Answers

1. What is bonding?

Answer: Bonding is a way to connect the dental material used for restoration of teeth with the tooth structure. Any material (metal, porcelain, composite) can be bonded to tooth structures using special process of priming the surface and connecting the material with a dental adhesive.

Cosmetic bonding uses this technology by sculpturing the appropriate composite material on the tooth surface and hardening it by a special light. It requires a deep knowledge of the physical properties of many different composites and an artistic ability to create a beautiful makeover for teeth.

2. Are ceramic (white) fillings better than silver fillings?

Answer: The silver filling is, in fact, not made from silver. They represent a blend (amalgam) of several metals, which hardens after they are mixed together with mercury. Therefore, mercury makes about half of the "silver filling". In the past the common belief was that after the mixture is hardened it becomes a new substance. It turned out that mercury continues to evaporate from these fillings every time you chew, or drink something hot. There is an evidence of the increased mercury level in blood and urine associated with these fillings. The harmful effect of mercury on human body is well known - mercury is a heavy metal poison leading to many health problems reflected by chronic fatigue, irritability, headaches, depression, loss of memory and concentration, etc. Is the amount of the mercury evaporating from these fillings considerable enough to affect the general health? This remains the subject of many debates and controversies. In some countries the use of such material is forbidden and in the US the scrap from these fillings considered to be an environmental hazard. Without taking sides in those debates we invite you to study this issue and come to your own conclusions. The ceramic fillings, on another hand, are esthetically pleasant; they blend with your teeth and are made from a very strong polymers or porcelain. Sculptured either directly on the tooth in one office visit or custom produced for you in the lab the ceramic replacements are not only beautifully replicate the original shape of your tooth but also are firmly fastened to it by the process called bonding. What is also very special about it is the fact that, unlike silver fillings, this process includes the creation of a tough layer on the prepared surface hermetically sealing your tooth from bacteria that cause tooth decay. For almost two-decades we have not been using the mercury contained fillings maintaining safe and mercury free environment in our office. Instead, we have been pioneering and perfecting the technique of ceramic replacements that gives you so many benefits and advantages.

3. What is the advantage for me to veneer my front teeth?

Answer: If you teeth are discolored, or have some mismatching fillings, or slightly misaligned and you want to look your best then the porcelain or hardened composite covering the front of your teeth may be the best solution. The procedure of direct composite cosmetic bonding has some limitations including the difficulty to control color, shape, strength etc. Instead, porcelain is the natural cosmetic remedy for natural teeth. These veneers (covers) produced in the dental lab and these shortcomings of a direct bonding are mostly eliminated. They could be tried on first so that you can see if you like it and then bonded to your teeth.

4. I have two crowns on my front teeth and I hate to see the dark line when I smile. What can be done?

Answer: Most of today’s crowns are made on a strong metal base. The porcelain is later shaped and baked on top of this metal. The area where the crown margin comes close to the gum very may show dark band of metal or be just unpleasantly discolored. This is especially upsetting with the conventional crowns if the gum recedes and if the smile line is high enough and shows this area. While there are techniques to eliminate the metal in the zone that is very important for overall esthetic, there is a newest technology that produces a very strong ceramic base under the porcelain. This produces a restoration as strong as with metal base.

5. My teeth are yellow and I’d like to make them whiter but I am concern about bleaching. Will it damage the teeth?

Answer: Bleaching of the teeth is achieved by exposing them to the well-known product - hydrogen peroxide. Hydrogen peroxide is the final product of any bleaching agents regardless of its name and of how this agent is activated: by light, by laser, by heat etc. Higher concentrations (30-33%) are used only in the dental office; lower concentrations (3%-12%) are safe to use at home under dentist's supervision. The free atom of oxygen that breaks away from H2O2 molecule does the job working on the enamel and dentine of the tooth making them lighter. Not all teeth would bleach equally well. Gray shaded or affected by tetracycline teeth are responding very poorly to bleaching and the result may not be what you expect at all. Yellow teeth respond to bleaching the best. The process takes from two to four and more weeks with home bleaching and brings dramatic changes to your appearance. Usually, as time goes by, you may experience some change in the brightness but only slightly. It is recommended to maintain the brightness of bleached teeth by applying the bleaching gel once a month overnight.

You may experience increased sensitivity of the teeth that can be controlled by your dentist. Overall, bleaching teeth under dentist's supervision is a safe and rewarding procedure.

6. I have very short teeth. Do I need veneers?

Answer: Proportions pay an important role in our perception of esthetics. The position of your upper lip when smiling, the proportion on the length and the width of the teeth is the major factor in the beauty of a smile and a face. The disproportional short teeth are not pleasing to the human eye and it is especially noticeable when you have an open smile showing the whole tooth. Sometimes it is not really a short tooth, it just has too much of a gum burring it inside. By performing a cosmetic reshaping of the gum we can cerate a striking difference in your appearance. The way to look your best is not necessary the most complicated dentistry and you may not need anything else but the cosmetic reshaping of your gums in such a way that the pleasing proportions and the symmetry of your gums would greatly improve your smile.

7. Are the jewels that go on the teeth strong?

Answer: Body art sometimes takes extreme forms. Among piercing and skin tattooing the decorations bonded to your teeth are very safe and long lasting. They also can be changed in a matter of minutes should you decide to change the stile and your message. Whether they are made in plain yellow gold or silver, have the precious stones incased in the metal or plastic when the bonding is done as meticulous as for reliable dental procedure they will last a long time giving you a special smile.

8. I have all my teeth in the back filled with silver. I understand that today dentists use different white fillings. Are they better than silver fillings?

Answer: The silver filling is, in fact, not made from silver. They represent a blend (amalgam) of several metals, which hardens after they are mixed together with mercury. Therefore, mercury makes about half of the "silver filling". In the past the common belief was that after the mixture is hardened it becomes a new substance. It turned out that mercury continues to evaporate from these fillings every time you chew, or drink something hot. There is an evidence of the increased mercury level in blood and urine associated with these fillings. The harmful effect of mercury on human body is well known - mercury is a heavy metal poison leading to many health problems reflected by chronic fatigue, irritability, headaches, depression, loss of memory and concentration, etc. Is the amount of the mercury evaporating from these fillings considerable enough to affect the general health? This remains the subject of many debates and controversies. In some countries the use of such material is forbidden and in the US the scrap from these fillings considered to be an environmental hazard. Without taking sides in those debates we invite you to study this issue and come to your own conclusions. The ceramic fillings, on another hand, are esthetically pleasant; they blend with your teeth and are made from a very strong polymers or porcelain. Sculptured either directly on the tooth in one office visit or custom produced for you in the lab the ceramic replacements are not only beautifully replicate the original shape of your tooth but also are firmly fastened to it by the process called bonding. What is also very special about it is the fact that, unlike silver fillings, this process includes the creation of a tough layer on the prepared surface hermetically sealing your tooth from bacteria that cause tooth decay. For almost two-decades we have not been using the mercury contained fillings maintaining safe and mercury free environment in our office. Instead, we have been pioneering and perfecting the technique of ceramic replacements that gives you so many benefits and advantages.

9. I was recommended to restore my upper tooth with onlay? What is it and why can it just be filled?

Answer: The tooth decay starts on the surface and expand inward and outward. In the beginning when the decay is relatively small it can be reliably filled directly. As the decay progress and more of the tooth structure needs to be replaced the direct fill technique (in one visit) may not be so good; the strengths of the tooth and the longevity of the filling become problematic. Then the indirect technique that involves the dental laboratory produced hardened material is used to restore the affected tooth. It creates a stronger restoration and is better controlled during the bonding process which attaches this inserts to the tooth. Since the tooth is prepared before an impression is taken in such a way as to preserve the remaining tooth structure the replacement piece is perfectly matches residual tooth structures inside and outside. In the past when the tooth was considerably decayed the crown used to be made. That always requires a substantial preparation of the tooth. Instead, the dental inserts made from a tooth colored reinforced material which is neutral to the body (biocompatible) allow saving the tooth tissue with minimum grinding, bringing back the strength and beauty, get rid of any potentially harmful metallic substructure.

The onlay means that this insert covers the top of the tooth so that you bite on it making the restoration and the tooth stronger.

10. I’ve lost a couple teeth in the back and I avoid chewing on this side because it is uncomfortable. I was told that if they are not replaced I may get some problems with my jaw joints. I do not want to have implants. What are my options?

Natural teeth are designed to receive a tremendous pressure. The jaws can clench with a force of 600 pounds per square inch. That’s what happened when you chew. Traditional crowns and bridges are made on the metal base in order to withhold such pressure. The porcelain alone is too fragile for this job. The best and the most biocompatible (neutral for your body) material is gold in any form of a strong dental alloy that serves as a strong replacement what was originally there and got lost. One sided chewing is not a good idea and teeth should be replaced as soon as possible. With a new crown or a fixed bridge you’d get a new chance and you’d feel the teeth like you are born with them. You can brush them inside your mouth like before.

11. What can be done with the loose denture? My mom complains that her false teeth are very uncomfortable and loose. She can not enjoy food because of that. She had them redone few times in the past with several dentists and has now quite a collection of false teeth in a bag. She is forced to use some sort of glue and she hates it. I'd like to help her. Is there a solution to her problem?

Answer: Creating a comfortable denture can be a challenge for the patient and for the dentist. It requires special skills and training of the dentist. And even then a complete denture experience especially the lower one could be very challenging. There is a new technology that allows stabilizing the denture with relatively simple mini dental implants (screws). What makes it different from conventional implants is the fact that it does not require the surgery, suturing, months of healing and has only a small fraction of the cost associated with regular implants. The complete procedure to stabilize the denture takes one short visit and allows the patient to enjoy comfortable eating immediately.

12. I have a bunch of missing teeth and have been postponed their replacementy due to the personal economic problems. I've heard that implants are great. Are they good for me?

Answer: Implants have been around for years and they have been widely used in dentistry and in surgery (artificial joint like hip and/or knee) but only now after decades of clinical and scientific research they became a reliable and a main stream procedure in dentistry. Like in case with the roots of your own teeth implants provide the support for substructure which could be used for fixed bridges, crowns and removable dentures. The results are fantastic. The miracle of dental implants is hard to underestimate. But they do not come inexpensive and it takes an oral surgery for their insertion and requires several months of healing. In the end they’d give you and the unbelievable sense of security, strengths and longevity.

13. Can gum infections cause general health problems?

Answer: This disease is proven not only to be contagious (kissing) but the bacteria get easily into you blood stream possible damaging vital organs and even potentially contributing to the heart attacks and strokes. There is also a correlation between diabetes and the gum disease. There are a substantial number of related scientific publications. It is a whole new understanding of this disease. (Top)

14. I was told that I need a root canal but my friend said that it is a painful procedure and that he still feels the tooth after it was done? Why do I need it?

Answer: Root canal therapy is the procedure that saves your teeth by eliminating or preventing the infection inside the root of the tooth (root canals). There are two reasons the root canal therapy needs to be performed: 1. when there is a large decay coming close to the nerves inside the tooth. This condition can give you a severe tooth ache at any time and then would infect the tooth as a whole. None of this thing should happen. If the content of the roots is removed and the canals are cleaned and shaped to be filled that would prevent these problems and saves this tooth. 2. when the tooth is already infected and has a lesion on the root tip. The root canal therapy would help to heal this lesion and the tooth.

Since the original decay has already destroyed a great deal of the tooth structure this tooth needs to be rebuild with the crown or onlay. Together wit a root canal therapy this is the right way to get your tooth back in service. It should not be any pain during and/or after the root canal therapy if it is done right. Only slight postoperative sensitivity and discomfort for the next few days could be sometimes expected.

15. My jaw is clicking when I eat. It is embarrassing. Sometimes I get pain when I chew. What is going on?

Answer: The reason for the condition associated with your symptoms is usually a muscle spasm inside the jaw joints that create an internal misalignment of the joints. Untreated this condition would probably progress to more pains and discomforts. In a wide range of options for treatment we’d usually start with non invasive approach that brings the internal join structures in balance and eliminate pain, discomfort, clicking and migraines related to this condition.

16. How do I know if I have bad breath?

Answer: Most of the time people get so accustomed to their own odors that they cannot smell their bad breath. Usually, you can realize that there is something wrong if people you talk to turning the head away, rubbing their noses or in some other way giving you indirect signals. Persons close to you or your family may tell you openly about your problem. We can get your breath analyzed using Halimeter - the device that shows the level of a gas produced by the bacteria.

17. How can I get rid of bad breath?

Answer: The bacteria in your mouth hide deep inside the gums advancing via root's surfaces down to the bone that supports teeth and creating focal points of chronic infection. Proper diagnostics early is essential. Undiagnosed problem gets worse year after year. To get rid of bad breath means to get rid of the bacteria that cause it. Our special program helps to accomplish this goal by combining the initial therapy with new concept of home care and nutritional support. It brought relief to a lot of people and it will help you too.

18. If I get the treatment is the result permanent?

The proliferation of certain bacteria changes the "ecosystem" in your mouth. The balance is shifted toward the aggressive type of bacteria that give you bad breath. Our patients feel relief after the treatment and most of them notice the change even before it is finished. However, it takes consistent effort to reverse this unbalanced ecosystem around. That requires your commitment to the effective home care and regular maintenance. Sticking to the individually designed home hygiene protocol you'll get consistently better as the non-aggressive types of bacteria restore the ecosystem. Staying healthy is also significant because like with any disease having a good immune system is important.

19. I’ve been trying any mouth rinse and tooth paste advertised on TV. But they did not help me. Why do not they work?

Answer: These products do not address the bacterial problem focusing instead on masking the odor and giving a false impression of "a magic pill". However, there are products (toothpaste, mouth rinse, etc.) which contain chlorine dioxide - a well-known antiseptic - that works in some cases. Also, if you have a heavy bacterial build up on the back of the tongue you might benefit from scraping it off. Special irrigation also was proven to be a great tool. We've put together a couple of simple and inexpensive antibacterial bad breath kits for home care that might be good for you. It can be purchased on line or by calling our office. Or you may prefer to call for a free initial consultation and consider getting on our treatment program.

20: I brush my teeth twice a day and floss them too. But I still have a bad breath. Why doesn't brushing and flossing do anything?

Answer: For a lot of people it seems inconceivable that they would have bad breath originated in their mouth - after all you brush you teeth. But bacteria, which accumulate around the teeth, start their harmful work between them especially in the back where it is hard to reach and where very few people floss. The underlying problem of bad breath is the bacterial infection. The bacterial toxin works on pulling off the gums from the teeth allowing the bacteria to advance very deep. No floss, or brush, or mouthwash can get deep inside. Actually, these affected sites are just like the chronic wounds and if they are not properly cared for the process never stops and only gets worse. Our goal is to halt the progression of this disease and to eliminate your bad breath. The effective program that we've designed integrates for you all the necessary components of treatment and the follow up care.

21. I have bead breath and was recommended the gum surgery. Will it help?

Answer: Usually the gum surgery is performed in order to open the infected areas inside the gums and to access the hidden parts of teeth and bone. It is like lifting the curtains if you want to clean your windows thoroughly. The problem is that people skip after surgery the most important part - regular maintenance. If you've cleaned up your neglected weedy garden you'll see the weeds will grow wildly again soon unless you keep coming back repeatedly and control it. What makes the difference in our program and why it works is because we strictly conform to the follow up care. And we rarely have to resort to the gum surgery. Not only we teach our patient about everyday oral hygiene but we also support the instructions with special appliances and antibacterial products for better tooth cleaning and irrigation. You new and effective daily routine is easy to follow and it lives you mouth and your teeth pleasantly clean and fresh. The best part is that you do not have to recourse to mints and gum.