Frequently Asked Questions

To the right are some questions that are asked frequently by the patients about issues related to oral health and dentistry. In case you have other questions or you want to schedule appointment, we would love hearing from you.

I have bad breath, what should I do?

Having bad breath can be embarrassing and unpleasant condition. Many people don’t realize they have bad breath. However, everyone has bad breath from time to time, especially in mornings.
There are different reasons for bad breath. In healthy people major source of bad breath is the microbial deposits which develop on tongue. According to some studies one can reduce bad breath up to 70 percent by simply brushing tongue.

What are the causes of bad breath?

Certain Foods – Onions, garlic, etc. Some foods contain odor compounds which cause odor. These compounds enter blood stream and are transferred to lungs. They are exhaled from lungs.

Morning Time – The flow of saliva almost stops when one is sleeping. It reduces the cleaning power and allowed the growth of bacteria. The result is bad breath.

Poor habits of oral hygiene – Food particles which remain in the mouth promote the growth of bacteria.

Periodontal disease (gum disease) – The colonies of the bacteria and the food debris that reside under the inflamed gums cause bad breath.

Dental appliances fitted improperly, orthodontic appliances and dental cavities – These can also cause bad breath.

Dieting – There are certain chemicals known as ketones which are released in breath as fat is burned by body. These can cause an unpleasant smell.

Tobacco Products – Tobacco products can dry one’s mouth, which results in bad breath.

Dry mouth – Dry mouth or Xerostomia can be caused by some medications, continuous breathing from mouth or problems of salivary gland.

Dehydration, missed meals and hunger –Saliva flow is increased by chewing foods and drinking water and it washes away the bacteria.

Certain illnesses and medical conditions –Diabetes, kidney and liver problems, pneumonia, chronic infections of sinus and bronchitis are some conditions which can cause bad breath.

By keeping record of what food you are consuming, you can identify causes of the bad breath. You should also review the current medications that you have, any recent illness or surgeries with the dentist.

What you can do to prevent the bad breath?

See the dentist regularly – You should get checkup with your dentist and have cleaning twice every year. In case you currently have or previously had the periodontal disease, frequent visits would be recommended by the dentist.

Practice good oral hygiene – You should at least brush twice every day with a toothbrush and toothpaste that is ADA approved. Floss daily in order to remove the plaque and food debris from under gum line and between teeth. Brush the tongue in order to clean it and while doing so reaches back areas. Make sure that you replace the toothbrush after every couple of months. In case you wear removable bridges or dentures, thoroughly clean them and place them back in the mouth in morning.

Stop smoking or chewing tobacco – You can ask the dentist about their recommendation for breaking this habit.

Use mouthwash – Some over the counter products provide only a temporary solution for masking the unpleasant odor. You should ask the dentist about the antiseptic rinses which alleviate bad breath as well as kill germs that are the cause of the problem.

Frequently drink water – Water helps to keep the mouth moist and it washes away the bacteria.

Your dentist will be able to treat cause of the bad breath in most of the cases. In case it’s determined that the mouth is fine and healthy and the bad breath problem remains persistent, the dentists might refer the patient to a physician in order to determine cause of odor and for appropriate plan of treatment.

How often should I floss and brush?

By flossing and brushing, it helps to control bacteria and plaque which causes the dental disease. The plaque is film of the food debris, saliva and bacteria which sticks to gums and teeth. Bacteria found in plaque convert some food particles in to acids which cause the decay of teeth. Also, in case the plaque isn’t removed, it becomes calculus (tartar). In case calculus and plaque are left there and not removed, they start destroying the bone and gums, causing the periodontal disease. The formation of plaque and its growth happens continuously and it can be controlled only by flossing and brushing regularly.

Tooth brushing – You should brush the teeth minimum twice every day (especially before at night before you go to bed) with a soft brush and a toothpaste that is ADA approved.

The correct way of brushing is to brush at angle of 45 degree to gums. Brush gently by using smaller circular motion. Make sure that you feel bristles on your gums. Brush inner, outer and the biting surfaces of every tooth. Make use of tip of brush head in order to clean inside the front teeth. In order to remove the bacteria and to freshen the breath, brush the tongue. You can also use the electric toothbrushes. They are recommended as they can be used easily and they are effective and efficient in the removal of plaque. Simply place bristles of the electric toothbrush on your teeth and gums and then allow the toothbrush to do its job, many teeth at one time.

Flossing – A great way of cleaning between your teeth and below gum line is daily flossing. Not only these spaces are cleaned by flossing but flossing also disrupts the buildup of colonies of plaque, preventing the damage to your gums, bone and teeth.

To floss take 3040 cm (1216 inches) of the dental floss and then wrap it around the middle fingers while leaving only 5 cm (2 inches) of the floss between hands. Use the forefingers and thumbs in order to guide floss, by using sawing motion, gently insert this floss between your teeth. Then curve floss into “C” shape around every tooth and then under the gum line. Gently move floss up and down and clean sides of every tooth. In case you are having a difficulty in using the conventional floss, you can use the floss holders.

Rinsing – It’s important that you rinse the mouth using water, after you brush and after meals in case you are not able to brush. In case you are using some over the counter product to rinse, consulting with the dentist or some dental hygienist on the appropriateness of the product for you will be a good idea.

Are the amalgam (silver) fillings safe?

There have been concerns about safety of the amalgam (silver) fillings, over the years. An amalgam is blend of silver, copper, zinc and tin, bound by the elemental mercury. This blended metal has been used by the dentists in order to fill the teeth since more than hundred years. Reason for the controversy are claims that exposure to vapor and the minute particles from mercury can cause different health problems.

According to ADA (American Dental Association), about 76% of the dentists use the silver which contains mercury in order to fill the teeth. ADA also says that the silver fittings are safe and studies have not been able to find link between the silver that contains mercury with any medical disorders. There is a general consensus that it is safe to use the amalgam fillings. In addition to ADA, World Health Organization, CDC (Center for the Disease Control), FDA and other support use of the silver fillings as cost effective, durable and safe. According to U.S Public Health Service only reason for not using silver filling is when the patient has allergy to components of the filling. There have been less than 100 incidents reported to ADA about allergy to the components of the silver filling. And this number is from millions of fillings of silver that are placed over many decades. Although it has been indicated by studies that no measurable risks to the health of patient exist due to use of silver fillings, we are aware of the fact that mercury is toxic when it’s exposed to high and unsafe levels. As an example, we are warned about consumption of some fish types which carry high mercury levels in them. But in the amalgam fillings, ADA says that when mercury is combined with other components of fillings, an active substance is formed which is safe. Numerous alternatives of the silver fillings exist, including the composite (tooth colored), porcelain and the gold fillings. You should discuss the options with the dentists in order to determine the option which will be best for you.

How often you should have dental examination and cleaning?

One should have his teeth cleaned and checked at least two times every year, though the dental hygienist or dentist might recommend more visits. It is essential to have the regular cleaning visits and dental exams in order to prevent the dental problems and to maintain health of the teeth and the gums. The teeth are cleaned at these visits and are checked for the cavities. In addition, there are other things as well which are checked and are monitored in order to help in detection, prevention and maintenance of the dental health. Other things include:

Medical history review: By knowing status of the current medical condition, new illnesses and medications, insights are obtained regarding dental health and overall health of the person.

Examination of the diagnostic X-rays (radiographs):It is essential for the detection of tumors, cysts, bone loss and decay. X-rays are also helpful in determining the positions of root and tooth.

Screening of Oral Cancer:Checking of face, lips, tongue, neck, throat, gums and tissues for oral cancer signs.

Evaluation of Gum Disease:Checking of bone and gums around teeth for periodontal disease signs.

Examination of tooth decay:The tooth surfaces are checked for the decay with dental instruments specially made for the purpose.

Examination of the existing restorations:Checking of current fillings and crowns.

Removal of the Calculus (tartar):The hardened plaque which is left on teeth since sometime is known as calculus. It is attached firmly with surface of tooth. It is formed below and above gum line. Calculus has to be removed with special dental instruments.

Teeth polishing:The stains and the plaque is removed which otherwise isn’t removed during scaling and tooth brushing.

Plaque removal: Plaque is sticky and invisible film which forms on teeth. It’s a growing colony of the bacteria, saliva and food debris. Toxins are produced by bacteria which inflame gums. The inflammation is beginning of the periodontal disease.

Recommendations for oral hygiene:Aids for oral hygiene are reviewed and recommended as needed (special aids for cleaning, fluorides, rinses and electric toothbrushes)

Review of dietary habits: The eating habits have an important role when it comes to one’s dental health. Good dental examination and cleaning is not simply checking for the cavities or simply polishing the teeth, there is much more involved in it. We can provide you with best care possible. In order to do this we require you to have regular cleaning and checkups.

How can you know if you have periodontitis (gum disease) or gingivitis?

Roughly four out of five people have the gum disease. Many people do now know because this disease is not painful in early stages. Usually tooth decay causes discomfort, but on the other hand periodontal disease often doesn’t have any noticeable symptoms. By having the regular checkups and the periodontal examinations one can detect the periodontal disease when it occurs. The periodontal disease starts with plaque, colorless and sticky film of the bacteria, saliva and food debris is left on gums and teeth. Toxins are produced by bacteria which inflame gums and gradually destroy the bone. Flossing and brushing properly and regularly will make sure that plaque isn’t left behind and doesn’t do the damage.

Poor oral hygiene is just one factor which can cause periodontal disease; there are many other factors as well which are stated below.

Smoking / chewing tobacco – The users of tobacco are more likely than the nonusers to get tartar and plaque on their teeth and gums.

Certain conditions of tooth or appliance – The bridges which no longer properly fit, defective fillings or crowded teeth can trap bacteria and plaque

Many medications – drugs of cancer therapy, steroids, blood pressure medicines, oral contraceptives. There are some medications which have the side effects of reducing saliva. It makes the mouth dry and the plaque is easier to adhere to the gums and teeth.

Puberty, Oral contraceptives and Pregnancy – Changes in the hormone levels can be caused, resulting in the gum tissue becoming more sensitive to the bacteria.

Systemic diseases – HIV/Aids, disorders of blood cells, diabetes, etc.

Genetics might play a role – there are some patients who might be predisposed to more aggressive kind of periodontitis. The patients who have family history of the tooth loss must pay special attention to the gums.


Symptoms and signs of the periodontal disease

Bleeding gums – The gums should not bleed, even if one brushes vigorously or uses dental floss.

Red and puffy gums – The gums should not be swollen or red.

Persistent bad breath – It’s caused by bacteria present in mouth

Loose teeth – It is also caused by weak periodontal fibers (the fibers supporting tooth to bone) or because of bone loss.

New spacing between teeth – It is caused by loss of bone.

Pus around gums and teeth – It is a sign of presence of infection.

Discomfort or Tenderness – Teeth and gums are irritated by the presence of bacteria, plaque and calculus.

Receding gums – It is caused by the loss of gums around teeth.

Balanced diet, good oral hygiene and regular visits to dentist can help in reduction of the risk of developing the periodontal disease.

Why using dental floss is important?

By brushing the teeth, the food particles, bacteria and plaque are removed from the surfaces of teeth but not form in between teeth. The toothbrush, unfortunately cannot reach these places which are very highly susceptible to the decay and the periodontal or gum disease. Best way of cleaning between teeth is daily flossing.  Flossing helps clean such places and disrupts the buildup of the colonies of plaque, thus preventing damage to teeth, bone and gums.

Plaque is sticky and almost an invisible film which forms on teeth. It’s a growing colony of the living bacteria, saliva and food debris. Toxins (acids) are produced by bacteria which cause the cavities and cause irritation and inflammation to the gums. When the plaque isn’t removed below and above gum line it becomes hard and it turns in to calculus (tartar). It further irritates and inflames gums and slowly destroys the bone. It’s the start of the periodontal disease.


Proper method of flossing:

To floss take 3040 cm (1216 inches) of the dental floss and then wrap it around the middle fingers while leaving only 5 cm (2 inches) of the floss between hands. Use the forefingers and thumbs in order to guide floss, by using sawing motion, gently insert this floss between your teeth. Then curve floss into “C” shape around every tooth and then under the gum line. Gently move floss up and down and clean sides of every tooth. In case you are having a difficulty in using the conventional floss, you can use the floss holders.

Daily flossing can help you in keeping beautiful and healthy smile for life!

How can the cosmetic dentistry help you in improving appearance of your smile?

In case you are feeling somewhat self-conscious about teeth or you simply would like to improve the smile, the cosmetic dentistry might be the answer to confident and more beautiful smile. Cosmetic dentistry is very popular since last few years, because of the advances in the procedures of cosmetic dentistry and the related materials. Another reason for its popularity is the increasing focus of the patients on improving the overall health. It includes the dental prevention as well as having whiter, healthier, and a more radiant smile.

Many cosmetic dental procedures are available for improving one’s teeth and for enhancing the smile. Depending on the particular needs of a person the treatments of cosmetic dentistry can change one’s smile dramatically.

You can get your dentists advice as to how you may improve beauty and health of your smile by using cosmetic dentistry.

The Cosmetic Procedures:

Composite (tooth colored) Fillings: They are also called “bonding” and now are used widely instead of the amalgam (silver) fillings for repairing teeth with the cavities and for replacing the old and defective fillings. The tooth colored fillings is used for repairing the discolored, broken or chipped teeth as well. These fillings are also useful for filling in the gaps and for protection of sensitive, exposed surfaces of root that are caused by the gum recession.

Teeth Whitening:The teeth which are discolored or stained because of food, drink, age and smoking are lightened by bleaching. The teeth which are darkened because of some injury or because of taking some medicines can be bleached too, but effectiveness is dependent on degree of staining.

Porcelain Crowns: Crown is a tooth colored, custom made covering which enhances entire surface of the tooth, restoring it to the original size and shape. Teeth which can’t be restored with the fillings are protected and strengthened by crowns. Crowns are best for the teeth having large, broken or fractured fillings and also for the ones that are decayed badly.

Porcelain Veneers: The veneers are the thin custom made tooth colored shells which are bonded on to fronts of the teeth in order to create beautiful individual smile. These can help for restoring or camouflaging the damaged, poorly shaped, misaligned, or discolored teeth. Unlike the crowns, the veneers require a minimal structure of tooth to be removed form surface of tooth.

Orthodontics: The less visible, more effective wires and brackets are making the teeth straightening with orthodontics more appealing for the adult patients. The teeth are straightened with the custom made clear and removable aligners instead of braces, in some cases.

Dental Implants: These are the artificial roots which are placed surgically into jaw in order to replace one or more missing teeth. Bridges, dentures and porcelain crowns can be made for fitting and attaching to the implants, giving the patient a stable, strong and durable solution to the removable dental appliances.

All thanks to advances in the modern dentistry, the cosmetic treatments can now make a big difference in making your smile shine!

What are the porcelain veneers and how they can improve your smile?

Porcelain veneers are the very thin shells of tooth shaped porcelain which are crafted individually in order to cover fronts of the teeth. They are durable and do not stain. It makes them popular solution for the people seeking restoration or enhancement of the beauty of smile.

The veneers might be used for restoration or correction of following dental conditions:

  • Uneven or unwanted spaces
  • Severely stained or discolored teeth
  • Chipped or worn teeth
  • Misshapen teeth
  • Slight teeth crowding
  • Teeth which are too large or small

Usually two visits are required for getting veneers. The veneers are made from a mold (impression) of the teeth which is then sent to professional dental lab where each veneer is custom made (for color and shape) for a person’s individual smile

With no or very little anesthesia, the teeth are made by lightly shaping and buffing front surface of teeth in order to allow for small thickness of the veneers. Then the veneers are fitted carefully and are bonded on to surface of the tooth with special cement for bonding and sometimes a light is used for hardening and setting the bond.

Veneers are a great dental treatment which can improve the teeth dramatically and give a beautiful natural smile.

What you can do about the discolored or stained teeth?

Since the teeth whitening now has become top aesthetic concern for many patients, a number of methods and products are available for achieving brighter smile.

Bleaching or teeth whitening, is simple, noninvasive treatment which is used for changing color of the natural enamel of tooth. It is a great way of enhancing beauty of the smile. Products which can be bought without any prescription are available as well. But those are not as effective as the professional treatments and they might not have the approval of the ADA (American Dental Association).

With age, tooth enamel’s outer layer wears away. It eventually reveals yellow or darker shade. Color of the teeth also comes from inside of tooth, which overtime can become darker. Fluids like wine, tea and coffee, and smoking can also be the factors contributing to discoloration of tooth, making them dull and yellow. Sometimes the teeth get discolored because of taking certain medicines as child, like tetracycline. The teeth can also become discolored because of excessive fluoridation during the development of tooth. It is important that you get the teeth evaluated by a dentists in order to determine if you are should get bleaching. Occasionally the stains of fluorosis and tetracycline can be difficult to get rid of with bleaching and dentist might offer you other options, like crowns or veneers in order to cover these stains. Since the teeth whitening works only on the natural enamel of tooth, evaluating the old crowns, fillings etc. is also important before bleaching starts.  Once bleaching has been done, the dentists can now match new restorations to shade of newly whitened teeth.

Teeth whitening isn’t permanent and touchup might be needed after several years in order to keep your smile bright.

Most commonly used professional systems of teeth whitening:

Teeth whitening at home: Usually at home products come in gel form which is placed in custom fitted mouthguard (tray) which is created from mold of the patient’s teeth. These trays are either worn twice every day for about 30 minutes, or are worn overnight while sleeping. Usually it takes many weeks for achieving desired results. The exact time depends on degree of staining and desired whitening level.

Teeth Whitening at office: The treatment is carried out in dental office. The results are seen immediately. More than one visit might be required and each visit lasts thirty to sixty minutes. The gums are protected and bleaching solution is applied to teeth. Special light might be used for enhancing action of agent while teeth are whitened.

Tooth sensitivity might be experienced by some patients after having the teeth whitened. The sensation is temporary and it subsides shortly after the bleaching process is completed, usually within few days to a week. Teeth whitening can be very effective and it can give you whiter, brighter and a more confident smile!