• Q. Where does bad breath come from? A. One source of bad breath, or halitosis, is dental plaque which collects on and around your teeth as well as on your tongue. The bacteria within plaque produce sulfur compounds that have a foul odor. You can help stop bad breath by keeping plaque levels down. Flossing, and brushing your teeth and tongue regularly will reduce plaque. Infections of the teeth and gums will also product malodor. Yet another source of halitosis is the foul smelling gases that are produced when food you eat is broken down in your stomach. Spicy foods and those containing garlic are the worst. Watching what you eat; brushing your teeth and tongue; flossing; seeing your dentist to prevent infections; and seeing your dental hygienist for a regular professional cleaning will help to control bad breath.

  • Q. What is air abrasion and does it hurt? A. The dental drill is used in most dental offices to remove decay from your teeth. In the past, air abrasion was used as an alternative to the drill. Recently it has shown a renewed interested in the dental community. It relies on shooting tiny particles (usually Aluminum Oxide), under air pressure onto your teeth to remove decay. It is a similar concept to sand blasting but much more delicate. This product has been promoted to remove decay without pain, thereby eliminating the need for freezing. By controlling the amount of air pressure, theoretically it should prevent pain when cutting into even the second layer of teeth where you normally would feel pain with the drill. However, in reality, it can do this only in select cases where decay isn’t too deep. Your dentist is then faced with judging whether the depth of your cavity is shallow enough to use this method without freezing. Ask your dentist if they have air abrasion and if you are a good candidate for this time of treatment.

  • Q. When should our toddler have their first dental visit? A. On average, we are able to check your child’s teeth at 3.5 years old. If they have older siblings, sometimes they will want to have their teeth checked at a younger age… which is preferable. What parents should be looking for before their first visit is if the child is eating properly without complaining of pain; when brushing their teeth look for brown or black holes in their teeth; look for unusual lumps or swellings on the gum adjacent to their teeth. If parents notice any of these or have any other concerns, they should consult their dentist.

  • Q. When should I start using toothpaste to brush my toddler’s teeth? A. A good rule of thumb is to only use toothpaste if your child is able to spit when asked to. This way they will not swallow any; which if done in excess can cause problems with the enamel of their adult teeth. Fluoride given topically to the teeth through toothpaste is good; but ingested in excess amounts can cause fluorosis or weaken and discolor the adult teeth. It can also cause an upset stomach. When they are able to spit when asked, use only a pea-sized amount of toothpaste on their toothbrush. Prior to that time, use a wet toothbrush without toothpaste. Manually removing the plaque with the bristles is the main objective. The toothpaste will enhance this, but don’t feel that you are neglecting the teeth by not using it as this young age.

  • Q. Do the store-bought bleaching strips work? A. Yes. They are one of the latest methods introduced directly to the consumer to help lighten your teeth. They use the same active ingredient we do, but in a lesser concentration. However, they do have their limitations. If you have slightly crowded teeth, the strips do not lighten in between as well; they also do not lighten near the gumline as effectively. A gel system in a custom fitted tray made by your dentist or applied directly to your teeth in a dental office will more effectively reach all those difficult to get areas. They will also lighten more quickly and to a greater extent due to the concentrations. The reasons we can use higher concentrations is because the trays are made to selectively apply the gel to your teeth… not gums where it can cause harm; as well, there are soothers in our products that protect from tooth sensitivity. The in-office technique uses special resins to cover and protect your gums when it is applied. Ask your dentist what is best for you.

  • Q. What medications will discolor your teeth? What can you do to avoid this? A. Chlorhexidine, an antibacterial mouthrinse, can cause brown stains on the outside of your teeth. (a cleaning will remove this stain.) Brushing your teeth and cleaning your tongue 30 min before you rinse will also help minimize this. Other medications can affect the internal color of your tooth as it is developing prior to the age of six. Tetracycline, an antibiotic, is the most common culprit for this type of staining. This stain will not be removed by a cleaning, and bleaching may not be effective to completely remove the stain. Usually porcelain veneers are placed over the front of these teeth to cover the color. To avoid this problem, ask your doctor about alternative antibiotics if your child has an infection prior to the age of six.

  • Q. When should my child start losing their baby teeth? A. The average age that baby teeth will start falling out is 6 ½ years old. It is usually the lower 2 front teeth that are first. Secondly, the upper front two teeth will fall out around the same time as the ones next to the lower front adult teeth. This is usually around 7 ¼ years old. So by the age of 8 years old, the 4 top and 4 bottom front teeth are usually erupted. Also around 6 ½ years old, the adult molars will be erupting at the very back. The above are averages only and timing can vary by 18 months either way. If you have any concerns about the eruption of your child’s teeth, ask your dentist.

  • Q. I had impression done for a partial and next week I have to go back for wax impressions. Why? A. When making partial dentures to replace missing teeth, the first step is to take impressions of your mouth. From those impressions, stone models are made. If you are missing several back teeth, the lab technician will be unable to mount the upper to the lower model to accurately represent your natural biting position. Therefore, the lab makes wax occlusal rims onto those models and the dentist will use those to take a bite registration on the second appointment. In plain words, in order to mesh the top and bottom teeth together accurately, you need the wax bite taken on your second visit. The color, shape, and size for your denture teeth is also chosen during the first or second visit.

  • Q. My child’s bottom front adult teeth are coming in behind the baby teeth. Is this normal? A. Yes. Usually the lower front adult teeth erupt on the tongue side. The baby teeth will normally already be getting quite loose by this time. Once they fall out, the tongue will push the new adult teeth forward into proper position if there is adequate space present. If there is not enough space, or the roots of the baby teeth have not dissolved properly, the baby teeth will need removal. Ask your dentist if it appears normal.

  • Q. I heard the use of teeth whitening products is being overused and is causing damage to teeth. Is this true? A. In the past, many over-the-counter whitening products were acidic and could therefore damage the surface layer of enamel. The newer products for whitening are mostly neutral and use hydrogen peroxide as their active ingredient. They do not damage your teeth and are very safe and effective. A custom-fitted tray-based professional system provided by your dentist is the most effective and can be re-used for future touch-ups. Some people may experience temporary sensitivity during the 2-3 week process but it is only temporary. Some of the tooth whitening toothpastes are abrasive to remove surface stains, and are therefore hard on enamel. You should ask your dentist which method of whitening is best for you, as there are many options.

  • Q. I had to have a back tooth pulled. I now need to replace the tooth. What is the best method? A. If you are missing only one molar in the arch and have teeth on either side of the space you have 2 options available. If the adjacent teeth have no fillings on them and the bone where your tooth was pulled is adequate, an implant can be placed into the bone and a crown placed on top of it. If the adjacent teeth are already heavily filled, placing a bridge by hooking around those teeth is the better option. Ask your dentist what would suit your needs best.

  • Q.Do lightening toothpastes work? Are they safe? A. Yes. If they have the CDA stamp of approval or recognition, they have been scrutinized for effectiveness and safety. They tend to work well on surface stains and slightly on intrinsic color. Professional whitening systems at your dental office are more effective. As a precaution, lightening toothpastes tend to be more abrasive, so ask your dentist if it is safe to use on your teeth. If you have recession, the abrasiveness may be hard on your roots.

  • Q. My 7 year old has a cross bite. Does this need correcting now, or can we wait until he’s older to have braces? A. Normally the arch that the lower teeth are in fits inside the upper teeth’s arch. Sometimes one or more teeth are fitting in an opposite way. A simple appliance to correct the cross bite prevents premature wear and trauma to the teeth, prevents the jaw from shifting to one side which can lead to asymmetrical growth, and improves function and esthetics. It is important to correct this before the jaw bones fuse at about 15 years old. An appliance now can avoid jaw surgery later on. Your dentist and orthodontist will know what appliance will best suit your child.

  • Q. Do I need to see an endodontist for my root canal? A. Most general dentists do root canal treatment. However, certain difficulties or conditions may necessitate a referral for the following reasons: the canals are calcified and therefore difficult to access, you have a tooth with a severely curved canal; you have a tooth that has been already treated but is still bothering you so there may be extra nerve canals that have been missed or difficult to enter; and some general dentists simply prefer not to do root canals. Root canal treatment is not 100% successful even if done to ideal standards, but has a very high success rate ~ 90%. Ask your dentist why you’ve been referred.

  • Q. I can hear my child grinding their teeth at night. What should I do? A. It is actually fairly common for children to grind their teeth and cause premature wear of the baby teeth and in severe cases they will become very shortened by the time the adult teeth replace them. Because the process is gradual, the nerves recede on the teeth as they’re worn, and therefore the child will not usually have pain. Your child may outgrow the habit. If they don’t, we make them a night guard to protect them from wear once all the adult teeth have erupted and established their position. We cannot stop the habit… only protect the teeth from the damage.

  • Q. How do I care for my infants teeth and mouth? A. You should be getting them used to having you clean their mouth by using a face cloth to rub their gums as in infant. By the time their teeth come in, they’ll be used to you cleaning their mouths and it will be easier to brush their teeth. At first, only use an infant brush with very soft bristles (running under hot water helps to soften them). Do not introduce toothpaste until they can spit on their own so as not to swallow it. If you have any concerns about your infants mouth, ask your dentist.

  • Q. My child’s teeth are really crowded. Do I need to do anything about it now, or can I wait to get braces later? A. Your dentist can help alleviate many minor issues when the adult front teeth are erupting. We try to transfer crowding from the front to the middle segments where you gain space later on. Not treating some conditions early on can cause pre-mature tooth wear, gum inflammation and asymmetrical jaw growth. Ask your dentist if intervention now is necessary.

  • Q. What snacks are good for your children’s teeth and which are bad? A. A good rule of thumb is to avoid sticky foods like candy, crackers, fruit chews etc. These snacks with sugar in them and breads which ferment to sugars lead to tooth decay. Crunchy snacks are usually good… such as carrots and celery as they clean out the breads and sticky foods from the grooves in your teeth. If you end the snack with a piece of cheese, this will buffer and neutralize any acids on the teeth. Ask your dentist if the snack your child likes is good or bad for their teeth.

  • Q. Is it possible to have gum disease and not know it? A. Yes Gum disease or periodontal disease is usually a chronic condition that happens over a long period of time and causes gum swelling, bleeding, recession, and leads to bone loss around the teeth. Because it usually does not cause pain until it is far advanced, it is possible to have it and not be aware of it. Eventually, if left untreated, it will cause the teeth to loosen and they will be lost prematurely. It is caused by poor oral hygiene, smoking, and sometimes there is a genetic predisposition to it. This is why it is very important to have regular professional cleanings to prevent it.

  • Q. My son’s wisdom teeth are coming in. He has no pain, but the dentist recommends removing them. Why should we? A. Over 95% of patients should have their wisdom teeth removed. The most common reason is that they are not coming in straight and therefore will not completely erupt through the skin. This makes it difficult to clean under the flap of skin covering part of the tooth which can lead to infection as you get older. As well, they can push on the other good teeth which can add to crowding pressures as well as resorb the roots of the teeth directly in front of them. Impacted wisdom teeth can also develop cysts around themselves and thereby dissolve the surrounding jaw bone. In some cases, there is enough space for them, they come in straight and can function well. In this case, we simply leave them as is. Dealing with their removal at a younger age will result in excellent healing and less risk.

  • Q. I get canker sores often. What can I do to help with this? A. Apthous ulcer is the clinical term for canker sore. They are usually caused by an over reactive immune response to a slight cut in the tissue. You can avoid spicy foods, switch toothpastes, and inform your dentist. He/she may prescribe an anti-inflammatory cream to help it heal quicker and take away some of the pain. There could be another cause for the sore in your mouth. Because of this, your dentist will also look for sharp teeth that could be cutting the tissue, grinding/clenching habits which often include biting your cheeks, and review other possible causes with you.

  • Q. True or False. We get fluoride from the water so we don’t need topical fluoride at the dentist. A. False. Systemically given fluoride through the water does help strengthen the enamel as it is developing in children. The surfaces of adult teeth are in constant flux with the acid exposures in your mouth and topical fluoride reseals and strengthens the surface layer to combat these exposures. Adults with fillings need fluoride topically to help seal off micro-gaps around fillings and prolong the fillings lifespan.

  • Q. My children’s baby teeth will fall out anyway, so I don’t need to fix cavities in them…. True or false? A. False. If left untreated they will abscess and cause infection, pain and hospitalization. As well, the infection will damage the adult tooth growing underneath. As well, if they are pulled rather than fixed with fillings, space loss occurs and the adult teeth will not come in straight or be blocked out.

  • Q. Having children sucked all the calcium from my teeth and now I have all these cavities… True or false? A. False. Being pregnant may cause you to crave food high in sugar or fermentable carbohydrates which lead to tooth decay. Also, your gums may swell and be sensitive which in turn can make you alter how you are brushing. Frequent snacking causes more acid exposure to your teeth throughout the day. These things will lead to more tooth decay indirectly. The calcium in your teeth is not removed to feed your growing baby.

  • Q. Should your child ever knock out one of their adult front teeth in an accident, what should you do? A. Time is of the essence. Place the tooth immediately in a milk solution or saliva to keep the cells of the ligament alive. Call your dentist or the hospital dental emergency ASAP. They will give you immediate advice and likely have you come down to the office immediately. They will likely place the tooth back into the socket after gently cleaning out the socket. It will be splinted with wire and composite filling material to the adjacent teeth to stabilize it. This will remain for 1-8 weeks depending on the surrounding trauma. The tooth will likely need root canal treatment in the future to prevent infection.

  • Q. Does placing aspirin on the gums beside a sore tooth remove the pain? A. No. Aspirin is an acid and will burn the gum tissue if left in direct contact too long. You should see your dentist to determine the cause of your pain before it becomes a bigger problem to fix.

  • Q. My child is 10 months old and getting new baby teeth. The ones on the bottom are turned and angled toward each other. The ones coming in on the top are towards the sides and not in the middle. Is this normal and do I need to do anything about it? A. The eruption times and sequence varies considerably in baby teeth. It is more predictable with adult teeth. Therefore, sometimes they do get the ones to the sides before the front ones. As well, the lowers will likely straighten somewhat once they are taller and the tongue can mold them into position. What you are seeing is fairly common. Ask your dentist if you have any further questions.

  • Q. The dental hygienist always tells us to floss, but flossing causes my gums to bleed. What should I do? A. Bleeding gums are a sign of inflammation caused usually by plaque or tartar build-up. Other causes could be food collecting between the teeth, rough or bulky fillings or crowns. If you get a professional cleaning, you should floss regularly afterwards. The bleedings gums will usually stop if you continue the flossing for a week or so. The gums sometimes need time to heal after the cleaning and to get used to the flossing. Healthy gums should not bleed when flossing, so don’t let bleeding gums stop you from flossing.

  • Q. There are so many different choices of toothpastes today. What type of things should I be looking for when making my choice? A. The toothpaste should be non-abrasive to root structure. Some of the baking soda based one’s are abrasive. It should have fluoride to prevent decay. Also, look for the C.D.A seal of approval to know that is has been “recognized” or “recommended”. Recognized means it is safe. Recommended meant it has been reviewed by a more thorough study to show it effectiveness. I usually do not try to endorse brands, but I use Colgate Total as it also helps keep down tartar build-up. If you have sensitive teeth to hot and cold because of recession or multiple fillings, you may want to try Sensodyne F or Crest Sensitivity. If you stop using these sensitivity toothpastes, the sensitivity will usually return.

  • Q. What is a crown? And why is it needed? A. A crown is what most people refer to as a “cap.” When a tooth has been badly broken by trauma; fractures from chewing hard foods; has had extensive tooth decay; has been severely worn from grinding; or has been restored with a very large filling with thin remaining tooth structure, then a crown will help to restore the tooth in both strength and esthetics. The crown will cover the entire part of your tooth above the gumline. With a multitude of new materials to choose from, crowns have become a common cosmetic restorative option.

  • Q. What are sealants and how do they help prevent tooth decay? A. The deep grooves of back teeth are the most susceptible areas to decay in your mouth. Bacteria can enter these deep grooves, but your toothbrush bristles may not be fine enough to clean effectively to the depth of the grooves. By flowing a plastic coating into these deep grooves and curing it there, we keep the bacteria out and make it easier to clean. These sealants are placed on adult teeth as they come in, and in select cases on baby molars if needed. Ask your dentist if your child is a good candidate for this.

  • Q. My son is 6 years old and has cavities in his baby molars. Do I really need to have them fixed because they’ll be falling out anyway? A. Yes, the baby molars fall out between the ages of 10 and 12. If you wait that long, they can abscess, causing infection and pain. The infection will affect the shape of the adult teeth growing directly under the baby ones. As well, if you wait until they hurt or abscess and then need to be pulled, the adult teeth behind push forward and will cause space lost, thereby crowding out the adult tooth. So fixing them allows for proper, pain free function and holds the space for the adult teeth to come in.

  • Q. I recently had a root canal and now my dentist recommends crowning the tooth. Can I not just put a filling in it? A. You can. However, you take the risk that you may fracture the tooth. Root canal teeth have had a significant loss of tooth structure which weakens them and makes them more prone to fracture. If they get a vertical root fracture, they are not restorable and will need to be pulled. Sometimes front teeth can get by with a filling after a root canal as long as they haven’t had large fillings on them prior to the root canal treatment. The reason for this is that higher chewing forces occur on back teeth. The crown is the best option for you to keep your tooth for a long time.
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