Ask The Doctor

We've provided answers to a number of commonly asked dental questions. If you have a question that is not addressed here, please call us at (508) 379-0900. We look forward to resolving all of your dental concerns.

• What causes bad breath?
• Is there an easy way of repairing my chipped tooth?
• Is tooth bleaching safe?
• What are porcelain veneers?
• Why do I need a crown instead of a bigger filling?
• Why should I replace silver-mercury fillings?
• What do I do if my tooth is loose or knocked out?
• How do I manage dry mouth?
• What is periodontal disease?
• What are dental implants?
• What should I do if I lose a tooth?
• What is tooth decay?

Q: What causes bad breath?

A: While bad breath might be a symptom of some other disorder, it most likely stems from dental decay and periodontitis. Periodontitis is a disease affecting gums and bone that support the teeth, and it results from inadequate tooth brushing and flossing. In this disease, the irritated gums pull away from the teeth and form pockets between the teeth and the gums. These pockets fill with bacteria which give off a foul odor.

Patients with bad breath need a complete dental evaluation. If gum disease and/or dental decay are diagnosed, it can be treated readily. The patient will no longer have an infection in his or her mouth, and he or she will no longer have the embarrassment of bad breath.

Q: Is there an easy way of repairing my chipped tooth?

A: Cosmetic bonding is an affordable, quick and painless way to repair many cosmetic flaws or injuries, including:

• Gaps in teeth
• Spots or stains
• Chipped teeth

Dental bonding sculpts individual teeth without requiring removal of any tooth structure. This technique bonds a composite material that looks, acts and feels like the real thing, to an existing tooth. This procedure usually doesn't require the use of an anesthetic; is relatively quick to apply; gives an immediate result and is less expensive than veneers.

Q: Is tooth bleaching safe?

A: Bleaching is a safe, effective and relatively easy means of producing a whiter smile. We offer several options for whitening your teeth.

• In-office bleaching- A bleaching solution is applied to your teeth and is activated by heat and light. This in-office procedure typically lasts 30 minutes to one hour and significantly whitens teeth after only one visit. Although stubborn stains may require another visit, results generally last for years and can be maximized with regular dental hygiene.
  
  
• At-home bleaching- During a visit to your dentist, you will be given a whitening gel and fitted with a custom-made whitening tray. Once you return home, you apply the gel to the tray and wear it for two to three hours per day for two or three weeks.

Even with today's advanced whitening techniques, not everyone's teeth will whiten with the same results. During the visit with your dentist, your situation will be carefully evaluated and you will be advised accordingly.

Q: What are porcelain veneers?

A: Porcelain veneers are often used for the same reasons as bonding; to lighten stains, close gaps and even alter crooked or malformed teeth. You can change the shape, color and length of your teeth using veneers. They are thin, durable shells designed to cover the front of the tooth. They are typically made of porcelain and are extremely durable, stain resistant, natural-looking and easy to maintain.

Veneers are custom-fitted to your teeth by removing a small amount of enamel and bonding the veneer to your teeth using a safe, high tech polymer resin. You can expect veneers to stay bright and strong for many years by performing good oral hygiene.

Q: Why do I need a crown instead of a bigger filling?

A: Teeth are often restored using silver or composite fillings. However, when too much of a tooth's structure is removed to support a filling, a crown or "cap" may be needed. A crown may be needed to:

• Restore a tooth when it is unable to support a large filling
• Attach bridges
• Protect a weak tooth from fracturing or restore fractured teeth
• Cover badly shaped or discolored teeth
• Cover dental implants

A crown essentially covers a tooth to restore it to its natural shape and size. This permanent covering fits over your original tooth to strengthen or improve the appearance of the tooth. Fitting a crown generally requires at least two visits to the dentist's office.

Q: Why should I replace silver-mercury fillings?

A: Until recently, dentists used an inexpensive silver and mercury amalgam to fill and seal cavities. Because silver fillings do not bond to a tooth, a chamber must be cut into the tooth that is larger than the exterior. This "undercut" keeps the filling in the tooth. Because a larger amount of the original tooth must be removed, these types of fillings often weaken teeth.

Recent innovations now allow us to replace old silver fillings with composite or porcelain fillings that are stronger, safer and more natural looking. Unlike silver fillings, composite fillings bond to the tooth and provide more protection from fracturing. The quartz-like material is layered into the tooth and hardened with highly intense visible light. The final surface is shaped and polished to match the tooth, making it virtually invisible to the naked eye. Say goodbye to "metal mouth" and hello to a beautiful new smile.

Q: What do I do if my tooth is loose or knocked out?

A: Know the proper first aid for saving a loose or dislocated tooth. If the tooth is loose, even extremely so, but is still attached in any way, leave it in place; do not remove it. If it is out of its socket completely and unattached, but still in the victim's mouth, it is best to have the person hold it there, if possible, until a dentist can attempt re-implantation. If it is out of the mouth, do not let it dry out. Handle it as little as possible.

Do not attempt to disinfect the tooth, or scrub it, or remove any tissue attached to it. If it is recovered from the ground or other soiled area, rinse it off in lukewarm water. Preserve it in milk until a dentist is available. If milk is not available, lukewarm water will suffice.

Time out of the socket is critical in the long-term success of re-implantation. After 30 minutes, the success potential begins to decline. However, re-implantation is still possible after several hours, so the attempt can still be made even if the tooth has been out for a long period.

Q: How do I manage dry mouth?

A: More seniors today have retained their own teeth, avoiding the trauma of removable dentures. Many are on medications creating dryness of the mouth as a side effect. Without the natural benefit of saliva to decrease bacterial action, we see an increase of cavities on the root surfaces of these patients. Anyone on a medication causing a dry mouth effect should be encouraged to see their dentist for regular dental cleanings and topical fluoride rinses.

Q: What is periodontal disease?

A: Gum disease, or more correctly called "periodontal disease", is a bacterial infection in the gums and supporting structures of the teeth. It is characterized by gum tissue that is red, puffy, and bleeds easily when touched with a toothbrush, floss or dental instrument.

Advanced periodontal disease destroys the bone supporting the teeth, causing eventual tooth loss. The treatment is more involved at these stages, usually consisting of a special cleaning with anesthesia and sometimes gum surgery. Periodontal disease can go on for years without pain and without detection unless specific examination procedures are performed. Effective prevention and treatment is available, but the damage caused as the disease progresses is irreversible. Early detection and treatment is critical to prevent tooth loss and disfigurement.

Q: What are dental implants?

A: The loss of just a single tooth can set a course that can destroy an entire mouth. Teeth will drift and tip into a space that is created by missing teeth. When you lose a tooth, a dental implant may be needed to replace the tooth root and crown. Dental implants are simply "anchors" that permanently support replacement teeth. They are secure and durable and can be cleaned and cared for much like your natural teeth.

The procedure requires a titanium root be fitted into your jaw to replace the lost tooth's root. Once the implant is anchored into the bone, the bone around the implant requires six weeks to six months of healing. Once the bone has healed, a support post and replacement tooth is anchored onto the implant.

Q: What should I do if I lose a tooth?

A: When a tooth is missing, the resulting gap will allow nearby teeth to tilt or drift from their normal position, and the teeth above the gap will move downward. Aside from the obvious cosmetic problem, the changed positions of these teeth can lead to severe bite problems causing jaw pain and headaches.

Missing teeth should be replaced to keep other teeth in their normal position. This can be done by means of a fixed bridge or a dental implant. Both of these treatments offer a good functional and cosmetic result.

Q: What is tooth decay?

A: Tooth decay occurs when bacteria in dental plaque damages the enamel of your teeth, leaving a hole or cavity. Any part of a tooth can decay, from the roots below the gum line to the chewing surface. If plaque bacteria reach and damage the pulp, the tooth will likely die, because the pulp contains nerves and blood vessels that supply the tooth. Tooth decay can occur due to a number of issues, including poor brushing and flossing habits, diets rich in sugar, the presence of risk factors such as smoking and lack of fluoride in the water supply.