FAQS

1. They stain over time, may chip and may need to be replaced more often.
2. Porcelain veneers are thin layers of stacked porcelain that are fabricated in the lab and bonded to teeth.
3. It usually takes 2 visits. Little tooth reduction and some anesthesia are required.
4. Porcelain veneers are stronger than dental bondings and less prone to staining.

• Persons with diets high in sweets, carbohydrates, and sugars
• Persons who live in communities with limited or no fluoridated water supplies
• Children and senior citizens

For more information on this condition, please refer to the Periodontal Disease section of our Patient Education Library.

1. Brackets, metal or plastic, clear or tooth-colored, that is bonded to teeth.
2. Lingual-type brackets that attach to the back of teeth, hidden from view.
3. Bands that cover most of the teeth with metal bands that wrap around the teeth.

All three types use wires to move the teeth to the desired position.

• Bacteria and plaque build-up
• Cysts development (a fluid-filled sac)
• Tumor development
• Infection
• Jaw and gum disease

1. In individuals who smoke before their recommended time. Smoking: decreases healing, decrease blood supply to the protective blood clot, brings toxic products to the area, injuries the gum tissue and the negative pressure of sucking removes the blood clot from the surgery site.
2. If you do not care for your extraction site as instructed by staff.
3. Not following your home care instructions.
4. Sucking action from smoking, sneezing, coughing, spitting or sucking, within the first 24 hours.
5. Women taking oral contraceptives are more susceptible.

Although teeth are the strongest substance in the whole body, they may chip or break due to various reasons. Some of the most common reasons are biting into something hard accidentally, tooth with a large filling, root canal treated tooth that is not capped and tooth undermined due to decay.

What to expect

Depending on the extent of fracture your tooth may be sensitive to temperature and pressure changes. Rinse your mouth gently with lukewarm water. Take a pain reliever if needed. See your dentist as soon as possible so he can determine the course of treatment.

How is it treated?

Fractures may involve only the superficial outer part of the tooth (enamel). In such a case your dentist may lightly polish the area to smooth the rough surfaces or place a filling and observe the tooth for further changes. If the fracture involves the enamel and the inner sensitive dentin your dentist may have to place a crown due to the extent of involvement. This will protect the tooth and prevent further damage. Sometimes fractures may involve the enamel, dentin and the nerve tissue inside the tooth. This will necessitate a root canal treatment and a crown. If the crack extends beyond the gum line it may require a crown lengthening procedure, which involves removal of bone to grasp enough healthy structure for the crown. However, if the crack extends to the root the tooth cannot be saved and will have to be removed.

Canker Sores

Canker sores are shallow, painful sores in your mouth. They are usually red or may sometimes have a white coating over them. You may get them on the inside of your lips, the insides of your cheeks, the base of your gums or under your tongue. Canker sores are different from fever blisters, which usually are on the outside of your lips or the corners of your mouth.

Anyone can get canker sores, but women people in their teens and 20s get them more often. Canker sores may run in families, but they aren’t contagious. Causes of canker sores are unknown but they may be triggered by stress, poor nutrition, food allergies, spicy foods and menstrual periods.

Treatment

Canker sores usually go away without treatment. However, for pain relief your dentist may recommend medicines such as Anbesol, Oragel, Orabase and Zilactin-B, which may prevent your canker sores from becoming irritated by eating, drinking or brushing your teeth. These medicines can be applied directing on the sore with your finger tip or a Q-tip. Gently dry the sore with a swab before applying. Do not eat or drink anything for 30 minutes after applying.

Prevention

Unfortunately, causes of canker sore formation are unknown. However, using toothpaste that does not contain SLS (sodium lauryl sulphate), avoiding hard, crunchy or spicy foods and chewing gum may help reduce mouth irritation. Brushing your teeth after meals, using a soft toothbrush and flossing every day will also keep your mouth free of food that might cause a canker sore. If you get canker sores often, or if they’re very painful, talk to your dentist.

Operculitis

Operculitis is an inflammation of the gum tissue found over partially erupted teeth. The most frequent site is the mandibular third molar region. The heavy flap of gingival tissues covering portions of the tooth crown of the tooth makes an ideal pocket for debris accumulation and bacterial incubation. In the acute phase, pain and swelling in the area are prominent features. Symptoms of a sore throat and difficulty in swallowing may be present. A partial contraction of muscles of mastication, causing difficulty in opening the mouth (trismus), may also be experienced. Abscess formation in the area may occur, leading to marked systemic symptoms of general malaise and fever.

Treatment involves careful cleaning below the flap and saline irrigation. It may also require antibiotic therapy if the condition warrants. Your dentist may decide to incise the gingival flap to make the area self cleansable. If in the third molar area it may require the extraction of the tooth.

What is bruxism?

Bruxism is the term that refers to an incessant grinding and clenching of the teeth, unintentionally, and at inappropriate times. Bruxers (persons with bruxism) are often unaware that they have developed this habit, and often do not know that treatment is available until damage to the mouth and teeth have been done. Damage caused by bruxism often includes the following symptoms. However, each individual may experience symptoms differently.
Symptoms may include:

• Abraded teeth
• Facial pain
• Oversensitive teeth
• Tense facial and jaw muscles
• Headaches
• Dislocation of the jaw
• Damage to the tooth enamel, exposing the inside of the tooth (dentin)
• A popping or clicking in the TemporoMandibular Joint (TMJ)
• Tongue indentations
• Damage to the inside of the cheek

The symptoms of bruxism may resemble other conditions or medical problems. Consult a dentist or your physician for a diagnosis.

What causes bruxism?

Although this habit is unintentional, oral health specialists often point to excessive stress and certain personality types as typical causes of bruxism. Bruxism often affects persons with nervous tension such as anger, pain, or frustration, and/or persons with aggressive, hurried, or overly-competitive tendencies.

Treatment for bruxism:

Treatment may involve:

• Behavior modification
• Night Guard
• A specially-fitted plastic mouth appliance may be worn at night to absorb the force of biting. This appliance may help to prevent future damage to the teeth.
• Biofeedback involves an electronic instrument that measures the amount of muscle activity of the mouth and jaw — indicating to the patient when too much muscle activity is taking place so that the behavior can be changed. This is especially helpful for daytime bruxers.

It is best if you refrain from using words around your child that might cause unnecessary fear, such as needle, pull, drill or hurt. Pediatric dental offices make a practice of using words that convey the same message, but are pleasant and non-frightening to the child such as sleepy juice for the anesthetic, vacuum for the suction and so forth.

Risk factors that put a person at a higher risk for tooth decay include:

• Persons with diets high in sweets, carbohydrates, and sugars
• Persons who live in communities with limited or no fluoridated water supplies
• Children and senior citizens

1. proper chewing and eating
2. providing space for the permanent teeth and guiding them into the correct position
3. and permitting normal development of the jaw bones and muscles

Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) are not replaced until age 10-13.

Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the childs teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child would not fall asleep without the bottle and its usual beverage, gradually dilute the bottle’s contents with water over a period of two to three weeks.

After each feeding, wipe the babys gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the childs head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the childs mouth easily.

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a “nerve treatment”, “children’s root canal”, “pulpectomy” or “pulpotomy”. The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and in the case of primary teeth, filled with a resorbable material. Then a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

Eruption Of Your Childs Teeth

Childrens teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.

Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.

Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).

For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.

The American Academy of Pediatric Dentistry recommends six month visits to the pediatric dentist beginning at your childs first birthday. Routine visits will start your child on a lifetime of good dental health.

Your pediatric dentist may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your childs molars to prevent decay on hard to clean surfaces.

Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride free toothpaste, using no toothpaste, or using only a “pea size” amount of toothpaste.

Some of these sources are:

• Too much fluoridated toothpaste at an early age
• The inappropriate use of fluoride supplements
• Hidden sources of fluoride in the childs diet

Two and three year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.

Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.

Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities. Another source of fluoride can be found in soft drinks at fast food restaurants, when blending the syrup and carbonation with the city water supply.

Parents can take the following steps to decrease the risk of fluorosis in their children teeth:

• Use baby tooth cleanser on the toothbrush of the very young child
• Place only a pea sized drop of children toothpaste on the brush when brushing
• Account for all of the sources of ingested fluoride before requesting fluoride supplements from your childs physician or pediatric dentist
• Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities)

Children who benefit the most from fluoride are those at highest risk for dental decay. Riskfactors include a history of decay, high sucrose carbohydrate diet, orthodontic appliances and certain medical conditions such as dry mouth.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding gets less between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.

• Instead of scolding children for thumb sucking, praise them when they are not
• Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking
• Children who are sucking for comfort will feel less of a need when their parents provide comfort
• Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents
• Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue
• If these approaches do not work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance

There are many risks involved with oral piercings including chipped or cracked teeth, blood clots, or blood poisoning. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!

Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.

So follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.

Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.

If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:
A sore that would not heal White or red leathery patches on the lips, and on or under the tongue Pain, tenderness or numbness anywhere in the mouth or lips Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.

Because the early signs of oral cancer usually are not painful, people often ignore them. If it is not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill. Help your child avoid tobacco in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums and cheek

Stage I – Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.

Stage II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your childs hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.

Stage III – Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.

Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.

Ask your pediatric dentist about custom and store-bought mouth protectors.

Your pediatric dentist can help your child avoid oral habits that may create orthodontic problems.

Brackets, metal or plastic, clear or tooth-colored, that is bonded to teeth, Lingual-type brackets that attach to the back of teeth, hidden from view, and Bands that cover most of the teeth with metal bands that wrap around the teeth. All three types use wires to move the teeth to the desired position.

Promptly contact with your pediatric dentist when an appliance breaks to keep orthodontic treatment on-time and on-track.

Canker sores are shallow, painful sores in your mouth. They are usually red or may sometimes have a white coating over them. You may get them on the inside of your lips, the insides of your cheeks, the base of your gums or under your tongue. Canker sores are different from fever blisters, which usually are on the outside of your lips or the corners of your mouth.

Anyone can get canker sores, but women people in their teens and 20s get them more often. Canker sores may run in families, but they aren’t contagious. Causes of canker sores are unknown but they may be triggered by stress, poor nutrition, food allergies, spicy foods and menstrual periods.

Treatment

Canker sores usually go away without treatment. However, for pain relief your dentist may recommend medicines such as Anbesol, Oragel, Orabase and Zilactin-B, which may prevent your canker sores from becoming irritated by eating, drinking or brushing your teeth. These medicines can be applied directing on the sore with your finger tip or a Q-tip. Gently dry the sore with a swab before applying. Do not eat or drink anything for 30 minutes after applying.

Prevention

Unfortunately, causes of canker sore formation are unknown. However, using toothpaste that does not contain SLS (sodium lauryl sulphate), avoiding hard, crunchy or spicy foods and chewing gum may help reduce mouth irritation. Brushing your teeth after meals, using a soft toothbrush and flossing every day will also keep your mouth free of food that might cause a canker sore. If you get canker sores often, or if they’re very painful, talk to your dentist.

Operculitis

Operculitis is an inflammation of the gum tissue found over partially erupted teeth. The most frequent site is the mandibular third molar region. The heavy flap of gingival tissues covering portions of the tooth crown of the tooth makes an ideal pocket for debris accumulation and bacterial incubation. In the acute phase, pain and swelling in the area are prominent features. Symptoms of a sore throat and difficulty in swallowing may be present. A partial contraction of muscles of mastication, causing difficulty in opening the mouth (trismus), may also be experienced. Abscess formation in the area may occur, leading to marked systemic symptoms of general malaise and fever.

Treatment involves careful cleaning below the flap and saline irrigation. It may also require antibiotic therapy if the condition warrants. Your dentist may decide to incise the gingival flap to make the area self cleansable. If in the third molar area it may require the extraction of the tooth.