FAQ: Dental Info+

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 listen to and respond 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?

As part of our effort to ensure that your visit is painless and pleasant, we offer a full range of sedation dentistry options, including nitrous oxide. Your comfort and safety are our top concerns, so we will always work with you to make your dental visit pain-free. All sedation procedures are performed by qualified, licensed dentists to protect patient safety.

Our office is committed to helping you find the right cosmetic solutions to any dental problem. Our cosmetic dental services are attractive, functional, and long-lasting and include a full range of cosmetic dentistry services, including veneers, composite and ceramic restoration, bonding, and bleaching.

Contact us today for a complete “smile evaluation,” during which we will discuss all available options for you to look your very best. We can even show you your expected cosmetic result before you decide to commit to any cosmetic procedure.

We are located in Irvine, CA, and serve patients from all areas of Orange County. For directions to our office, click here.

The most common cause of tooth sensitivity is the existence of a cavity or recession of the gum line, which may be associated with abrasion of the tooth in this area. If the sensitivity involves an area or side of your mouth, this could be due to clenching and grinding.

When a cavity (decay) is not treated early on, the decay process extends to involve the nerve of the tooth. This becomes inflamed and, in most situations, will require root canal treatment. Do not place aspirin adjacent to the tooth, as it will cause severe tissue burns. Take pain medication orally and place an ice pack over the area until you get to a dentist.

This is usually indicative of a crack within the tooth. It is important to see a dentist, as if left untreated, the tooth will eventually fracture, and if the fracture is too extensive, the tooth may require extraction.

This is usually due to clenching and grinding your teeth at night. This may be associated with headaches and neck stiffness. These are symptoms of what is known as TMD dysfunction. Treatment may include wearing a nightguard or, in some instances, adjusting the way your teeth meet. This clenching can also cause generalized, non-specific tooth sensitivity.

When gums bleed, this means that you have gingivitis (gum inflammation). This is usually associated with the presence of plaque and calculus (tartar), which may be aggravated by existing dental work. In most instances, a professional dental cleaning followed by effective homecare and flossing will resolve it. If it were associated with defective dentistry, this would need to be replaced. In some instances, this gingivitis may be a warning sign of gum disease. If you are pregnant, hormonal changes make the gums very sensitive to irritation, causing swelling and bleeding. Diligent hygiene with regular professional cleanings will help reduce inflammation.

If you have a broken fragment, the dentist may be able to reattach the broken segment with bonding techniques. so, make sure you bring it with you to your appointment. Other treatment options include composite bonding and sometimes a veneer or crown (cap) if most of the tooth is missing.

Do not attempt to glue it back. When a cap (crown) becomes loose, it may indicate an underlying problem such as secondary decay (cavity) under the crown.

There are some very simple steps that you can take to prevent 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 fluoride toothpaste.
• Floss daily after brushing.
• Eat nutritious and balanced meals and limit snacking. Limit the amount of sugar you and your children eat.
• Check with your dentist about the 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.

Most dental professionals recommend that toothbrushes be replaced at least every two to 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.

Yes, brushing alone reaches only 3 out of 5 tooth surfaces. These surfaces between the teeth 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.

Radiation in the amounts used to expose dental X-rays, is very small. In fact, the average American 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 bones 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.

You should advise your physician that you are continuing routine dental care during your pregnancy (regular cleanings). There are a number of reasons why dental care is vital during your pregnancy. Tooth development in the embryo begins as early as the fifth or sixth week of intrauterine life, often before your pregnancy has been confirmed. Hormonal changes during pregnancy make the gum tissue very sensitive to plaque and irritation, commonly causing gingivitis. In addition, your eating habits may change, causing changes in your oral health.

Normally, it’s best to schedule necessary visits during the second trimester of your pregnancy. Morning sickness commonly occurs in the first trimester, and during the last trimester, it may be less comfortable for you to sit in one position for any length of time. If you should have a dental “emergency” (such as unexplained pain or facial swelling) during your pregnancy, you should contact your dentist immediately. Also, remember to inform your dentist about your pregnancy before taking any medications.

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. When a child has all their primary teeth in place, it 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.

At about 5-8 months, the first two baby central incisors erupt on the bottom.

• From 8 to 10 months, four upper incisors come in. 
• At 10 to 16 months, the first baby molars, the lower lateral incisors, and the first baby molars come in.
• At 16 to 22 months, the cuspids (“fangs” or “canines”) erupt.
• Finally, when the child is 2-31/2 years old, all 20 baby teeth have usually arrived.

(These times are approximate.)

The baby teeth perform two functions that help with the proper eruption of the permanent teeth. First, the baby tooth holds the spaces available for the permanent tooth by preventing the movement of the adjacent teeth into the space. Second, the roots of the baby teeth help guide the permanent teeth into place if all goes as planned. Sometimes, when the baby teeth are pulled early, the gums heal over the site, and the adult tooth has a difficult time breaking through the healed gum tissue. There are three times when it is appropriate to pull a child’s teeth.

If they are in the way of other permanent teeth trying to erupt in the wrong place. If they are interfering with the child’s eating (usually because of infection), or if the baby tooth is fused to the bone and inhibiting the permanent tooth eruption.

Yes. If excess fluoride is ingested, it can result in a condition known as fluorosis. Fluorosis can cause varying degrees of staining and irregular enamel formation in your child’s permanent teeth. Most municipal water supplies are fluoridated at safe levels (1.0 ppm). If your water source is an independent well or if you drink only bottled water, you will have to investigate the level of fluoride that the water contains. Another potential source of excess fluoride is fluoridated toothpaste. Children should use a “pea”-sized dab of fluoridated toothpaste and expectorate as much as possible. Parents should always supervise young brushers.

Cavities most commonly start on the biting surfaces of the back teeth (molars and premolars) due to the existence of developmental grooves. These cavity prone grooves are sometimes too narrow for your toothbrush bristle to reach and clean. A dental sealant is a tooth-colored material that is applied to cover these deeper susceptible grooves to “seal-out” the harmful bacteria and therefore reduce the chance of decay. Sealants are most beneficial at an early age, when the teeth are most susceptible to decay. As decay may start in the deeper section of the groove and go undetected, it is important for the dentist to make sure that there is no hidden decay before placing the sealant. As this may seal the decay under the sealant, it is recommended that the dentist flare the groove first to ensure there is no underlying decay. As sealants are weaker and susceptible to chipping, we recommend the use of preventive resin restorations instead.

Ask your dentist if sealants are an option for your child. It is recommended that sealants be applied to a child’s primary (baby) molars by the age of three or four years. Once the six-year molars (the first permanent back teeth) appear, it is best to apply preventive resin restoration if needed. As a child’s most cavity-prone years continue until the mid-teens, the premolars should also be sealed as they appear.

Often, it will be obvious early that the permanent teeth are not coming in properly. This is usually due to some level of overcrowding. However, this does not always mean that braces or removable retainers should be put in at once. In conjunction with the braces specialist [orthodontist], the decision must be made as to whether the adult teeth should be allowed to come in before the braces are placed or whether the orthodontist should intervene immediately and possibly place appliances twice – once early and again after the permanent teeth erupt.

One of the main factors to consider in early intervention is whether the child must move the jaw to the left, right, or forward to make the teeth fit together. This can lead to jaw growth problems and should be treated right away. I would otherwise wait for the permanent teeth to come in to put braces on. Of course, there are many other factors to weigh, and an orthodontist should always be consulted.

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

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.

Periodontal disease is a dental disorder that results from the 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.

When a tooth dies on the inside, where the nerve is, it becomes an area that is ripe for infection. If left alone, the tooth will become infected, and pressure will build up, causing a toothache. It is very difficult to treat the inside of a tooth like a regular infection because blood-carrying antibiotics cannot reach inside the tooth to help kill the bacteria. So, the dentist opens into the center of the tooth, removes the bacteria and debris (removing the infection), and fills the center with a rubbery substance to seal the dead space.

Dental implants are made of titanium, which is biocompatible. These are surgically placed into the jawbone to anchor permanent replacement teeth. Replacement teeth are then attached to the part of the implant that projects the gums. Approved and tested dental implant systems are very successful. In fact, some have lasted more than 30 years with a success rate of 95-98 percent. Patients who have good oral hygiene habits and regular dental checkups can enjoy implants that last a lifetime.

When you approach 17 years of age, your last set of teeth is due to erupt. These teeth are called third molars, or wisdom teeth. Often, since the jaw is already formed when they erupt, there is not enough room for the wisdom teeth, and they become wedged between the back of your lower jawbone and the tooth in front of them. This is called an impaction.

Impactions are usually brought to your attention when they begin hurting because of an infection of the surrounding gum and then need to be extracted as an emergency. Most specialists (oral surgeons) recommend that even impacted wisdom teeth that are not causing you problems should be removed when you are young because of potential problems when you are older (the bone is more resistant and the teeth are harder to extract). In cases where braces are put on, most dentists and orthodontists want wisdom teeth extracted so that they don’t erupt and ruin the straightened teeth.

Crown-and-bridge treatment is a permanent method of replacing missing teeth. A crown is placed on an individual tooth (somewhat like a thimble over your finger) where there is no longer sufficient tooth structure left to place a filling. A bridge spans a space where one or more teeth have been lost in the dental arch. The teeth on either end of the span are crowned, and are referred to as abutments. The false teeth in a bridge that join the abutments are referred to as pontics. Crowns and bridges are most often made from a combination of precious metals (gold), platinum, palladium, porcelain, or zirconia (white metal ceramic). Both esthetics (appearance) and function are considered when selecting the material most suitable for you.

Today, there are many options for tooth 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 molds 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 mold of your teeth, so they fit only your mouth. It comfortably holds the bleaching agent closely against your teeth for maximum results. The most effective results are obtained by having power bleaching followed by the home system. Results differ depending on the type of staining and the genetic color of your teeth. Stains that are the result of smoking, colored foods/drinks such as coffee, tea, 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.

There are many signs and symptoms of TMD syndrome, not all of which are necessarily present in all cases. Here are some of the most common:

• Tenderness of the jaw muscles with limitations in opening
• Pain in or around the ear that often spreads to the face
• Pain or difficulty in chewing, yawning, or opening wide
• Headaches, particularly those present upon awakening
• Jaws that get stuck or lock
• Earache or pain when no infection is present
• Dizziness
• Clicking, popping, or grating sounds when opening or closing the mouth.