If a toothache is from one tooth, why is my whole mouth hurting?

This is not uncommon or unusual. Often, the pain level from one infected tooth can get high enough to cause the entire mouth to hurt. The dentist will then use a number of examination techniques to distinguish the specific tooth that is the source and repair it.

I was told I needed a root canal and that I would need a crown. Why would I need a crown and how long does the entire procedure usually take?

A root canal tooth, especially one in the back, needs protected by a crown so you can eat with it and not worry about it breaking.

The crown procedure takes 2 visits to the office separated by 3-4 weeks. This allows time for the lab work to make the crown.

I have a front tooth that needs to come out, but I don't want to walk around with a big gaping hole in the front of my mouth. What can be done?

A temporary false tooth can be put in at the same appointment as when the front tooth comes out. Later, when the gum is healed, a permanent false tooth can be put in the space. This would involve using a bridge, an implant or a removable partial denture.

If I got gas to put me to sleep before a dentist started working in my mouth, how long would it take me to get over the gas and wake up?

The gas I use does not put you to sleep; it only relaxes you. This is all most people need and it is safer and less expensive. It would be out of your system by the time you leave the office, making it safe to drive afterwards.

I have heard stories about dentists putting people under gas and then doing something to them. Is that possible?

No, this type of gas does not put you to sleep. You are fully awake, alert and in full control of the situation.

My teeth are really in bad shape and I have been told I need to have them removed and get dentures. How long does it take to pull them and get the dentures?

Immediate dentures are designed to be put in on the same day that your teeth are pulled. Prior to that day, the dentist will see you 2-3 times to get your new denture ready.

Regular dentures, however, take longer because they are made 6 weeks after you've had your teeth pulled.

I have a 9-year-old son who is afraid of the dentist. He is afraid of getting hurt and he is afraid of needles. What can I tell him?

Tell him that this dentist has 2 children of his own that don't mind coming to his office because he is very gentle. Many patients, especially children, have fear and anxiety when it comes to visiting the dentist. That is understandable and something I am fully aware of. I apply whatever technique is necessary to make all patients comfortable and the procedure as pleasant and pain-free as possible, including staying abreast of new and easy ways to work on teeth.

What exactly is a crown?

A crown (same as a cap) is a cover that fits over the outside of a tooth. It is usually made of metal that is covered with porcelain that matches the color and appearance of your natural teeth. As a way to improve your smile, we will often make the crown look better than the original tooth.

I smoke and drink a lot of coffee, so I have yellow, stained teeth. Is there anything that can be done for that?

I start with the simple basics and work toward the more complex techniques until we've reached our cosmetic goal. So first would be a good professional cleaning with appropriate home care training. Whitening (bleaching) for a minimum of 2 weeks would be the next step. Following that, we would consider veneers (facings) and crowns.

When are braces recommended for a child and what is the procedure in getting them put on?

Braces are recommended when the dentist sees a bad bite. Early treatment is usually better than late. It is important that your child have regular checkups during his developing years so braces can started at the right time.

When the time appears right, the dentist will take diagnostic records that he uses to design a treatment plan.

Putting them on involves gluing a small metal bracket to each tooth. A thin flexible wire then connects the teeth together and the spring tension in this wire causes the teeth to move.

What would you tell a new patient who is afraid of needles?

There are many techniques that dentists use for getting beyond this fear and believe me, that it is a genuine fear. No one likes the thought of someone pushing a sharp needle into such a sensitive area as the mouth or gums. For some patients, nitrous gas totally relaxes them but again, it depends on the individual patient and what technique works best for them. My biggest compliments come from patients who walked into my office, afraid, but tell me they felt nothing during the procedure when they left.

I had a upper back tooth pulled several years ago and all I have left is a hole. Since it does affect my chewing, is there anything that can be done about it?

Definitely, that tooth needs to be replaced. There are different ways to accomplish this depending on the condition of the rest of your teeth. After examining your mouth, your dentist will explain the best choices for you. Bridgework is the most common answer, but a partial denture or an implant is sometimes better. A "bridge" is explained more thoroughly in another question.

How frequently should someone have a checkup or their teeth cleaned?

You should have a checkup at least every six months. Your dentist may find conditions that require more frequent visits such as heavy tarter buildup or gum disease. It is also a good rule to have your teeth cleaned every 6 months, but again, people who have heavy tarter buildup should get their teeth cleaned every 3-4 months. Gum disease is also a reason to get more frequent cleanings.

I was told a few weeks ago that I probably need a filling and should see a dentist. I have not done it yet because the last thing I want to do is open my mouth and all you see is silver. Is there filling that would match the color of my tooth?

Yes. Composite resins are tooth-colored, plastic materials (made of glass and resin) that are used both as fillings and to repair defects in the teeth. Because they are tooth-colored, it is difficult to distinguish them from natural teeth. Composites are often used on the front teeth where a natural appearance is important. They can be used on the back teeth as well depending on the location and extent of the tooth decay. Composite resins are usually more costly than amalgam fillings.

I have a filling now. My tooth doesn't hurt, but I was told this filling needs to be replaced. Why?

Constant pressure from chewing, grinding or clenching can cause dental fillings, or restorations, to wear away, chip or crack. Although you may not be able to tell that your filling is wearing down, your dentist can identify weaknesses in your restorations during a regular check-up.

If the seal between the tooth enamel and the restoration breaks down, food particles and decay-causing bacteria can work their way under the restoration. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to infect the dental pulp and may cause an abscess.

If the restoration is large or the recurrent decay is extensive, there may not be enough tooth structure remaining to support a replacement filling. In these cases, your dentist may need to replace the filling with a crown.

What exactly is gum disease and can it be treated?

Gum disease (also called periodontal disease) is an infection of the tissues surrounding and supporting the teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless you may not know you have it.

Gum disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. This bacteria create toxins that can damage the gums.

In the early stage of gum disease, called gingivitis, the gums can become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.

In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth can become seriously damaged. The teeth can become loose, fall out or have to be removed by a dentist.

What is a root canal?

Once upon a time, if you had a tooth with a diseased nerve, you'd probably lose that tooth. Today, with a special dental procedure called a root canal therapy you may save that tooth. Inside each tooth is the pulp which provides nutrients and nerves to the tooth. It runs like a thread down through the root. When the pulp is diseased or injured, the pulp tissue dies. If you don't remove it, your tooth gets infected and you could lose it. After the dentist removes the pulp, the root canal is cleaned and sealed off to protect it. Then your dentist places a crown over the tooth to help make it stronger.

Most of the time, a root canal is a relatively simple procedure with little or no discomfort involving one to three visits. Best of all, it can save your tooth and your smile!

It seems like whenever I go to a dentist, one of the first things they want to do is give me an X-ray. Why?

Many diseases of the teeth and surrounding tissues cannot be seen when your dentist examines your mouth.

An X-ray examination may reveal small areas of decay between the teeth, infections in the bone, abscesses or cysts, developmental abnormalities and some types of tumors.

Finding and treating dental problems at an early stage can save time, money and unnecessary discomfort. It can detect damage to oral structures not visible during a regular exam. If you have a hidden tumor, radiographs may even help save your life.

What do wisdom teeth really so, since everyone I know seems to have had them removed?

Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems develop that require their removal. When the jaw isn't large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may grow sideways, emerge only part way from the gum or remain trapped beneath the gum and bone.

Extraction of wisdom teeth is generally recommended when they only partially erupt, leaving an opening for bacteria to enter around the tooth and cause an infection, when there is a chance that poorly aligned wisdom teeth will damage adjacent teeth or when a cyst (fluid-filled sac) forms, destroying surrounding structures such as bone or tooth roots.

Patients should ask the dentist about the health and positioning of their wisdom teeth. The dentist may make a recommendation for removal or send the patient to an oral surgeon for further evaluation.

A friend of mine was just told by her dentist that she needed a space maintainer. What is that?"

If your child loses a baby tooth early through decay or injury, the child's other teeth could shift and begin to fill the vacant space. When your child's permanent teeth emerge, there's not enough room for them. The result is crooked or crowded teeth and difficulties with chewing or speaking.

To prevent that, your dentist inserts a space maintainer to hold the spot left by the lost tooth until the permanent tooth emerges. The space maintainer might be a band or a temporary crown attached to one side of the vacant space. Later, as the permanent tooth emerges, your dentist removes the device. And presto! Your child is ready for a lifetime of smiles.

How do you wear a removable partial denture?

Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and they are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps. Consult with your dentist to find out which type is right for you.

How long will it take to get used to wearing a denture?

For the first few weeks, your new partial denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Follow all instructions given by your dentist. Your denture should fit into place with relative ease. Never force the partial denture into position by biting down. This could bend or break the clasps.

When a dentist talks about a "bridge," what are they talking about?

If you're missing one or more teeth, you may notice a difference in chewing and speaking. There are options to help restore your smile.

Bridges help maintain the shape of your face, as well as alleviating the stress in your bite by replacing missing teeth.

Sometimes called a fixed partial denture, a bridge replaces missing teeth with artificial teeth, looks great, and literally bridges the gap where one or more teeth may have been. The "artificial" tooth is attached between two (2) "crowns" and those crowns are then attached directly to the teeth on either side of the "hole" where the missing tooth was. Simply put, the two healthy teeth, on either side of the "hole," from the missing tooth, hold the artificial tooth in place. The restoration can be made from gold, alloys, porcelain or a combination of these materials and is bonded onto surrounding teeth for support.

Unlike a removable bridge, which you can take out and clean, a fixed bridge stays attached with permanent cement.

An implant bridge attaches artificial teeth directly to the jaw or under the gum tissue. Depending on which type of bridge your dentist recommends, its success depends on its foundation. So it's very important to keep your remaining teeth healthy and strong.

Is there another way I can have a tooth replaced other than a bridge?

Yes. Dental implants can provide artificial teeth that look natural and feel secure. Dental implants can also be used to attach full or partial dentures. Implants, however, are not an option for everyone. Because implants require surgery, patients must be in good health, have healthy gums, have adequate bone to support the implant and be committed to meticulous oral hygiene and regular dental visits. If you are considering implants, a thorough evaluation by your dentist will help determine if you would be a good candidate.

How does a sealant help prevent decay?

A sealant is a plastic material that is usually applied to the chewing surfaces of the back teeth—premolars and molars. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids.

Thorough brushing and flossing help remove food particles and plaque from smooth surfaces of teeth. But toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque. Sealants protect these vulnerable areas by "sealing out" plaque and food.

Why is thumb sucking a problem?

You may be concerned about your child's thumb sucking and wonder if it is harmful, at what age your child should stop, or what could happen if your child doesn't stop.

Children suck on things because sucking is one of a baby's natural reflexes and as infants get older it serves many purposes. It may make them feel secure and happy and helps them learn about their world to suck on their thumbs, fingers, pacifiers or other objects. Young children may also suck to soothe themselves. Since thumb sucking is relaxing, it may help induce sleep.

After the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and alignment of the teeth. It can also cause changes in the roof of the mouth. The intensity of the sucking is a factor that determines whether or not dental problems may result. If children rest their thumbs passively in their mouths, they are less likely to have difficulty than those who vigorously suck their thumbs. Some aggressive thumb suckers may cause problems with their baby (primary) teeth. If you notice changes in your child's primary teeth, consult your dentist.

Children should have ceased sucking by the time the permanent front teeth are ready to erupt. Usually children stop between the ages of two and four years.

Pacifiers can affect the teeth essentially the same ways as sucking fingers and thumbs. However, it is often an easier habit to break.

Can you recommend anything that will stop thumb sucking?

Praise children for not sucking, instead of scolding them when they are. Children often suck their thumbs when feeling insecure or needing comfort. Focus on correcting the cause of the anxiety and provide comfort to your child.

For an older child, involve him or her in choosing the method of stopping. Your dentist can offer encouragement to a child and explain what could happen to their teeth if they do not stop sucking.

If the above tips don't work, remind the child of their habit by bandaging the thumb or putting a sock on the hand at night. Your dentist or pediatrician may prescribe a bitter medication to coat the thumb or the use of a mouth appliance.