| FREQUENTLY ASK QUESTIONS: Q. I've had a lot of x-rays Dr., why do I have to have them every year? A. Without x-rays it is like seeing only the tip of the iceberg. X-rays are the only way we can see certain disease areas in the teeth and bone. It just wouldn't be fair to you or ethical of me to treat you without seeing the whole picture. Q. Does having x-rays more than once a year present risk? A. The risk of radiation from having x-rays is really less than if you were out in the sun for a couple of hours a week. I can assure you we will only take the minimum of x-rays here, but the ones we take are the bare necessity, and I just can't treat you without them. Q. How come my other dentist never told me I have gum disease? A. I really can't answer for your former dentists, but I can tell you this, we have learned so much about gum disease, even in the last five years or so. I'm able spot the disease so much earlier now and help patients get it under control so much better than I used to be able to. The truth is about 80% of the population over 35 have some degree of periodontal (gum) disease. Q. If I have a tooth that was filled a long time ago - why would it need a crown now? A. Fillings do 'outlive their usefulness' and can weaken what is left of the tooth. In most cases we can detect decay under the filling and/or see crack lines in the tooth. If there is a crack that means the tooth is going to break. If you wait for it to break, you might be lucky; it may break in a way that a crown can still be done. But sometimes they break up into the root system, and if that happens it means an extraction and an implant or bridge that is 3 times the expense of a crown. So it is not a question of what to do with the tooth, but when to do it. I always try to communicate the importance of doing a crown or an onlay in a timely fashion so the patient does not to lose a tooth. Q. I've got an abscess? How come it never really hurt? A. Not all abscesses are painful. If the nerve in a tooth has a fast death, that hurts, but sometimes the nerve dies so slowly that there is not even any discomfort. When they form slowly, I call it a quiet abscess. But it is an abscess just the same and an abscess is actually a pus sac that you can only get rid of by doing a root canal on the tooth and cleaning out that dead nerve. Q. I lost that molar 15 years ago, and I can chew fine without it. Why do I need to get it replaced now? A. When a tooth is lost, the remaining teeth shift, drift and tip out of position. It causes problems with the your bite, with gum tissue and bone. If you don't do anything, it is like taking a keystone out of an archway, the other stones will eventually follow. A replacement bridge or an implant stops the movement. Assuming the rest of your mouth is in good shape, it would just be a shame to let that area deteriorate when it could be stopped with a bridge or an implant. Q. How long will this crown last? A. Well, that is really impossible to say. It is like asking how long will a will car last. Is it being driven by a crazy teenager who never lifts up the hood, or your grandmother who just drives to church on Sunday and changes the oil once a month? Same thing with dental work the better you take care of it the longer it will last. Q. My gums have always bled - that's just the way they are. A. I have often wondered how fast people would run to the ER if they were bleeding from their eye or from their ear. But yet people's gums bleed and they think it is normal. The truth is bleeding gums are a sign of GUM DISEASE and when we get your gums healthy, you will be able to clean your mouth thoroughly and have no bleeding at all - that is actually a sign of good health gums. Q. If I have all of this gum disease, why does nothing hurt? A. I tell people that gum disease is a lot like diabetes or high blood pressure. You can go a long time having those problems and not have any symptoms. Just like with gum disease, by the time you have pus coming out of your gums, and loose teeth and pain you are about to lose teeth. Fortunately we can catch your problem at a early enough stage that we can get it under control. But, also like diabetes and high blood pressure we really can't cure gum disease. We can get it under control, and by that I mean the patient and I working together, to keep it under control. It is a situation you are probably going to be dealing with the rest of your life. If or when it gets out of control, you are going to lose a little bit more that we can't get back Q. Why do you want to replace all of those missing teeth, I can chew just fine? A.I know you think you can chew ok, but the truth is without any back teeth you are really chewing "rabbit style" - just with the front teeth. The front teeth just can't grind up food like the back teeth, so I know you are really swallowing your food almost whole and if your teeth are not doing their job properly, then your stomach has to do extra duty. It can do that for awhile, but sooner or later we see people without any back teeth developing stomach problems from all the extra wear and tear. When you've got some back teeth to really chew with you will notice the difference right away. You have just gotten used to a bad situation. Q. If you do a crown on a tooth, does that mean it will need a root canal? A. Well usually not, those are two different treatments. The crown is put on your tooth to strengthen because it is weak. A root canal treatment is done when the nerve in a tooth goes bad. Actually it more often works the other way around. Most root canal teeth are already weak and then the treatment makes them even more fragile so they usually needed to have a crown. Q. But what is root canal anyway? A. I magine your tooth divided down the middle, you'd see a space that runs the length of the tooth and that's where the nerve is. When the nerve goes bad, we go into that space, take out what's left of the nerve and seal up the space. At that point the tooth is technically a dead tooth and you can't feel pain or hot or cold from it but it's actually just like any other tooth in your mouth. Q. I don't understand, I thought you took the nerve out of that tooth. Why does it still hurt when I bite on it? A. There's a membrane that surrounds the root of your tooth and it acts like the shock absorber for the tooth. Sometimes when we do root canal work, that membrane swells up a little bit just enough to push your tooth down into your bite so you hit it a little before any other tooth and that squeezes against that swollen membrane. When that happens, I adjust your tooth so you can't hit it so hard and it should calm right down. Q. That tooth never hurt until you filled it. Now it's killing me - why? A. A lot of times decay can work so slowly into a tooth that you don't have any pain but when I go in to clean it out, I find the decay was really close to the nerve. Just from all the work I had to do and the deep filling I had to put in there, the nerve is probably very agitated. If we're lucky, we can get it to calm down, but sometimes in a deep cavity like that one the nerve actually starts to die. I can't promise anything, but I will do everything I can to keep it alive. It may be reacting like this for awhile and get better or it could eventually die. Q. What about dentist prescribed whitening systems vs over the counter whitening? A. The key differences are FIT OF THE TRAY and QUALITY of the product used. No one has a "one size fits all mouth", and the tray MUST fit well for the whitening to work well. If not, you could get spotty results, or burn your gum tissue. The professional gels are more consistent and contain desensitizers that the cheaper over-the-counter gels do not have. Whitening results are also faster using the professional gels.
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