Frequently Asked Questions
Preventative / Hygiene
How often should I come to the
dentist?
When should I first bring my child in for a check-up?
What are dental sealants?
At what age are sealants usually placed?
Does everyone need sealants?
Can my child still get a cavity after sealants are placed?
How long do sealants last?
What is gingivitis?
What is periodontal disease?
Why should I care if I have Periodontal Disease?
What are probing, or pocket depths?
What is the purpose of Fluoride?
Our household uses a well, how do I know if there is enough Fluoride
in the water?
Does fluoridated water make as much difference to adults as it does
for kids?
What causes cavities or caries?
Treatment
What is a filling?
What is the Difference between tooth colored and silver fillings?
What is a crown?
Why did my dentist recommend a crown, Can't I just get a filling?
What is root canal treatment?
Why do I need root canal treatment?
Will a root canal treated tooth turn dark?
What are dental implants?
Cosmetic
What is tooth whitening?
How does tooth whitening work?
Which method for tooth whitening is best/most cost effective?
Does tooth whitening work for everyone?
Can you whiten a root canal treated or
"dead" tooth?
What about whitening toothpaste?
What are possible side effects of tooth whitening?
Insurance / Financing
What does my insurance pay for?
Why doesn't my insurance pay for procedure "X"?
What insurance do you recommend?
Do you take Medicaid / Title XIX?
Does your office take payments?
Preventative / Hygiene
How often should I come to the dentist?
Your dentist may recommend a different recall time for you depending
on your overall dental health. Typically, exams and cleanings are
done every 6 months, but your dentist will custom tailor a plan just
for you. He or she may recommend a recall as long as a year or as
short as 1 month. If you have questions about the length of recall
that your dentist chooses, be sure to ask! [ Back to top ]
When should I first bring my child in for a check-up?
The American Academy
of Pediatrics says
that you should first bring in your child to have a dental exam
6 months after you see the first tooth in the mouth (usually a
lower
front tooth) or by age 1. This is considered a regular checkup
meant to both educate the parent on preventing tooth decay, and
introduce
the child to a pleasant visit at the dentist (before he or she
has time to get cavities). Early prevention has time and time again
proven
to be the best method to stop tooth decay. The dentist will usually
do a visual exam with the parent present at this appointment.
[ Back to top ]
What are dental sealants?
Sealants are tooth colored or transparent coatings that are usually
placed on the biting surface of permanent molars. These coatings
fill up the grooves in the teeth where 80% of all decay occurs.
The placement of sealants results in a drastic decrease in
the chance
of getting cavities where they are most likely to occur.
[ Back to top ] At what
age are sealants usually placed?
Sealants are placed as soon as the first permanent molars
appear in the mouth. This usually means age 6-7 on the
first molars
and again at age 12-13 on the second molars. Occasionally
your dentist
may recommend sealants are placed on primary or baby teeth
as well. The reasoning behind this is usually very deep
grooves or if your
child is at a very high risk for cavities.
[ Back to top ]
Does everyone
need sealants?
No. While not every child needs sealants we see that most
children do benefit from them. If your child has very
shallow grooves
(as determined by examination with magnification), and
is at low risk
for cavities, he or she may not require sealants. Occasionally
your dentist may recommend sealants are placed on primary
or baby teeth
as well. The reasoning behind this is usually very deep
grooves or if your child is at a very high risk for cavities. [ Back to top ]
Can my child still get a cavity after sealants are placed?
Yes. Sealants can only be placed on the grooves on the
biting surface of the teeth. While this is where 80%
of the decay
happens, it
doesn't mean that cavities cannot happen on the 4 other
sides of the tooth.
In addition, even a properly placed sealant can begin
leaking and allow a cavity to form if proper brushing
and sugar
intake recommendations
are ignored. [ Back to top ] How long do sealants last?
Sealants are meant to last through adolescent years,
but may last longer if properly cared for. Their
condition will be
monitored at hygiene visits and will be replaced
if they are lost or show
signs
of leakage.
[ Back to top ]
What is gingivitis?
Gingivitis is defined as an inflammatory process
that involves only the soft tissues around the
teeth, namely
the gums.
Gingivitis does
not always lead to periodontal
disease,
but it is a good indicator that something is
wrong. The best and most cost effective
way of preventing periodontal disease it to stop
it before its starts. Your dental team will give
you many ways to improve your home care
and reduce your risk of disease.
[ Back to top ] What is periodontal disease?
Periodontal disease or gum disease is defined as a usually painless,
destructive process that effects structures around your teeth,
namely the gums and bone. Unlike tooth decay, periodontal disease
does have some genetic disposition. Some people are more likely
to have gum disease than others. In addition to genetic factors,
any type of tobacco use is an important risk factor. Tobacco users
have a much higher rate of periodontal disease than non users.
Perio disease is usually preceded by <gingivitis> and involves
the vertical or horizontal loss of bone around all or some teeth.
The important thing to remember with perio disease is that it is
a controllable disease that can be dramatically slowed or halted
with proper maintenance. As one of my perio professors in school
answered as his only response on one of his own perio tests in
his specialty program:
Question: "What is the secret to controlling
periodontal disease?
Answer: Keep 'em clean, and keep 'em!"
[ Back to top ]
Why should I care if I have Periodontal Disease?
Periodontal disease can be compared to having an open, chronically
infected cut in your tissue. Periodontal disease has been found
to affect many other things in your body besides just your
teeth. Links
have been found to many diseases including Cardiovascular (heart)
Disease, Diabetes, and upper respiratory infections. Bacteria
that live in your mouth and contribute to periodontal disease
can have
widespread effects on your body and affect your overall health.
[ Back to top ]
What are probing, or pocket depths?
A pocket depth is a measurement of the space between your
tooth and the sleeve of tissue that encircles each and every
tooth in your mouth. Normal pockets range from 1 to 3 millimeters
in the
healthy mouth (stack two pennies on top of one another and
you have about 3 millimeters). A pocket of 3 millimeters or less
is reasonably
easy for each and every one of us to clean on a daily basis.
Pockets much over 3 millimeters can only be reached with a hygenist's
special
instruments. This means that these deeper portions of your
tooth are only cleaned when you visit your dentist. Imagine never
brushing
one or two whole teeth but twice a year! This is simply not
often enough to maintain healthy gums. Your dentist and hygenist
may recommend
various treatments to help combat this. Your dental team
may also recommend that you see them 3-4 times a year rather
than the normal 2 times
a year. This is to
both keep closer tabs on your disease process and to clean
those hard to reach pockets more often.
[ Back to top ]
What
is the purpose of Fluoride?
Fluoride may be the single best preventative discovery in
dental history. Fluoride is a molecule that is added to public
water
supplies in EXTREMELY low concentrations. These concentrations
are around
one part per million. The most important time to have fluoride
in your water is when your teeth are forming. This includes
children from age birth to around 16 years of age. In the
same manner
that different metals are added together to make much stronger
alloys,
fluoride incorporates into forming teeth to DRAMATICALLY
reduce their
susceptibility to cavities. With proper care this resistance
will last a lifetime!
[ Back to top ]
Our household uses a
well, how do I know if there is enough Fluoride in the water?
Based on our current testing, the answer is more than likely
NO. Wiswall Family Dentistry offers fluoride testing for
all its patients.
If you are wondering about the quantity of fluoride in the
water you drink, ask us for a kit. You will be asked to provide
a small
sample of the water you use every day. From there we can
suggest the best plan to protect your children and your own
teeth.
[ Back to top ]
Does fluoridated water make as much
difference to adults as it does for kids?
Fluoride makes the biggest difference to children. When your
children's teeth are forming is when you really NEED to make
sure that they
are getting the proper amount of fluoride. You will never
have another chance to incorporate this decay preventing
mineral into
their teeth
and teach them about the importance of routine dental care!
[ Back to top ]
What causes cavities or caries?
Cavities, also known as "caries" are caused by several
factors. These factors must all be present or cavities
will not happen. The factors you need are: Teeth, Bacteria, Food,
and Time. Most of
us have the teeth, and all of us with teeth have the bacteria.
I don't know about you, but I can't go for very many days without eating.
The time factor is the time between when you eat and when
you brush
your teeth. Bacteria are small, if we pile them up like
a mound of sand, it takes nearly a million organisms before we
could see only
a speck with our naked eyes. This means that they can get
into every little nook and cranny that we have in our mouths. Every
time we
feed our selves we also feed the bacteria on our teeth.
Every time these bacteria eat, they produce an acid environment.
This acid is
what breaks down our tooth structure and makes it soft.
As the tooth softens it allows bacteria to actually start living
in the tooth,
speeding the process. Luckily we have a natural substance
called saliva to help wash this acid away from our teeth. Saliva
takes about
an hour to wash away the acid and return your teeth to
safe PH levels. Bacteria don't need much to eat, a sip of soda
or a piece of candy
is enough. so, if we are sipping on a Coke all day, the
acid levels never do return to normal!
[ Back to top ]
Treatment
What is a
filling?
A filling, or a restoration, is a material that is used
to replace lost tooth structure when a tooth decays.
A hole
can not be
left in the tooth, so something must be placed to
fill up or restore
the tooth to its natural shape and size. [ Back to top ]
What is the Difference between
tooth colored and silver fillings?
Fillings are usually made out of one of two materials.
The silver
filling is a silver amalgam. This filling is made
by mixing a small amount of mercury with a silver
alloy. This mixture makes a
metal that is able to be molded into the shape
of a tooth. These teeth must be chewed with carefully for
24 hours after the filling
is placed. This allows the filling to become completely
solid. Another type of filling is a tooth colored
filling or a "composite" restoration.
This material better matches the natural color
of the tooth. Usually a smaller amount of natural
tooth structure
can be removed for a
composite restoration. Clinical studies have shown
that when done correctly, both fillings are equal
in how long they last in your
mouth. Our office chooses to use only tooth colored
restorations for various reasons.
[ Back to top ]
What is a crown?
A crown, or a "cap" is a long lasting restoration that
usually provides full coverage of a tooth. Modern materials for crowns
include: full porcelain (all tooth colored material), porcelain fused
to metal (tooth colored material over a gold crown), or full gold
in color. Every type of crown has its ups and downs. The full porcelain
crown looks the most like natural tooth but is known to be a bit brittle.
While the full porcelain crown is usually reserved for front teeth
because of it's superior esthetic qualities, the materials are quickly
becoming as durable as your other options. The porcelain fused to
metal restoration is a compromise between a gold and a porcelain
crown. It is fairly esthetic, but tends to be a little more durable
than full porcelain. A full gold crown is usually considered the
most durable restoration. Gold is strong and wears the most like
natural tooth, but its esthetic qualities are somewhat lacking. The
average life of a crown is about 15 years. Most of the time, with
proper maintenance, they will last MUCH longer.
[ Back to top ]
Why
did my dentist recommend a crown, Can't I just get a filling?
The dentist may recommend a crown for various reasons.
One of the most common reasons is that the patient has a broken
tooth.
A crown works much better in these cases. Any time a significant
amount of tooth is missing, a crown will always provide a better,
longer lasting solution. Many times the only option to restore
a tooth is a crown. Another reason to consider a crown is that
a fairly
large filling may already exist in a tooth. Your dentist knows
better than anyone the types of forces that your tooth may need
to withstand.
In almost ALL cases, a crown is significantly stronger than a
filling and lasts SIGNIFICANTLY longer. A second reason is that
if you wait
until the tooth has broken, the crown is usually much harder
to construct, less likely to last as long, and may result in
loss of the tooth!
A cracked tooth can be a difficult situation to deal with, and
is usually best treated by PREVENTION.
[ Back to top ]
What is root canal treatment?
A Root Canal or Root canal treatment is done
under profound local anesthesia to insure patient comfort.
In this procedure, the pulp,
also known as the "nerve" of the tooth, is cleaned
out and replaced with a non-permeable rubber material called
Gutta Percha.
Think of a root canal as a restoration or "filling",
that fills the tooth all the way to the end of the roots.
When doing a
root canal or RCT, it is very important to clean out all
of the nerve, as a missed canal or remnants of the nerve
can lead
to post operative
pain an/or infection. Since this is one of most challenging
procedures in dentistry, your dentist may at times recommend
that you see a
root canal specialist to avoid complications with your specific
tooth. If you have one of these "difficult" teeth
take your doctors word for it, you will find that the specialist
(endodontist) will
get it done faster AND with a higher success rate. Success
rates on root canals vary from 85-95% at 10 years out depending
on many
different factors.
[ Back to top ]
Why do I need root canal treatment?
Patients can require root canal treatment for many different reasons.
Most causes are linked to tooth decay.
1: Gross "Large" decay
If decay in your tooth has progressed to the point where
it nears or enters the pulp, the doctor usually
has very few options
but
to start a root canal. This is because bacterial
contamination has more
than likely already entered a space that it shouldn't
be. Infection or irreversible damage to the nerve
could soon
follow. Occasionally,
a nerve dies just because the decay had been close
to the pulp. This is the situation in which we may tell
you that
the decay
was large
but we would like to give the tooth time to heal.
Most of the time, this healing process progresses without
incident. But,
in a small
percentage of people, we may need to go back and
do
root canal treatment at a later date.
2: Necrotic or "dead" tooth
A tooth can die for various reasons. Many times they
die for no real reason at all. The most common
non-decay related
cause
is
trauma.
A patient may bump a tooth while playing sports,
being in a car accident, or falling off a bike. Many times
this bumped
tooth
may have not
been a memorable event. At any rate, there is
a small
possibility that this tooth could need a root
canal sometime in the
future. Any time a patient has a "dead" or
necrotic tooth in his or her mouth, a root canal
may be needed to avoid future infection.
3: Unknown
reason
Occasionally a tooth may die for no real reason
at all. Regardless of the cause of nerve death,
root canal
treatment
may be
indicated.
[ Back to top ] Will a root canal treated tooth
turn dark?
Most of the time, a root canal treated tooth
will not darken. Occasionally, depending
on materials and methods
used,
a tooth can have this
side effect. To combat this change in color,
we may recommend what we
call non-vital or internal bleaching. This
method involves placing whitening material
inside of
your root canal
treated tooth and
lightening until it matches your adjacent
teeth. Often this takes 2 or more
short visits and a few weeks to accomplish.
The whitened tooth is usually fairly stabile
in color
after this
procedure.
[ Back to top ]
What are dental
implants?
Dental implants are titanium post devices
that are used to replace single or multiple
teeth
in your mouth.
Implants
are usually
placed in two stages. In the first stage,
the implant is surgically placed
into the bone. This procedure is done
under local anesthetic. With most patients, it
has very little
if any post
operative pain associated
with it. No tooth or structure is attached
to the implant at this first appointment.
After the bone has had time
to
heal
around the
implant, a crown or other fixture is
attached to replace missing teeth, or to hold a
denture
in place.
When properly cared
for, implants have one of the highest
sucess rates of any procedure that
we do in dentistry.
[ Back to top ]
Cosmetic
What is tooth whitening?
Tooth whitening is a process in which natural tooth is made to
look whiter with products available from your dentist or over
the counter.
Most methods use either carbamide peroxide or hydrogen peroxide
to make teeth whiter. While certain types of staining will
hinder the
process most teeth can be whitened to the patients liking. Tooth
whitening has become so popular that everyone today is looking
for that "Hollywood Smile." There are only a few
complications with tooth whitening. The first is that only the
teeth are whitened.
This means that if you have tooth colored or composite fillings
or crowns on your front teeth, they may need to be replaced
to match
your new smile. A second possible problem is that some people
tend to get short term sensitivity to hot and cold after whitening.
This sensitivity is usually short lived and does not effect
the
health
of the teeth in other ways. Sensitivity is almost always lessened
by stretching out time between treatments to a few more days
or more. [ Back to top ]
How does tooth whitening work?
Tooth Whitening products work with a substance called carbamide
peroxide, similar in chemical composition to hydrogen peroxide
to make teeth
whiter. This compound is a fairly tissue compatible substance
that actually lightens the outside of natural teeth. Methods
for whitening
fall into one of two categories. Over-the-counter solutions
include clear plastic strips Crest Whitestrips, paint-on gels,
and tray
and gel systems. Professional methods are either custom tray
and gel
systems, Professional Strength Crest Whitestrips, or in office "power
bleach" systems. All of these methods can achieve and
maintain teeth many shades lighter than when you started.
[ Back to top ]
Which method for tooth whitening is best/most
cost effective?
Professional methods are usually thought of as being the
best and cost effective methods of whitening. A professional
custom
tray
gives you the most even application of whitening material.
Professional Stregth Crest Whitestrips are more cost effective,
but they do
not
whiten quite as evenly. The custom tray will be safer and
more comfortable because it keeps whitening product solely
on the
teeth, rather than
on the teeth AND gums. In addition, strengths of the whitening
materials are usually higher from professional kits than
the over-the-counter competitors. The general opinion is
that the
slightly higher cost
in professional kits is more than made up for by the efficiency
of
the system. All methods will suffer from what is called "rebound." Rebound
is described as the gradual (and usually slight) re-darkening
of teeth after whitening. If you don't minimize what caused
the staining
in the first place, rebound can be a real problem. "Power
bleach" methods
are in a slightly different category.
[ Back to top ]
Does tooth whitening work for everyone?
Tooth whitening does NOT work for everyone. All whitening
systems only whiten teeth, not previous placed crowns
and fillings.
Additionally, certain teeth may be stained in a way that
bleaching will not
be that effective. Ask your dentist before spending money
on ANY solution,
professional or over-the-counter.
[ Back to top ]
Can you whiten a root canal treated or "dead" tooth?
Yes. To do this we use a procedure called non-vital bleaching. See
also: Will a root canal treated tooth turn dark?
[ Back to top ] What
about whitening toothpaste?
Whitening toothpaste provides minimal change in tooth
color. They may however minimize rebound after using
one of the
above methods
to achieve your desired shade. Other methods are
considered more effective.
[ Back to top ]
What are possible side effects of tooth whitening?
Sensitivity is the most common complaint of patients
that whiten their teeth. This sensitivity is
almost ALWAYS temporary,
and
usually short lived. A second side effect is
related to fillings. Whitening
products whiten only tooth surface, not composite,
or tooth colored fillings or crowns that have
been placed
in the
past. Ask your
dentist if you have any of these fillings in
areas that would show. The last
problem with whitening is related to staining
that lies on the inner portions of your tooth. Sometimes
whitening
the
outside of the tooth
alone would not change the color of the tooth
to an acceptable level. Ask your dentist if any of
these conditions types
of staining
exist
in your mouth before spending any money on whitening
products.
[ Back to top ]
Insurance / Financing
What does my insurance pay for?
All insurance plans are different. We are very familiar with most
of them. We will do our best to sort out all your insurance questions
before you receive care. [ Back to top ]
Why doesn't my insurance
pay for procedure "X"?
If its so important then why does my insurance not cover this?
Dental plans are unlike medical insurance plans because most
dental problems
are preventable. Dental insurance plans have undergone almost
no changes in the past 20-25 years. While costs have rapidly
risen
for dental materials, supplies, education, and care, the maximum
that
your insurance pays has stayed almost EXACTLY the same. Insurance
premiums on the other hand have increased SIGNIFICANTLY. The
insurance companies are always the last ones to accept a treatment.
Everything
that we do or recommend is based on research that says it works.
If we can't back up what we are doing with research, we will
not be doing it! Just like you wouldn't want to take your 2007
Toyota
to a mechanic from 20 years ago, you don't want to accept treatment
based on rules that are outdated. [ Back to top ]
What insurance
do you recommend?
We recommend a plan called Direct Reimbursment. This plan
allows you to pick any dentist that you want.
[ Back to top ]
Do you take Medicaid / Title XIX?
We take a limited number of New Patients that consist of
children and patents with special needs every month.
Current rules of
Title XIX prevent us from seeing a patient (even on an
emergency basis)
if we are not able to see them as a regular patient. In
this way Title XIX is hindering patients from recieving emergency
care when
they really need it. If you or anyone close to you has
ever
been denied treatment because of this system please express
your opinion
to your state legislature.
[ Back to top ]
Does your office take payments?
we have various interest free payment plans available for those who
qualify. Please feel free to
call us if you have any questions.
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