healthy teethHere are some of the most frequently asked questions our patients have about dental procedures and oral health issues.  If you have any questions not listed, or would like to schedule an appointment, please call or contact our office today.  Another resource available is healthtap.com, a website where you can submit a medical or dental question which will be answered by a doctor.

Q:   What should I do if I have bad breath?
Bad breath, or halitosis, can be an embarrassing and unpleasant condition.  In healthy people the major reason for bad breath is microbial deposits on the tongue, especially on the back of the tongue.  Some studies have shown that bad breath can be reduced as much as 70 percent by simply brushing the tongue.

Causes of bad breath:

  • When you wake up in the morning:  During sleep saliva flow almost stops and the reduced cleansing action allows bacteria to grow which causes the bad breath.
  • Certain foods:  Onions, garlic, etc.  Some foods contain odor-causing compounds, which enter the bloodstream, then are transferred to the lungs where they are exhaled.
  • Poor oral hygiene habits:  Any food particles left inside the mouth will promote bacterial growth.
  • Periodontal (gum) disease:  Inflamed gums harbor bacteria and food debris.
  • Dental cavities & improperly fitting dental appliances:  These may contribute to an increase of bacteria in the mouth.
  • Dry mouth (Xerostomia):  May be caused by salivary gland problems, continual mouth breathing, or by certain medications.
  • Tobacco products:  These dry the mouth, which causes bad breath.
  • Dieting:  Chemicals called ketones are released in the breath as fat is burned.
  • Hunger, missed meals and dehydration:  Lack of chewing food and drinking fluids decreases saliva flow, which promotes bacteria growth.
  • Certain illnesses and medical conditions:  Chronic sinus infections, liver and kidney problems, bronchitis, diabetes, and pneumonia are conditions that may contribute to bad breath.

Q: How can I prevent bad breath?

  • Practice good oral hygiene:  You should brush at least two times a day with an ADA approved toothpaste and toothbrush.  Flossing daily will remove food debris and plaque from under the gumline and in between the teeth.  Brush your tongue or use a tongue scraper to clean the tongue making sure you reach the back areas.  Your toothbrush should be replaced every 2 to 3 months.  Any dentures or removable bridges should be cleaned thoroughly and placed back in the mouth in the morning.
  • See your dentist regularly:  Have a dental cleaning and exam at least twice a year.  If you have or have had gum disease your dentist may recommend more frequent visits.
  • No smoking or chewing tobacco:  Your dentist can recommend ideas to help you break the habit.
  • Drink plenty of water:  This will keep your mouth moist and wash away bacteria.
  • Mouthwash/rinses:  Many over-the-counter products provide only a temporary solution to mask mouth odor.  Ask Dr Yash about antiseptic rinses.  They not only eliminate bad breath but they kill the bacteria that cause bad breath.
  • Keep a record of what you eat:  This will help determine the cause of the bad breath.  Your current medications, recent surgeries, and illnesses should be reviewed as well.

Dr Yash can usually treat the cause of bad breath.  If the problem persists even though your mouth is healthy, he may refer you to your physician who will identify the cause of the odor and recommend a treatment plan.

Young Woman Brushing Teeth In StudioQ:  How often should I brush my teeth and floss?
 Both brushing and flossing help to control the plaque and bacteria that cause dental disease.

Plaque is a coating on the teeth and gums that is caused by food debris, bacteria, and saliva.  Bacteria in the plaque converts food particles into acids that can cause tooth decay.  If plaque is not removed it can turn into calculus (tartar).  If plaque and tartar are not removed they can destroy the gums and bone, causing periodontal (gum) disease.  Plaque is constantly forming and growing and can only be controlled by brushing and flossing regularly.

Brushing your teeth:  Brush at least twice a day, especially before going to bed at night.  Use an ADA approved soft bristle brush and toothpaste.

  • Use a small circular motion, holding the brush at a 45 degree angle to the gums.  You should always feel the bristles on the gums.
  • Brush the inner, outer, and biting surfaces of each tooth.
  • Clean the inside of the front teeth using the tip of the brush head.
  • Brush your tongue.  This will remove bacteria and keep your breath fresh.

Using an electric toothbrush is very effective.  They are easy to use and they remove plaque efficiently.  All you need to do is place the bristles of the brush on your gums and teeth and the brush does the rest, several teeth at a time.

Flossing:  Flossing daily is the best way to clean between the teeth and under the gumline.  Flossing helps to clean these spaces, but it also breaks up plaque colonies and prevents them from building up and damaging the teeth, gums, and bone.

Use 12-16 inches (30-40 cm) of dental floss.  Wrap it around your middle fingers, leaving about 2 inches (5 cm) of floss between your hands.

Guide the floss with your thumbs and forefingers.  Insert it between teeth with a gentle sawing motion.

Curve the floss into a “C” shape around the tooth and under the gumline.  Move the floss up and down.  This cleans the side of the tooth.

Use a floss holder if you have difficulty using conventional floss.

Rinsing:  You should rinse your mouth with water after brushing.  It is also important to rinse with water after meals if you are not able to brush.  If you prefer to use an over-the-counter product for rinsing, you should consult your hygienist or Dr Yash.

Q: How safe are amalgam (silver) fillings?
 Amalgam fillings are a blend of copper, silver, tin, and zinc, bound by elemental mercury.  This blended material has been used by dentists to fill teeth for over 100 years.  There has been concern that exposure to vapor and minute particles from mercury can cause health problems.

The general opinion is that amalgam fillings are safe.  The ADA (American Dental Association) states that studies have not found a link between amalgam fillings and any medical disorder.  Although we know that mercury is a toxic material if we are exposed to it at high levels, the ADA asserts that when mercury is combined with the other materials in an amalgam filling, the mercury becomes an inactive substance that is safe.  The Center for Disease Control (CDC), the World Health Organization, and the FDA agree that silver fillings are safe, durable, and cost effective.  The U.S. Public Health Service states that the only reason to avoid silver fillings is when the patient is allergic to any component of the filling.  There have been fewer than one hundred incidents of allergies to silver fillings ever reported to the ADA.

Alternative types of fillings are available.  These include composite (tooth colored), porcelain, and gold.  Dr. Yash is happy to discuss these options with you.

Q.  How often should I get a dental exam and cleaning?Closeup of beautiful smile
 You should have your teeth examined and cleaned twice a year.  In some cases Dr Yash recommends more frequent cleanings.

Having regular dental exams and cleanings is essential in maintaining oral health and preventing dental problems.  A dental cleaning includes removal of tartar and plaque, then polishing the teeth.

Removing plaque:  Plaque is an almost invisible, sticky film that forms on the teeth.  It is a colony of food debris, saliva, and living bacteria.  Toxins (poisons) that inflame the gums are produced by the bacteria.  This inflammation is the beginning of periodontal disease.

Removing calculus (tartar):  Tartar is hardened plaque that has been on the tooth for a while and becomes firmly attached to the tooth surface.  Tartar forms above and below the gum line. It must be removed with special dental instruments.

Polishing the teeth:  This removes stains and plaque that has not been removed by brushing and scaling.

During the exam we check for cavities and other things in order to keep your mouth healthy.

  • Medical history review:  Awareness of current medical conditions, medications, and illness gives us insight to your overall and dental health.
  • Evaluation of diagnostic x-rays:  X-rays are essential to detect decay, tumors, cysts, and bone loss as well as determining tooth and root positions.
  • Oral cancer screening:  the face, neck, lips, tongue, throat, tissues, and gums are checked for any signs of oral cancer.
  • Gum disease evaluation:  The gums and bone around the teeth are checked for any signs of periodontal disease.
  • Examination for tooth decay:  All surfaces of the teeth will be checked with special instruments for decay.
  • Examination of existing restorations:  We check your current crowns, filling, etc.
  • Oral hygiene recommendations:  We will review and recommend oral hygiene tools as needed (electric toothbrush, special cleaning aids, fluoride, rinses, etc.)
  • Review your eating habits:  Your diet plays a very important role in your oral health.

Q: How can I tell if I have gingivitis or periodontitis (gum disease)?
Four out of five people have some sort of gum disease and don’t know it!  Most people are not aware of having gum disease because it is usually painless in the early stages, unlike tooth decay which often causes discomfort.  Having regular dental exams is very important and will detect if periodontal problems exist.

Periodontal disease begins when plaque (a colorless, sticky film of food debris, saliva, and bacteria) is left on teeth and gums.  The bacteria produce acids, or toxins, that cause inflammation of the gums and slowly destroys the bone.  Regular brushing and flossing will make sure that plaque is not left to do this damage.

There are several factors other than poor oral hygiene that increase the risk of periodontal disease:

  • Smoking or chewing tobacco
  • Poor tooth or appliance conditions:  Bridges that do not fit properly, defective fillings that trap plaque and bacteria, or crowded teeth.
  • Medications:  Some medications such as steroids, cancer therapy drugs, blood pressure meds, and oral contraceptives have side affects that reduce saliva.  This makes the mouth dry which makes it easier for plaque to adhere to the teeth and gums.
  • Pregnancy, oral contraceptives, and puberty:  Changes in hormone levels can cause gum tissue to become more sensitive to the toxins made by bacteria.
  • Systemic diseases:  Diabetes, blood cell disorders, HIV / AIDS and other diseases can lower immunity and/or cause inflammation that will affect the gums.
  • Genetics:  Some people are predisposed to a more aggressive type of periodontitis.  If there is a history of tooth loss, we advise our patients to take particular care of their gums.

Signs & Symptoms of Periodontal disease

  • Red & puffy gums:  Gums should never be swollen and red.
  • Bleeding gums:  Gums should never bleed, even when you use dental floss or brush vigorously.
  • Bad breath:  Persistent bad breath is caused by bacteria in the mouth.
  • Movement of or new spacing between teeth:  Caused by bone loss
  • Loose teeth: Caused by bone loss or weakness of periodontal fibers (fibers that hold the tooth to the bone).
  • Pus  around gums and teeth:  Sign of infection
  • Receding gums:  Due to loss of gum around a tooth
  • Discomfort or tenderness:  Tartar, plaque, and bacteria irritate the teeth and gums.

Q: Why should I use dental floss?
 Brushing is adequate to remove food particles, plaque, and bacteria from all tooth surfaces except in between the teeth.  Our toothbrush cannot reach those areas that are highly susceptible to tooth decay and gum disease.

Flossing is the best way to clean between teeth and under the gumline.  This is where plaque colonies can grow.  Plaque is an almost invisible sticky film that grows in the mouth.  It is caused by food debris, saliva, and bacteria that produce toxins (acids) which irritate and inflame the gums and cause cavities.  When plaque is not removed it hardens and turns into tartar which causes further damage to gums and bone.  Flossing disrupts plaque colonies from growing, thus preventing damage to teeth, gums, and bone.

How to floss:

Use 12-16 inches (30-40 cm) of dental floss.  Wrap it around your middle fingers, leaving about 2 inches (5 cm) of floss between your hands.

Guide the floss with your thumbs and forefingers.  Insert it between teeth with a gentle sawing motion.

Curve the floss into a “C” shape around the tooth and under the gumline.  Move the floss up and down.  This cleans the side of the tooth.

Use a floss holder if you have difficulty using conventional floss.

Q:  How does cosmetic dentistry improve the appearance of my smile?
If you are feeling self-conscious about your teeth, or just want to improve its appearance, there are cosmetic dental treatments that can give you a more confidant, beautiful smile.  There have been many advances in cosmetic dental procedures and materials that can change your appearance dramatically, from a single tooth restoration to a full mouth makeover.

Cosmetic Procedures:

Teeth Whitening:  Teeth that have been stained or discolored by food, drink, smoking, age, injury, or taking certain medications can be lightened.  There are several techniques and their effectiveness depends on the degree of staining.  Dr Yash is happy to discuss the options available to you.

Composite (tooth-colored) fillings:  Composite fillings (also known as “bonding”) are a widely used alternative to amalgam (silver) fillings to repair teeth with decay and also to replace old defective fillings.  Composite fillings can be used to repair broken, chipped, or discolored teeth.  They are also used to fill in gaps and to protect sensitive, exposed root surfaces due to gum recession.

Porcelain Veneers:  Veneers are custom-made, thin tooth-colored shells, which are bonded onto the surface of teeth.  They are used to restore or camouflage poorly shaped, damaged, discolored or misaligned teeth.  Unlike crowns, a veneer requires minimal tooth structure to be removed from the tooth.

Porcelain Crowns (caps):  A crown is a custom made tooth-colored covering that encases a tooth, restoring it to its original size and shape.  Crowns strengthen and protect teeth that can’t be restored with fillings.  Crowns are perfect for teeth that have large, broken, or fractured fillings, or for teeth that are badly decayed.

Dental implants:  Implants are artificial roots that are surgically inserted into the jaw to replace one or more missing teeth.  Bridges, dentures, and porcelain crowns can be custom made to attach to implants, making a stable, strong, and durable solution to removable appliances.

Orthodontics:  Straightening teeth with orthodontics is much more appealing to adult patients with today’s less visible and more effective brackets and wires.  Teeth may also be straightened with Invisalign clear braces, which are custom made, practically invisible removable aligners.

 Q:   What are porcelain veneers?

Porcelain veneers are custom-made, thin tooth-colored shells, which are bonded onto the surface of teeth.  They are used to restore or camouflage poorly shaped, damaged, discolored or misaligned teeth.  Unlike crowns, a veneer requires minimal tooth structure to be removed from the tooth.

Veneers are used to correct or restore the following dental conditions:

  • Severely stained or discolored teeth
  • Uneven or unwanted spaces
  • Chipped or worn teeth
  • Tooth overcrowding
  • Misshaped teeth
  • Teeth that are too large or too small

Getting veneers usually requires two visits to the dentist.  First, an impression (mold) of your teeth is made and then sent to a professional dental laboratory where the veneer is custom made.  On the next visit your teeth are prepared by lightly buffing and shaping the surface, with little or no anesthesia.  The veneers are attached to the tooth with bonding cement.

Case 25 beforeQ:   What can I do about discolored or stained teeth?
Teeth whitening is the number one aesthetic concern of many patient and there are many products and methods available to accomplish this.

Teeth darken or discolor for a variety of reasons.  As we age the outer layer of enamel wears away leaving a darker or yellow color.  Smoking, drinking coffee, tea, and wine also contribute to tooth discoloration.  Teeth can also become discolored by taking certain medications as a child or from excessive fluoridation during tooth development.

Professional teeth whitening is a simple dental treatment which changes the color of the natural tooth enamel.  There are products available over-the-counter as well, but they are much less effective than the treatment you can get in a dental office.

It is important for Dr Yash to evaluate your teeth to determine if you are a good candidate for bleaching.  Sometimes if tetracycline or fluoride stains are too difficult to bleach, you may want to consider other options such as veneers or crowns that would cover the stains.  Teeth whitening only works on natural tooth enamel so you may want to consider replacing old fillings or crowns so that they match your newly whitened teeth.

Types of professional teeth whitening systems:

Home teeth whitening:  Dr Yash will make a custom fitted mouthguard or tray created from an impression of your teeth.  You will use a whitening gel in the tray and wear it either twice a day for 30 minutes or overnight.  Usually it takes several weeks to achieve the desired level of whitening.

In office teeth whitening:  Dr Yash uses the Zoom system.  A bleaching solution is applied to the teeth, then a light is used to enhance the bleaching action.   This technique will yield immediate results but may require more than one visit.

KoR before and afterKoR bleaching:  The KöR deep bleaching system is a whitening system invented by an internationally renowned cosmetic dentist and whitening science expert, Dr. Rod Kurthy.  It is by far the most reliable, effective whitening system ever developed.  In fact, the KöR system is so effective it is the only recognized bleaching system that whitens even tetracycline-stained teeth in a short time.  The amazing KöR whitening results are typically achieved with little or no sensitivity.  This system uses a custom bleaching tray with special gel to be worn at home for at least two weeks plus one or two whitening visits to our dental office.  The KöR whitening system is 100% guaranteed or your money back.

Some patients report tooth sensitivity after having their teeth whitened.  This feeling is temporary and will go away shortly after the bleaching process is completed.

Teeth whitening is not permanent so it may be necessary for a touch-up to keep your teeth bright.