How do I choose a dental office?

It is important to find a dentist that looks at your overall health and well-being in addition to treating your dental care needs. Quality of care, attention, respect and dignity should be the cornerstone of care in a dental practice.  Preservation of natural tooth structure, longevity of treatment results, comfort, and function all add to the value of good dental treatment.     

How often should I see my dentist?

The mouth and oral tissues are subject to potentially serious diseases and should be examined on a routine basis.  Regular visits allow your dentist to check the soft tissues of your mouth, including the tongue and cheeks. These examinations are important so the dentist can spot any infections, mouth conditions or even mouth cancer at the earliest stages. Dentists recommend a dental check-up at least once a year even for patients who have no teeth. Professional dental cleaning intervals vary between the patients and depends on each patient’s condition. Professional cleaning for majority of the patients is usually performed once or twice a year.

What causes tooth loss?

Tooth decay and periodontal disease are the most common causes of tooth loss.  Periodontal disease is an infection of the gums caused by the buildup of biofilms (plaque), often accompanied by calcium deposits (calculus or tartar).  Periodontal disease can also be caused by poorly fitted dental restorations (fillings, crowns, etc) as well as inadequate home care.  Decay occurs when bacterial plaques dissolve the tooth’s mineral content with acids which leads to penetration and a hole (cavity) in the tooth.  Decay and periodontal disease can be treated in early or even moderately advanced stages successfully to avoid tooth loss.

How many times a day should I brush my teeth?

Most dental professionals recommend that you brush your teeth at least twice a day.  Brushing after every meal (and flossing at least once a day) is also a good way to maintain dental health.  Teeth are susceptible to acid erosion (teeth dissolve in acid).  If you have exposed your teeth to excessive acid (grapefruit, oranges, carbonated beverages _ diet or regular, sport drinks, etc.), it is advisable to rinse thoroughly with water immediately and postpone brushing for an hour or so.  This allows the natural mineral replacement properties of saliva to work and decreases erosion of tooth structure while it is soft.     

When should a child have his/her first dental appointment?

Ideally, a child should have the first dental appointment by 18 months, but no later than his/her third birthday.  Many dentists recommend a child have his first appointment when his first tooth comes in.    

What causes oral cancer?

Historically, tobacco (cigarettes, pipes, cigars, chewing tobacco, and snuff) was noted as the most common cause of oral cancer.  Combining tobacco use with alcohol intake was also recognized to increase the development of oral cancer.  More recently, there has been an alarming increase in oral (and throat) cancer related to HPV (human papilloma virus) infection.  Sun exposure to the lips and certain chronic irritation to oral tissues may also increase cancer risks.

What are the warning signs of oral cancer?

Early symptoms of oral cancer can include: a sore on the lip, in the mouth, or in the throat that does not heal.   A lump in the lip, mouth, or throat, a red or white (especially irregular white and red) patch found anywhere in the mouth could possibly be a cancerous lesion.   Unusual pain or bleeding in the mouth, throat, or tongue; sudden, persistent swelling anywhere in the mouth; any difficulty or discomfort felt in chewing or swallowing can all be signs of areas that should be checked and diagnosed. 

Which is better: a manual toothbrush or an electric one?

Comparisons have been made between power-assisted (electric) toothbrushes and manual toothbrushes to look at the ability of each to remove plaque buildup and found both manual and electric toothbrushing to be equally effective when used correctly.  Brushing habits and physical abilities may determine an advantage or electric or manual in individual patients.

What kind of toothpaste should I use?

There are a lot of products to choose from, and much of the decision depends on individual preference (especially taste preference).  A fluoride toothpaste is recommended for optimal dental health.  Some patients may react to specific ingredients or benefit from additives (anti-tartar, desensitizing, mineral replacement, prescription level fluoride, whitening) determining an individual best choice.

What is the best way to get my teeth whiter?

Most people have teeth that are naturally darker than “pure” white.  Also, even very white looking natural smiles are not a monochromatic (one color) white.  Naturally, polishing external stains (coffee, tea, red wine, iron or mineral well water, etc) will make the teeth look brighter.   Most teeth will naturally darken (yellow) over time.  Bleaching of teeth has proven safe and effective when used properly.  Bleaching techniques vary, but all are comparable and the choice should be to the benefit of the individual patient.

How do I get rid of bad breath?

Bad breath can result from less-than-optimal oral health.  Sometimes people are not aware that they are not performing oral hygiene as effectively as they should. A dental hygienist or dentist will be able to evaluate your oral health procedures and make recommendations for improvement.  There are other factors in the throat, lungs, and stomach than can cause odors.  The tongue and upper throat can be coated with odor producing biofilms and sinus drainage.  Often more thorough brushing, flossing, and tongue cleaning will reduce bad breath odors.  Sometimes a physician appointment is necessary.

What is minimally invasive dentistry?

The goal of good oral health should always be based in preservation of natural tissues.  Any surgical or tooth treatment should restore nearly natural condition with the least amount of trauma.  This type of treatment usually involves high magnification along with experience, skill, and patience.

Why would a dentist use a microscope?

Small discrepancies in dental treatment can be invisible to the naked eye, but the natural tissues and biofilms (plaque) will be unfavorably affected with more inflammation and disease.  High magnification loupes (special glasses), clinical operating microscopes (patient treatment), laboratory microscopes (for fabrication of crowns, inlays, etc), and the skill to operate at high magnification will most likely produce a much longer lasting,  maintainable result.

Do I really need a crown?

When there is a lack of healthy enamel to restore a tooth, a crown (replacement of enamel structure from the gum level to biting surface) may be the best treatment.  Inlays and onlays are partial replacements of weakened tooth structure, fabricated in a lab or a chairside milling machine before  cementation.  There are many times when a portion of the tooth fractures off, or an old larger filling needs replacement that most dentists will prescribe a crown.  There are a few dentists highly skilled in adhesive composite dentistry that can get lasting, comfortable, esthetic results and still preserve more of the natural tooth.

What is implant dentistry?

Implant dentistry is a treatment available to replace missing teeth.  Implants are titanium root replacements that heal in the jaw and then can be used to place crowns, bridges, or stabilize dentures.

What factors contribute to the long term success of dental implants?

Success will depend on the quality and quantity of bone in addition to patient healing capacity.  The experience and ability of the dentist will be a factor.  The care in planning the placement and restoration of the implant in addition to accommodating the patient’s healing is a big part of implant success.  Experience and ability of the dentist to get the best function, esthetics, and long term health is extremely important.

Are there any age limitations for dental implants?

No.  Any person at any age can have dental implants as long as there is enough bone available in which to place the implants.

What might be some factors that would prevent me from being an implant candidate?

There are some medical factors that might prevent a person from being a good candidate for dental implants.  Some of these may be uncontrolled diabetes, chemotherapy or radiation therapy, parathyroid disorders, blood disorders, some bone density medications, rare bone disorders or bone marrow cancer. Some physical factors may include insufficient or poor quality bone, low sinuses or nerve bundles.

How often will I need to have my implants checked?

The success of your implants will depend greatly on how well you maintain them.  They will need to be professionally cleaned and examined at regular intervals, just like natural teeth.

Is dental implant surgery painful?

No.  An effective local anesthetic is used during the surgery so that you do not have any discomfort during the placement of the implants.  The mild discomfort you might experience after surgery can be controlled with medications.

When can I return to work after implant surgery?

You can go to work the next day, unless some particular surgical circumstance arises.  We will discuss all postoperative instructions with you.

Is there an alternative to gum grafting?

Modern techniques for the reversal of receding gums (and exposed, sensitive, cavity prone root surfaces) have been available for many years. The surgery involves meticulous skills to provide beautiful results with only moderate discomfort and healing times of a couple of weeks. Dr. John Chao’s “Pinhole Gum Rejuvenation” procedure can produce similar results without the traditional surgical incisions and sutures. This less invasive alternative to gum grafting also has much faster healing time and generally more comfortable healing for the patient. Dr. Hamilton was fortunate to be among the first 120 dentists worldwide to be trained and certified in this technique first available to our patients in January 2014.

Can receding gums be reversed?

Receding gums can lead to increased gumline tooth sensitivity, increased decay at the gumline (even with crowns and fillings), and erosion of the roots (disappearing tooth root causing notches or indentations near the gumline). The best treatment of receding gums is to re-grow the gum tissue and replace the loss to cover the vulnerable root surface. Pinhole Gum Rejuvenation is the best new alternative to gum grafting and we are now honored to be able to offer this service in our practice.