The Top 8 Questions about General Dentistry Answered
September 15, 2022
What treatments are available for covering exposed roots? Exposed roots are an interesting problem in dentistry because some patients have exposed roots that really hurt, and other patients have exposed roots that don’t bother the patient at all. In fact, there are patients who have exposed roots on both sides of their mouth, but are only sensitive on one side. Exposed roots most often happen due to gum recession – a condition caused by a number of conditions including age, brushing with a hard toothbrush, and dental restorations or filings that don’t fit properly and irritate the gums. To fix exposed roots we first want to figure out why the recession (exposed roots) are present, and if possible, stop the cause. After that, the treatments for exposed roots range from using sensitivity toothpastes such as Sensodyne or Prevident (by prescription only and if sensodyne isn’t effective), or covering the exposed root with a bonding (composite filing).
What is dental bonding? From a technical standpoint dental bonding is the process by which we place dental fillings that adhere to the tooth vs. older-type filings that were held in by the shape of the filling. A dental bonding is also known as a composite filling or “white filling”. When we talk about tooth-colored fillings, we are referring to dental bondings. Dental bonding can also refer to the way in which we cement crowns and veneers to your teeth. While we still use dental cements to hold crowns and veneers on teeth, if we need a stronger bond for a short tooth or for an area with heavy use such as the front teeth, we can bond the restoration (crown or veneer) to the tooth.
I have constant bad breath. What could the problem be? There are a number of reasons why someone can suffer from bad breath. From a dental perspective, something as simple as having poor oral hygiene can lead to bad breath because when your teeth aren’t clean, the food debris and bacteria build up and start to smell. In order to combat this odor, make sure you are brushing your teeth 2x/day and flossing (tiny food particles can hide in between your teeth in places your toothbrush can’t reach). Similarly, odor-producing bacteria can live on your tongue – many people don’t know that you should be brushing your teeth AND your tongue! And you don’t need to buy a special tongue brush – you can use your regular toothbrush to keep your tongue clean – just be gentle and don’t “scrub” your tongue. If you have persistent bad breath, it’s also possible that there is a medical condition that’s causing the problem. Diseases such as diabetes can lead to bad breath as can certain types of acid-reflux disease, be sure to consult with your physician if you have bad breath that doesn’t seem to resolve.
Can I fix a cracked tooth naturally? No. The good news, however, is that tooth cracks can vary in seriousness and severity, and as such not all tooth cracks require treatment. For very large cracks in teeth where the tooth is split underneath the gum line, the tooth will most likely need to be extracted; if there isn’t enough tooth above the gumline to hold on a crown, the tooth can’t be saved. Sometimes a part of the tooth can crack or form a small chip, especially if you have an existing large filling in the tooth or if you accidentally bite the wrong way on a hard piece of food. For these types of cracks we can often do a filling (for smaller cracks) or a crown (for larger cracks). For very small chips or cracks, we can sometimes polish the rough edges of the area and stop there – without placing any type of filling. Then there are very thin lines in teeth that may look like cracks, but aren’t cracks in the sense that a part of the tooth is missing or chipped. These micro-cracks are called craze-lines, and depending upon a patient’s bite and oral habits (does the patient grind their teeth at night), no treatment is indicated other than to carefully observe the tooth or teeth in question, and/or to consider fabricating a night-guard to protect the teeth.
Is tooth whitening permanent? No. But there are things you can do to make the effects of whitening treatment last longer. Regardless of whether you have over-the-counter whitening, in-office whitening or take-home whitening (or a combination), one of the most important things you can do to maintain the bleaching is to eat clear or light food – especially in the beginning and right after treatment. We know very well that dark liquids such as coffee, tea, and red wine can stain your natural teeth – so as you might imagine, these liquids can also dampen the success of whitening treatment. And especially during the whitening treatment (e.g. take-home whitening), avoid dark foods such as red sauces, red fruits such as strawberries, and purple foods such as grapes.
Do Wisdom Teeth always have to be taken out? No. But they often do. We hear mostly about wisdom teeth when people talk about needing to have them extracted, and while it’s true that not everyone needs their third molars removed, a large percentage of people will need to have their wisdom teeth taken out at some point in their lives. The most common reason for needing a wisdom tooth (or wisdom teeth) taken out is because there is no room in the patient’s mouth for the teeth to erupt (grow in) properly. This can mean that the teeth are partially erupted (you only see a small part of the tooth in the mouth) or that they are impacted (unerupted under the gum so you can’t see them in your mouth, but at an angle that can damage the tooth in front of it). We will also look to remove wisdom teeth if they are affecting the teeth in front of them. The last thing you want is for a wisdom tooth to cause a cavity or gum problems on the tooth in front of it Thus, if we see a cavity starting to form on the tooth in front of the 3rd molar (most often a 2nd molar) or if we see food constantly getting stuck in between the third molar and the 2nd molar causing inflammation and bone loss, we’ll often recommend that the 3rd molar be removed. And of course if you have a wisdom tooth that’s erupted into your mouth (or partially erupted) we will recommend that the tooth be extracted before the cavity gets worse and leads to discomfort. Though in some select cases we will do fillings on wisdom teeth (but this is a less common situation).
What are the different types of dentures? Are different types of dentures more expensive than other types? In general there are two big categories of dentures – full dentures for patients who don’t have any of their natural teeth and have to replace all of their teeth, and partial dentures for patients who have some of their natural teeth and only need to replace a few missing teeth. Full or complete dentures are made out of acrylic and there usually isn’t much variety in the material. Partial dentures, however, are different. Partial dentures can be made with cast metal, making them very strong for eating and chewing, or they can be made with a flexible material, which gives them the advantage of aesthetics because there are no metal hooks showing. Of course it a patient does not need hooks in the front of their mouth (depending upon which teeth are missing) then a cast metal partial can be just as esthetic as a flexible partial denture. Finally, the third type of removable partial denture is the least expensive one and it’s made entirely of acrylic and with metal hooks to help hold it in place. This type of partial denture is often known as a flippler, or a transitional, and is designed as a temporary cosmetic band-aid for esthetics. In some cases, however, patients who need a removable partial denture but have teeth that are too weak to support a metal or flexible partial, do wear acrylic flippers as a definitive denture.
What is a deep cleaning and why would I need one? Before we discuss deep cleanings, let’s talk about normal cleanings first. A routine dental cleaning (a “normal” cleaning) is one where we clean the teeth surface above the gums and around the gums. For many people, this is the only type of cleaning they will need. However, when someone has periodontal disease (gum disease) plaque and debris start to build up below the surface of the gum and around the tooth root, a deep cleaning is needed to remove the material. It’s called a “deep cleaning” because we have to clean the teeth deeper down on the root surface than we do with a routine cleaning. If you have periodontal disease and you don’t have deep cleanings, you may see your teeth start to get loose. The reason for this change is because if the debris around the tooth roots is allowed to remain underneath the gum, the resulting inflammation can lead to the loss of bone around the teeth. You may have heard us talk about “bone loss” when we talk about gum disease, and it’s this bone loss that causes people who have periodontal disease to lose their teeth.