FAQ's

Q. Which type of toothbrush should I use?
A. The brand of toothbrush is not as critical as the type of bristle and the size of the head. A soft toothbrush with a small head is recommended because medium and hard brushes tend to cause irritation and contribute to gum recession and tooth abrasion. A small head allows you to get around each tooth more completely and is less likely to injure your gums.

Q. Is one tooth paste better to use than others?
A. Generally, no. However, it is advisable to use a fluoride containing toothpaste to decrease the incidence of dental decay. We recommend our patients use what tastes good to them as long as it contains fluoride. There are some toothpastes that we would recommend to some patients for sensitive teeth or to re-mineralize early decay.

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Q. How often should I floss?
A. Flossing of the teeth once per day, preferably in the evening helps to prevent cavities from forming between the teeth where your toothbrush can't reach. Flossing also helps to keep your gums healthy.

Q. What is local anesthesia?
A. Local anesthesia has dramatically changed dentistry. We are able to provide quality care that requires slow and judicious treatment while the patient is pain free and comfortable. Patients have two concerns regarding dental injections. The first being the discomfort of the injection itself and then if the anesthesia will be adequate to provide pain free treatment. The ability to provide pain free or almost pain free injections is mostly in the control of the dentist. Below is a list of steps that can be taken-

1. Relax the patient with a few minutes of conversation
2. Use a topical gel to start surface numbness
3. Inject very slowly
4. Give the injection in two steps…inject a little to numb the gum, wait, then complete the rest of the injection totally pain free.
5. Wait an adequate amount of time for the anesthesia to take effect.

Today we use extremely thin, very smooth surface, disposable needles. This adds tremendously to the pain free effect.

When injections are used for routine dental treatment the outcome is usually favorable. When there is infection and pain there are reasons why anesthesia may not be 100% effective. When there is an infection, patients many times present with a “HOT” tooth. The body produces chemicals in response to infection. They are inflammatory markers such as prostaglandins, histamine, kinins, and substance P. They enter the nerve and can prevent the anesthetic from having an effect. The Ph or acidity of the tissue is also altered by inflammation. This also prevents local anesthetics from having their full effect. When inflamed you may be given antibiotics in lieu of treatment to reduce the inflammatory process so that the anesthetic can provide better anesthesia at the next visit.

I hope this short discussion on local anesthesia will allay some of your fears and explain what a dentist can do to make your dental care as comfortable as possible.

Q. What's the difference between a crown and a cap?
A. These are restorations to repair a severely broken tooth by covering all or most of the tooth after removing old fillings, fractured tooth structure, and all decay. The restoration material is made of gold, porcelain, composites, or even stainless steel. Dentists refer to all of these restorations as crowns . They are the same.

Q. What's the difference between a bridge and a partial denture?
A. Both bridges and partial dentures replace missing teeth. A bridge is fixed to the abutment teeth or, in some cases, implants. A partial denture is attached by clasps to the teeth and is easily removed by the patient. Patients are usually more satisfied with bridges than with partial dentures.

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Q. What about silver fillings versus white fillings?
A. Although the U.S. Public Health Service issued a report in 1993 stating there is no health reason not to use amalgam (silver fillings), more patients today are requesting white or tooth-colored composite fillings. We also prefer tooth-colored fillings because they bond to the tooth structure and therefore help strengthen a tooth weakened by decay. White fillings are also usually less sensitive to temperature, and they also look better. However, white fillings cannot be used in every situation, and if a tooth is very badly broken-down, a crown will usually be necessary and provide better overall satisfaction for the patient.

Q. Do I need to have a root canal just because I have to have a crown?
A. No. While most teeth which have had root canal treatments do need crowns to strengthen the teeth and to return the teeth to normal form and function, not every tooth needing a crown also needs to have a root canal. Root canal treatment is needed for root infections, decay or fracture close to or entering the nerve or a dead or dying nerve due to trauma, decay or fracture. The dentist may recommend root canal if the decay or fracture is close to the nerve, or has been there for a while since experience shows that these situations frequently lead to nerve death over time.

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