Frequently Asked Questions
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Are x-rays neccessary and how often should they be taken?

How does bleaching work?

What are sealants?

When are crowns necessary?

Is there any correlation between the plaque that forms on teeth and plaque in the arteries?

When is it necessary to remove wisdom teeth?

What is root canal treatment? When is it necessary?

How do I know if I have gum disease?

What are cavities and how do they occur?

What are dental implants?

Why should I replace missing teeth?

When are white fillings appropriate?

Are dental amalgams safe?


Are x-rays neccessary and how often should they be taken?

Radiographic or X-ray examinations provide your dentist with an important tool that shows the condition of your teeth, its roots, jaw placement and the overall composition of your facial bones. X-rays can help your dentist determine the presence or degree of periodontal disease, abscesses and many abnormal growths, such as cysts and tumors. X-rays also can show the exact location of impacted and unerupted teeth. They can pinpoint the location of cavities and other signs of disease that may not be possible to detect through a visual examination. Your radiographic schedule is based on the dentist's assessment of your individual needs, including whether you're a new patient or a follow-up patient, adult or child, rate of decay and amount of existing dental work already present. In most cases, new patients require a full set of mouth X-rays to evaluate oral health status, including any underlying signs of gum disease and for future comparison. Follow-up patients may require X-rays to monitor their gum condition or their chance of tooth decay. As a rule of thumb either full mouth or panoramic scanning X-rays should be taken every three years, and cavity check bitewing X-rays every 12 to 18 months depending on the patient’s decay and periodontal history.

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How does bleaching work?

Bleaching is done with chemical called carbamide peroxide, which actually lightens the tooth enamel that it comes in contact with. Peroxide-containing whiteners typically come in gels of different concentrations (10%, 16%, 22%), and are placed in a mouth guard. Usage regimens vary. Most are intended for use for 1-2 weeks, 2 - 4 hours per day. If you obtain the bleaching solution from your dentist, he or she can make a custom-fitted mouth guard for you that will fit your teeth precisely. Generally treatment does not have any side effects, but occasionally teeth can become sensitive during the period when you are using the bleaching solution. In many cases, this sensitivity is temporary and should lessen once the treatment is finished. The effects of bleaching gradually diminish over time, but a short regimen of additional bleaching on a yearly basis will usually return the teeth to their whiter color.

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What are sealants?

A dental sealant is a thin plastic film bonded to the chewing surfaces of molars and premolars (the teeth directly in front of the molars). Because sealants act as a physical barrier to decay, protection is determined by the sealants' ability to adhere to the tooth. As long as the sealant remains intact, small food particles and bacteria that cause cavities cannot penetrate through or around a sealant into the thin groove of the biting surface of your tooth where cavities most commonly start. Sealant protection is reduced or lost when part or all of the bond between the tooth and sealant is broken. However, clinical studies have shown that teeth that have lost sealants are no more susceptible to tooth decay than teeth that were never sealed. At Waterford Dental Associates missing sealants done at our office are replaced free of charge if the patient has maintained a regular recall schedule.

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When are crowns necessary?

A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to protect weak teeth from fracturing, restore fractured teeth, support a large filling when there isn't enough of the tooth remaining, support a root canal treated tooth, or cover badly shaped or discolored teeth. To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth. Depending on the position in the mouth of the tooth to be crowned, aesthetic concerns and the biting stresses it will be exposed to, the crown can either be made out of tooth colored porcelain, cast gold, or a combination of both.

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Is there any correlation between the plaque that forms on teeth and plaque in the arteries?

There is a strong correlation between dental disease related to plaque and the incidence of hardening of the arteries, heart disease and stroke.

The association with heart disease is particularly strong in people over 50.

Dental plaque is a bacterial film on the teeth. The most common kind of
bacteria found in dental plaque, causing gingivitis and the more severe gum disease called periodontitis, can also escape into the bloodstream.

There, the substances emitted by the bacteria, such as prostaglandins, may be implicated in a buildup of arterial deposits, blood clots, and artery hardening recent research suggests.

Meanwhile, people with very severe gum disease, especially those who have lost some teeth, have been found in some studies to have notably higher rates of stroke caused by plaque in the arteries that serve the brain.

The theory is that gum disease is part of a chain reaction of inflammatory damage. Now researchers are undertaking more studies to further correlate the fact that treating gum disease can ward off heart and artery disease.

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When is it necessary to remove wisdom teeth?

Wisdom teeth (third molars) are the most posterior located teeth in the normal dentition, usually erupting into the mouth at around age 16 to 25 years. When wisdom teeth are prevented from erupting into the mouth properly, they are referred to as impacted. Teeth that have not erupted are not necessarily impacted. It may be that it is still too early in someone's dental development, and if time passes they might grow in properly. A dentist must examine a patient's mouth and his or her x-rays to determine if the teeth are impacted or will not grow in properly. Impacted teeth may cause problems. Impacted teeth can result in infection, decay of adjacent teeth, gum disease or formation of a cyst or tumor from the follicle, which is the tissue that formed the crown of the tooth. Erupted wisdom teeth may also need to be removed. The dentist may recommend this if the tooth is non-functional, interfering with the bite, badly decayed, involved with or at risk for periodontal disease, or interfering with restoration of an adjacent tooth. Once again, every case is different and only your dentist can determine if there is a reason for you to have a tooth removed.

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What is root canal treatment? When is it necessasry?

Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the pulp, which carries the tooth's nerves, veins, arteries and lymph vessels. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth commonly has between one and four root canals. When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow and cellular activity, and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks. Root canal therapy consists of cleaning out the pulp contents and filling the cleaned canals with a material to prevent further infection. In this way the tooth can be retained and restored, usually with a new core and crown.

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How do I know if I have gum disease?

Gum disease or periodontal disease, a chronic inflammation and infection of the gums and bone, is the major cause of about 70 percent of adult tooth loss, affecting three out of four persons at some point in their life. The warning signs include red, swollen or tender gums, bleeding while brushing or flossing, gums that pull away from teeth, loose or separating teeth, puss between the gum and tooth, persistent bad breath, change in the way teeth fit together when the patient bites, and exposed roots. While patients are advised to check for the warning signs, there might not be any discomfort until the disease has spread to a point where the tooth is unsalvageable. That's why patients are advised to get frequent dental exams.

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What are cavities and how do they occur?

Tooth decay is the disease known as caries or "cavities". Unlike other diseases, however, caries is not life threatening and is highly preventable, though it affects most people to some degree during their lifetime. Tooth decay occurs when your teeth are frequently exposed to foods containing carbohydrates (starches and sugars) like soda pop, candy, ice cream, cakes, and even fruits. Natural bacteria live in your mouth and form plaque. The plaque interacts with deposits left on your teeth from sugary and starchy foods to produce acids. These acids damage tooth enamel over time by dissolving, or demineralizing, the mineral structure of teeth, producing tooth decay and weakening the teeth. Left untreated tooth decay will eventually eat through the hard tissues of the tooth and cause an infection of the nerve. It is at this point that the tooth will become painful. Regular checkups with x-rays, proper hygiene and a diet low in carbohydrates are the best way to prevent decay before it reaches this more serious stage.

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What are dental implants?

A dental implant is an artificial tooth root (made of titanium) that is surgically anchored into your jaw. An abutment or precision attachment is locked into the implant and acts to hold a replacement tooth, bridge or denture. The benefits of using implants include the fact they don't rely on neighboring teeth for support, they appear more natural and are easier to clean when selected over a convential bridge, they don't decay and can tighten the fit of a denture or partial. Strategically placed, implants can now be used to support permanently cemented bridges, eliminating the need for a denture all together. Implants are one of the true miracles of modern dentistry.

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Why should I replace missing teeth?

Nature designed your teeth to work together as a unit. The loss of even a single tooth can cause a deterioration of the dentition as a whole. What is often not understood is that teeth will continue to shift and also grow throughout life. The removal of a tooth will generally result in the teeth next to the space tending to tip and drift into the open space, while the tooth or teeth that normally bite into the missing tooth will tend to erupt (grow) into the space created. This tends also to create periodontal (gum) problems in these areas, sometimes leading to early loss of these teeth. Also additional stress is placed on all the remaining teeth in the mouth and can lead to breakage, wear of the biting surfaces and migration out of normal alignment. The more teeth that are missing the worse the problems with the remaining teeth are likely to be.

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When are white fillings appropriate?

New improvements in tooth colored composite fillings allow them now to be often used in situations that once required the silver amalgam fillings. A composite resin is a tooth-colored acrylic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used to restore decayed areas, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth. However in certain situations where it is impossible to obtain complete dryness, such as cavities that extend under the gum line, other alternatives such as inlays, amalgam fillings or crowns must be used.

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Are dental amalgams safe?

Yes. Mercury in dental amalgam is not poisonous. When mercury is combined with other materials in dental amalgam, its chemical nature changes, so it is essentially harmless. The amount released in the mouth under the pressure of chewing and grinding is extremely small and no cause for alarm. In fact, it is less than what patients are exposed to in food, air, and water. Ongoing scientific studies conducted over the past 100 years continue to prove that amalgam is not harmful. Claims of diseases caused by mercury in amalgam are anecdotal, as are claims of miraculous cures achieved by removing amalgam. These claims have not been proven scientifically. We at Waterford Dental Associates believe that silver amalgam fillings are appropriate for some situations.

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