Dental Patient Education

At City Place Dental, we want you to be an active participant in your own health. We take the time to listen to your concerns & explain different options, so you can make informed decisions about your dental care & stay involved. We encourage an open dialogue between our dental professionals & our patients. Like any health professionals, we are prone to doctor-speak, but we always strive to speak plainly & avoid jargon! If we ever say a word you don’t understand, please ask us to explain. We believe that the more our patients understand their care, the healthier their smiles will be.

Here are some frequently asked questions about dental care. Please take a look & feel free to contact us if you want more information on any topic.

Bad breath (halitosis) can be an unpleasant & 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 reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What may cause bad breath?

  • Morning time – Saliva flow almost stops during sleep & its reduced cleansing action allows bacteria to grow, causing 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.

  • Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.

  • Periodontal (gum) disease – Colonies of bacteria & food debris residing under inflamed gums.

  • Dental cavities & 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, & missed meals – Drinking water & chewing food increases saliva flow & washes bacteria away.

  • Certain medical conditions & illnesses – Diabetes, liver & kidney problems, chronic sinus infections, bronchitis, & 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 you 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 & toothbrush.  Floss daily to remove food debris & plaque from in between the teeth & under the gumline.  Brush or use a tongue scraper to clean the tongue & reach the back areas.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly & place them back in your mouth in the morning.

  • See your dentist regularly – Get a check-up & 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 & 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, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor & an appropriate treatment plan.

Over the years there has been some concern as to the safety of amalgam (silver) fillings. An amalgam is a blend of copper, silver, tin & zinc, bound by elemental mercury. Dentists have used this blended metal to fill teeth for more than 100 years. The controversy is due to claims that the exposure to the vapor & minute particles from the mercury can cause a variety of health problems.

According to the American Dental Association (ADA), up to 76% of dentists use silver containing mercury to fill teeth. The ADA also states that silver fillings are safe & that studies have failed to find any link between silver containing mercury & any medical disorder.

The general consensus is that amalgam (silver) fillings are safe. Along with the ADA’s position, the Center for Disease Control (CDC), the World Health Organization, the FDA, & others support the use of silver fillings as safe, durable, & cost-effective. The U.S. Public Health Service says that the only reason not to use silver fillings is when a patient has an allergy to any component of this type of filling. The ADA has had fewer than 100 reported incidents of an allergy to components of silver fillings, & this is out of countless millions of silver fillings over the decades.

Although studies indicate that there are no measurable health risks to patients who have silver fillings, we do know that mercury is a toxic material when we are exposed at high, unsafe levels. For instance, we have been warned to limit the consumption of certain types of fish that carry high levels of mercury in them. However, with respect to amalgam fillings, the ADA maintains that when the mercury combines with the other components of the filling, it becomes an inactive substance that is safe.

There are numerous options to silver fillings, including composite (tooth-colored), porcelain, & gold fillings. We encourage you to discuss these options with your dentist so you can determine which is the best option for you.

You should have your teeth checked & cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

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

  • Medical history review: Knowing the status of any current medical conditions, new medications, & illnesses, gives us insight to your overall health & also your dental health.

  • Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, & bone loss.  X-rays also help determine tooth & root positions.

  • Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, & gums for any signs of oral cancer.

  • Gum disease evaluation: Check the gums & 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 some time & is now firmly attached to the tooth surface.  Calculus forms above & below the gum line, & 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, & saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!

  • Teeth polishing: Removes stain & plaque that is not otherwise removed during tooth brushing & scaling.

  • Oral hygiene recommendations: Review & 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 & cleaning involves quite a lot more than just checking for cavities & polishing your teeth.  We are committed to providing you with the best possible care, & to do so will require regular check-ups & cleanings.

Brushingflossing help control the plaque & bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, & saliva that sticks to the teeth & 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 & calculus are not removed, they begin to destroy the gums & bone, causing periodontal (gum) disease.

Plaque formation & growth is continuous & can only be controlled by regular brushing, flossing, & 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 & 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, & biting surfaces of each tooth.

  • Use the tip of the brush head to clean the inside front teeth.

  • Brush your tongue to remove bacteria & freshen your breath.

Electric toothbrushes are also recommended.  They are easy to use & can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums & teeth & allow the brush to do its job, several teeth at a time.

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

  • Take 12-16 inches (30-40cm) of dental floss & wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.

  • Using your thumbs & 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 & under the gumline.  Gently move the floss up & down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing – It is important to rinse your mouth with water after brushing, & 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.

Four out of five people have periodontal disease & 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 & periodontal examinations are very important & will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, & saliva, is left on the teeth & gums.  The bacteria produce toxins (acids) that inflame the gums & slowly destroy the bone. Brushingflossing regularly & 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 nonusers to form plaque & tartar on their teeth.

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

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

  • Pregnancy, oral contraceptives, & 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.

SignsSymptoms of Periodontal Disease

  • Red & 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 & gums – Sign that there is an infection present.

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  • Receding gums – Loss of gum around a tooth.

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

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

Brushing our teeth removes food particles, plaque, & bacteria from all tooth surfaces, except in between the teeth.  Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay & periodontal (gum) disease.

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

Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, & saliva.  The bacteria produce toxins (acids) that cause cavities to irritate & inflame the gums.  Also, when plaque is not removed above & below the gumline, it hardens & turns into calculus (tartar).  This will further irritate & flame the gums & also slowly destroy the bone.  This is the beginning of periodontal disease.

How to floss properly:

  • Take 12-16 inches (30-40cm) of dental floss & wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.

  • Using your thumbs & 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 & under the gumline.  Gently move the floss up & down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Daily flossing will help you keep a healthy, beautiful smile for life!

If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures & materials available today, but also because patients are becoming more & more focused on improving their overall health.  This includes dental prevention & having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth & enhance your smile.  Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over.  Ask your dentist how you can improve the health & beauty of your smile with cosmetic dentistry.

Cosmetic Procedures:

Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, & smoking.  Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present.

Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, & also to replace old defective fillings.  Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth.  This type of filling is also very useful to fill in gaps & to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile.  They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth.  Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.

Porcelain Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape & size.  Crowns protect & strengthen teeth that cannot be restored with fillings or other types of restorations.  They are ideal for teeth that have large, fractured or broken fillings & also for those that are badly decayed.

Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth.  Porcelain crowns, bridges, & dentures can be made specifically to fit & attach to implants, giving a patient a strong, stable, & durable solution to removable dental appliances.

Orthodontics: Less visible & more effective brackets & wires are making straightening teeth with orthodontics much more appealing to adult patients.  Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth.  They are very durable & will not stain, making them a very popular solution for those seeking to restore or enhance the beauty of their smile.

Veneers may be used to restore or correct the following dental conditions:

  • Severely discolored or stained teeth
  • Unwanted or uneven spaces
  • Worn or chipped teeth
  • Slight tooth crowding
  • Misshapen teeth
  • Teeth that are too small or large

Getting veneers usually requires two visits.  Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape & color) for your individual smile.

With little or no anesthesia, teeth are prepared by lightly buffing & shaping the front surface of the teeth to allow for the small thickness of veneers.  The veneers are carefully fitted & bonded onto the tooth surface with special bonding cements & occasionally a specialized light may be used to harden & set the bond.

Veneers are an excellent dental treatment that can dramatically improve your teeth & give you a natural, beautiful smile.

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products & methods available to achieve a brighter smile.

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, & is an ideal way to enhance the beauty of your smile.  Over-the-counter products are also available, but they are much less effective than professional treatments & may not be approved by the American Dental Association (ADA).

As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade.  The color of our teeth also comes from the inside of the tooth, which may become darker over time.  Smoking, drinking coffee, tea, & wine may also contribute to tooth discoloration, making our teeth yellow & dull.  Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline.  Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.

It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching.  Occasionally, tetracycline & fluorosis stains are difficult to bleach & your dentist may offer other options, such as veneers or crowns to cover up such stains.  Since teeth whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins.  Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.

Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening systems:

Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth.  The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep.  It usually takes several weeks to achieve the desired results depending on the degree of staining & the desired level of whitening.

In office teeth whitening: This treatment is done in the dental office & you will see results immediately.  It may require more than one visit, with each visit lasting 30 to 60 minutes.  While your gums are protected, a bleaching solution is applied to the teeth.  A special light may be used to enhance the action of the agent while the teeth are whitened.

Some patients may experience tooth sensitivity after having their teeth whitened.  This sensation is temporary & subsides shortly after you complete the bleaching process, usually within a few days to one week.

Teeth whitening can be very effective & can give you a brighter, whiter, more confident smile!

Our mouths are constantly changing depending on what we eat & drink, our habits & our age. Seeing a dentist regularly is the best way to catch a potential problem before it becomes a big deal. Not to alarm you, but lots of dental conditions don’t necessarily have obvious symptoms that you can rely on to spot something early. Dentists have the expertise & advanced tools to properly examine your oral health in a way that patients simply can’t do for themselves.

Not everyone needs to see the dentist every six months: some patients need to see us more often. Depending on your oral health situation, the dentist will recommend the frequency at which you need to visit us. Some patients see us every 3 or 4 months, especially if they have gum disease. If the dentist asks you to come in more frequently than you did in the past, please know that this advice is given with the idea of keeping you healthier in the long run.

Your regular visits are your best chance for keeping your teeth strong, clean & white & your breath fresh. Hygienists can remove stains that regular brushing & flossing & in-home whitening treatments can’t! Plus, we’re always happy to give you refresher training on the best techniques for your at-home oral hygiene routine.

As children, we’re taught that eating too much candy causes cavities, so it must be sugar that causes tooth decay, right? Actually, that’s an overly simple way of explaining the process. Sugar is more like the fuel for decay & it doesn’t just come from sweet foods. When you eat, chemicals called enzymes in your saliva break down carbohydrates into sugars. These sugars—plus the sugar compounds that occurs naturally in fruit & foods sweetened with refined sugar or corn syrup—are then eaten by the bacteria in your mouth. Unless you brush or floss them away, these bacteria hang out in your mouth, consuming the sugar & excreting a waste product in the form of acid. This acid is what eats holes in your tooth enamel & the softer dentin layer underneath, causing cavities & tooth decay.

Children should see the dentist when their first tooth comes in or by age 1, whichever comes first. That doesn’t mean you shouldn’t be caring for your baby’s oral health before then. After feeding, you can clean your baby’s gums by rubbing them gently with a damp washcloth. For more advice about caring for your baby’s mouth, please feel free to ask your pediatrician or us.

Tell us! The last thing we want is for you to be uncomfortable in silence. Being nervous at the dentist is not uncommon so don’t be embarrassed about it. Knowing that you are a nervous patient helps us prepare properly for your appointment. There are steps we can take to make you more comfortable during your visit. We may be able to provide music, movies, or TV to distract you during your visit. We can take things slower & explain more about what we’re doing at each step. We can work with you to develop a communication system so you can tell us clearly when something is bothering you or you need to take a break. Sedation is also an option in some cases & we’d be happy to discuss it.

One of the biggest ways we can help you overcome your nervousness is by working through it together. We want our office to be a warm, welcoming & pleasant place for you. The easier & less intimidating we can make your visit, the better we’ll be able to care for your oral health, now & in the future. If there is anything we can to do improve your experience, just ask. We promise you, you won’t be the first person who has brought up these concerns.