patient education

What should I do the same day of the extractions?

• Do not rinse your mouth.
• Do not use a straw, spit, or smoke.
• Some bleeding is to be expected following extractions. If persistent bleeding occurs, place gauze over bleeding and bite down firmly for one half hour, repeat if necessary and contact your dentist if bleeding continues.
• Ice bags to be placed over affected area if instructed by the dentist. In most cases an ice bag or a cold moist cloth should periodically be applied to operated area for the first 6 hours only after the extractions.
• Light diet is advisable during the first 24 hours.
• Take the medication that your dentist prescribed on time.

What should you do the day after the extractions?

• Rinse your mouth gently every 3 to 4 hours (especially after meals) using one quarter teaspoon of salt to a glass of warm water. Continue rinses for several days.
• Brush, floss your teeth and keep proper oral hygiene.
• Small sharp bone fragments may work their way up through the gum during healing; these are not roots. If you feel discomfort, return to your dentist for evaluation.
• If any unusual symptoms occur, call your dentist at once. The proper care following oral surgical procedures will quicken recovery and prevent complications.

Brushing and flossing every day will help keep your teeth and gums healthy. Having clean teeth also makes you look and feel better. Your breath is fresher, brighter, and your teeth feel smooth.

How to brush

• Brush after meals, using a soft toothbrush and a fluoride toothpaste. Start in one place and work all the way around your mouth. Brush the front, back, and top of each tooth as explained below.
• Hold the brush at a 45 angle and gently brush the outer surfaces, circular and/or back and forth motion.
• Brush the inner surfaces of the back teeth using the same circular back and forth motion.
• Turn the brush and use the tip to clean the inner surfaces of the upper and lower front teeth.
• Clean the chewing surfaces using a scrubbing motion. Brush then rinse well.

How to floss

• Floss at least twice a day to remove plaque between the teeth and below gums. Start at one place and work all the way around your mouth. Floss between each tooth as explained below.

1. Wrap 18 inches of floss around your middle fingers. Secure it with fingers
   and thumbs.
2. Ease the floss between your teeth. Press it against one side, then wrap to
   form a C shape.
3. Work the floss back and forth, and up and down, going below the gums where
   plaque collects.

Note:

• If you have a bridge or wear braces, use a floss threader to get the floss under the
  bridge or the wires.

What are canker sores?

• Canker sores are ulcers of the mouth that affect millions of Americans every year causing pain and discomfort. The cause of canker sores is unknown but several factors have been identified. Normally, the canker sores heal after 7 to 10 days.

What are the factors that trigger canker sores?

• Immune system dysfunction.
• Toothpaste ingredients such as SLS (sodium lauryl sulfate) may cause canker sores in many people.
• Trauma and mouth injury (dental treatment, braces, ill fitting dentures)
• Nutritional deficiencies.
• Stress.
• Food. Some people gets canker sores after eating certain kinds of foods such as nuts, buckwheat, rye, chocolate, soy, mustard, pineapples, citrus fruits, vinegar, apples and milk.

What can I do about canker sores?

• Always consult your physician or dentist about your canker sores. Corticostroides ointment and gels are available with a prescription. Other over-the-counter pain relieving gels and medications are effective in reducing the pain and the discomfort. Antibacterial mouthwashes such as (peridex) might help. In addition to medication, the more you learn about the canker sores the more control you have on their episodes.

When should a child first visit the dentist?

• Unless there is a problem or complaint from the child, the first dental visit should be between ages 2 1/2 and 3. It is an important visit where parents learn the appropriate way of maintaining a child's oral health.

What is the appropriate way of maintaining good oral hygiene for a child?

• As a parent, be a role model by practicing good oral hygiene.
• When teeth first erupt clean them with soft cloth while the child is in your lap.
• Brush and floss the teeth twice a day until the child is old enough to do it the proper way.
• Feed your child a balanced diet and avoid sticky candy.
• Ask your dentist about fluoride and dental sealants.
• If your child is active in contact sports, ask your dentist about a protective mouth guard.
• Make sure your child has regular dental check ups twice a year.

Baby teeth will be lost, Why should they be fixed?

• The baby (primary) teeth provide a foundation and guidance for the permanent teeth. If a child has teeth that are improperly spaced or have extensive decay, crowding, shifting or poor oral habits, early corrective treatment may be necessary to prevent more extensive treatment (including orthodontia braces) in the future.
• Early tooth development also affects a child's ability to eat, chew, form speech patterns and swallow. This is especially important for your child's sense of social confidence and self esteem. If baby teeth are lost early, cosmetic appliances and space maintainers are available to replace them, or to provide space for the permanent teeth to come through.

What are some problems to watch for?

• Tooth Decay:

  Children should keep good oral hygiene especially after eating meals and snacks. A child should not sleep with a bottle especially milk, juice or any other sugary liquids, that might cause severe decay to the teeth (rampant decay).

• Thumb Sucking and Pacifiers:

  Thumb sucking is normal and provides security for babies and young children. However, if children continue to suck on their fingers or other objects pass age four it might cause the upper front teeth and the upper jaw to tip forward.

When do you call the dentist?

• If an adult tooth is loose or if the tooth is knocked out, do not wash the tooth, put it in milk and take it to the dentist as soon as possible to be put back in place (it has to be placed in within 2 hours for the treatment to be successful).
• When noticing dark spots on a child's teeth.
• When seeing permanent teeth erupting crooked where the baby teeth are still in place.
• When a child's teeth change color (very common in the front teeth where kids fall and hit these teeth when playing).
• When seeing changes in the tissue shape or color (bump or redness in the gum).

What is composite bonding?

• Composite bonding is an esthetic way to restore and treat teeth.

When is composite bonding indicated?

• Restore cavities in front and back teeth.
• Replace old or amalgam restorations 'silver fillings'.
• Restore teeth abrasion (expose notched root by gum recession or aggressive brushing).
• Covering these areas helps prevent cavities, root sensitivity and improves tooth appearance.
• Reshape crooked teeth.
• Restore chipped teeth.
• Improve or change the color of permanently discolored teeth.
• Close diastemas 'spaces between teeth'.

What are the steps of the treatment?

• First, the decay (if present) is removed and a protective coating might be placed inside the tooth. The tooth then is etched with a mild acidic solution.
• This roughens the enamel surface and allows the bonding material to adhere to the tooth. A shade of the filling material is chosen that matches your natural tooth. Then a bonding agent is applied to the etched tooth surface. Finally, the bonding composite is placed and shaped to match to contour of the natural tooth. In most cases, the dentist will use an ultraviolet light to help harden the material. The surface of the composite is then smoothed and polished to achieve a natural luster and appearance.

What are the advantages of composite bonding?

• Appearance:

  Available in variety of colors and shades, composite bonding can be made to look like your natural tooth.

• Strength:

  Composite bonding, although not as strong as 'silver fillings,' produces a filling that supports a tooth, making it less likely to break.

• Tooth conservation:

  In composite bonding, only a small amount of natural tooth structure is removed.

• Reduced anesthesia required:

  Bonding usually does not require anesthesia unless decay is present. Your teeth can be restored with little or no discomfort.

• Economics:

  Composite bonding is affordable compared to more expensive procedures like full crowns or veneers.

How long will composite bonding last?

• Although not as strong as crowns or veneers, with proper care a bonded restoration may last five years or more before requiring touch up or replacement.

What is a crown?

• A crown, also called a 'cap,' is a tooth like restoration that is placed over a prepared existing tooth to restore the function, contour, appearance and strengthens the damaged tooth. Crowns serve to support the tooth when there is no longer sufficient tooth structure left to place a filling. Crowns may also be used to protect the structure of a tooth that is fractured, broken, or root canalled.

What is a bridge?

• A bridge is a custom device anchored to neighboring teeth that replaces one or more missing teeth. When a lost tooth is replaced with bridgework, the teeth on either side of the missing one must be prepared to serve as abutments to hold the pontic (replacement) teeth in place.

What is crown and bridge treatment?

• Crown and bridge treatments are a long term method of restoring or replacing missing teeth. A crown is placed on an individual tooth. A bridge spans a space where one or more teeth have been.

If you lose a filling?

• If you are in pain, it could be a sign of a large cavity, or a crack in the tooth. Take any pain medication and see your dentist as soon as possible. If you don't have pain, keep the area clean and see your dentist as soon as you can. If the broken tooth has a sharp edge that keeps cutting your cheek or tongue, just place dental wax or a pre-chewed sugarless gum on the sharp edge till you see your dentist.

If your crown falls off?

• For either a temporary or a permanent crown, never use a super glue to put it back in. Simply save the crown and see your dentist as soon as you can.

If a bracket in your braces breaks?

• Simply place dental wax or a pre-chewed sugarless gum on the sharp end and see your orthodontist as soon as you can.

If you knocked out a tooth?

• If it is a baby tooth:

  Don't worry about it. Have the area evaluated by the dentist since trauma to a baby tooth may affect the permanent tooth bud.

• If it is a permanent tooth:

  Rinse it gently with water, without scrubbing it, and gently put it back into the tooth socket.
• If you can't put it back in, keep it moist in a glass of milk and rush to your dentist as quickly as possible. The tooth can be saved if it can be put back in within the first 90 minutes.

If you have pain after an extraction?

• If you have severe pain after 24 hours of the extraction, that could be a sign of a dry socket. This is when a blood clot in the tooth socket couldn't develop. Pain medication might reduce the pain temporarily, but you should see your dentist as soon as possible for a dry socket treatment in which a special dry socket dressing has to be placed inside the tooth socket.

What are dental implants?

• Dental implants are the permanent replacement of missing teeth with artificial teeth or dentures that are attached to metal anchors, usually made of titanium, and have been surgically inserted inside the jawbone.
• The procedure is often performed in the dental office using local anesthetic by the general dentist, oral surgeon, periodontist, or a team of these doctors. During surgery, each implant is within the jawbone to serve as an anchor for the attachment that will eventually support the replacement teeth. Generally, four to six months is allowed for the bone tissue to grow around the implants and hold them securely in place. Once the jawbone has firmly healed around the implant, a small attachment is placed on top of each implant. The attachment protrudes through the gum-line and serves as an anchor for the replacement teeth. After your gums have healed, an impression of the attachments and your mouth is taken, then the permanent teeth or dentures will be fabricated in a dental lab and will be placed on top of the attachment in your final visit.

What are the benefits of dental implants?

• Durability

  Longevity and reliability with proper oral hygiene and care. Scientifically tested and approved dental implant systems have been shown to last as long as 20 years or more with few or no complications.

• Confidence

  Increased self confidence because dental implants function like natural teeth, most people who get them experience a renewed sense of self-confidence.

• Improved biting pressure

  Healthy teeth are able to absorb over 500 pounds of biting pressure per square inch. If you have worn dentures for long time, that pressure may be diminished significantly, to one-tenth that of natural teeth. Dental implants can often restore the amount of pressure that can be withstood to nearly the same level of healthy natural teeth.

• Comfort and fit

  Because your replacement teeth are anchored securely to the implants in your jawbone, they can't slip and slide like unsecured dentures can.

What type of care is required for dental implants?

• Proper oral hygiene habits:

  With brushing, flossing and regular dental check-ups your implant will serve you well. It will increase the longevity of the implant and you will have overall satisfaction.

What are dental veneers?

• Veneers are a thin porcelain shell that is permanently bonded to the teeth. Veneers are a cosmetic alternative for a variety of dental conditions of the front teeth including:
• Diastemas (spaces between the teeth.)
• Broken or chipped teeth.
• Stained or washed out fillings.
• Permanently stained or discolored teeth.
• Misshapen or crooked teeth.

What are the advantages and benefits of veneers?

• There are many benefits and advantages to having porcelain veneers placed on your front teeth. The advantages of veneers are:
• Only a small amount of tooth structure is removed during the procedure. A healthy 'natural' look is achieved with little or no discomfort.

How are veneers different from fillings or crowns?

• A composite resin filling is used when only a small amount of tooth structure needs replacing or repair.
• A full crown is indicated when a tooth has had root canal treatment or when a substantial amount of the entire tooth structure (enamel) has been lost.
• A porcelain veneer is indicated when a portion of the front surface of a tooth needs to be esthetically restored.

How are porcelain veneers created?

• Similar to the resin bonding procedure, veneers are attached directly to the existing tooth structure. The dentist will take an impression of your tooth to make an exact replica. During your next appointment, a mild conditioning gel is applied to etch the enamel and help adhere the veneer to the tooth. Finally, the veneer is cemented using tooth colored bonding material.

What can you expect from your veneers?

• Veneers can last for years, depending on how well you take care of them. Veneers are stronger than simple bonding, they are also more resistant to stains and chipping. However, it is important to maintain regular oral hygiene, to avoid bad habits such as biting nails or chewing ice, and to visit us regularly for routine cleaning and exams. These precautions will help ensure that your veneers will last a long time and keep looking as good as new.

What is full or partial denture?

• It is an appliance that replace the missing teeth in the mouth.

Why should missing teeth be replaced?

• It is very important to replace missing teeth with full or partial dentures. Replacement teeth help fill out the space and restore your smile by giving support to the cheeks and lips. This will give a youthful feeling, a more appealing appearance by holding up facial muscles and also aids in speaking, chewing, swallowing and smiling.

Will chewing and speaking be different?

• Somewhat. At first you might find it hard to chew and speak since you have something in your mouth that you are not use to. This is normal. As time passes by, your tongue will get used to the appliance and the spaces that have been filled.
• At first you may choose a soft or liquid diet, also cutting food in smaller bites might help. Make sure to avoid sticky or hard foods. Your dentures might need adjustments, especially if you get sore spots. Always check-up with your dentist.

How long will it take to get used to replacement teeth?

• Every patient is different. Some patients adapt immediately. For others, it may take a little longer.
• Patients who choose to undergo full extractions and have immediate dentures placed should leave the dentures in until the postoperative appointment, which is usually 24 hours after delivering the immediate dentures. During healing, the dentures should be left in most of the time because the immediate denture acts as a 'bandage', giving support to the oral tissues as they heal.
• It is required that the immediate denture be relined within four to six months. This is to accommodate the space created by shrinkage of the supporting bone tissue during healing.
• You should remove the dentures every evening. Remember however, if the denture is removed, it must not be allowed to dry out as this causes shrinking or distortion of the material causing ill fitting. Always soak the removable denture in water until returning them to your mouth.
• If you wear a partial denture, make certain that when you floss and brush your natural teeth, that you take special care to clean around the clasps, as trapped food particles, may cause these abutment teeth to be more susceptible to decay.

Should denture adhesive be used?

• Generally, you shouldn't need them. A well-fitted denture will adhere to the oral tissues with the natural aid of saliva and suction. In fact, some denture adhesives actually distort the denture material, which may make the fit worse! Check with your dentist before routinely beginning the practice of using any denture adhesive material.

Are there alternatives to dentures?

• Implants and bridges are the alternative of choice to dentures. The cost usually tends to be greater but the feeling more resembles the natural feel of real teeth.

Helpful tips:

• Rinse your dentures after eating to clean them from food particles using a soft denture brush and mild liquid soap or denture toothpaste.
• Brush your denture over a folded towel or a sink full of water. That way, it won't be damaged if you drop it.
• Soak your denture in denture cleaner to help prevent staining and odor.
• If you have partial dentures, brush and floss at least twice a day.

What is digital x-ray?

• It is a system that sends images of the patient's teeth to a computer monitor, while the patient is still sifting in the dental chair, by placing a small sensor in the patient's mouth. The sensor will read the x-ray beam and record it as an image on the computer.

What is the advantage of the system?

• Less time.
• Less x-ray exposure by 90 percent.
• Patient can see and understand the treatment diagnosed.

The electric toothbrush has been marketed since the 50's, designed for everyone. It works well for patients with special problems, like excessive bleeding, periodontal disease, or poor manual dexterity.

What are the advantages of an electric toothbrush?

• Remove plaque bacteria, twice as much as the manual toothbrush.
• Ability to clean in hard to reach places like between teeth and far back teeth.
• Reverse the effect of gingivitis, such as bleeding gums.
• Remove light stains, such as coffee and tobacco.
• Especially maintains good oral hygiene.

      

What is gum disease?

• Gum disease is an inflammatory disease that attacks the gums, bone and other supporting structures causing loss of teeth. Gum disease is caused by plaque, a sticky colorless film of bacteria that continuously forming on the teeth. Plaque contains potentially harmful bacteria. Plaque irritates the gums, causing them to become red, tender and swollen. It causes the gums to bleed easily, a condition called gingivitis. Also, your body defends itself against bacteria by producing increased level of enzymes which begin to break down tooth and gum tissue. Eventually, the tissue that attaches the gums to the teeth is destroyed by the irritants in plaque. The gums pull away from the teeth and small pockets form between the teeth and gums. These pockets become filled with more plaque. Eventually, the jawbone supporting the teeth is destroyed, a condition called periodontitis.
• Periodontal disease is usually a slow, painless, and progressive disease. Most adults with gum disease are unaware that they have it. If diagnosed early the teeth can be saved.

Contributing factors:

In addition to plaque, a number of factors cause gum disease including:

• Physical and chemical irritants

  Impacted food, smoking, chewing tobacco, excessive alcohol consumption, improper use of dental floss and toothpicks.

• Oral conditions that cause abnormal stress on mouth tissues

  Badly aligned teeth, poor fitting bridges or partial dentures and defective fillings; also habits such as grinding, clenching the teeth and chewing ice.

• Unbalanced diet

  Evidence shows a link between nutritional deficiency and the body's ability to fight off infection. Vitamin C deficiency has been linked to gum disease.

• Pregnancy

  Increased hormone levels may aggravate a condition commonly referred to as pregnancy gingivitis.

• Diseases

  Diabetes, uremia, liver cirrhosis, anemia and leukemia may affect the health of your gums.

• Certain medications

  Oral contraceptives, antiepilepsy drugs, steroids and cancer therapy drugs may also affect the gums.

What are the signs?

• Gums that bleed during brushing and flossing.
• Red, puffy and tender gums.
• Gums that have receded or separated from the teeth.
• Pain when chewing.
• Calculus or tartar build up.
• Teeth that seem loose or that change position.
• Changes in your bite.
• Changes in the way your partial dentures fit.
• Persistent bad breath or a bad taste in your mouth.
• Teeth that are overly sensitive to hot and cold.

Treatment:

• Scaling and root planing removes the tartar and the soft tissue lining the periodontal pocket. This helps eliminate the inflammation and reduce the pockets and restore gingival health. Gingivectomy is the surgical removal of the soft tissue wall of a pocket to eliminate the depth of the pocket. Flap surgery allows access to the root of the tooth for removal of calculus, plaque and diseased tissue. The gum is then sutured back into place.

Helpful Tips:

• Practice appropriate home care such as brushing and flossing at least twice a day. Eat a well-balanced diet.
• Examine your mouth routinely for any early signs of gum disease or other oral changes. Visit your dentist at least twice a year for a thorough cleaning and oral examination.

Incidence and survival:

• Oral cancer will be diagnosed in an estimated 30,000 Americans every year, and will cause approximately 8,000 deaths. On average, only half of those with the disease will survive more than five years.

What is the importance of early detection?

• With early detection and timely treatment, death from oral cancer could be dramatically reduced.
• Early detection of oral cancer is often possible; tissue changes in the mouth that might signal the beginning of cancer can often be seen and felt easily.

What could be the warning signs?

Possible signs and symptoms of oral cancer that might be noticed are:

• Leukoplakia (white lesions).
• Erythroplakia (red lesions).
• Lump or thickening in the oral soft tissues.
• Difficulty chewing or swallowing.
• Difficulty moving the jaw or the tongue.
• Numbness of the tongue or other areas in the mouth.

If the above problems persist for more than two weeks, a clinical and laboratory test is necessary for a definitive diagnosis.

What are the risk factors?

• Tobacco, especially chewing tobacco, and excessive alcohol use increases the risk of oral cancer.
• Exposure to the sunlight is a risk factor to the lips.
• Oral cancer is typically a disease of older people.
• Oral cancer strikes men twice as much as it does women.

Treatment:

• Surgery to remove the cancer in the mouth.
• Radiation therapy, which is a high-energy ray, is used to kill cancer cells.
• Chemotherapy, which is the use of drugs to kill cancer cells.

Oral piercing is a growing trend, which include piercing the lip, tongue, and other oral tissue in the mouth.

What are the risk factors associated with oral piercing?

• Airway obstruction from swallowing the jewelry.
• Chipped teeth.
• Speech impediment.
• Swelling and bleeding.
• Blood poisoning.
• Nerve damage.
• Keloid scaring.
• Promote the spread of Hepatitis B, C, Aids, and STDs.

What are the measures that you should take before oral piercing?

• Have the piercing done by a professional.
• Make sure the instruments used are sterilized.
• Choose the right design, size, and material of jewelry.
• Practice good oral hygiene around the pierced area.
• Ear piercing guns are never appropriate for oral piercing.

How does pregnancy affect my oral health?

• It's a myth that calcium is lost from the mother's teeth and 'one tooth is lost with every pregnancy.' However, you may experience some changes in your oral health during pregnancy. The primary change is a surge in hormones, particularly an increase in estrogen and progesterone, which is linked to an increase in the amount of plaque on your teeth.

How does a build-up of plaque affect me?

• If the plaque isn't removed, it can cause gingivitis red, swollen, tender gums that are more likely to bleed. So called 'pregnancy gingivitis' affects most pregnant women to some degree, and generally begins to surface in second trimester. If you already have gingivitis, the condition is likely to worsen during pregnancy. If untreated, gingivitis can lead to periodontal disease, a more serious form of gum disease.
• Pregnant women are also at risk for developing pregnancy tumors, inflammatory benign growths that develop when swollen gums become irritated. Normally, if the tumors left alone, then they will usually break down on their own. However, if a tumor is very uncomfortable and interferes with chewing, brushing or other oral hygiene procedures, the dentist may decide to remove it.

How can I prevent these problems?

• You can prevent gingivitis by keeping your teeth clean, especially near the gumline.
• You should brush with fluoride toothpaste at least twice a day, and after each meal when possible. You should also floss thoroughly each day. If tooth brushing causes morning sickness, rinse your mouth with water or with anti-plaque and fluoride mouthwashes.
• Good nutrition, particularly plenty of vitamin C and B12, help keep the oral cavity healthy and strong. More frequent cleanings from the dentist will help control plaque and prevent gingivitis. Controlling plaque also will reduce gum irritation and decrease the likelihood of pregnancy tumors.

When should I see my dentist?

• If you're planning to become pregnant or suspect you're pregnant, you should see a dentist right away. Otherwise, you should schedule a check-up in your first trimester for a cleaning. Your dentist will assess your oral condition and map out a dental plan for the rest of your pregnancy. A visit to the dentist also is recommended in the second trimester for cleaning, to monitor changes and gauge the effectiveness of your oral hygiene. Depending on the patient, another appointment may be scheduled early in the third trimester, but these appointments should be kept as brief as possible.

Are there any procedures I should avoid?

• Non-emergency procedures generally can be performed throughout pregnancy, but the best time for any dental treatment is the fourth through sixth months. Women with dental emergencies that create severe pain can be treated during any trimester, but your obstetrician should be consulted during emergencies that require anesthesia or when medication is being prescribed. Lastly, elective procedures that can be postponed should be delayed until after the baby's birth.

What can I do to keep my mouth healthy?

• The first step is to see your dentist before you start radiation therapy, and have all the necessary dental treatments that are recommended. Once your treatment starts, it's important to look in your mouth every day for any changes.

Helpful Tips:

• Keep your mouth moist by drinking a lot of water and using a saliva substitute to help moisten your mouth.
• Use sugarless gum or sugar-free hard candy.
• Brush your teeth, gums and tongue with a soft toothbrush and fluoride toothpaste.
• Floss your teeth every day.
• Don't use mouthwash with alcohol in it.
• Rinse your mouth several times a day with a solution of 1/4 teaspoon baking soda and 1/8 teaspoon salt in one cup of warm water. Follow with a plain water rinse.
• Choose foods that are good for you and easy to chew and swallow, also sipping liquids with your meal will make eating easier.

Stay away from:

• Sharp, crunchy food, like tacos or chips, that could cut your mouth.
• Hot, spicy, or foods high in acid.
• Sugary food, like candy or soda.
• Toothpicks.
• All tobacco products.
• Alcoholic drinks.

Remember:

• Visit your dentist before treatment starts.
• Take good care of your mouth during treatment.
• Call you doctor or your dentist if you have any mouth problems.

Root canal is the treatment of the diseased nerve (also called the pulp) of the tooth. A root canal treatment enables you to save and keep your original damaged tooth.

What makes a root canal necessary?

• Physical irritation caused by deep decay or a very large filling
• Severe gum disease
• Crack in the tooth.
• Trauma, such as physical blow to a tooth or a constant striking of a tooth in the opposite jaw that traumatizes the tooth

Regardless of the initial cause, the tooth pulp becomes stressed and infected. Bacteria grows within the tooth pulp, causing pressure and pain, sometimes accompanied by swelling of the area. Sometimes the deterioration of the pulp happens so gradually that little pain is felt. Either way, eventually the infection can destroy the pulp and spreads to the bone and surrounding tissues causing abcess at the root tips.

What are the steps of the procedure?

• Once it has been determined (with X-rays and clinical examination) that the root canal treatment is necessary, you will be scheduled for one or more appointments. It's important that you keep these appointments, in order to prevent delays in treatment and healing.
• The tooth may be isolated with a piece of rubber dam. This confines the treatment area and protects the mouth from bacteria and chemical agents that will be used to clean the root canal.
• After isolating the tooth, the, canals will be cleaned, enlarged and shaped using hand files, or rotary instruments.
• The canals will be washed and cleaned using different chemical agents.
• One or few x-rays might be taken to ensure all the measurements and that the walls inside the canal are smooth.
• Then, the root canal will be permanently filled using root canal sealant. or in some cases, a temporary medication will be placed inside the tooth to control bacterial growth and reduce infection, and the root canal will be filled in your next appointment.
• A temporary filling is placed in the opening of the tooth until next visit.
• Finally, in your next visit a post will placed inside the canal to strengthen it and the tooth will be crowned (capped) and fully restored to chewing function.

What care follows the treatment?

• Brittleness

  A non vital tooth is more brittle than a vital one and is more susceptible to fracture. Therefore, in most cases, it is recommend that your root canal tooth be crowned (capped) following treatment.

• Discoloration

  You may notice that your treated tooth (especially a front tooth) might change color. Be sure to ask your dentist about tooth whitening if the tooth is not restored with a crown.

Helpful Tips:

• Don't chew on the treated tooth for 48 hours.
• Take the medication prescribed by your doctor.

Snoring is a common problem that people might not be aware of. It can be defined as a loud breathing sound during sleep that is caused by the vibration of the soft palate (the soft part of the roof of the mouth). Snoring is normal, but in rare cases can be a sign of a serious medical problem like sleep apnea.

What are the main causes of snoring?

• Not known cause.
• Chronic nasal congestion.
• Too much alcohol or sedation.
• Obesity.
• Enlarged adenoids and tonsils.
• Sleep apnea (episodes of no breathing).

What can I do to reduce snoring?

• Avoid sleeping on the back.
• Weight loss can reduce snoring.
• Avoid drinking alcohol before bedtime.
• Using an appliance can help, like snore guard.
• Always check with your health provider.

People often grind their teeth in their sleep. You may not even know you're doing it. The causes are not clear. Stress is one possible cause, but often the reason for the habit is not known.

Symptoms of grinding:

Your dentist may ask whether you have certain symptoms such as:

• A sore, tired jaw
• Dull headaches
• Earaches
• Sensitive teeth

Symptoms like these may be a signal that you grind your teeth.

Treatment:

• Mouth guards:

  A mouth guard is a plastic device that fits over your teeth. It protects them from grinding damage. A mouth guard is worn at the times when you're most likely to grind you teeth.

• Stress Reduction:

  Stress is suspected in many cases of bruxism. Reducing stress may help relax your jaw muscles and make grinding less likely. Your dentist may suggest regular exercise or other ways to reduce stress.

• Medication:

  In some cases medication may be given. It may help relieve sore muscles or reduce stress.

• Fixing damaged teeth:

  Your dentist can discuss ways to fix teeth damaged by bruxism. Crowns and onlays are two ways to fix damaged teeth.

Teeth sensitivity is a common problem that faces many people every day. Because of the discomfort involved, especially in brushing, some people tend to avoid the sensitive areas. This may result in complicating the problem.

What causes teeth sensitivity?

• Root sensitivity (exposed root surface) usually occurs after gum recession or gum treatment.
• Tooth abrasion (loss of tooth enamel at the gum line).
• Tartar control toothpaste will sometimes cause teeth to be sensitive.
• Old and poor fitting fillings.
• Cavities.
• Occlusal trauma.

What can be done to reduce teeth sensitivity?

• Check with your dentist to find the cause and get the proper treatment.
• Fluoride treatment.
• Proper brushing techniques using soft toothbrush.
• Use desensitizing toothpaste.
• Decrease the intake of acid-containing food and liquids.

What is teeth whitening?

• Whitening (bleaching) is a simple procedure that can be done at the dentist office or at home. During the procedure a solution of hydrogen peroxide is applied to lighten the discolored and darkened teeth.

What causes teeth discoloration?

• Tetracycline (antibiotic) staining
• Excessive fluoride
• Trauma (injury) to the teeth
• Pulp (nerve) degeneration
• Restorations (silver, gold)
• Genetic and acquired illnesses
• Aging
• Food, drinks (such as coffee and tea), and tobacco.

Another consideration in determining whether tooth whitening is for you is the condition of your teeth. Careful clinical examinations and x-rays will help determine whether you are a candidate for this procedure.

Does whitening (bleaching) damage the teeth?

• No. When the active whitening agent comes in contact with water, hydrogen peroxide is released, which whitens the teeth. Bleaching does not weaken or soften the teeth.

Can I bleach my teeth during pregnancy or while nursing?

• It is always recommended as a precaution measure to not use bleaching products during pregnancy or while nursing.

What happens during at-home tooth whitening?

• Your teeth are examined:

  Before you begin at-home bleaching, your teeth must be clean. Any gum problems need to be treated. Any cavities must be filled, and old fillings may need to be replaced.

• Your molds are made:

  Models of the teeth will be made.

• You receive your trays and gel:

  You will be shown how and when to use the trays and bleaching gel, how many days you will need to use the bleaching gel depends on how badly discolored the teeth are.

What happens during in-office tooth whitening?

• Your teeth are examined:

  Before you begin in-office bleaching, your teeth must be clean. Any gum problems need to be treated. Any cavities must be filled, and old fillings may need to be replaced.

• Your teeth are bleached:

  A piece of rubber dam might be used to isolate the teeth, a whitening gel will be applied to the teeth, and an ultraviolet light will be used to accelerate the whitening process, that will take about ten minutes, the teeth after that will be washed an cleaned, the procedure will be repeated 6-8 times till the desired shade is reached.

What are the advantages of in-office tooth whitening?

• Safe and simple procedure.
• Fast and can be done in one hour.
• Limited sensitivity.

Are over the counter whitening products safe?

• Many of these products are too abrasive, and can damage the teeth with extended use. Supervision by your dentist is the safest way to whiten your teeth.

Helpful tips:

For best results, follow these tips:

• Brush and floss your teeth before placing in the bleaching trays.
• Follow your dentist's directions exactly, and use only the materials your dentist gives you.
• Spit out any excess saliva. The bleach won't harm you if swallowed, but it can irritate your throat.
• Don't eat or drink while you have the trays in your mouth.
• Rinse your mouth out well after bleaching.
• Avoid citrus fruits and other acidic foods, they can make your teeth more sensitive.
• Call your dentist if your throat, teeth, or gums feel irritated.

What is TMJ?

• The temporomandibular joint (TMJ) is a joint that connects the jaw bone to the skull and is located just in front the each ear. It is a sliding ball and socket, it is one of the most complex joints in the body.

What are the signs of TMJ disorder?

• Noises associated with the movement of the jaw (clicking, popping, or crunching).
• Pain when the jaw is opened wide.
• Ear pain not related to ear infection or ear ringing.
• Clenching or grinding teeth.
• Limited mouth opening.
• Frequent headaches.

What causes TMJ disorders?

TMJ disorder may develop for any number of reasons:

• Lost or crooked teeth.
• Overbite.
• Malocclusion (teeth that fit together poorly).
• Head and neck injuries.
• Clenching or grinding teeth.
• Degenerative arthritis.

Treatment:

• If malocclusion is diagnosed, teeth may require restoration, crowns, or orthodontic treatment to correct and improve the bite.
• If grinding or clinching teeth diagnosed a splint may fabricated to fit the teeth and separate the upper and the lower teeth slightly, patient may be instructed to wear the splint at day time or only when sleeping.
• Relaxation and psychological consulting are important to relieve the stress and anxiety; physical therapy can help to exercise the jaw and relief any tension in the muscles, medication and ultrasound therapy can provide significant relief of symptoms for many patients.
• When arthritis is present, various procedures are performed to repair or replaced severe or perforated discs and smooth the bone surfaces.
• Only in small cases surgery is required to correct TMJ disorders.

What are the problems with wisdom teeth?

• Infected gums:

  When the tooth has erupted partially through the gum, bacteria can enter through the opening or the pocket around the tooth and cause the gum to become infected causing pain. This uncomfortable condition is best avoided and treated is by having the wisdom teeth removed.

• Decay:

  Partially-erupted wisdom teeth are difficult to clean. Plaque containing bacteria may form on the surface causing cavities in the wisdom tooth and the adjacent tooth.

• Crowding:

  Pressure from wisdom teeth might cause crowding and teeth might loose it's proper position in the mouth. Then cleaning becomes more difficult and teeth may wear unevenly or permanently with structural damage as result.

• Other problems:

  Impacted wisdom teeth might form a cyst that is capable of damaging adjacent teeth, the jawbone and nerves. Wisdom teeth could be the cause for unknown headaches.

Why should I have my wisdom teeth removed?

• Problems with wisdom teeth develop gradually and symptoms may not be present, the best way to prevent trouble is to visit your dentist regularly for check-ups, x-rays and consultation.

When is the best time to remove wisdom teeth?

• The best time is before the roots have been fully developed and that is between 16 and 20 years of age. Removal of wisdom teeth at that age decreases the risk of damaging the nerve in that area.

What are the risks in having the wisdom teeth removed?

• Dry socket:

  After your wisdom teeth are removed, a blood clot forms to cover the socket as part of the normal healing process. If the blood clot dissolves or is washed away, you will probably experience the steady, throbbing pain of a dry socket. If this should occur, call your dentist immediately to get proper treatment. Generally, a dry socket dressing will be placed in the area.

• Numbness:

  Nerves near your wisdom teeth are sometimes injured when the tooth is removed, causing numbness that might stay for few days, months, or life time. In most cases the numbness will disappear gradually.