1. What should I look for when choosing a dentist?

During your first visit, you should be able to determine if this is the right dentist for you. Consider the following:

• Is the appointment schedule convenient for you?
• Is the office staff friendly and courteous?
• Is the office close to your home or job?
• Does the office appear to be clean, neat and sterile?
• Was a thorough medical and dental history taken and reviewed with you?
• Does the dentist explain your treatment options and listens and responds to your concerns?

Your dentist should be a partner in maintaining your dental health.

• Are emergency after hours visits available and if the dentist is not available are arrangements made to be referred to a dental colleague?
• Are insurance benefits, fees and payment plans reviewed before treatment is scheduled?

2. What happens if I miss a dental appointment?

Ask your dentist about his or her appointment policy. Many dentists ask that you call to cancel at least 24 hours in advance. This will allow time to find someone else for your appointment. Those who don't call to cancel may be charged a missed appointment fee. If you feel ill, but well enough to keep your dental appointment, keep it unless you've got a fever, strep throat, difficulty breathing or are too uncomfortable to sit in the chair. Some dentists also request patients to cancel if they have an active herpes virus (cold sore) around the mouth. If in doubt, ask your dentist if the visit should be rescheduled.

3. What is the best way for me to prevent cavities in myself and in my children?

There are some very simple steps that you can take in the prevention of cavities that can save you much pain and money in the long run. Here are a few of the major ones.

• Brush twice a day with a fluoride toothpaste.
• Floss daily after brushing.
• Eat nutritious and balanced meals and limit snacking. Limit the amount of sugars you and your children eat.
• Check with your dentist about use of supplemental fluoride, which strengthens your teeth, and about use of preventive resin restorations (stronger than sealants) applied to the chewing surfaces of the back teeth to protect them from decay.
• It is important to visit your dentist regularly for professional cleanings and oral examinations.

4. How often should I change my toothbrush?

Most dental professionals recommend that toothbrushes be replaced at least every two-three months. Toothbrushes should also be replaced after you or your family members have had any upper respiratory tract infections such as a cold or the flu. It is also recommended to rinse your toothbrush with an antiseptic before use and keep it covered when not in use.

5. Do I really need to floss my teeth?

Yes, as brushing alone reaches only 3 out of 5 tooth surfaces. These surfaces between the tooth that brushing can't reach are areas where cavities and periodontal disease (gum disease) most frequently get started. Daily flossing is essential for healthy teeth and gums.

6. Are amalgam (silver) fillings safe?

The majority of the dental community feel that amalgam fillings are safe and that the risk associated with the mercury contained in these restorations is minimal. There are trace amounts of mercury, which are bound to other elements of the filling. You probably ingest more mercury from the fish you eat! If you have any concerns about amalgam fillings your dental professional will be happy to discuss alternative restorative options. See article on amalgam (silver) fillings.

7. Are routine dental x-rays safe & necessary?

Radiation in the amounts used to expose dental X-rays, is very small. In fact, the average American actually receives more radiation from sitting in front of the family television for a period of one year than from routine X-rays taken at the dental office. Dental x-rays are taken to diagnose problems that may be occurring in your teeth and supporting bone that are not visible to the naked eye. If the condition is allowed to develop until it is detectable by a visual exam the problem will have progressed significantly and require more extensive treatment than if it was caught in the early stages. Nevertheless, the radiation we receive from all sources is cumulative over our lifetime, so we need to be aware of exposures. Discuss with your dental professional the need and frequency for x-rays and have your original x-rays forwarded if you change dental care providers.

8. What about teeth bleaching or whitening gel?

Today there are many options for teeth bleaching or whitening. There are over-the-counter whitening toothpastes and whitening products as well as professional whitening systems. These dentist-administered systems can be done in-office by the dentist (power bleaching) or at home using professional products. Whitening toothpastes DO NOT work. The drugstore whitening products have bulky uncomfortable moulds and do not retain the bleach properly causing some bleach to be swallowed. The professional bleach trays made by a dentist are customized from a mould of your teeth, so it fits only your mouth. It comfortably holds the bleaching agent closely against your teeth for maximum results. The most effective results are obtained by having the power bleaching followed by the home system Results differ depending on the type of staining and genetic color of your teeth. Stains that are the result of smoking, colored foods/drinks such as coffee, tea and or age may respond well to bleaching. Staining from antibiotic (tetracycline) use or excess fluoride intake during childhood is less likely to respond to these treatments. Before trying any whitening procedure, discuss your condition with your dentist and together you can decide which treatment will achieve the best results.

9. Do I need a "cleaning" appointment every six months?

All patients are individuals, and have varied needs. The interval of six months for "cleaning & check-up" is a commonly recommended time frame, which may or may not be appropriate for you. If you have concerns about the frequency of your "recall" appointments you should discuss them with your dental professional. Together you can reach a "recall" schedule that is appropriate for your oral condition and that fits your busy schedule.

10. Are fluoride treatments effective for adults?

Yes. Topical application of fluoride increases the level of fluoride in the outermost surface of the tooth, regardless of the age of the tooth. While we tend to think of children as being more prone to cavities, adults still get decay. People are maintaining their natural teeth longer and root decay is a condition that is more likely to occur as we age. The key is multiple applications of fluoride with fluoridated toothpaste, possibly a home fluoride gel, and in-office treatments. Your dental professional will be able to prescribe the best home care and in office treatment options for your dental condition.

11. When should children have their first dental appointment?

Certainly parents should not wait until their children have cavities or a toothache to see the dentist. The first few appointments should be fun and foster a trusting relationship. We have found that there are far fewer difficulties with children who know that the dentist is there to help them - before they need dental work. The goal is to have your child's first dental experience be a positive one. Generally speaking, when a child has all of their primary teeth in place is a good time to have their first oral exam. The first cleaning and check-up appointment can follow a few months later, depending on the child's maturity and his readiness to accept the treatment.

12. What exactly is Gingivitis, and what causes it?

Gingivitis is a form of Periodontal Disease (gum disease). Periodontal disease involves inflammation and/or infection that results in destruction of the tissues that support the teeth. This supporting unit comprises the gingiva (gums), the periodontal ligaments (hold the tooth in place), and the tooth sockets (bone).

Gingivitis (inflammation of the gums) is caused by the long-term effects of plaque deposits. Plaque is the sticky material that develops on the exposed portions of the teeth, consisting of material such as bacteria, mucus, and food debris. It is a major cause of dental decay. Un-removed plaque mineralizes into a hard deposit called calculus (tartar) that becomes trapped at the base of the tooth. Plaque and calculus cause mechanical and chemical irritation and inflammation of the gingiva. Bacteria and the toxins produced by the bacteria, cause the gums to become infected, swollen and tender.

13. What is the best prevention for Gingivitis?

Good oral hygiene is the best prevention against gingivitis because it removes the plaque that causes the disorder. The teeth should be brushed at least twice daily and flossed gently at least once per day. For people who are prone to gingivitis, brushing and flossing may be recommended after every meal and at bedtime. Consult the dentist or dental hygienist for instructions on proper brushing and flossing techniques.

14. How is Gingivitis treated?

The goal of treatment is reduction of gingival inflammation. The teeth are cleaned thoroughly by the dentist or dental hygienist. This may involve the use of various instruments or devices to loosen and remove deposits from the teeth. Meticulous oral hygiene is necessary after professional tooth cleaning. The dentist or hygienist will demonstrate brushing and flossing techniques.

Professional teeth cleaning in addition to brushing and flossing may be recommended twice per year or more frequently for severe cases. Antibacterial mouth rinses or other aids may be recommended in addition to frequent brushing and flossing. Repair or replacement of dental work or orthodontic treatment of misaligned teeth may be recommended.

15. How are Periodontal Disease and Gingivitis related?

Periodontal Disease is a dental disorder that results from progression of gingivitis, involving inflammation and infection of the ligaments and bones that support the teeth. This gradually causes the destruction of tooth support and if left untreated will lead to tooth loss.