FREQUENTLY ASKED QUESTIONS

Q: Which type of toothbrush should I use?
A: The brand of the toothbrush is not as critical as the type of bristle and the size of the head. A soft toothbrush with a small head is recommended because medium and hard brushes tend to cause irritation and contribute to recession of the gums, and a small head allows you to get around each tooth more completely and is less likely to injure your gums. It's unnecessary to "scrub" the teeth as long as you are brushing at least twice a day and visiting your dentist at least twice a year for cleanings.

Q: Is one toothpaste better than others?
A: Yes. Some toothpaste are designed specifically to address problems including sensitivity, stains, periodontal (gum) issues and others. Some toothpaste containing chlorophyll will breakdown older white fillings, and can cause damage to margins. While most toothpaste are ADA approved, it does not guarantee you will not experience gum irritation, burning, excessive wear of some restorations, abraded teeth, or increased sensitivity. For information associated with your needs, or experience, please ask our staff during your next appointment. It is advisable to use a fluoride containing toothpaste to decrease the incidence of dental decay for children and adolescence. We recommend our patients use a toothpaste that is compatible for their needs, and conditions. More important, we encourage brushing and flossing using proper techniques and timing.

Q: How often do I need to brush each day?

A:  How often is a common question when a child or adult find they have cavities or problems with their teeth. The most common thought is that brushing 3 times a day will prevent mosts problems. This is a misleading concept especially with young children. It is more important "when" you brush, and "how long and thorough" you brush. A common mistake is waking up with morning breath and brushing yours, or your child's teeth, then, eating breakfast and heading out to school or work. This leaves your teeth exposed to harmful foods and bacteria until the next time you brush. Often, this done after dinner and before bed. Unfortunately, if you then have a before bed snack or glass of milk, the teeth are again left exposed throughout the night. Plaque takes 24 hours to begin to build. Calculus or tartar can take several days. A thorough brushing will avoid buildups that can only be removed by a dental practitioner or hygienist.

Q: How often should I floss?
A: Flossing of the teeth once per day helps to prevent cavities from forming between the teeth where your toothbrush can't reach. Flossing also helps to keep your gums healthy.

Q: What's the difference between a "crown" and a "cap"?
A: These are restorations to repair a severely decayed, deformed, or broken tooth by covering all or most of the tooth. The crown is placed after removing old fillings, fractured tooth structure, and all decay. Crowns are made using several techniques and materials. The base or inside framework is often constructed of metals, or gold. Persons with allergies to nickel, cheap jewelry, should always use a gold metal base. ALERT: many labs are purchasing metals from China, India, and Pakistan. Many of these metals have contaminants and heavy metals that may present risks to patients. Dr. Clark maintains continual contact with his labs and always insists on the highest quality products produced in ADA approved areas excluding China and others. For natural tooth appearance, porcelain is baked over the metals or gold. Some crowns can be constructed completely with porcelain or composite plastics, and compomers. These restorations are not as durable, and must be cared for with avoidance to trauma eating and during function. The life span of all porcelain or compressed composite crowns can be significantly shorter than metal, porcelain to metal, gold, or porcelain to gold crowns. A less expensive method often used on deciduous (baby) teeth, are stainless steel crowns premade and fitted to the patient as close as possible. Dentists refer to all of these restorations as "crowns". Patients often refer to full coverage restorations as "caps" describing the design.

Q: What's the difference between a "bridge" and a "partial denture"?
A: Both bridges and partial dentures replace missing teeth. A bridge is permanently attached to abutment teeth or, in some cases, implants. A partial denture is attached by clasps to the teeth and is easily removed by the patient. Patients are usually more satisfied with bridges than with partial dentures. Today, implants are rapidly becoming the preferred choice of missing tooth replacement. Ask your dentist what your best options would be for your long-term needs.

Q: What about "silver" fillings versus "white" fillings?
A: Although the U.S. Public Health Service issued a report in 1993 stating there is no health reason not to use amalgam (silver fillings), more patients today are requesting "white" or tooth-colored composite fillings. Ten or more States have outlawed the use of amalgam, or required the dentist to provide warnings and consent before placing silver restorations. Silver restorations are a very successful method to treat patients economically and for many years of service. The most common risks associated with amalgum include: exposure to Mercury, expansion and contraction of the metal vs. the natural teeth resulting in fractures over time, corrosion, sensitivity, and the discoloration of teeth and sometimes gums with "amalgum tattoos." The design of the cavity preparations require undercuts and greater loss of tooth substance to wedge and hold the filling in place. Eating hot pizza (184 degrees) and then drinking ice-tea (32 degrees) creates exceptional expansion and contraction of the teeth and fillings. Over time, the teeth become more brittle, worn, and subject to fracture. All white fillings are not the same. The development of tooth colored fillings has taken years to find materials that were strong enough to withstand compression, chewing, and tearing forces. They also needed to be resistant to stain, contamination, absorption of odors, bacteria, and excessive wear. Today, the problems of past white fillings are solved for most people. Some persons are not able to use white fillings. This may be due to deep bites, larger nerves, worn and ground down teeth, or personal habits. We prefer tooth-colored fillings because they "bond" to the tooth structure and therefore help strengthen a tooth weakened by decay. While fillings are also usually less sensitive to temperature, and they also look better. When a tooth-colored filling is not reliable, or if a tooth is very badly broken-down, a crown will usually be necessary and provide better overall satisfaction for the patient.

Q: Do I need to have a root canal just because I have to have a crown?
A: No. While most teeth which have had root canal treatments do need crowns to strengthen the teeth and to return the teeth to normal form and function, not every tooth needing a crown also needs to have a root canal.

Q: Why do root canal teeth sometimes hurt after the root canal, and sometimes do not hurt before the root canal?

A: This is a confusing situation for most patients. Teeth have nerves inside the chamber or roots. The area inside the tooth crown is called a pulp chamber, while the area traveling through the root, or roots is called a canal. Teeth may have 1,2, 3, or even 4 and more canals. When a root canal has been completed, the nerve tissue, blood supply, and infection have been removed from the inside of the tooth and root canals. It is then filled with a special filling material to prevent recontamination. Why a root canal hurts sometimes after treatment is the same as why it often hurts before treatment when the nerve is already dead. The pain comes from the surrounding bone, ligaments supporting the tooth. It is similar to the pain you feel when a finger has been hit and blood builds pressure under the nail. The nail has no feeling or nerves, but pressure or temperature changes on the nail will increase the pressure resulting in pain from the supporting tissue. A tooth has even more sensitivity from the nerves in the jaw bone. FOLLOWING treatment, infection may linger or inflammation and need to be treated for with stronger antibiotics and anti-inflammatories. As well as with amputations, phantom pain can also linger for months or even years in extreme cases. NICO lesions are scar type lesions that case pain even after some root canal teeth are extracted (removed).