FAQs

Q: Why straighten teeth? (Or: Why wear braces or aligners?)

A:

Straighter teeth perform chewing, biting, speaking and airway functions more effectively than crooked teeth. In addition, a straight smile boosts confidence, is aesthetically pleasing to look at, and can help prevent a wide variety of dental ailments (see below).

There are several types of malocclusion including overbite, underbite, crossbite, and overcrowding. Each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth.

Here is a brief overview of some of the main disorders associated with crooked teeth:

Periodontitis – Periodontitis or gum disease begins with a bacterial infection. The bacterial infection is caused by inadequate oral hygiene. Crooked teeth are hard to effectively clean, which means that debris, plaque, and bacteria can build up in hard-to-reach areas. Adults experiencing gum disease may have their heart health negatively affected by it, in addition to possibly losing their teeth through such infections. Straight teeth are much easier to clean and are at less risk of contracting gum disease.

Temporomandibular Disorder (TMJ) - Crooked teeth can lead to improper jaw alignment, which in turn causes a painful condition known as TMJ. Severe headaches, jaw pain, lockjaw, and grinding of teeth characterize this debilitating disorder.

Constricted Airway function, or Sleep Apnea - Common but harmful behaviors like mouth-breathing, tongue-thrust, thumb-sucking… not only lead to narrow and collapsed palates and crowded teeth but also directly affect the space, size, and shape of the nasal cavity. This leads to constricted and narrow nasal cavities which make breathing through your nose more difficult. This compromised airway effects EVERYTHING from daytime cognitive performance (ADD / ADHD) to nighttime sleep quality (sleep apnea), because the body cannot properly oxygenate the organs. Daytime sleepiness, fatigue, headaches, poor school performance, general nervousness, snoring and grinding of teeth characterize different symptoms of airway dysfunction.

If a narrow upper jaw develops due to harmful habits or mal-development, it traps the lower jaw from growing - think of the lower jaw as a car trying to move forward into a garage [as the upper jaw] which has narrow, constricted walls —it can’t move forward in this case. If the lower jaw, or mandible is trapped or blocked from achieving its natural forward growth, this constricts the wind pipe and air-flow behind it. You can now understand how a healthy airway is the foundation of ideal orthodontic treatment results and why addressing all the CAUSES, not just addressing the teeth, is important to your child’s smile AND general health.

Tooth injury – Straight teeth create a strong wall, which means injuries are less likely to occur. Crooked teeth are weaker and often protrude, making them far more vulnerable to external injury.

Uneven wear – Crooked teeth cause some of the teeth to work harder than others when biting and chewing. Straight teeth share the workload evenly, meaning less risk of injury and better aesthetics.

Teeth can be straightened using either orthodontic braces or customized aligning trays. Orthodontic braces are usually affixed to the teeth for a set duration. The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete. Fixed braces can be placed on the front side or back side of the teeth and are effective for most types of malocclusion.

Aligning trays are fully removable and are used where the malocclusion is less severe, and the teeth need to move a shorter distance. These trays are replaced every few weeks for the duration of the treatment, and have proven to be equally effective for straightening teeth.

If you have questions about orthodontics and straightening teeth, please contact our office!

Q: What is the COST of dental braces or clear aligners (Invisalign)?

Q: Is there a correlation between heart disease and periodontal disease?

A:

Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health. Periodontal disease is one of the most common infections - often more prevalent than the common cold! Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!

Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis. It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth. The bacteria in plaque produce toxins/acids that irritate and infect the gums, eventually destroying the jaw bone that supports the teeth. When periodontal disease is not treated it can eventually lead to tooth loss!

There are numerous studies that have looked into the correlation between gum disease and major medical conditions. These studies suggest people with periodontal disease are at a greater risk of systemic disease. They also indicate that periodontal disease can allow oral bacteria to enter the bloodstream and travel to major organs, beginning new infections. Research suggests that periodontal bacteria in the blood stream can:

Contribute to the development of heart disease
Increase the risk of stroke
Compromise the health of those that have diabetes or respiratory diseases
Increase a woman’s risk of having a preterm, low-birth weight baby

While there is still much research to be done in order to fully understand the link between periodontal disease and systemic diseases, research has shown that infections in the mouth can wreak havoc elsewhere in the body.

To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation. Also, diligent home care and a proper diet can help reduce plaque and bacteria in the mouth.

Remember the mouth body connection! Taking care of your oral health can contribute to your overall medical health!

Q: Is there a correlation between Periodontal Disease (Gum Disease) and crooked teeth (or bad bite)?

Q: What should I do if a tooth is knocked out?

A:

We’re all at risk for having a tooth knocked out. More than 5 million teeth are knocked out every year! If we know how to handle this emergency situation, we might be able to save the tooth. Teeth that are knocked out can possibly be re-implanted if we act quickly and follow these simple steps:

Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
DO NOT scrub or use soap or chemicals to clean the tooth. If it has dirt or debris on it, rinse it gently with your own saliva or whole milk. If that is not possible, rinse it very gently with water.
Keep it moist & Get to a dentist within 30 minutes. You may keep it in your saliva. The longer you wait, the less chance there is for successful re-implantation.

Ways to transport the tooth

Try to replace the tooth back in its socket immediately. Gently bite down on gauze, a wet tea bag or on your tongue / teeth to keep the tooth in place. Apply a cold compress to the face for pain and swelling as needed.
If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk. You can also place the tooth under your tongue or between your lower lip and gums. Keep the tooth moist at all times. Do not transport the tooth in a tissue or cloth.
Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit. The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive. So be prepared, and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

Wearing a mouthguard (or Sport Guard) when playing sports
Always wearing your seatbelt
Avoiding fights
Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.

Q: What are my options if I have missing teeth?

A:

Removing a tooth is the LAST option we'd recommend because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced after the extraction. With many state-of-the-art dental treatments and prevention options available in dentistry today, there are less reasons for having to extract (remove) teeth.

Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid long-term dental problems in the future.

When a tooth is lost, the jaw bone that helped support that tooth begins to atrophy (shrink), and the face may show signs of aging, such as sagging of areas of skin, because of the loss of support of teeth and bones. The teeth on either side to shift or tip into the open space of the lost tooth. Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on. These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems. These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.

Options for replacement of missing teeth:

(1) Orthodontics: We can use braces to close the gap, or replace the missing teeth with other existing teeth, making you look like (almost) you've never lost a tooth! Plus it will straighten and correct other areas in your mouth if you were planning on having your teeth straightened anyway. This will avoid the $2000-$3000 bridge work or the $5000 implant work altogether, with your natural teeth, and there won't be any replacement restorative work needed in the future (as bridge/implants might need)! (This becomes a LOT of Savings in the long-run.)

(2) Removable bridges - This type of bridge is only a temporary solution for replacing one or more missing teeth for a few months, especially in complex dental situations where other replacement options are not possible at the time. If you wear them too long, your tissue and bones will shrink ("Atrophy"), and you will run into many other issues in the long-term (besides aging effects): it will be much harder to close the gap or replace the tooth with a fixed solution later. These removable bridges are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth but might be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal. And the teeth that are used the "carry" the clasps may slowly become damaged.

(3) Fixed bridges - This type of bridge is generally made of porcelain or composite material and is permanently anchored (cemented) to a natural tooth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable), and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place, AND the teeth that are used to "carry" the bridge may become weaker or tilted, or even damaged over long period of time. The average life span of a crown or bridge is between 6 - 12 years. It is important to consider the long-term health and results of the treatment before you make the decision.

(4) Dentures - This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patient’s original teeth. It is much more suitable for people who have accepted their aging effects and are used to taking care of removable dentures. Please keep in mind that the teeth that are used the "carry" the clasps or bear the pressure-points of the artificial teeth may slowly become damaged.

(5) Implants - Are a great (and expensive) way to replace one or more missing teeth. They also require a lot of maintenance (both daily and periodic). They can also provide great support for ill-fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants can be very stable, durable (7 - 20 years), and are the most aesthetically pleasing tooth replacement option, but are the most expensive, because bone grafts and tissue grafts might be required to support the artificial root and esthetic parts (average $5000 to $7000 each). Daily cleaning at home (home oral hygiene) MUST ALSO BE EXCELLENT in order for the gums to be healthy to support the artificial parts long-term. Failure of implants is slightly possible, but re-implant after such failure might also be successful in some cases.

If you are missing teeth, ask us about the options that may be available to you. Prevention and early treatment are always less involved and less costly than delaying treatment and allowing a serious problem to develop.

GET A FREE Consultation and be in-the-know of your options (& costs) ! - Call: 979. 543. 2411.

Q: If my previous Invisalign or braces treatment has failed, can I get treated again to make my teeth straighter or fit better?

Q: What should I do if I have bad breath?

A:

Bad breath (halitosis) can be an unpleasant and embarrassing condition. Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are various causes that attribute to bad breath, but in healthy people, the major source is microbial deposits between teeth and on the tongue.

What causes bad breath?

Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth. Bacterial plaque that is NOT brushed or flossed off from teeth surfaces AND from between teeth can brood A LOT OF bacteria and their by-product (think: they eat and poop, too!)
Morning time – Saliva flow almost stops during sleep, reducing its cleaning power and allowing bacteria to grow, which results in bad breath.
Certain foods – Garlic, onions, etc. Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
Tobacco products – Dry the mouth, causing bad breath.
Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath. Also, review your current medications, recent surgeries, or illnesses with your dentist.

What can I do to prevent bad breath?

Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque from in between the teeth and under the gumline. Brush or use a tongue scraper to clean the tongue and reach the back areas. Replace your toothbrush every 2 to 3 months. If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
See your dentist regularly – Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, your dentist will recommend more frequent visits.
Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor. Ask your dentist about antiseptic rinses that not only alleviate bad breath but also kill the germs that cause the problem.

In most cases, your dentist can treat the cause of bad breath. If it is determined that your mouth is healthy and bad breath remains persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

Q: How often should I brush and floss?

A:

Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay. Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
Brush the outer, inner, and biting surfaces of each tooth.
Use the tip of the brush head to clean the inside front teeth.
Brush your tongue to remove bacteria and to freshen your breath.

Electric toothbrushes can be helpful (but you don't have to have one in order to brush well). They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

Flossing – Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.

Floss holders, go-between brushes ("proxy-brushes"), and other little helpers are recommended if you have difficulty using conventional floss. Find them in the isles at a grocery store or pharmacy (or online).

"WATERPIK" - this is one of the most important products that can help you tremendously: both you and other household member(s) can each have a tip to use, with the same unit of water reservoir. Starting with lower power, and over a period of time increasing its power levels, you may find it super easy and helpful removing plaque around all kinds of difficult-to-reach places! HIGHLY RECOMMENDED!

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

Q: Why is it important to use dental floss?

Q: How can I tell if I have gingivitis or periodontitis (gum disease)?

A:

Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

Smoking or chewing tobacco – Tobacco users are more likely than non-users to form plaque and tartar on their teeth.

Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.

Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.

Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.

Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.

Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

Red and puffy gums – Gums should never be red or swollen.

Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.

Persistent bad breath – Caused by bacteria in the mouth.

New spacing between teeth – Caused by bone loss.

Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).

Pus around the teeth and gums – Sign that there is an infection present.

Receding gums – Loss of gum around a tooth.

Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Q: How often should I have a dental exam and cleaning?

A:

You should have your teeth checked and cleaned at least twice a year, even though your dentist or dental hygienist may recommend more frequent visits for you depending on the conditions and risk factors of your gums - Statistically speaking: about 30% to 40% of people may require 4-time a year cleanings or deep cleanings. (As an analogy: there are people needing more frequent maintenance & care, JUST LIKE there are cars needing more frequent maintenance and care :))

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums. At these visits, your teeth are cleaned and checked for cavities. Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health. These include:

Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
Examination of diagnostic X-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
Examination of existing restorations: Check current fillings, crowns, etc.
Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface. Calculus forms above and below the gum line, and can only be removed with special dental instruments.
Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gums. This inflammation is the start of periodontal disease!
Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
Review dietary habits: Your eating habits play a very important role in your dental health.

As you can see, a good dental exam and cleaning involves much more than simply checking for cavities and polishing your teeth! We highly recommend that you seek a stable and satisfying relationship with your dental provider for regular check-ups and cleanings.