Dental Questions & Answers | Richardson Family Dentist Dr. Mirsepasi
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Frequently Asked Questions

What should I do if I have bad breath?

Bad breath – known medically as halitosis – can be an unpleasant and embarrassing condition.  We all have it from time to time, even without knowing it.  Bad breath occurs for a variety of reasons.  In healthy people, it is primarily due to microbial deposits on the tongue, particularly toward the back. Some studies have shown that simply brushing the tongue can reduce bad breath by as much as 70 percent.

What may cause bad breath?

  • Morning time – If it’s noticeable just after you wake up in the morning, that’s typical.  One of the functions of saliva is to cleanse the mouth, but salivary flow almost stops during sleep.  The reduced cleansing action allows bacteria to grow, causing odorous breath in the morning.
  • Certain foods – You’re probably aware that certain foods are associated with strong mouth odor. Foods such as garlic, onions and others contain odor-producing compounds, which enter the bloodstream and are exhaled after being transferred to the lungs.
  • Poor oral hygiene habits –If bad breath is a constant plague, examine your oral hygiene regimen.  Food particles remaining in the mouth promote bacterial growth, so be sure to keep up with brushing and flossing!
  • Periodontal (gum) disease – If you’ve noticed that your gums look a bit tender, then gum disease might be contributing to your breath’s odor.  Colonies of bacteria can reside under inflamed gums along with food debris.
  • Dental cavities and improperly fitted dental appliances – If it’s been a while since you had a dental check-up, then undetected cavities
    and poorly fitting dental appliances could be the culprit.  Be sure to see your dentist on a regular basis!
  • Dry mouth (Xerostomia) – A chronically dry mouth can also be responsible for bad breath.  As mentioned above, saliva helps prevent
    halitosis by cleansing the mouth of bacteria and food fragments.  Xerostomia – the medical term for dryness of the mouth – can be the result of salivary gland problems, certain medications or continuous mouth breathing.
  • Tobacco products – If you use any tobacco products, you’ve got another reason to quit. Cigarettes and chewing tobacco dry the mouth, causing bad breath.
  • Dieting – A stringent dieting regimen can sometimes contribute to unpleasant breath. Chemicals known as ketones are exhaled through the lungs when the body burns fat, causing a distinctive smell.
  • Dehydration, hunger, and missed mealsDehydration and missed meals cause salivary flow to be suboptimal, and as a result, bacteria are not washed away as they would be with proper food and fluid intake.
  • Certain medical conditions and illnesses – You may have one or more medical conditions that require you to make an extra effort to manage your breath odor.  Diabetes, liver disease, kidney dysfunction,
    chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

What can I do to prevent bad breath?

  • Practice good oral hygiene – Brush at least twice a day with an ADA-approved toothbrush and fluoride toothpaste.  Floss daily to remove food debris and plaque from in between the teeth and under the gum line.  Use a brush or a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly before placing them back in your mouth in the morning.
  • See your dentist regularly –  Get a check-up and cleaning at least twice a year.  If you have periodontal disease or have experienced it in the past, you dentist may recommend more frequent visits.
  • Stop smoking/chewing tobacco – Ask your dentist what he or she recommends to help you break the habit.
  • Drink water frequently – Water keeps your mouth moist and washes away bacteria.
  • Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor.  Ask your dentist about antiseptic rinses that not only alleviate bad breath but also kill the germs causing the problem.

In most cases, bad breath can be treated.  If your mouth appears healthy but your bad breath persists, your dentist may refer you to a physician to determine the cause of the odor and an appropriate treatment plan.

How often should I brush and floss?

Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums.  The bacteria in plaque convert certain food components into acids that eat away at tooth enamel.  If plaque is not removed, it turns into a hard material called calculus or tartar.  A combination of plaque and calculus can damage the gums, causing periodontal disease.

Plaque forms on a continuous basis and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing

Brush your teeth at least twice a day – most importantly, just before going to bed at night – using an ADA-approved soft bristle brush and toothpaste.  Hold the brush at a 45 degree angle to the gums and maneuver it gently with small, circular motions, making sure that you can feel the bristles on your gums.  Brush the outer, inner, and biting surfaces of each tooth, using the tip of the brush head to clean the inner surfaces of your front teeth.  Don’t forget to brush your tongue in order to remove bacteria and freshen up your breath.

Electric toothbrushes are also recommended.  They are easy to use and efficient in removing plaque.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

A Formula for Flossing

Daily flossing is the best way to clean the spaces between teeth and the grooves just under the gum line.  By clearing these spots of food debris, you can prevent the formation of plaque colonies and the associated damage to gums, teeth, and bone.  Take 12-16 inches (30-40 cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5 cm) of floss between your hands.  Using your thumbs and forefingers to guide the floss, gently insert the strand between two teeth using a sawing motion.  Curve it around the lower part of each tooth so that it clears the pockets under the gum line.  Gently move the floss up and down to clean the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing

It is important to rinse your mouth with water after brushing, as well as after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist to make sure it’s appropriate for you.

Are amalgam fillings safe?

There has been some concern in recent years as to the safety of amalgam fillings.  Amalgam is a blend of copper, silver, tin and zinc bound by elemental mercury.  Dentists have used this blended metal to fill teeth for more than 100 years.  The controversy is due to claims that exposure to minute particles from the mercury can cause a variety of health problems.

According to the American Dental Association (ADA), up to 76% of dentists use silver combined with mercury to fill teeth.  The general consensus, supported by the ADA, is that amalgam fillings are safe.  Studies have not demonstrated any link between the mercury in amalgam and any medical disorder.  Alongside the ADA, the Center for Disease Control (CDC), the World Health Organization (WHO), and the Food and Drug Administration (FDA) all support the use of amalgam as a safe, durable, and cost effective filling material.  According to the U.S. Public Health Service, the only contraindication against using amalgam is in the rare instance when a patient has an allergy to one of the components in the metal blend.  The ADA has reported fewer than 100 incidents of an allergy to components of amalgam out of millions of silver fillings over the decades.

Mercury is toxic at high levels, but the amount of exposure from amalgam fillings is not high enough to warrant concern.  The ADA states that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.  There are several alternatives to silver fillings, including the tooth-colored composite material, porcelain, and gold.  We encourage you to discuss these options with your dentist so that you can determine which option is best for you.

How often should I have a dental exam and cleaning?

You should have your teeth checked and cleaned at least twice a year.  If you have any dental concerns that require special attention, your dentist or dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums.  At these visits, your teeth are cleaned and scrutinized for cavities.  Your dental care team will also perform a number of other check-up procedures in order to optimize your dental health.  These include:

Medical history review:  It is important for your dentist to be aware of any current medical conditions and medications, as these provide insight to your dental health and may affect treatment options.

Diagnostic X-ray examinations (radiographs):  This procedure is essential for the detection of cavities, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.

Detection of existing restorations:  Your dentist will check for current fillings, crowns, etc. in order to plan further treatment appropriately.

Prophylactic polishing:  This procedure removes stains and plaque that are not taken care of during regular brushing.

Gum disease evaluation:  Your dentist will examine your gums and the bone around your teeth for any signs of periodontal disease.

Tooth decay screening:  Your dentist will use special instruments to thoroughly check the surfaces of your teeth for decay.

Plaque removal:  Plaque is a sticky, almost invisible film that forms on the teeth.  It consists of growing bacterial colonies, food debris and saliva.  The bacteria produce toxins that inflame the gums and cause periodontal disease to start developing.

Calculus (tartar) removal:  Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface.  It forms above and below the gum line and can only be removed with special dental instruments.

Oral cancer screening:  Your dentist will check your face, neck, lips, tongue, throat, inner cheek area and gums for any signs of oral cancer.

Oral hygiene recommendations:  Your dentist will review your dental records and recommend certain oral hygiene aids as needed, such as electric toothbrushes, special cleaning aids, fluorides, or rinses.

Review of dietary habits:  Your eating habits play a very important role in your dental health.  Your dentist will discuss any dietary changes that may be needed to slow and perhaps reverse damage to your teeth and gums.

A good dental exam and cleaning involves much more than simply checking for cavities and polishing your teeth. We are committed to providing you with the most thorough care possible, and we encourage you to schedule dental exams on a regular basis.

How can I tell if I have gingivitis or periodontitis (gum disease)?

Four out of five people have periodontal disease and don’t know it!  Unlike tooth decay, which often causes discomfort, gum disease is usually painless in its early stages.  This makes it easy to miss.  It is important to have regular dental check-ups in order to detect periodontal problems as early as possible.

Periodontal disease begins when plaque – a sticky, colorless film of bacteria, food debris and saliva – is left on the teeth and gums.  The bacteria produce acids that inflame the gums and slowly destroy the bone holding teeth in place.  A solid daily regimen of brushing and flossing will ensure that plaque is not left behind to cause damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease.  These include the following:

Smoking or chewing tobacco.  Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.

Problems with tooth positioning and restorations.  Crowded teeth, bridges that no longer fit properly, and defective fillings may trap bacteria and cause plaque to grow more freely.

Certain medications.  Steroids, cancer therapy drugs, blood pressure medications and oral contraceptives have all been associated with increased risk of periodontal disease.  Some medications reduce salivary output, making the mouth drier than normal and allowing plaque to adhere to the teeth and gums more easily.

Pregnancy, puberty and oral contraceptives.  All three cause changes in hormone levels, which may make gum tissue more sensitive to bacterial toxins.

Systemic diseases.  Gum disease is more prevalent among those suffering from diabetes, blood cell disorders, HIV / AIDS, and other chronic conditions.

Genetics may play a role.  Some patients may be predisposed to a more aggressive type of periodontitis.  If you have a family history of tooth loss, pay particular attention to your gums!

Signs and Symptoms of Periodontal Disease:

Red and puffy gums.  Gums should never be red or swollen.

Bleeding gums.  Gums should never bleed, even when you brush vigorously or use dental floss.

Receding gums.  Periodontal disease often leads to a loss of gum tissue around a tooth.

Persistent bad breath.  Gum disease can offer bacteria a better foothold, causing unpleasant mouth odor.

Tenderness and discomfort.  Plaque, calculus, and bacteria make gums extra sensitive while causing damage.

New spacing between teeth.  Severe gum disease can lead to loss of the bone supporting individual teeth.

Loose teeth.  Gum disease-induced bone loss and weakened periodontal fibers (fibers that support the tooth to the bone) can cause teeth to be wobbly.

Pus around the teeth and gums.  If you see this, an infection is present.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Why is it important to use dental floss?

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth. Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily brushing removes food particles, plaque, and bacteria from all outer tooth surfaces, but a toothbrush cannot effectively clean between teeth.  These areas are highly susceptible to decay and periodontal (gum) disease, so if you’re only using a toothbrush, you’re missing out on an important aspect of oral hygiene.

Daily flossing is the best way to clean between the teeth and under the gum line.  A strict flossing regimen prevents plaque colonies from building up and damaging the gums, teeth and supportive bone.

Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of bacteria mixed with food debris and saliva.  The bacteria produce acids that cause cavities and irritate and inflame the gums.  When plaque is not removed above and below the gum line, it hardens and turns into calculus (also called tartar).  This will further irritate and inflame the gums and also slowly destroy the bone.  Periodontal disease develops in this way.

How to floss properly:

—Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between your hands.

—Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.

—Curve the floss into a “C” shape around each tooth and under the gum line.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Daily flossing will help you maintain a healthy, beautiful smile for life!

How can cosmetic dentistry help improve the appearance of my smile?

If you’re feeling somewhat self-conscious about your teeth, or just want to make your smile look as nice as can be, you may be interested in cosmetic dental treatments.

Cosmetic dentistry has become very popular in the last several years.  There have been many recent advances in cosmetic dental technologies, and patients have been taking advantage of this increase in opportunities to focus more on improving their dental health.  They have been putting more effort into scheduling regular preventive treatments and striving for healthier, whiter and more radiant smiles.

Cosmetic dental procedures are abundant today.  Depending on your particular needs, these treatments can dramatically improve your smile, whether you get a single tooth restored or undergo a full mouth make-over.

Common cosmetic procedures include the following:

Teeth whitening:  A bleaching lightens teeth that have been stained or discolored by age, food, drink, and/or smoking.  Teeth darkened as a result of injury or certain medications can also be bleached, but the procedure’s effectiveness depends on the amount of staining present.

Composite (tooth-colored) fillings:  Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities and to replace old, defective fillings.  They can also be used to repair chipped, broken or discolored teeth.  This type of filling is very useful for filling in gaps and protecting sensitive root surfaces exposed by gum recession.

Porcelain veneers: Veneers are thin, tooth-colored shells that are custom-made to bond onto the fronts of teeth.  They can help restore damaged, discolored, poorly shaped or misaligned teeth and make a smile look even and natural.  Unlike crowns, veneers require very little material to be removed from the surface of a tooth.

Porcelain crowns (caps):  A crown is a tooth-colored, custom-made covering that encases the entire tooth surface and restores it to its original shape and size.  Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations.  They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.

Dental implants:  Dental implants are artificial roots that are surgically placed into the jaw to stand in for one or more missing teeth.  Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a durable solution to the problem of lost teeth.

Orthodontics: Less visible and more effective brackets and wires are making teeth-straightening procedures much more appealing to adult patients.  In some cases, teeth may be straightened with aligners that are see-through, custom-made and removable – and no braces are necessary!

Thanks to advances in modern dentistry, cosmetic treatments can make your smile shine brighter than ever.  Ask your dentist for his or her smile-rejuvenating recommendations.

What are porcelain veneers and how can they improve my smile?

Porcelain veneers are extremely thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth.  They are very durable and will not stain, and these two qualities make them a very popular solution for people seeking to restore or enhance the beauty of their teeth.

Veneers may be used to treat teeth that are:

—Misshapen, worn or chipped

—Oversized or undersized

—Severely discolored or stained

—Slightly crowded or spaced too far apart

Getting veneers usually requires two visits.  During the first visit, your dentist will obtain an impression (mold) of your teeth to be sent to a professional dental laboratory where the veneer is custom-made.  On the following visit, the veneer will be fitted to your teeth.  With little or no anesthesia, your teeth will be prepared by lightly buffing and shaping the front surface of the teeth to allow for the slight thickness of veneers.  The veneers are carefully attached onto the tooth surface with special bonding cements.  Occasionally, a specialized light may be used to harden and set the bond.

Veneers are a reliable dental treatment that can dramatically improve your teeth and give you a natural-looking and beautiful smile.

What can I do about stained or discolored teeth?

A preventive program is a cooperative effort by the patient, dentist, and dental staff to preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions.

Preventing dental disease starts at home with good oral hygiene and a balanced diet. It is continued in the dental office by the efforts of your dentist and dental hygienist to promote, restore, and maintain your oral health.

Prevention also includes regular dental exams, cleanings, and x-rays. Sealants and fluoride are also great preventive treatments that help protect the teeth.

Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.