fit to your teeth and prevent the chemicals from getting on your gums. Therefore, your dentist will provide you with a much stronger and more effective bleaching solution.

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Q. One of the main reasons I haven’t gone to the dentist regularly is because frankly, I’m scared. I really want to make the appointment; what do you suggest that might relax me?

A. Well the most important thing you need to know is that you’re not alone. I am amazed at the number of people who are scared to death of being in a dental chair. Most of the reasons for people’s apprehension are purely psychological although some are justifiable through past dental experiences, especially if your first office visit took place during the 1950’s or 1960’s when the quality of rotary instruments and anesthetics were not nearly as good as they are today. In today’s dentistry we have anesthetic patches than can replace the shot and rotary instruments that spin so fast that the grinding is over before you know it. Although today’s dentistry is much more pleasant than it was just 20 years ago, a mild sedative can be prescribed by your dentist for those patients who can’t get themselves to relax. And by all means let your dentist know that you don’t like going to the dentist. He’s only heard this a thousand times and will probably go out of his way to make you feel comfortable.

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Q. I have a space between my front teeth and they’re a little crooked also. Do I have any options, other than braces?

A. Although I’m certain that orthodontics would correct your problem, some people would rather not wear braces if they don’t have to. After a thorough orthodontic consultation with your dentist you may consider placing porcelain or composite veneers over the surface of your existing teeth. A porcelain or composite veneer is a tooth shield similar to a false finger nail. This tooth shield (or veneer) is fabricated by a dental laboratory using very durable and natural looking materials. The front surface of your natural teeth would be slightly adjusted to reduce some of the crooked corners and prepare space for a laboratory fabricated veneer. The lab can design a new size and shape for your teeth. When the veneers are completed your dentist will bond the veneers right to the surface of your natural teeth. The net effect is a very conservative procedure with very nice results.

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Q. With such a huge variety of toothpastes available, does it matter which brand I use? My grandma just used baking soda; what’s best?

A. The kind of toothpaste that you choose to use is fairly insignificant. It is the process of mechanically removing food particles off the surface of the teeth that is most important. Allowing food particles to remain on the surface of your teeth is what allows the process of tooth decay to begin. What’s good about commercial toothpaste is that most of them contain a mild abrasive which helps remove plaque. Now about your grandmother’s idea. She was absolutely correct. In fact mixing your baking soda with a 3% solution of hydrogen peroxide before brushing could help you maintain excellent dental health for your entire life. Before you get over the fact that it doesn’t taste as good as fudge sundae the benefits begin. Not only is the baking soda a mild abrasive, the sodium bicarbonate will neutralize the acids that cause cavities. Additionally the sodium will also reduce periodontal inflammation improving the health of your gums. The 3% hydrogen peroxide solution will penetrate the gums killing the bacteria that leads to gum disease.

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