FAQ Topics:

• Fillings & Restorative Materials
  
• Dentures
  
• Decay & Disease
  
• Children
  
• Brushing & Tooth Whitening
  
• X-rays
  
• Bad Breath
  

1. What is dental decay and how does it occur?
   

   Dental decay or cavities (dental caries) is a destruction of the tooth enamel (outer layer of a tooth) by a bacterial infection. Cavities occur when certain foods containing carbohydrates (starches and sugars) are not brushed from the tooth surfaces. Foods such as milk, candies, soda, cakes, etc., contain carbohydrates. Bacteria that live in the mouth grown and thrive on these carbohydrates and, as a by-product of their growth, produce acids. These acids are responsible for destroying tooth enamel and other tooth layers, resulting in the formation of dental caries. Therefore, diet, bacterial mouth components, genetics, salivary flow, and frequency of brushing and flossing all influence the dental caries rate in any given individual.

2. How can I prevent dental cavities?
   

   Any adult or child can help themselves to prevent dental decay by doing the following items on a regular basis:

   - Brush at least twice a day with a fluoride containing toothpaste;
   - Use dental floss or an interdental cleaner daily;
   - Use a tongue cleaner/scraper on a daily basis;
   - Eat well balanced and nutritious meals low in sugars and carbohydrates that promote tooth decay. Also, limit the amount of snack foods and sugar-containing beverages. Drink plenty of water to flush out the mouth;
   - Check with your dentist about the use of supplemental fluoride, as a rinse for adults, in vitamins for children, especially if you live in an area that does not have community fluoridation. Ask your dentist about the use of very cost-effective dental sealants (plastic coating placed over the back teeth) that are used to prevent dental decay;
   - Regular visits to the dentist for examination and professional cleaning.
   
3. Are there things that I can do to help me prevent oral cancer?
   

   When you reduce your risk factors, specifically tobacco (both smoking and chewing tobacco products) and alcohol consumption, and have regular dental check ups where an oral cancer screening is part of a routine dental check up, this will greatly reduce the risk of developing this common cancer. Dental screenings for oral cancer allows for early detection and early treatment. If you notice at any time any changes in appearance of the tissues of your mouth or have any of these signs and symptoms, please see your dentist at once:

   - A sore or irritation which does not heal in a short time;
   - Intraoral color changes such as the development of red and/or white spots.;
   - Numbness, pain, or tenderness anywhere in the mouth or on the lips;
   - An eroded area, lump, thickening or rough spot in or around the mouth;
   - Difficulty in speaking, chewing, swallowing or movement of the jaws or tongue;
   - Change in your bite relationship.
   

   Long term smokers ar times develop a thick, whitish colored patch which forms on the cheek, palate, gums or tongue, and is caused by excessive cellular growth in response to the heat and chemicals found in tobacco products. This lesion can also be found in denture wearers or individuals who bite their cheeks. The danger with leukoplasia is that the lesion may develop into oral cancer. If this is picked up upon a routine dental examination, the dentist may wish to take a small piece of tissue (biopsy) to determine if this is a threatening growth.

4. Why and how did I get a dental abscess?
   

   When the dental pulp of a tooth becomes infected by decay causing bacteria (often from a large cavity or cracked tooth), it spreads the infection throughout the pulp of the tooth into the roots of the tooth. If root canal treatment is not performed, that is removal of the infected pulpal tissue of the tooth and filling it with a root canal filler, the infection will travel to the tip of the root and into the surrounding bone. This causes the bone around the tooth to erode. A pocket of pus (bacterial breakdown products) that forms there is called the abscess. When the abscess increases in size, it becomes very painful, the tooth hurts, and it becomes loose in its socket.

5. I hear that adults get gum disease and can lose all their teeth from this. What is this all about?
   

   Gum or periodontal disease affects more than 75% of adults at some point in their lives. Because the disease is not often painful, you may be unaware of its progress until irreversible changes in your dentition have taken place. As you inspect your mouth and you have any of these signs or symptoms, contact your dentist to make sure you do not have periodontal disease:

   - Your gum tissues bleed when you brush your teeth;
   - Your gums are red, swollen and/or tender to brushing;
   - You have bad breath all the time;
   - You notice pus between your gums and teeth;
   - You have teeth which are loose or are moving apart and separating;
   - Your bite feels different when you chew; or
   - You notice a change in the fit of your removable partial dentures.
   

6. How does a dentist treat gum disease?
   

   The type of dental treatment given by a dentist to treat gum disease (periodontal disease) depends upon how sever it has progressed. This is a long-standing (chronic) disease process. The first step always includes removing dental plaque and tartar (calculus) from beneath the gum line. The root surfaces of the teeth need to be smoothed (root planning) to allow the gum tissue to heal and reattach to the tooth surface. The dentist will use antibiotics or irrigation with antimicrobial agents to help control the amount of periodontal disease-causing bacteria. These periodontal pathogenic bacteria produce toxins and cause periodontitis. In some cases, dentists may place fibers containing antibiotics in the periodontal pockets after scaling and root planning to assist in controlling the infection. When periodontal pockets, which are between 4-6 mm, remain after thorough root planning, it is difficult for the patient and dentist to keep these areas clean. The dentist may recommend that these pockets be eliminated by surgical procedures so that the pocket depth is eliminated, making it easier for the patient to maintain the tissues in a state of oral health. Bone surgery may also be necessary to change the shape of and/or rebuild defects caused by periodontal disease.

7. Is it always necessary to remove "wisdom teeth"?
   

   Wisdom teeth (third molars) like all teeth are valuable in an individual’s mouth when they are healthy and properly positioned. Oftentimes problems develop with these teeth which then require their timely removal. In some individuals, the jaws do not grow large enough to accommodate these third molars. These wisdom teeth then become impacted -- that is, they are unable to erupt normally or are misaligned. They may either grow sideways, erupt through the gum only part ways or remain buried beneath the gum in the surrounding bone. Dentists recommend extracting these teeth when:

   - They partially erupt and leave an opening in the gum, allowing bacteria to enter and cause repeated infections. Pain, swelling, jaw stiffness and a general unwell feeling occur;
   - There is the possibility that a poorly aligned third molar will damage the adjacent tooth;
   - A fluid-filled sack (cyst) develops around the third molar which then destroys the surrounding tooth roots or jaw bone.