Dental FAQs

Is bleaching teeth safe for your teeth and cant I just use toothpaste for a similar result?

Bleaching of teeth is very safe and does not weaken the enamel.

Having said that it often leads to some transient temporary sensitivity. There are effective ways to mitigate the sensitivity by utilizing prescription-strength fluoride in the bleaching trays immediately after bleaching, we recommend CTX 4 as the best one.

The most effective way to bleach teeth is with professionally fabricated trays and a professional-strength whitening agent. It is most effective to bleach twice in a row with a refreshed application each time, as long as sensitivity is not a problem. This will lead to the quickest results.

While some toothpaste does contain the same agent as we prescribe it is at such a low concentration and limited tooth time exposure that it is ineffective at bleaching. Keep in mind the bleaching materials have to be in direct content with the tooth for a minimum of 20 minutes. The material is penetrating the enamel and reaching the deeper structure of the tooth to bleach out protein strands.
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Why can’t you do implants in a day like you see on TV?

The advertisements that you see on TV are generally for multiple implants that support a full denture, often opposing another denture. Because the plastic denture is being supported by multiple implants, minimum of 4, it is possible to “load” the implants earlier as there is a shared risk, sort of like laying on a bed of nails rather than just 1 or 2.

The more implants the less risk on each.

Furthermore, implants against non-teeth(plastic/denture) have significantly less force than natural. When we are doing just one or two implants it is not necessary nor wise to prematurely load the implant(s) as the person generally has supporting teeth in front and back of the implant on which to chew.

When an implant is first placed it has initial ‘Primary Stability’ which is like a screw going into wood. Over time the initial stability gives way to secondary stability which is the bone growing around the implant creating a much harder and ridged connection.
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Do I have to be numb?

A dental anesthetic is usually required for dental procedures that involve procedures beyond the enamel. Occasionally enamel-based restorations (shallow fillings or no-preparation veneers) may be possible without having an anesthetic.

Additionally, teeth that have already received root canal therapy can be worked on with a very minimal level of anesthetic to put the gum tissue to sleep.

We realize that people do not enjoy the needle or the feeling of numbness however it is much safer for you to receive your care with proper anesthetic as sudden flinches or movement in response to pain often results in further trauma to the tooth.

Buffering of the dental anesthetic will make the procedure more comfortable and create a quicker onset of numbness.
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Will my dental Insurance cover this?

Dental insurance, or more accurately ‘Pre-paid Dental benefits’ have a common feature in that they do not necessarily care about you and your problem. The “insurance” is a relationship between you, your employer, and the company from which it was purchased.

It is a contract that was put forth by your employer which has clearly defined benefits with regards to most of the more commonly encountered dental diagnoses and treatments.

When we diagnose a problem in your mouth we do so with what the clinical picture is and we offer solution(s) according to best practices of dentistry.

On occasion, there will be two appropriate solutions for the same problem. Most of the time, pre-paid dental benefits will ‘steer’ you to the least costly solution. Often they will have ‘missing tooth’ clauses which means if you enter the plan missing a tooth they will not help you replace it.
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Should I have my silver fillings replaced I hear they are bad for you?

Silver fillings, aka Amalgam fillings, have been used in dentistry for over 100 years and are an adequate inexpensive restoration for dental caries. While they are losing popularity quickly amongst modern dentists, they still serve a role with certain types of patients and scenarios.

Replacement of Silver fillings (or Mercury fillings if the dentist is trying to sway you) is not always the best course of treatment.

Sometimes when a filling has encompassed over 50% of the tooth replacement will do nothing but further, weaken the tooth.

In this case, a crown or onlay would be the better procedure as the tooth needs strengthening not further weakening. In the case of small amalgam fillings with the ABSENCE of cracks/fractures in the tooth, yes, the replacement of silver fillings will most likely improve the survivability of the tooth.

BUT if there is any fracturing of the enamel and dentin it will do nothing to lower the risk and improve the prognosis of the tooth. Removal of amalgam fillings needs to be done under a rubber dam with copious water irrigation to mitigate any vapors that form.
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Why do I need fluoride?

Fluoride as an ingested (drinking water) additive works by incorporation into the enamel matrix of the developing tooth. The fluoride ion is incorporated into the hydroxyapatite crystal structure of the enamel and it makes it much harder and therefore resistant to caries.

As an adult, Fluoride works more topically but it still very beneficial to the health of the enamel. In high-risk mouths (one decayed tooth in 3 years) it is highly recommended to utilize a prescription-strength product 3-4 times a week to help lower your risk.

Fluoride gets bad press but in the correct concentration and usage is 100% safe for you. Children, however, can get sick from the high concentrations of Fluoride as they are smaller and tend to swallow toothpaste at a greater percentage than adults.
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What is the difference between a cap and a crown and will they last forever?

There is no difference between the two, it is merely nomenclature. There is a difference between various materials to make a crown. Most dentists today use monolithic porcelain to make crowns. Monolithic crowns lack a metal substructure and look better but also have lower fracture rates if utilized correctly.

They adhere to the tooth differently than the old-school porcelain/metal crowns. Furthermore, the dentist can be more conservative and save more healthy tooth structures with the newer materials.

Typically a crown should last 15 years if appropriate home care and diet is followed. Often the question comes up “Why won’t this last forever?” dentistry has gotten a great deal better in the past 20 years but with the use of Non-genuine spare parts it is still not 100% of original parts!
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Why do I need a CBCT?

CBCT are 3-D x-rays that allow us to see the missing dimension of standard dental x-rays. If you have had any root canal treatments in the past or are considering replacing your missing teeth as CBCT is necessary to look at the root tips and evaluate the root canals and it also allows us to look at bone volume and quality to determine the best implant placement.
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Why do I need to have periodontal therapy instead of a routine cleaning?

Periodontal therapy is a treatment to address a periodontal disease that is active while a routine cleaning or prophylaxis is to address gingivitis which is NOT a periodontal disease.

All periodontal disease starts as gingivitis however not all gingivitis becomes periodontal disease.

Periodontal disease is a host modulated response to bacterial infection. This means that the person’s immune system must mount a response to the bacteria in the form of an autoimmune response. This is manifested in redness, bleeding, suppuration, deep pocketing, etc.

On a cellular level, periodontal disease is a cascade of processes such as increase TNF (tumor necrosing factor), IL (interleukin) responses, and a complex pathway of immune responses attacking the gums and connections.

We are not 100% why some get it and others do not but certain risk factors such as poorly controlled diabetes and smoking play a big factor. 50% is a genetic predisposition to the disease. Once you have a periodontal disease life-long treatment and management should be considered.
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Are all implant systems compatible?

Implant systems are a bit like automobiles in that the parts are not interchangeable usually. Also, there are distinct differences in the quality of the titanium that manufacturers utilize.

The other difference is in the restorative platform which means how the crown is attached to the actual implant. Certain platforms have notorious problems with bone loss while others are more favorable and seem to maintain the bone better.

We utilize Nobel implants at our office which are the earliest pioneers in implant technology and have been well researched and offer great long-term solutions to missing teeth.
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What types of Dentures are there for missing teeth?

Dentures are NOT tooth replacement solutions but rather solutions for missing teeth.

Removable appliances can have wildly different profiles, complexity, and expense. Conventional dentures are completely supported either by the lower mandible ridge or suction as in the upper teeth. Done correctly in the right mouth they MAY offer a suitable solution and decent clinical outcome.

They seem to be better accepted by patients who have worn dentures for years and are looking for a replacement set. There are also other more predictable solutions such as attachments for existing lower dentures where two implants are placed in the mandible and the lower denture is snapped over the locators.

These can be removed at home by the patient and do offer much better retention over conventional dentures. Other solutions utilize move implants, as few as 4 on the mandible and 6 on the maxillary, and much more stability by ridged connections that may or may not be removable by the patient at home. Of course, with increased complexity comes higher costs for restoring and maintaining the appliance.
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