Dental Tips Blog


Misconceptions About Braces

Posted in Braces

Braces have come a long way in recent years, but there are many misconceptions about braces that make patients hesitant about getting braces.  This is very unfortunate because braces not only improve a patient’s smile, but they can also improve a patient’s overall health.

First up is the discomfort issue.  There is no question that having braces is less comfortable than not having braces, but modern braces are far more comfortable than those used 15 to 20 years ago.  Smaller brackets, more precise adjustments, and shorter treatment times mean that patient discomfort is minimized.

Next, it used to take years for braces to do their work but these days braces are usually worn about one to two years.  Improved techniques and more precise adjustments minimize the time it takes to complete the process.  For patients without bite issues, the procedure can be completed in as little as six months.

Recent innovations in orthodontics have made the “metal mouth” look a thing of the past.  There are many different alternatives to traditional metal braces that are much less noticeable.  These include invisible braces such as clear or tooth colored braces, inside braces that attach to the back of the patient’s teeth, and invisible aligners which work like braces but use a clear plastic tray or guard to move the teeth.

Finally, to prevent the patient’s teeth from shifting after treatment a retainer was traditionally worn for a year or two after the braces come off.  We now understand that teeth can shift at any time and maintaining tooth alignment may require wearing the retainer indefinitely, at least at night.


Replacing Fillings

Posted in Fillings

Regular dental cleaning and checkups are very important for maintaining good oral health.  If tooth decay is identified during a check-up, your dentist will repair the tooth by removing the decay and placing a dental filling.  Dental fillings normally last for many years.  The length of time varies depending on the patients’ oral hygiene habits, how well the placement was done, and other variables but in general an amalgam (silver) filling can be expected to last 10 to 15 years.  Composite (white or tooth colored) fillings don’t last quite as long – about 5 to 7 years.

Dental fillings are under a lot of stress from chewing, grinding teeth, and clenching.  Over time, a filling can wear away or it can chip, crack, or fall out of the tooth.  Fillings can wear around the edges and leave a small space between the filling and the tooth enamel.  Bacteria can enter this space and cause tooth decay around the filling.

Good oral hygiene including good brushing habits will help reduce the incidence of tooth decay around fillings.  Brushing twice a day and daily flossing will reduce the amount of decay causing bacteria and help prevent tooth decay.  Regular dental check-ups can identify a damaged filling or tooth decay around a filling before extensive damage occurs.

Worn, chipped, and cracked fillings should be replaced promptly.  In most cases, the filling can be replaced but if the patient waits until the tooth hurts or the filling falls out, the tooth may have too much damage to repair.  In this case, your dentist will need to install a crown instead of replacing the filling.


Types of Restorations

Posted in Crowns

There are a range of different types of restorations for restoring damaged or decayed teeth.  These include fillings, inlays, onlays, and crowns.  Which type of restoration is best depends on  the extent of the damage, the health of the remaining tooth, and the chewing load the tooth is expected to bear.

Dental fillings are referred to as direct restorations because they are formed and placed by the dentist in the office during a single visit.  Crowns, inlays, and onlays are called indirect restorations because they are made in a dental laboratory and require at least two visits to the dentist’s office.  During the first visit the tooth will be prepared and a mold will be made and sent to the lab.  During the second visit the dentist will cement the restoration in place.

Fillings are the restoration used for the most minor damage.  The dentist removes the decay from the tooth and fills the cavity with amalgam (silver color) or composite (tooth colored) filling material.  Fillings are only effective when there is sufficient healthy tooth to support the filling.  A filling that is too large will leave the tooth weak which could cause it to break or crack.

For much more extensive damage to the tooth, the dentist removes the decay and damaged material and will also remove enough additional tooth material to allow a crown to be placed over the tooth.  A crown (also called a cap) is made in a dental laboratory and cemented in place by your dentist.  The crown completely encircles or “caps” the tooth and provides a strong restoration for a seriously damaged tooth.

Dental inlays and onlays are used to repair damage that is too much for a filling, but not enough for a crown.  Inlays and onlays are indirect restorations similar to crowns, but cover less area of the tooth.  An inlay fits in between the cusps or rounded edges of the tooth while an onlay covers one or more of the cusps or even the entire biting surface.


Don’t Put Off Regular Dental Checkups

Few people look forward to visiting the dentist, but regular dental cleanings and check-ups can protect your oral health and protect your wallet!  Avoiding the dentist might save a little money and inconvenience in the short run, but in the long run you will spend far more money on expensive dental restorations and you will end up facing exactly what you were trying to avoid in the first place:  a long, uncomfortable session in the dental chair.

The irony to all this is that regular dental check-ups and cleanings are the most important and effective way to avoid expensive and uncomfortable dental procedures.  Most dental issues start out as small problems such as some minor tooth decay that causes a small cavity to form.  Most people will not even notice it, but your dentist will see it during a check-up and can place a filling during a relatively short, comfortable and affordable procedure.

However, if you avoid regular dental check-ups, the decay will go unnoticed until it starts to cause you some pain and discomfort.  By this time, the decay has caused a large cavity and extends all the way to the tooth’s pulp which is why it has become painful.  Repairing this extensive tooth damage will require much more extensive and uncomfortable dental work.

A root canal may be needed and it’s likely that a cap will need to be placed instead of a filling.  You may even need a bridge or an implant.  All of these procedures are far more expensive than a filling and typically require multiple visits to the dentist.

The lesson to be learned here is don’t wait until your teeth hurt to go to the dentist.  Have regular dental check-ups and cleanings and get those cavities filled promptly.


Direct Dental Restoration Alternatives

Posted in Fillings

Direct restorations refers to fillings that are placed in your teeth during a single visit such as amalgam (silver colored) fillings and composite (tooth colored) fillings.  Indirect restorations usually take more than a single visit because the restoration is made in a dental laboratory and include crowns, caps, inlays, and onlays.

Advances in dental materials and techniques have given you and your dentist more options for direct dental restorations of damaged or decayed teeth.  Most traditional materials such as amalgam and gold still have a place in modern dentistry due to their lower cost, strength, and durability.  Future developments will likely result in even better materials with attributes that rival their traditional counterparts.

Choosing the right material for dental fillings depends on various factors including the patient’s oral health, the strength of the tooth after the decayed material has been removed, where the filling will be placed, and the chewing load that will be placed on the tooth.

Amalgam is the silver colored material that has been used for dental fillings by dentists for over 100 years.  It’s durability and relatively low cost assures that it will continue to be a popular material for restorations, especially in back teeth where the silver color will not be as obvious.  Amalgam is strong and can tolerate high chewing loads which makes it a great choice for molars.  The silver color can be a negative for many patients, especially for front teeth that will show when the patient smiles or talks.  Amalgam can also be sensitive to hot or cold.

Composite fillings are made from a resin mixture and are dyed to match your tooth color.  They are not as strong or as durable as amalgam, but they are an attractive option for front teeth that are visible when a patient speaks or smiles.  These teeth have lower chewing loads which makes composite fillings ideal.  Composite fillings take a little longer to place and are usually a little more expensive than amalgam.


Adult Braces

Posted in Braces

If you are an adult and are unhappy with your smile, consider joining the millions of American adults who are using braces to get the smile they have always wanted.  Braces aren’t just for adolescents anymore.  In fact, almost half of orthodontic patients are adults and experts say age does not matter when it comes to using braces to get straighter teeth and a more attractive smile.

If concerns about that “metal mouth” look have been holding you back, you will be pleased to know that in the past 15 years braces have improved considerably.  These days there are many options available that are far less obtrusive than traditional full banded metal braces.

Ceramic braces are similar to traditional braces except that they are made from tooth colored ceramic material that blends in with your teeth.  Since they are not shiny metal, they are much less noticeable than traditional braces.

Another option is inside braces that attach to the back of the patient’s teeth instead of the front.  These are almost unnoticeable, but some patients have difficulty getting used to them.

Invisible braces are a great option for adults.  Instead of using brackets and bands affixed to the teeth, invisible braces use a series of clear removable “trays”  called aligners that fit over the patient’s teeth.  The aligners are computed designed so that each aligner applies gentle pressure to move the teeth a little further than the previous aligner.  An aligner is worn for two to three weeks and then replaced with the next one.  These are nearly invisible and can be removed for eating and cleaning.

Finally, consider six months braces.  This procedure uses clear or tooth colored braces and focuses on aligning just the patient’s front teeth.  Since the procedure does not attempt to address bite problems or severe misalignments, it is usually completed in six months.



Affordable Dental Care

Finding affordable dental care can be a challenge, but don’t be one of the millions of Americans who simply don’t get much needed dental care because they think they can’t afford it.  Neglecting your dental health might save some money in the short run, but in the long run you will end up spending much more for extensive dental work.  The most cost-effective solution is to take good care of your teeth and that includes regular dental cleanings and check-ups and taking care of small dental problems before they can become large problems.

Over half of Americans these days do not have dental care insurance.  Dental insurance is expensive, especially if you have to buy your own policy, but having insurance is a great way to manage your dental care costs.  When you have dental insurance, you can be confident that you won’t be hit with large dental bills at a time when you can least afford it.  You will be more likely to get the dental care you need and you will avoid expensive dental work due to neglect.

If you don’t want to buy insurance, there are ways to manage costs.  One option is to enroll in a dental discount plan or prepaid dental plan.  These plans are not insurance, but instead provide members with steep discounts on dental care as long as you go to a dentist who participates in the plan.

If there is a dental school in your area, they usually offer dental care at significantly reduced prices.  You will receive care from a dental student without much experience, but all students are under the supervision of a licensed dentist.

Finally, see if your dentist offers a discount for payment in advance.  Many dentists offer a discount to patients who pay in full up front.  It’s worth it to them to avoid billing hassles and the risk of non-payment and it’s a nice incentive for the patient.



Conquering Mild Dental Anxiety

If you have been avoiding your dentist due to dental anxiety, you will be happy to find out that dentists offer a wide range of sedation that can help you conquer that dental anxiety and provide you with a comfortable, stress free dental experience.  Dental anxiety is very common and it is believed that about 15% of the population has some form of dental anxiety.  It can range from being anxious and tense throughout your dental treatment to a full blown dental phobia which causes patients to become terrified at even the thought of going to the dentists.

Patients with severe dental anxiety or dental phobia are probably better off seeing a dentist that specializes in sleep and sedation dentistry, but mild to moderate dental anxiety can usually be addressed by most dentists.

Communication with your dentist is critical.  Unless your dentist knows about your anxiety, he or she cannot help you.  Don’t be shy or embarrassed about bringing up the subject with your dentist.  As mentioned previously, dental anxiety is very common and your dentist wants you to have a good dental experience.

Many dentists practice sedation dentistry using nitrous oxide to help patients with mild to moderate dental anxiety.  Nitrous oxide or “laughing gas” is administered through a small mask while the patient is in the dental chair.  It works quickly to relax the patient and the effect is similar to being mildly intoxicated.  The patient is calm and relaxed and can easily tolerate the dental procedure.

An advantage of nitrous oxide is that it wears off quickly after the procedure is completed.  The patient can drive themselves home from the appointment without any problems.  Side effects are rare, but some patients may experience nausea.


Wisdom Teeth Extraction

Posted in Oral Surgery

Wisdom teeth are the third set of molars that typically erupt in teenagers and young adults.  Because they are the last set of teeth to erupt, there is often little or no room left and they can cause all sorts of problems such as crowding and poor bite.  For many adults, wisdom teeth will come in sideways and become impacted.  Impacted wisdom teeth cause pain, swelling, and infection.  They can also cause the surrounding teeth to shift and affect the patient’s bite.

In addition, impacted wisdom teeth can lead to the formation of tumors and cysts in the bone and gum tissue.  There is also some indication that wisdom teeth aggravate sinus congestion and cause headaches.  There are a few advantages to keeping wisdom teeth, but in most cases the problems caused far outweigh any advantage and they need to be removed.

Removing impacted and un-erupted wisdom teeth is much more difficult than removing an erupted tooth and most dentists do not handle the procedure.  An oral surgeon has the equipment, training and skill necessary to remove impacted and un-erupted wisdom teeth.  In most cases, the patient will be kept comfortably sedated or under a light general anesthesia during wisdom teeth extraction.

After the wisdom teeth are extracted, the patient can expect some moderate pain and swelling.  The pain can usually be controlled with acetaminophen or ibuprofen and the swelling will subside after 3 to 5 days.  In the meantime, applying an ice pack to the affected area will help reduce the swelling.

The patient may have stitches and if so, will need to return to the dentist’s office to have them removed.  Most patients are fully recovered in 5 to 7 days except for the gum area which may take up to 4 weeks to completely heal.


Dental Treatment For Sleep Apnea

If you are one of the millions of Americans who are affected by obstructive sleep apnea (OSA) and want to explore your treatment options, talk to your dentist about whether a mandibular advancement device (MAD) is a good option for you.  These devices are also known as a mandibular advancement splint and are only a treatment option for obstructive sleep apnea.  Central sleep apnea requires different types of treatment.

The two common treatment options for obstructive sleep apnea are a continuous positive airway pressure machine (CPAP) and mandibular advancement devices. A CPAP machine supplies the patient with a stream of air through a mask worn while sleeping.  Many patients find CPAP machines uncomfortable, noisy, and difficult to adapt to.

A mandibular advancement device is a sleep apnea appliance that fits over the patient’s upper and lower teeth and is worn while the patient is asleep.  It treats sleep apnea and snoring by moving the jaw forward and opening up the airway.  A mandibular advancement device is much less obtrusive than a CPAP.  It is silent and while it takes some patient a little while to get used to wearing the device, it is much more comfortable than a CPAP.

One problem encountered with mandibular advancement devices is that they can move a patient’s teeth over time if they are improperly fitted.  It is very important to have the device properly fitted and adjusted by a dentist with the proper training and experience.  Never buy a mandibular advancement device from a vendor who claims that no fitting is needed.  These devices can cause serious dental problems.  Avoid these problems by obtaining the device from a qualified dentist and follow up with regular dental checkups.

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