I once had an instructor in dental school who gave me an interesting view on this subject. He said, "Just floss the ones (teeth) that you want to keep!". Flossing is not optional - it is just as important as brushing. It removes the plaque between the teeth which cannot be reached with a toothbrush or waterpik. Or flossing can lead to cavities or gum disease. For most people, flossing is best accomplished by wrapping the floss around one index finger and guiding it with the other index finger. Some people have a hard time getting the floss between their teeth. There are some good products to help with this. One is Glide floss from W.L. Gore; another is the Oral-B Satin floss. These are made to be especially "slippery" to get in between tight spaces. Lastly, there are some products on the market to help you if you cannot floss the way described above. Some people have arthritic or large fingers and can't reach their teeth very well. Products such as Dr. Du-Mores and Oral-Bs Hummingbird flossers can be of help.

Loose teeth can leave you feeling unsure and even helpless. It is a natural desire to want and keep them. I'm assuming that you probably have some form of either moderate or advanced gum disease. If your teeth are too loose, than it may be time to extract them. Sometimes, there are things you can do to keep them a little longer. The first and most obvious is to have regular cleanings. This could mean having your teeth cleaned 3,4 or even more times per year. These regular cleanings can reach deep down between the tooth and gum and clean areas where your toothbrush and floss may not reach. While these cleanings may not prevent the eventual loss of your teeth, they may help you to keep them significantly longer. Secondly, there is another procedure that can help. It is called splinting. Splinting is when your bond loose teeth together. This helps teeth absorb the strain from biting and chewing together. The most common way is to bond the front or usually backside of the teeth together with a composite resin. Sometimes a single wire may be bonded to help join all the teeth together, at first it may feel foreign, but most people soon forget it's there.

First of all, by having properly aligned teeth, you may prevent jaw problems. When teeth don't slide across each other correctly, your jaw joint can become uncomfortable. If you are already experiencing jaw problems, orthodontic treatment could alleviate the symptoms. Another benefit for adults is that by having properly aligned teeth, you may prevent further wear on your teeth. Many adults out there already have noticed that their teeth are shorter than when they were younger. While there is more than one possible cause, misaligned teeth can cause much faster than normal wear. Many adults have lost teeth. By having orthodontic treatment, these spaces may be closed. This could possibly prevent the need for implants, bridges, or other restorations.
It is estimated that about 1 in 5 orthodontic patients is an adult. Many people 50 years and older are currently receiving treatment. There really are no age limits. Also, many orthodontists give free consultations, so it would be a good idea to have a second opinion. Besides bringing you a beautiful smile, braces can improve the health of your teeth.

       On the plus side for composites, they are attractive and can keep the natural healthy appearance of your teeth and smile. Another benefit of composites is that they can preserve tooth structure. Since they are placed with an adhesive, only the decayed portion of the tooth need be removed.
       Sometimes with amalgams it is necessary to remove more than the decayed portion so that the shape of the prepared area will prevent the amalgam filling from dislodging. Also, composites can be very thin whereas if an amalgam filling is too thin it may crack. Since composites are bonded they can actually help support and strengthen tooth structure. To be fair, there are a couple of potential disadvantages to composites. Until the last few years, composite fillings could have a tendency to be slightly sensitive. With the new glues, I really believe this has been resolved for the most part. Composite fillings are also "technique sensitive". This means no bleeding or saliva should contaminate the tooth just prior to placement. This is an area where an amalgam has a distinct advantage.
       If you have a large filling that needed to be placed at or below the gum - the ideal treatment may be a crown or onlay, but to save money the patient requests a filling. It would be difficult or impossible to place a composite in this example as saliva may keep flowing in. Here an amalgam may work quite well. These are rare cases.

        If a tooth needs a root canal, it will NOT get better. It may not hurt for awhile, but that's different.  First, each tooth has a vein, artery and a nerve that run through them. This is why they feel pain and can ache and throb. Secondly, we'll look at a common cause for root canal treatment. Frequently, it starts with a cavity. If the cavity is deep enough, it may invade the space where the vein, artery and nerve reside. Remember, the cavity process involves bacteria. These same bacteria can cause the vein, artery and nerve to become infected. Once infected, the nerve will die. It will NOT regenerate. Now a bacterial infection occupies the space where the nerve once lived.
        When you take antibiotics, it may temporarily clear up the infection and then you feel better. Eventually, though, and it could be from one week to several months, the bacteria will invade this space again. It is best to avoid repeated cycles of antibiotics - this is not healthy. Furthermore, repeated infections of the tooth may cause significant bone loss around the tooth, possibly causing it to need an extraction. So once you know you need a root canal, get it done as soon as possible.

           Bad breath (halitosis) can be caused by many different things. Sometimes it is just temporary. You eat something with onions or garlic. You brush your teeth and the problem goes away. You may brush your teeth and have bad breath five minutes later. This often indicates there is an underlying problem. One cause of bad breath can be periodontal (gum) disease. This is something that will be determined by a dentist. As food gets trapped under the gums, bacteria will multiply. These bacteria can produce toxins that have a bad odor. It takes a deep cleaning at the dentist to help. Other possible causes of bad breath can come from medical problems such as diabetes, ear/nose/throat infections, kidney problems, etc. If the dentist has eliminated any gum disease or mouth problems as the source, you may need to see your doctor. A very common source of bad breath is when people forget to brush their tongues - particularly the back part of their tongue. Also, it is important to brush the gums as well as the teeth. Even the tonsils can harbor bacteria that cause bad breath. There are also special mouthwashes and treatments if all sources have been eliminated. A visit to the dentist is the right place to start.

              It would be difficult to say without an exam. Bleeding is not normal for routine brushing. There is a good chance you have some level of gum disease. Gum disease affects about 9 out of 10 adults at some point in their life. In fact, it is listed as the most common disease in the world. When there is bleeding with brushing, it likely means there is some inflammation of the gums. This inflammation can be signaling you that you have lost bone and or gum tissue support around your teeth. Quite frequently the process of gum disease may not hurt, even well into the advanced stages. There is more and more evidence that shows a connection between gum disease and heart disease and strokes. Inflamed gums release a C-reactive protein. This is the same protein that shows a stronger relation to heart attacks and strokes than high cholesterol levels. In other words, gum disease could be causing harm to your heart.

         In most cases you will probably brush your child's teeth for them until they are 6-7 years old. In some cases, you might need to wait until they are even older. The child should not be getting cavities and should be getting good checkups. Also, you should be monitoring your child's brushing at home. The best way to do this is with disclosing tablets (the little pills you chew up until your mouth turns pink). Give your child a disclosing pill to chew after they have told you they have brushed. There should be little or no pink on any of the teeth or gums. When your child can pass this test on a consistent basis, they may be ready to go on their own. Even so, you will probably need to check up on them from time to time. Even adults can benefit from the disclosing tablets. To help your child do a good job, make sure they are brushing 2-3 times a day. A thorough brushing should take 3-4 minutes. You may want to buy them an egg timer or something similar. Most people think they are brushing longer than they really are. Help your child to start a good habit that will last a lifetime. If you're not sure - of course then ask your dentist or hygienist. They can probably give you some clue as to your child's capabilities.

           First, deciduous (baby teeth) have pretty much hardened (calcified) by about the six month of pregnancy. By age 2 to 2-1/2 usually all the baby teeth are in and the adult teeth under them are well underway to being calcified. A typical child may lose their last baby tooth anywhere from 11-12 years old and this can vary. This means that your child is going to need to chew on these teeth for nine years or so. 
          If the tooth is going to fall out soon, there may be nothing wrong with not fixing it. But cavities left untreated can result in an abcess (infection), so we obviously don't want to subject our children to infections. Deciduous teeth are very important in the development of speech as well. Also premature loss of the baby teeth can result in the improper eruption of adult teeth. This can mean the adult teeth don't end up where they belong and in turn, this can mean the need for braces - a very costly and, perhaps otherwise unnecessary treatment for your child. Lastly, and not necessarily least important, is your child's smile. Kids love to have a beautiful, healthy smile just like adults and don't want to be made fun of. Social development is important. Children should start to visit the dentist sometime after the age of about 2-1/2 years old. Please remember, these are not just "baby teeth". These teeth are critical for your child's health, development and overall well-being.

          There would seem to be more downside than upside. On the positive side, chewing gum can help increase saliva flow, this in turn helps prevent cavities, but only if it is sugar free. Chewing gum seems to help some people focus on a task and some also claim it keeps them alert while driving. Chewing gum can help remove some food particles and freshen your breath as well. On the negative side, chewing gum can be a real stress on your jaw joint. For some people, there is a direct relationship between their TMJ (jaw joint) problems and chewing gum. Chewing gum can also be linked to tension headaches, constipation and gas, if swallowed. Lastly, and most importantly, chewing any gum that is not sugar free will promote tooth decay. The potential harm from gum probably outweighs any slight advantage for most people.

              Cold sores, fever blisters, canker sores, most all of us are familiar with those little white ulcers that show up on our lips and gums periodically. First there needs to be a distinction made between what we call cold sores and canker sores. 
             Canker sores (apthous ulcers) are similar to cold sores in that they both may have a similar appearance and last 1-2 weeks. Both may be triggered by trauma or stress. Canker sores have a tendency to be in areas of the mouth that have loose or mobile tissue (mucosa). A topical steroid such as Kenalog in Orabase may help shorten the course. It is estimated that only about 10% of the population may suffer from canker sores. 
             It is estimated that about 80% of the population is affected by cold sores. Cold sores are very contagiuos and may last 1-2 weeks once they appear. They are caused by the herpes simplex virus. They are often called "fever blisters" because they can be caused by stress such as an illness. Outbreaks can also be triggered by UV light (sun) or trauma (such as dental cleaning). Since cold sores are caused by a virus, the treatment is very different than for canker sores. An antiviral ointment or pill can shorten the course or even help prevent an outbreak. If you get sores after dental cleanings, for example, you can medicate a few days prior to your appointment to help prevent an outbreak. If you do suffer from these, please see the dentist to help determine what you have and how best to treat them.

           Dry mouth is known as xerostomia. Many people probably once thought that getting a dry mouth was part of the normal aging process. But there are actually many causes - at the top of the list are medications. Prescriptions for high blood pressure, anxiety, muscle tension, urinary incontinence, and allergies can all help lead to a dry mouth. Other causes can be nerve damage in the head or neck area, chemotherapy or radiation treatment. Conditions such as Alzheimers, strokes, Sjogren's Syndrome, and mouth breathing can also lead to a dry mouth. And lastly, tobacco products such as cigarettes, cigars and chewing tobacco can help contribute to this problem. 
          Sometimes having a dry mouth just seems like a slight nuisance, but it can cause problems. Saliva is important in that it helps to wash away the food from your teeth. This in turn can help reduce plaque formation. Plaque can play an important role in the development of cavities and gum disease. Minerals found in saliva can actually help promote repair of early tooth decay. And lastly, saliva aids in the digestion of food, makes it easier to swallow, and can enhance your ability to taste food.
           There are other symptoms that may accompany having a dry mouth. Some are more obvious, such has having thick or stringy saliva and difficulty swallowing and speaking. Other symptoms that can be present are sores or split skin at the corners of your mouth. Sometimes the tongue may tingle or burn. This can also cause an altered sense of taste. With more plaque accumulating, you may notice bad breath more frequently. 
            An exam by the doctor would be absolutely necessary to help rule out things such as cysts or tumors. It may be necessary to have a blood test or imaging scans of the salivary glands. The doctor may want to either adjust the dosage of your current medication, or change it altogether. Sometimes your doctor can prescribe medication called pilocarpine to help stimulate saliva production. There are a few things you can do for yourself. You might try sipping water frequently or purchase an over-the-counter saliva substitute. Also make sure you breathe through your nose and not your mouth. Sucking on SUGAR-FREE hard candies can help. If you are developing more cavities because of the additional plaque, then a fluoride gel such as Gel-Kam can be very useful.

        Spaces from even one missing tooth can affect the rest of your mouth. Besides the gaps looking unattractive, they can potentially cause chewing problems depending on where the missing tooth is located. Even if only one tooth is missing, other teeth may slowly shift, too. This could potentially cause a change in the way your teeth fit together. If your teeth don't fit together well, this could potentially cause problems with your jaw joint. So you see, the problems with missing teeth are not just how well you can chew, but there could be other problems from this that develop gradually over time. It is often difficult to convince someone that they need treatment when there is no pain and especially if there are no immediate consequences. But, missing teeth can cause real problems. Treatment options can sometimes be easier and less expensive if you do it sooner rather than later. Perhaps a consultation with a dentist may be necessary to discuss what your specific problems might be.

           Children's teeth and adult teeth are very different. Children's teeth do not do as well with fillings, especially large fillings as adult teeth do. What the studies showed was after 3 years 1/3 to 1/2 of the children's fillings (back teeth only) needed to be replaced. After 8 years, almost 89% of all stainless steel crowns were still working or had been extracted for braces. This is consistent with what I observe in the office. If a cavity is only in the middle of the tooth and doesn't go out to the side, then a filling may be very appropriate. It is when the filling goes down in between the teeth that the trouble begins. For these teeth a crown would be appropriate. You might save more at first if you go with the filling, but if you replace it even once, the crown is less expensive. Remember 1/3 to 1/2 of fillings needed replacement after 3 years and that almost 89% of all crowns survived 8 years. Now there are crowns available that are white or tooth colored for your child. In general, I would say don't feel bad about spending more on the crowns because they will last longer.

            There is a great debate these days over not just how much fluoride to give, but whether children should receive supplements at all. It can be difficult to determine how much. Some groups, such as the Fluoride Action Network (FAN) state the fluoride supplements are dangerous. There are different ways for a child to receive fluoride supplements. To me, the safest are the "topical" ones, ones that are applied directly to the teeth and not ingested or swallowed to any great degree. These supplements may include things such as your regular fluoridated toothpaste, the fluoride treatment from your dentist, or a daily fluoride mouth rinse such as ACT. I like these because they are applied only to the teeth, so they affect nothing else. The potential problem with fluoride drops or pills that you swallow is that it can increase the fluoride levels in your bloodstream. This in turn can affect your child's developing teeth. Too much fluoride (fluorosis) can cause chalky, weak teeth. 
           In my 12 years as a dentist, I have seen the daily-recommended fluoride levels decrease drastically. Currently the Public Health Service (PHS) recommends a community water fluoride level of .7-1.2ppm, depending on air temperature. Many people have wells for water here. I have personally tested over 300 wells and have found the fluoride concentrations vary from .2-3.2ppm. The point is this: there are many variables in how much fluoride your child may already ingest. Even sodas and bottled water may have fluoride concentrations depending on where they were produced. The topical applications have less risk of fluorosis. Greater thought and care should be given before using fluoride drops. This should include a thorough analysis including the child's dietary habits and a knowledge of the child's home or caregiver's drinking water fluoride levels.

          I'm sure that many of my patients have heard me say this: "My most happy patients are implant patients". The reason for this is simple. Implants work extremely well.
          Some of the earliest implants are credited to the ancient Egyptians and Etruscans. One technique that was used was to take tooth-shaped fragments of seashells and pound them through the gums into the jawbone. The credit for implants as we know them today is usually credited to a Swedish orthopedist named P.I. Brandemark. In 1965 he placed the first titanium implant similar to the ones we use now. This technology found its way to the United States around 1980.
           Implant is the replacement of the entire tooth. There is an artificial root as well as the tooth (crown) itself. The placement is usually fairly simple with no hospital stays required. Indeed, it is often done with regular anesthesia (just like getting a filling). Implants enjoy a phenomenal success rate. Depending on the patients health and placement of the implant, implants have a success rate of somewhere around 94-98%. With good home care, an implant should last a lifetime. They can be used to replace one, or all of your teeth. They can be used to anchor bridges, partials, and even help hold dentures in place. There are a few downsides. There may be some discomfort for a few days after the initial placement. Mostly, the biggest concern is cost. The implant may seem expensive - but it is a good value.  A person with NO teeth could begin chewing again without dentures - for a lifetime!

          Many people are aware that when a tooth is badly broken down it is time to place a crown. If the amount of decay is fairly small, then only a simple filling is required. Sometimes the amount of tooth structure missing may not be a lot, but may be more than a little. Often the dentist and patient still may opt for a filling. But there is the option for an inlay or overlay. Inlays and onlays are made outside the mouth, the same way a crown is. They are called indirect restorations. A filling is said to be a direct restoration because it is placed and formed directly into the tooth. Inlays and onlays are cemented or bonded to the tooth and can actually help strengthen it. A while back, many inlays and onlays were made of gold. Today, the tooth-colored ceramic ones are far more popular. Also, an inlay or onlay can provide many years of service like a crown. Many people opt for fillings because they are less expensive, but the inlay or onlay may be an attractive long-term option for you.

            Dental Benefit Plans were designed to help share the cost of dental treatment. Many plans cover between 50-80% of dental costs. But there are a lot of dental plans with a lot of variation. The following are some common terms: 
           UCR - this means usual, customary and reasonable. This usually refers to how much an insurance company will be willing to pay for a particular procedure. An insurance company is a business that wants to make a profit, so they will offer no more than they feel they have to. The UCR is commonly paid in one of two ways. First, it can be based on the dentist's fees - a common example might be that your insurance pays 80% of the filling regardless of the fee. The other way is that the insurance company may use some sort of data to determine what is reasonable. They may for example, use the average fees of all dentists in southern states. This works well if you live in a low cost area, not so well if the cost of living is high such as in our area. There is NO regulation as to how insurance companies determine a reimbursement level and they are not required by law to disclose how they determine those levels. 
          Another term that is used is called the annual maximum. The purchaser of the insurance plan determines this. Very often, this means the employer. A person's annual maximum may not cover all their needs. Although the cost of dental care has increased significantly over the years, the annual maximum on many plans has risen little or none since the late 1960's. People who exceed their annual maximums frequently want to wait again until the next year. While this is very understandable, waiting may result in other procedures that can be more costly. 
          The term "preferred providers" applies to those dentists who have a contract with your dental benefit plan. You may be able to choose a dentist who is not in network, but your level of reimbursement may be less. 
           Least-expensive alternative treatment - this part of insurance often leaves people very frustrated. The dentist may recommend a crown, but your insurance will only pay for a large filling. This doesn't mean you don't need a crown, it just means this is all your insurance company will pay for. They will pay for no more than they feel they have to. 
           The last term we will address is called "pre-existing conditions". Your plan may not cover a procedure if you had that need or condition prior to enrolling in their plan.
           The plan sponsor should be in the best position to explain your coverage. You are responsible for being aware of how your benefits work.

           Basically, a non-participating dentist means that the dentist has not signed a contract with your particular insurance company, although most dentists are always willing to help you. The difference between a participating and non-participating is usually the co-payment. A contracted provider has not only agreed to accept a discounted fee to provide services to you, he has also agreed to all terms and conditions that the insurance company has set. 
          For instance, if a dentist states that a patient needs a crown on a tooth that already has a large filling with new decay, the insurance company may only pay for the least expensive treatment. This may leave the dentist in a position to give the patient the least expensive treatment - but not necessarily the best treatment. People will sometimes decide what treatment they receive based on what their insurance company will pay, when they really need to have the treatment they need. 
          Remember, the insurance company is a business, and as a business, their focus is on making a profit. If a dentist is not a participating provider, it does not mean that a dentist will not help you with your insurance needs. Many dentists are willing to submit insurance claims for you. They should also explain your benefits to you and give advice on how to get the most out of your insurance benefits.

       Parents give their child a pacifier for a number of reasons. As far as dentistry is concerned, a pacifier may be considered if the baby has a thumb or finger sucking habit. A pacifier is better than a finger or a thumb because it causes fewer problems with tooth development; also, when the time comes, it is easier to take away a pacifier than a finger or a thumb.
        When choosing a pacifier, it is best to choose one that most closely resembles the mother's natural anatomical shape. An improperly shaped pacifier is more likely to cause problems with the development of the jaws and teeth. It is also best to use it no more than you have to. Again, the more hours in a day that a baby or child has a pacifier in his/her mouth, the greater the risk for speech and tooth development problems. 
       Never dip the pacifier in sugar or honey, as this can lead to cavities. Honey can also lead to botulism, which is a type of food poisoning. Most children will become less dependent on thumbs and pacifiers with age, but the desire can continue up until ages six or eight. Most children will quit by age two to four and should be done by age six, which is when the permanent front teeth erupt. Most importantly, you should always visit with your pediatrician to determine what is best for your baby.

          One of the most common reason that a dentist may refer to a periodontist (gum specialist) is to help eliminate deep pockets. The pocket is the space that exists between the tooth and gum. If a pocket is between 1-3mm deep, then this is normal. Pockets that are 6mm or deeper may require a visit to a specialist. The deeper pockets can be from the loss of bone around a tooth. When you have bony holes or defects next to your tooth, food, plaque, and bacteria may accumulate in these defects. These defects are too deep to clean with a toothbrush or floss and may even be too deep to reach with regular cleaning instruments from the dental office. 
           There is more than one way to get rid of these defects. One of the oldest ways was to expose the tooth and lower the rest of the bone around the tooth so there is no longer a hole or defect. Now all the bone is the same level around the tooth. It can be very effective. However, it can lead to sensitive teeth because now more of the tooth is exposed. Another way to fix this problem is to "fill in" the hole. This is the more preferred method, but may not always be possible. In this instance, the hole may be filled with some of your own bone taken from another site, cadaver, or synthetic material that allows your bone to gradually fill in the hole. It is possible with this type of grafting to put your tooth back into excellent health. So the periodontist can be a great partner in helping you keep your teeth.

Safety concerning your unborn baby's health is an important issue. First, if you have an infection in your bloodstream, then so might your child. There are a lot of things to consider about the timing of treatment. If there is an infection or abscess already present, then something should be done. You indicated you needed a root canal, so there is some sort of infection involved. While there are some general guidelines from various organizations regarding pregnancy and dental treatment, there are no specific ones. When treating pregnant patients, it is always a good idea for the dentist to consult with the M.D. in charge. If you come in with a very small cavity and are ready to deliver in a few weeks, then you would be scheduled to come in for your filling after delivery. If you came in during your 1st Trimester with swelling and an abscess, then treatment would have to be done before delivery. In this last instance, the risk from infection and doing nothing is greater than treating the tooth.
So far as x-rays go, there is no set limit for diagnostic exposure. The rule here is, no more x-rays than are necessary. Obviously all precautions should be taken to reduce exposure. Fortunately, dental x-rays are fairly focused. Most important is the dentist and the M.D. in charge should communicate with each other before treatment.

         Maybe, depending on the problem. Often, a patient will come in with a medium cavity or large cavity. When the decayed tooth structure is removed it may leave the nerve very close to the surface or even possibly partially exposed. If the filling is now close to the nerve, the tooth may be sensitive at first, epecially to temperature. If the tooth adjusts well, this may go away in several weeks. This would be considered normal. Other possibilities are that the new filling may be leaking, that a possible space exists between the filling and tooth. If this is the case, then the dentist may have to either reseal the margins of the filling or replace it. It could also be that the filling has a "high spot", that you hit that tooth first before the others. When you bite harder on one tooth, it often leaves it feeling sore or tender. This, by the way, could eventually lead to an abcess, which could require root canal treatment. The dentist checks for high spots when you leave, but sometimes when you are numb, you may not bite the same way you always do. If there is no high spot, but the tooth hurts when you bite on it, then the tooth could be cracked. The tooth may then need to be restored with a crown. In general, if the tooth feels better day-by-day, then you might be all right. As you can see, there are a number of possibilities. You should consult with a dentist to check your bite and the margins.

            The major concern with root canal treatment is pain. There is also a lot of confusion as to what is really happening during root canal treatment. First, root canal treatment should NOT hurt. The tooth should be numb during treatment and the patient should feel no pain. Probably a big reason for the painful root canal stories is that often the tooth is already hurting. This is what frequently brings a patient to the office. Sometimes root canal therapy will begin while there is active pain and swelling to help drain the infection. More often, the patient is placed on antibiotics, and then therapy is begun when the infection has subsided. At the end of root canal treatment you may expect some minor discomfort for 2-3 days, especially with chewing. 
            Describing a root canal is a little more difficult. Probably the most common misconception is this - the root is NOT removed from the tooth. The part of the tooth that you can see in your mouth (the crown) is hollow. The crown may have one or more roots attached to it. These roots have canals that connect to the hollow part of the crown. In these canals are veins, arteries, nerves and connective tissue. When you have a cavity, these hollow areas can become infected. During root canal treatment these infected areas are reached and cleaned out through the top of the tooth and then filled. The tooth is then ready for a crown.

             This is a fairly common concern we hear from patients who have gum disease. First of all, the "regular" cleaning is usually for healthier gums, for patients who have pocket depths of 3mm or less. A "pocket" is how far down things can go in between your gums and teeth. A standard tooth brush can only clean down about 3mm. The rubber cup with polishing paste will also not clean past 3mm. So if the pockets around your teeth are greater than 3mm, you can't keep them clean. Food and bacteria will get trapped in these areas causing further gum disease. Only your dentist or hygenist will be able to clean down in these deeper pockets with specialized instruments. The technique of using specialized instruments to reach down into the deeper pockets is often referered to as "scaling and root planing". It is the ONLY way to get these pockets clean. Sometimes this can also require the use of anesthesia. So it is a lot more work and, of course, costs more. Hopefully this is not a procedure you will have repeated or at least not often. Lastly people who need scaling and root planing will probably require more frequent follow-up cleanings - even if your insurance will not pay for them. These will be absolutely necessary to continue the healing of the gums.

         Sealants have been around since the 1960's and have been placed regularly since the 1970's. Unfortunately, studies show that fewer than 20% of children get them. A sealant is a resin coating on your tooth. This resin coating fills in the natural cracks and grooves of the teeth. This prevents food and bacteria from getting into these little spaces where cavities begin. It is most effective when placed on newly erupted, permanent teeth. Sealants are usually applied to the molars and premolars. This is the area where as much as 75% of all cavities develop. A sealant can be up to 100% effective in preventing cavities. Sealants can last five years and even longer. Avoiding habits such as crunching ice can help them last. More and more insurance companies are adding this as a benefit. But even if they don't, the cost of a sealant can be 1/4th the cost of a filling, not to mention the extra time spent going to more appointments for fillings, and they don't require shots. Sealants are a wonderful preventative measure.

              Many, many people suffer from sensitive teeth. Many of them do nothing about it fearing that they will need root canals or crowns. Often, though, the treatment can be simple. Sometimes, the patients can take care of it themselves.
              It could be natural wear and tear - the hard outer shell of the tooth is worn away exposing a more sensitive portion of the tooth. You might also have a broken or chipped tooth that has exposed this part of the tooth. Other possibilities are gum disease or receding gums that expose more of the tooth. People who grind their teeth at night might also suffer from sensitive teeth. Also, if you whiten your teeth - this can contribute temporarily. 
             There are many good desensitizing toothpastes on the market. Examples are Sensodyne and Arm & Hammer for Sensitive Teeth. Both contain potassium nitrate as the desensitizing agent. These products must be used every day. If you have more serious cold issues, then an in-office procedure might help you. Usually they are just painted on your teeth. No need for anesthetics or drills. These procedures can relieve sensitivity for weeks, months, or even longer. All this begins with a visit to the dentist. They need to make sure you don't have cavities and that your teeth are hitting correctly. Poorly aligned teeth can cause sensitivity. If you have aching or throbbing at night, then you really need to see a dentist.

        Your face has four sinus cavities. Your sinuses are hollow spaces in the bone that air passes through. Sometimes these spaces become infected or filled with fluid and can hurt. The ethmoid sinuses are located directly behind the nose. If these are infected then you may feel like you have pain between your eyes. It may hurt worse if you wear eyeglasses. The sphenoid sinuses are behind the ethmoids. Discomfort from these may be felt very deep, behind your eyes, at the top of your head or at the nape of your neck. The frontal sinuses are in the forehead area, over the eyes in the brow area. If these are involved, you may feel pain in the forehead area. Last are the maxillary sinuses. These are located inside the cheekbone. If these sinuses are involved, you may feel like you have a toothache - especially if it's in the upper back teeth.
        The reason a maxillary sinus infection can feel like a toothache is because the roots of your upper back teeth can project into the sinus. If the sinus is filled with fluid, it can apply pressure and aggravate the nerves of the maxillary teeth. Sometimes a routine x-ray can show a maxillary sinus infection. It can sometimes be difficult to tell if the pain is from a toothache or a sinus infection. If you have a history of sinus infections and this feels like "another one", then see your physician. If you are not sure, it would be fine to start with either your dentist or physician.

             Males are more likely to snore than females (42% vs 31%). The most common age range is 55-64 yrs old. This is according to a poll by the National Sleep Foundation. By the way, 2-13% of children snore. Primary snoring is caused when your soft palate and/or uvula (the thing that hangs down in the back of your throat) produce a vibration that can be hard - snoring. Snoring can be anything from an incomplete obstruction of the airway to a complete obstruction of the airway where no air passes through. This is called apnea and can be a much more serious condition. 
            Sometimes a sleep study called a polysomnogram may be needed to help determine the cause. There are many reasons why people snore, and in fact, there could be more than one cause. Being overweight and drinking alcohol can both contribute to snoring. Smoking is a potential contributor as well as the position of your head and neck. 
           There are just as many potential cures as there are causes. One of the simplest and most common aids are the nasal strips you can place across your nose at night to help keep it open. Abstaining from alcohol and smoking about four hours before bedtime can help. Losing weight can be a big help. You don't just lose weight on the outside parts. Also, you could try to sleep on your side. There are also anti-snoring devices you can get at your dentists' office. These devices can work by elevating the soft palate or bringing the lower jaw forward or keeping the tongue from falling back. Lastly, there are some surgeries available. Above all, do this first - visit your medical doctor to help ensure that any treatment you choose is safe for you.

            A patient health history in a dental office can have a lot of questions that seemingly have little or nothing to do with dentistry. Questions about past surgeries, child birth, asthma, and drinking alcohol may all seem remote, but actually, nothing could be farther from the truth. The health history is a well thought out series of questions designed to, not only keep the dentist from causing harm, but to also promote your dental health. Everyone would agree that it is important for the dentist to know if you are allergic to any medications. If you are allergic to it - you could die. But why should you share with the dentist all the drugs you are taking - both legal and illegal? Because some drugs (both legal and illegal - such as cocaine) can make the heart sensitive to other medications. Some of these medications we use routinely in dentistry. If the dentist is unaware of your history and gives you anesthetic to numb you, this could lead to a heart attack. It is important to know how well your kidneys functions so that they are not overloaded with too much anesthetic. It is important to know about your asthma, so that an asthma attack is not triggered at the visit. Blood pressure, the condition of your heart, are all critical to your visits. We are now aware that people with significant gum disease are at an increased risk for heart disease. It all matters. The dentist is just as obligated as any other medical professional to keep your information confidential. It is best to be open and honest with the dentist, so that you, the patient, have the safest and healthiest experience at your dental office.

         "Soft Teeth" is not an uncommon complaint from patients. When I think of soft teeth, I imagine someone having teeth the consistency of a jelly bean. What I think most people are trying to communicate is that "I keep getting a lot of cavities, there must be something wrong with my teeth". There can be a lot of reasons why people frequently get cavities and some can be out of your control. One thing is the bacteria in your mouth that are responsible for converting the sugars in your mouth into the acid that dissolves your teeth and causes cavities. Some people may have more of the bacteria then others. Some people may have bacteria that are more efficient at converting these sugars, while other peoples bacteria may not be efficient. While people may not truly have "soft teeth", they may not have a high quality enamel. For these people, the exposure to acid that does not cause cavities in most people, may cause a cavity for them. These may sometimes be referred to as "chalky" teeth. This is a fairly uncommon problem. The problem is usually  inadequate brushing and flossing. Also diet with a high sugar intake can be a problem. The worst offenders are sodas and hard candies. Hard candies take awhile to dissolve and expose your teeth to sugar for extended periods of time. Cough drops can be a major offender in this category. Do you have soft teeth? It's possible that yours are not as durable as everyone else's, but not likely. See a dentist and ask him to evaluate the quality of the enamel on your teeth and to review your dietary habits with you.

            Geographic tongue is fairly common (2% of the population) and is harmless. There are other terms for it, such as benign migratory glossitis and erythema migrans. These terms gave insight to the conditions. It is benign and its pattern may change (migratory). It may look like a map of islands or unknown countries that change location. The lesions may appear as a smooth area surrounded by a whitish border. As healing occurs in one area, new lesions may appear in another. It has been associated with psoriasis, dermatitis and stress. Women seem to have a higher incidence than men. There may also be a genetic component, it is often found in family members.
           There is really no treatment for geographic tongue. Most people will be entirely asymptomatic except for the appearance. On rare occasions some people may have a burning sensation. In these cases, the application of a topical steroid may help. Geographic tongue will resolve on its own, even without treatment.

            The 1900's saw a soar in the use of teen tobaccos. While the rates are down for teen tobacco use, the numbers are still very high. It is estimated that there are about 4.5 million children and adolescents in the United States who smoke. It is estimated that every day about 6,000 children across the country try their first cigarette. The risks are great. There are over 30+ cancer-causing agents in cigarettes. It is true that the older you get, the greater your risk for cancer. But it is more true that the longer you smoke, the greater your risk for cancer. In oral cancer, this risk may be four times greater than for non-smokers. The five-year survival rate for someone diagnosed with cancer of the throat or mouth is only about 56%. This is a dangerous habit.
            First, ask anyone who has smoked - there is possibly NO habit so hard to quit. Secondly, the smoking he does now may cause the damage or disease that comes later. Rather, the problems can occur much later. Besides the risk of oral and other cancers, there are so many benefits to NOT smoking. Here are a few reasons. It is expensive. It leaves you with bad breath and can make your mouth dry which leaves you more susceptible to cavities. It can stain your teeth. People who smoke may have more wrinkles, breathing problems, heart disease. One confidential survey showed that 70% of teenagers who smoke wish they had never started.

Mouth jewelry, sparkle, grilles, fronts, piercings, studs, bling, jibbers - I will refer to as mouth jewelry. Mouth jewelry has been around for a very long time and probably made its way over here from Africa. The current revived interest here in the US may have gotten its start from rap stars in New York. Infection is the biggest downside to having your tongue pierced. Most piercing websites I visited gave very detailed instructions for immediate post-piercing care. The reason they do is because this is a very real concern. Remember, the mouth is full of germs and is a dirty, hostile environment for a wound to heal in. Then the jewelry itself becomes a problem. Often, people choose what is called a "barbell" - two silver balls attached by a silver rod through the tongue. These little balls can knock against your teeth and cause them to crack or chip. Small tiny microfractures may occur first, causing the teeth to be sensitive. Some people may develop the habit of repeatedly tapping their knobs, rings or post against their teeth. Also, the mouth jewelry can rub against your gums - this seems to be more common against the back side of the lower front teeth. This can lead to loss of gum and bone around these teeth. Another concern is the need for removal of the piercing. If the wearer is having a procedure or surgery they may need to remove their jewelry. Even people who have been wearing their piercings for years may find that the holes can close in a matter of minutes - thus requiring the need to have the site pierced again. Seems like a lot of risk for a fashion statement.

          The toothbrush as we know it probably first appeared in China around 1600 A.D. This would have been a brush made from the hair of a boar. The first U.S. patent was granted in 1857 and the first nylon brush (similar to today) was made in 1935. The brushing "habit" didn't really occur until WWII, when this was implemented among the troops. Today, toothbrush technology has really exploded. They are made from nylon, polyester or some combination. Some are still made from boar's hair.
          Deciding which one to buy is another issue. Probably any with the American Dental Association Seal of Acceptance will be fine. Many of the better ones are already highly recognized names such as Oral-B or Colgate. You also have the choice between regular and "powered" brushes. There are many different kinds of powered brushes on the market that spin, vibrate, go back and forth. I am fond of the ultrasonic toothbrushes. There are many studies to show that they can help keep your teeth healthier than a manual toothbrush. I have seen more than one patient come back with better checkups. Make sure that, no matter which toothbrush you buy, that it is rated as Soft or Extra Soft. Never use a medium or hard brush as these can cause damage to your gums. It is best to change your toothbrush every 2-3 months, or even more often if you notice the bristles are bent. Also, if you have been ill, it would be a good idea to replace your brush. Studies show that the average person only changes their brush every 6 months.

              The answer is almost always going to be NO! Because the condition will often worsen. While there are always exceptions, in general, toothache pain can be divided into two categories. First, there is the "My tooth is sensitive" category. This is when you drink hot coffee or cold water and then the tooth will feel uncomfortable. Other than this, the tooth may not hurt. This is a good indication that the nerve may still be healthy and possibly could be fixed with a simple filling. So, if you wait, the cavity could grow and cause the tooth to need a root canal or crown. 
              The second type of pain is the aching or throbbing pain. In this case the problem is usually much more serious. This is the kind of pain that may wake you up in the middle of the night. The tooth may hurt when you chew or sometimes for no reason at all. But don't think it can't get worse, it can. At this stage, you might develop an abscess - sometimes accompanied by swelling. This is a serious health concern. If you wait too long, you may lose the tooth. NEVER wait if you have a toothache, there is no benefit to it and it may lead to a more serious problem. In general, it will be less expensive and easier to fix today than next week or next month.

          The answer to this common question is the one you use! Toothpaste may have begun with the Egyptians around 3000-5000B.C. Toothpaste as we know it first came out somewhere around the 1800's. The vast majority on the market are safe to use. There is concern about harsh abrasives that can erode your enamel or make your teeth more sensitive or cause staining. Some of the additives that might cause abrasion of your teeth are baking soda, silica, and calcium carbonate. Peroxide is a safe additive for whitening, but does not usually come in significant concentration. Fluoride helps prevent cavities. If using "all natural" ingredients is of concern, then consider using Tom's of Maine w/fluoride.

          Well first you should try to contact your dentist. They should have an answering service, forwarding number or some message on the machine to help you contact them. If that doesn't happen quickly enough, you can try your M.D. They are quite capable of giving a prescription until you see your dentist. Also, you can go to the emergency room at the hospital - they will probably do exactly the same thing, give you a prescription. So there are three possible resources to contact. 
          If it's the middle of the night and you don't want to go to the emergency room, there are some practical tips that can help alleviate some of the pain. Probably the first thing we think of is to reach for the pills. Usually Tylenol (the generic name is acetaminophin) or Motrin (the generic name is ibuprofen) is what most people will have on hand. Ibuprofen also comes in prescription strength, but you need to see your doctor about that. You can get a piece of cotton and use either clove oil, Anbesol, or an oral compound with benzocaine, and then place it onto the cotton. Place the cotton next to the hurting tooth. Another help might be a warm washcloth or ice pack. Many people find some comfort with the warm washcloth, although for some, the cold may feel better. Do NOT sleep with a heating pad on your face, it is dangerous. Lastly, if your health permits, you may want to try to sleep sitting in a more upright position. This can often help alleviate the throbbing or pulsing sensation that can accompany a toothache. Prevention is always best, but once the tooth hurts, see a doctor immediately.

          Carbonated soft drinks account for more than 27% of America's beverage consumption. What's more alarming is that children are consuming soft drinks at increasingly younger ages. It is estimated that 20% of one and two-year olds drink at least 7 ounces (~1 cup) per day. Almost one-half of children ages 6-11 drink about 15 ounces per day. The largest consumers are males age 12-29 with an average of 28.5 ounces per day. A regular size soda can is 12 ounces. What is possibly more disturbing is the ongoing drop in milk consumption. One survey has showed a decrease in milk consumption of 21% in young girls over a 15-year span. 
           Sodas can be very acidic. They can have ingredients such as phosphoric acid, which can literally dissolve your teeth. When you take a sip, a solution of carbonated water, sugars, and phosphoric acid bathes your teeth. The phosphoric acid can weaken your enamel and make them susceptible to bacteria. Furthermore, the sugars that adhere to your teeth are converted to acid by the bacteria in your mouth. This results in further attacks to the enamel. These acid attacks can last up to 20 minutes. After each sip, the cycle begins again. It is very destructive to your teeth. This process is even harder on young teeth with immature enamel.
           Lay off the sodas would benefit not only your teeth, but your overall health. If you must, then drink sodas less often. Think of them as the rare occasional treat, instead of the normal with meals. Brushing afterwards is an excellent idea, but if your toothbrush isn't handy, then try swishing with water. Also, drinking with a straw can be of some small advantage. This can minimize direct contact with the teeth.

         Many people want little or no x-rays taken these days. Americans are getting smart about their health, but not having any x-rays wouldn't be the smartest thing to do. X-rays are necessary and play a vital role in keeping your teeth healthy. Many of us were trained in dental school to take a full-mouth series on a patient once every 5 years. A full-mouth series consists of about 18 individual x-rays of all your teeth. Everybody should have had a full-mouth series of x-rays to begin with. There is no other way to detect some cavities, gum diseases, or other conditions. But, after that, the number of x-rays is something that should be determined by you and your dentist. It should be based on how many cavities you get, if you have gum disease, and how old your last x-rays were. Dentists are taking fewer x-rays than we used to. Furthermore, our patients are not exposed to as much radiation as they used to be. With digital x-rays and new high-speed films, the amount of radiation you receive is less than what you would naturally absorb on a hike to Wheeler Peak.

              Anyone who is going to participate in a sport or activity where there is a possibility of contact with others or hard surfaces should wear one. At present, there are only 5 sports that require mouthpieces. They are football, boxing, ice hockey, men's lacrosse and women's field hockey. People who participate in basketball, soccer, wrestling, and skakeboarding should also wear one. In these and other sports, there are over 200,000 injuries that occur each year to people's mouths and jaws.
             There are 3 basic types of mouthguards. The Stock Mouthguard - you buy it and wear it. It is the least expensive, but also, due to the poor fit, is the least effective. Boil and Bites are also available almost. You boil them in water, and bite into them so that they adapt to your teeth. These often end up being too thin, losing 70-99% of their thickness. The third type is Custom Fit - the dentist makes these for you. They fit much better, and are thicker in the right areas for maximum protection. Mouthguards protect against more than just chipped or broken teeth. They can help prevent more serious injuries such as a fractured jaw, concussion, cerebral hemorrhages and even neck injuries. If yor child is going to be active as described above, make a mouthguard part of their supplies. A typical mouthguard should last about 4-6 months, or one season. Even if you are wearing braces, you should get one.