ADA Patient Education

ADA American Dental Association
Patient Education Library

The ADA Patient Education Library provides the most popular topics in dentistry that will help you better maintain your dental health. Select an article or video below to get started now.

 

Articles

SCALING AND ROOT PLANING

ANTIBIOTICS AND DENTAL TREATMENT

TOOTH REPLACEMENT OPTIONS

SIPPING, SNACKING AND DECAY

TOOTH WHITENING

UNDERSTANDING YOUR INSURANCE

TEETH GRINDING

WHY DO I NEED A CROWN

TAKING CARE OF YOUR TEETH AND GUMS

TOOTH EXTRACTION

ROOT CANAL TREATMENT

IMPROVING YOUR SMILE 

 

Videos

PREVENTING PERIODONTAL DISEASE

IMPLANTS

Taking Care of Your Teeth and Gums

 

Scaling and Root Planing

Periodontal disease (also known as gum disease) is an infection of the gum and bone that support the teeth. If periodontal (perry-oh-DON-tal) disease is not treated, it can get worse and lead to tooth loss. Periodontal disease may not be painful. You may not be aware of a problem until your gums and supporting bone are damaged.

Fortunately, periodontal disease often can be treated with a deep cleaning called “scaling and root planing.” This brochure will tell you why treating periodontal disease is important, and how it can help you keep your teeth.

What causes periodontal disease?

Periodontal disease is caused by plaque, a sticky film of bacteria that is always forming on your teeth. If teeth are not cleaned well, plaque bacteria can cause your gums to become inflamed.

Inflamed gums can pull away from the teeth, forming spaces called “pockets.” These pockets trap more plaque that cannot be removed with toothbrushing. If the pockets are not treated, the periodontal disease can get worse.

Diseases such as diabetes and AIDS can place a person at higher risk for periodontal disease. Tobacco use also increases your risk of developing periodontal disease, and treatment may be less successful if you continue to smoke or chew.to smoke or chew.

Stages of Periodontal Disease

Healthy gums and bone hold teeth firmly in place. Gums hug the teeth tightly. There is little or no buildup of plaque and tartar (calculus).

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Gingivitis (jin-ja-VY-tis) is the early stage of periodontal disease. It develops as plaque irritates the gums. The gums become red, tender, swollen and likely to bleed. Gingivitis can usually be reversed with a professional dental cleaning plus improved oral hygiene. If plaque is not removed, it can harden into tartar.

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Periodontitis (perry-oh-don-TIE-tis) is a more serious condition that can develop if gingivitis is not treated. Periodontitis happens over time as plaque inflames the gums. The gums and bone that support teeth are damaged. Unless treated, the affected teeth may become loose and even require removal by a dentist.

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How is periodontal disease diagnosed?

If you schedule regular dental exams, your dentist can catch periodontal disease before the gums and the bone supporting your teeth are severely damaged.

  • During a periodontal evaluation, the dentist or hygienist uses a periodontal probe to gently measure the spaces between the teeth and gums. In a healthy mouth, this space (pocket) is usually less than three millimeters deep. Very deep pockets are a sign of advanced periodontal disease.

  • He or she usually takes x-rays to check the bone supporting the teeth. Low bone levels can be a sign of damage from periodontal disease.

  • If periodontal disease is diagnosed, your dentist may provide treatment or may refer you to a periodontist (a dentist who specializes in the diagnosis, prevention and treatment of periodontal disease).

Periodontal probe of healthy gums.
Periodontal probe in a periodontal pocket.
X-ray showing supporting bone.
X-ray showing periodontal bone loss.

How is periodontal disease treated?

Periodontal treatments depend on the type of the disease and how severe it is. If the disease is caught early (when it is gingivitis), and no damage has been done to the supporting structures under the teeth, you may simply need a professional cleaning. The dental team can give you tips for improving your daily oral hygiene.

Even with these measures, some patients develop more severe periodontal disease. The first step in treating the disease usually involves a special deep cleaning called “scaling and root planing.” In this treatment, the dentist removes plaque and tartar down to the bottom of each periodontal pocket. This treatment may be done over several visits, depending on your needs.

The root surfaces of the teeth are then smoothed (or “planed”) to allow the gum tissue to heal and reattach to the teeth. This treatment also may take more than one visit.

Your dentist may recommend medications to help control infection and pain or to aid healing. These can include a pill, a mouthrinse or a medication that the dentist places directly into the periodontal pocket after scaling and root planing.

If you smoke or chew tobacco, it is important to quit. Ask your dentist or physician for information about ways to stop.

Another dental visit will be scheduled within a few weeks or months after your last scaling and root planing treatment. At this visit, your dentist or hygienist will look at your gums to see how they have healed. He or she will measure the periodontal pockets again. If the pockets have gotten deeper and the supporting bone is lost, more treatment may be needed.

Scaling removes plaque and tartar from below the gumline.
Root planing smoothes the tooth root and helps the gums reattach to the tooth.

Care After Treatment

Once your periodontal treatment is completed, your dentist may recommend more frequent checkups and cleanings. Regular dental visits and deep cleanings are important to keep periodontal disease under control. In some cases, your appointments may alternate between your general dentist and periodontist.

Oral Hygiene at Home

Good oral hygiene at home also is very important to help keep periodontal disease from becoming more serious or from coming back. Daily home cleaning helps keep plaque under control and reduces tartar buildup.

  • Brush your teeth twice a day with a fluoride toothpaste.

  • Floss your teeth (or use another between-the-teeth cleaner) once a day.

You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a healthy diet and visit your dentist regularly for a lifetime of healthy smiles.

Antibiotics and Dental Treatment

Your mouth has bacteria that can get into your bloodstream. For most people, these bacteria don’t cause a problem. But there is concern that for some people, bacteria in the bloodstream can cause an infection elsewhere in the body. That’s why your physician or dentist may advise you to take an antibiotic before some dental procedures. The antibiotic can kill infection-causing bacteria.

Not everyone should take antibiotics before dental treatment. This brochure will explain who should take antibiotics in this case and who should not.

What is the dental connection?

Bacteria normally are found on and in some parts of the body, including the skin and mouth. The bacteria in the mouth can enter the bloodstream. This can happen during some dental treatments, like teeth cleanings, or even from daily activities like chewing, toothbrushing, and flossing. For most people, the body’s immune system fights any bacteria, so the risk of infection stays low.

There’s concern that for some people, bacteria in the bloodstream can cause an infection of the heart lining or valves (infective endocarditis) or an infection of an orthopedic implant (such as artificial joints or metal plates or rods).

Because of this concern, some people with certain heart conditions and orthopedic implants are told to take antibiotics before having certain dental treatments. This is done with the belief that antibiotics might help prevent infective endocarditis or an implant infection. Taking antibiotics before dental treatment is called antibiotic prophylaxis (or preventive medicine).

However, there is no scientific evidence to show that bacteria in the bloodstream cause orthopedic implant infections. There is also no scientific evidence that antibiotic prophylaxis defends against infective endocarditis or an implant infection.

Who should take preventive antibiotics?

The American Heart Association recommends antibiotics for patients who would be in the most danger if they developed a heart infection.

If you have one of these heart conditions, your dentist or physician may recommend that you take an antibiotic before dental treatment:

  • artificial heart valves

  • a history of infective endocarditis

  • certain specific, serious congenital heart conditions, including:

  • unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits

  • a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure

  • any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device

  • a cardiac transplant that develops a problem in a heart valve

The American Dental Association and American Academy of Orthopedic Surgeons also do not recommend antibiotics for all dental patients who have had orthopedic implants. However, some people with orthopedic implants may decide to take antibiotics. For example, people who have weak immune systems are at greater risk for artificial joint infection. Diabetes, rheumatioid arthritis, cancer, chemotherapy, and chronic steroid use can weaken the immune system. All patients should talk to their dentists and/or physicians before deciding whether or not to take antibiotics.

Why shouldn’t everyone with a heart condition or orthopedic implant take preventive antibiotics?

In most cases, taking antibiotics is more likely to cause a problem than defend against one. Antibiotics can cause side effects from mild stomach problems to severe allergic reactions. Taking antibiotics can destroy good germs that protect against infection. Also, improper use of antibiotics can lead to the development of drug-resistant bacteria.

Talk to your dentist or physician

Talk to your dentist or physician if you have any questions about antibiotics. If there are any changes in your health history or the medicines you take, let your dental office know so they can update your records.

You can maintain a healthy mouth by brushing twice a day, cleaning between your teeth daily, and visiting the dentist regularly.

Tooth Replacement Options

If you’re missing one or more teeth, you may be all too aware of their importance to your looks and dental health. Your teeth are designed to work together to help you chew, speak, and smile. When teeth are missing, it is difficult to do these things. Even the loss of a back tooth may cause your mouth to shift and your face to look older. Fortunately, missing teeth can be replaced.
The following are three options your dentist may suggest, depending on your needs. Replacement teeth should last for years at a time, so it is important to choose a treatment that’s right for you.

  • Implants

  • Fixed Bridges

  • Removable Partial De

  • ntures

Position of teeth immediately after a tooth is lost

If the tooth is not replaced, other teeth can drift out of position and change the bite. Shifting teeth can possibly lead to tooth decay and gum disease.

1. Implants

Many patients choose implants to replace a single tooth, several teeth, or to support a full set of dentures. Implants are posts that are surgically placed in the upper or lower jaw, where they function as a sturdy anchor for replacement teeth. They are made of titanium (a strong, lightweight metal) and other materials that are accepted by the human body.

Most patients find that an implant is secure and stable—a good replacement for their own tooth. However, implants are not an option for everyone. Because implants require surgery, patients should be in good health overall. Patients either must have adequate bone to support the implant, or be able to have surgery to build up the area needing the implant. Patients also should be ready to commit to a daily oral care routine and to regular dental visits.

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Chronic illnesses, such as diabetes or leukemia, may slow healing after surgery. Patients with these issues may not be good candidates for implants. Using tobacco can also slow healing. Your dentist can help you decide whether implant treatment is a good option for you.

What’s Involved?

There are many different kinds of implants. Treatment can take only one day, or it can take several months, or somewhere in between. Your dentist can outline a treatment plan that is most likely to be successful for you.

There are three general phases of implant treatment:

  • Placement of the implant: The dentist surgically places the implant into the jawbone. There may be some swelling and/or tenderness after the surgery, so pain medication is usually prescribed to ease the discomfort. Your dentist may recommend a diet of soft foods during the healing process.

  • The healing process: What makes an implant so strong is that the bone actually grows around it and holds it in place. This process takes time. Some patients might need to wait until the implant is completely healed, up to several months, before replacement teeth can be attached to the implant. Other patients can have the implants and replacement teeth placed all in one visit.

  • Replacing your missing tooth or teeth (prosthesis): The dentist or a lab will custom-make a crown, bridge or dentures to fit your mouth and your implants. Once completed, the man-made teeth are attached to the implant posts.

The prosthesis usually takes some time to make. In the meantime, your dentist may give you a temporary crown, bridge or denture. This can help you eat and speak normally until the permanent replacement is ready.

 

Implant-Supported Bridge

Missing teeth

A bridge is placed on implants

After the Bridge is placed

Advantages of implants:
  • An implant is most similar to a natural tooth.

  • Nearby teeth do not have to be involved in the placement procedure.

  • Implants may last for many years, even decades.

  • Some types of implants and artificial teeth or dentures can be placed in just one or two visits.

  • Implants may help prevent shrinkage of the jawbone from tooth loss.

Disadvantages of implants:
  • Implants are not right for everyone, since they require surgery.

  • Implant placement may take longer and may require more dental visits than other options.

  • Implants may cost more than other treatments.

2. Fixed Bridges

Another tooth replacement option is a fixed bridge. This is a restoration that fills the space where one or more teeth have been lost. A fixed bridge is bonded or cemented into place — only a dentist can remove it.

How is a bridge placed?

Placing a bridge usually takes more than one dental visit. On your first visit, your dentist prepares the teeth on either side of the gap. The bridge will later be attached to these teeth.

Your dentist then takes an impression of your teeth and the space and sends the impression to a dental laboratory. Technicians at the lab make the bridge out of metal, ceramics, glass-ceramics or a combination. Your dentist will place a temporary bridge to protect your exposed teeth while you are waiting for the permanent one.

When talking about bridges, your dentist may use these terms:

  • Pontic: the replacement for your missing tooth

  • Crown: a “cap” that covers the attachment tooth 

During one or more follow-up visits, the bridge is fitted, adjusted and cemented in place.

 

Bridge Placement

Before the bridge, teeth are shown with the space where a tooth has been lost.

Teeth next to the gap are prepared for placement of the bridge.

The custom-made bridge is placed over the prepared teeth.                  

The bridge is cemented into place.

Advantages of fixed bridges:
  • Look, feel and function like natural teeth

  • Don’t require removal for cleaning

  • Cost less than implants

Disadvantages of fixed bridges:
  • Likely to be more expensive than removable bridges

  • Affect the teeth next to the bridge

  • May require extra effort to clean under the pontic

3. Removable Partial Denture

As its name describes, a removable partial denture can easily be taken out of the mouth for cleaning. Partial dentures usually have replacement teeth fixed to a plastic base that matches the color of your gums. The plastic base may cover a metal framework. Partial dentures often have some form of clasp that attaches to your natural teeth.

Your dentist may also recommend crowns, or “caps,” on your natural teeth. Crowns may improve the way a removable partial denture fits your mouth.

Getting used to a removable partial denture

It takes practice to put in and take out a removable partial denture. It may feel odd or tight for the first few weeks. But in time, you should get used to it. Never force it into place by biting down. This could bend or break the clasps.

Removable partial dentures should not be worn 24 hours a day. Your dentist may tell you to take out the partial denture at bedtime and put it back in when you wake up. Usually your dentist will make follow-up appointments to look for pressure points or sore spots. He or she will adjust your denture so it fits comfortably.

Once your missing teeth are replaced, eating should be a much more pleasant experience. Since missing teeth can make it difficult to speak clearly, wearing a removable partial denture can help with that, too.

Over time, as you age and your mouth changes, your removable partial denture may no longer fit well. It also could break, crack or chip, or one of the teeth could loosen. Sometimes dentists can make the repairs, often on the same day. Complex repairs may take longer.

 

Removable Partial Denture 

Partial denture in the mouth (showing clasps)

Disadvantages of removable partial dentures:
  • Can be less stable than other choices

  • They can break or be lost

  • Can be uncomfortable

  • Some people are embarrassed to take out their teeth at night and for cleaning

  • May need more frequent replacement than other options

Partial denture being placed

Advantages of removable partial dentures:.
  • Usually less expensive than fixed bridges or implants

  • Usually easier to repair than fixed bridges

Explore All Your Options

How best to replace missing teeth is an important decision. Your dentist may refer you to a dental specialist for additional care. Here are some of the dental specialists who may be called upon:

  • Prosthodontist — restoration and replacement of teeth

  • Oral and maxillofacial surgeon — dental surgery and treatment of the entire oral cavity, including neck and face

  • Periodontist — treats periodontal (gum) diseases

Talk to your dentist. He or she can answer your questions and help you decide which option will work best for you: implants, a fixed bridge or removable partial denture.

Sipping, Snacking and Decay

Do you sip soft drinks or other sugary drinks all day at your desk? Do you use breath mints or eat candy often? Instead of eating meals, do you snack all day? Do you often grab a sports or energy drink when you are tired?

If you answered yes to any of these questions, you may be increasing your chances of tooth decay. Keep reading to find out why.

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What and how often you eat can affect your teeth

Eating habits and food choices can lead to tooth decay, or cavities. A steady supply of sugary foods and drinks, including sports and energy drinks, can damage teeth. But snacking or “grazing” all day long can also lead to tooth decay.

Plaque (sounds like “back”) is a sticky film of bacteria that forms on teeth. When you do not remove plaque from your teeth every day, it builds up. Plaque bacteria use sugar to make acid that attacks enamel, the hard surface of the tooth. The acid can attack tooth enamel for up to 20 minutes after you consume sugary foods or drinks.

When you have sugary foods or drinks many times a day or sip the same sugary drink for a long time, acid attacks the enamel again and again. Repeated acid attacks can cause tooth decay, which must be treated by a dentist.

One way of making smarter food and drink choices is to read their labels to make sure they are low in added sugar.

A healthy diet keeps your mouth healthy

Eating a healthy diet helps keep you from feeling tired, getting sick, being overweight, and having other health problems, like tooth decay. A healthy diet is one that

  • Is based on fruits, vegetables, whole grains, and fat-free or low-fat dairy products

  • Includes lean meats, poultry, fish, beans, and nuts

  • Is low in saturated fats, trans fats, salt (sodium), and added sugars

  • Has foods in the 

  • amounts shown on the my plate picture below

Almost all foods have some type of sugar. You cannot and should not remove all sugar from your diet. Many foods and drinks, like apples, carrots, and milk, naturally contain sugars and have vitamins, minerals, and nutrients that your body needs.

For teeth to be healthy, they need vitamins, protein, calcium, and phosphorous.

 

Reduce your risk of tooth decay

  • Limit sugary drinks and snacks between meals. Remember, many sports and energy drinks have sugar, too. If you do snack, choose foods that are low in sugar and fat.

  • If you have sugary foods and drinks, have them with meals. Saliva increases during meals and helps weaken acid and rinse food particles from the mouth.

  • Chew sugarless gum that has the ADA Seal. Chewing gum for 20 minutes after meals has been shown to reduce tooth decay.

  • Drink water. Drinking tap water with fluoride can help prevent tooth decay. And it can help wash away sugary drinks.

  • See your dentist regularly.

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Tooth Whitening

People generally think of teeth as being white. But tooth enamel can be many different shades. Over time, tooth enamel can change color or become stained. There are many reasons why teeth become discolored:

  • Genetics—tooth color can run in the family

  • Aging

  • Injury to the teeth

  • Illness

  • Medicines, such as some antibiotics

  • Tobacco use

  • Contact with stain-causing food and drinks over time (such as berries, sauces, coffee, cola, black tea, and red wine)

  • Getting too much fluoride while teeth are developing

If your teeth are discolored, tooth whitening may help. “Whitening” is any process that can make teeth look whiter. It may be safely done at home or in a dental office.

Whitening toothpastes help remove stains on the surface of your teeth. They are the gentlest kind of whiteners. Since they work using polishing action rather than chemicals, they usually do not have side effects. However, they do not get teeth as white as chemical products. Whitening toothpastes can lighten teeth a little bit at a time, over days or weeks.

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Whitening toothpastes can be bought over the counter. Several whitening toothpastes have earned the American Dental Association’s (ADA’s) Seal of Acceptance.

Home-use whiteners come from your dentist or are sold over the counter. They can be applied with trays, strips, a rinse, or a brush. They usually contain a chemical called peroxide, which gets below the surface to lighten tooth enamel. Home-use whiteners are meant to be used over days or weeks. It is best to consult your dentist before whitening your teeth.

Your dentist may make special whitening trays for your upper and lower teeth. You put the whitening gel in the trays and wear them for short times during the day or overnight. Your dentist will tell you how long to wear them. If you wear the trays for too long, the peroxide in the gel can irritate your teeth.

In-office whitening is done in the dental office. In-office whiteners are much stronger than whitening toothpastes and home-use whiteners, since they have more peroxide. They can change the color of your teeth faster than the other methods.

The in-office whitening is usually done in about one hour. To help protect the mouth from the peroxide, the patient’s gum tissues are covered either with a thin sheet of rubber or a protective gel. Sometimes a light or laser is used with the peroxide.

Before in-office whitening

After in-office whitening

Before-and-after whitening photos courtesy of Dr. Victor H. Burdick.

 

Side Effects

For a few days after treatment, your teeth may be sensitive to very hot or cold temperatures. Whitening may also irritate the gums for a short time. If the side effects do not go away after a few days, see your dentist.

To avoid harming your teeth and gums, always follow the product directions and any instructions from your dentist. If your teeth become very sensitive or you get sores in your mouth, stop using in-home products and call your dentist.

There is such a thing as too much whitening. Do not use whitening products for longer than advised in the product directions or by your dentist. Overwhitening can cause severe discomfort to your teeth and gums. Too much whitening can even harm your tooth enamel.

 

It’s not for everyone

Tooth whitening is not a good choice for all people. If your gums have pulled away from the teeth in some places, whitening may irritate these areas. If you have tooth decay or gum disease, your dentist may recommend that these be treated before whitening. Also, the color of fillings, crowns, and some stains cannot be changed by tooth whitening.

So talk to your dentist about tooth whitening before you begin. He or she will do an oral exam to find out if tooth whitening is right for you.

 

Keep your teeth white

Newly whitened teeth may stain more easily. To keep your teeth white as long as possible, avoid tobacco and stain-causing food and drinks for several days after whitening. Keep in mind that teeth usually return to their original shade over time. But if you steer clear of tobacco and large amounts of stain-causing food and drinks, your teeth may stay bright for several years.

Understanding Your Insurance

Having dental insurance or a dental benefit plan can make it easier to get the dental care you need. But most dental benefit plans do not cover all dental procedures. Your dental coverage is not based on what you need or what your dentist recommends. It is based on how much your employer pays into the plan.

When deciding on treatment, dental benefits should not be the only thing you consider. Your treatment should be determined by you and your dentist.

How Dental Plans Work

Almost all dental plans are a contract between your employer and an insurance company. Your employer and the insurer agree on the amount your plan pays and what procedures are covered.

Often, you may have a dental care need that is not covered by your plan. Employers generally choose to cover some, but not all, of employees’ dental costs. If you are not satisfied with the coverage provided by your insurance, let your employer know.

The Role of Your Dental Office

Your dentist’s main goal is to help you take good care of your teeth. Many offices will file claims with your dental plan as a service to you. The part of the bill not covered by insurance is your responsibility.

Cost-Control Measures Used by Dental Benefit Plans

Key terms used to describe the features of a dental plan may include the following:

UCR (Usual, Customary, and Reasonable) Charges

UCR charges are the maximum allowable amounts that will be covered by the plan. Although these terms make it sound like a UCR charge is the standard rate for dental care, it is not. The terms “usual,” “customary,” and “reasonable” are misleading for several reasons:

  • Insurance companies can set whatever amount they want for UCR charges. They may not match current actual fees charged by dentists in a given area.

  • A company’s UCR amounts may stay the same for many years. They do not have to keep up with inflation or the costs of dental care.

  • Insurance companies are not required to say how they set their UCR rates. Each company has its own formula.

If your dental bill is higher than the UCR, it does not mean your dentist has charged too much. It could mean your insurance company has not updated its UCR charges. It could also mean that the data used to set the UCR is taken from areas of your state that are different from yours.

Annual Maximums

This is the largest dollar amount a dental plan will pay during the year. Your employer decides the maximum levels of payment in its contract with the insurance company. You are expected to pay copayments and any costs above the annual maximum. Annual maximums are not always updated to keep up with the costs of dental care. If the annual maximum of your plan is too low to meet your needs, ask your employer to look into plans with higher annual maximums.

Preferred Providers

The plan may want you to choose dental care from its network of preferred providers. The term “preferred” means these dentists have a contract with the dental benefit plan; it does not mean these are dentists the patient prefers. If you get dental care from a dentist who is not in the network, you may have higher out-of-pocket costs. Learn about your plan’s costs when using both in- and out-of-network dentists.

Pre-Existing Conditions

A dental plan may not cover conditions that existed before you enrolled in the plan. For example, benefits will not be paid for replacing a tooth that was missing before the effective date of coverage. Even though your plan may not cover certain conditions, you may still need treatment to keep your mouth healthy.

Coordination of Benefits (COB) or Nonduplication of Benefits

These terms apply to patients covered by more than one dental plan. The benefit payments from all insurers should not add up to more than the total charges. Even though you may have two or more dental benefit plans, there is no guarantee that all of the plans will pay for your services. Sometimes, none of the plans will pay for the services you need. Each insurance company handles COB in its own way. Please check your plans for details.

Plan Frequency Limitations

A dental plan may limit the number of times it will pay for a certain treatment. But some patients may need a treatment more often to maintain good oral health. For example, a plan might pay for teeth cleaning only twice a year even though the patient needs a cleaning four times a year. Make treatment decisions based on what’s best for your health, not just what is covered by your plan.

Not Dentally Necessary

Many dental plans state that only procedures that are medically or dentally necessary will be covered. If the claim is denied, it does not mean that the services were not necessary. Treatment decisions should be made by you and your dentist.

If your plan rejects a claim because a service was “not dentally necessary,” you can appeal. Work with your benefits manager and the plan’s customer service department to appeal the decision in writing.

Other Cost Control Measures

  • Bundling– Claims bundling is when two different dental procedures are combined by the insurance company into one procedure. This may reduce your benefit.

  • Downcoding is when a dental plan changes the procedure code to a less complex or lower cost procedure than was reported by the dental office.

  • Least Expensive Alternative Treatment (LEAT) – Your plan may have a LEAT clause. That means that if there is more than one way to treat a condition, the plan will pay for only the least expensive treatment. However, the least expensive option is not always the best. For example, your dentist may recommend an implant for you, but the plan may only cover less costly dentures. You should talk with your dentist about the best treatment option for you.

Make Your Dental Health the Top Priority

Although you may be tempted to make decisions about your dental care based on what insurance will pay, remember that your health is the most important thing.

Dental insurance is one part of your healthy mouth plan. If you find out what your dental plan covers and plan accordingly, it can help you have a healthy mouth. Work with your dentist to take the best possible care of your teeth so they will last a lifetime!

Teeth Grinding

Bruxism is a habit of grinding or clenching the teeth. Clenching means you tightly hold your top and bottom teeth together. Grinding is when you slide your teeth back and forth over each other. Bruxism can happen in children and adults of any age.

Many people with bruxism wake themselves up during the night with a loud clenching or grinding sound. Sometimes the sound is so loud that other people can hear it. For other people, bruxism may be silent.

People who suffer from bruxism may have one or more of these symptoms:

  • headache or earache

  • sore jaw

  • jaw clicking

  • frequent toothaches

  • sensitive teeth

  • facial pain

  • worn or cracked teeth or fillings

  • tongue indentations

  • insomnia (trouble sleeping)

What causes bruxism?

The causes of bruxism are not known for certain. Stress, sleep disorders and an abnormal bite are some things that may play a role.

Your dentist can diagnose bruxism by checking for unusual wear spots on your teeth and looking at any related symptoms. Regular dental checkups are important to find damage in the early stages. Your dentist can help you manage bruxism and the related symptoms, as well as repair your teeth if necessary and help prevent further damage.

How is bruxism treated?

Treatment depends on each person’s situation. Your dentist may recommend one or more treatments, such as the following:

  • stress reduction methods

  • a protective nightguard worn over the teeth while sleeping

  • medication for pain or muscle spasms

  • exercises to relax jaw muscles

  • fillings or other dental treatment to repair damaged teeth

Your dentist may recommend that you wear a nightguard during sleep. Nightguards are custom-made by your dentist from plastic or acrylic. The nightguard slips over the upper or lower teeth and prevents them from touching. It protects teeth and helps keep them from wearing down.

Since bruxism has many causes, you may need to try a few different treatments to find out what works for you. You can help manage bruxism by paying attention to the symptoms, having regular dental visits and talking with your dentist.

Why Do I Need a Crown

What is a crown?

A crown is a cover or “cap” your dentist can put on a tooth. The crown restores the tooth to its normal shape, size and function. The purpose of a crown is to make the tooth stronger or improve the way it looks.

Crown Used to Replace a Filling

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Before – Filling with decay at the edge

After – Filling replaced by a crown

 “Crown Used to Replace a Filling” photos courtesy of John R. Nosti, DMD, FAGD, FACE, FACOI, SmileDesignNYC.com.

 

Why do I need a crown?

You may need a crown if you:
  • Have a cavity that is too large for a filling

  • Have a missing tooth and need a bridge

  • Need to cover a dental implant

  • Have a tooth that is cracked, worn down or otherwise weakened

  • Have had root canal treatment—the crown will protect the restored tooth

  • Want to cover a discolored or badly shaped tooth and improve your smile!

What is it made from?

Crowns are made from several types of materials. Metal alloys, ceramics, porcelain, composite resin, or combinations of these materials may be used. In the process of making a crown, the material often is colored to blend in with your natural teeth.

Full Porcelain Fused to Metal Crown Full Ceramic Crown

Your dentist wants to create a crown that looks natural and fits comfortably in your mouth. To decide on the material for your crown, your dentist will consider the tooth location, the position of the gum tissue, the patient’s preference, the amount of tooth that shows when you smile, the color or shade of the tooth, and the function of the tooth.

 

How is a crown placed?

Several steps are involved, and two dental visits are generally needed to complete the treatment.

  1. The dentist prepares the tooth by removing its outer portion so the crown will fit. Any decay is also removed. If additional tooth structure is needed to support the crown, the dentist may build up the core of the tooth.

  2. An impression is made to provide an exact model for the crown.

  3. You will get a temporary crown while you wait for the permanent crown to be ready—usually less than two weeks. While you have the temporary crown, this tooth may be sensitive to hot and cold. Also, avoid chewing gum or sticky foods during this time.

  4. The dentist or a laboratory technician then uses the model to help make the crown.

  5. When the new crown is ready, the dentist places it in your mouth and makes the necessary adjustments. When you and your dentist are satisfied with how it looks and feels, the crown is cemented in place.

Before crown: Worn filling with decay and broken

Crown is placed over prepared tooth

After crown placement

CARING FOR YOUR TEETH

To prevent damage to a crown, there are a few things you can do:

  • Brush twice a day and floss once a day to remove plaque, a sticky film of bacteria. Look for oral care products that have the ADA Seal of Acceptance. Products that display the Seal have met the American Dental Association’s standards for safety and effectiveness.

  • Avoid chewing hard foods, ice or other hard objects, such as pencils. This is especially important for tooth-colored crowns.

  • Be sure to see your dentist for regular exams and professional teeth cleanings.

Taking Care of Your Teeth and Gums

Good oral care is part of a healthy lifestyle. It’s easy to keep your teeth and gums in good health. A simple routine of daily teeth cleaning, good eating habits and regular dental visits can help prevent tooth decay (cavities) and gum disease.

Healthy Smile Tips for Life

Healthy smiles make great impressions! To keep your mouth in good condition,

  • Always brush twice a day,

  • Clean between your teeth daily,

  • Eat a balanced diet and limit snacks, and

  • Visit your dentist regularly for a dental exam and professional teeth cleaning.

What causes tooth decay and gum disease?

Your teeth are covered with a sticky film of bacteria called plaque (sounds like PLAK). After a meal or snack, these bacteria convert the sugar in foods into acids. These acids attack the enamel, the tooth’s hard outer layer. Repeated attacks can cause the enamel to break down and lead to cavities.

If you brush twice a day and floss once a day, you can remove most of the harmful plaque and bacteria. But if plaque stays on the teeth, it will eventually harden into tartar. It is harder to brush and floss when tartar builds up near the gumline.

Plaque that is not removed can also irritate and inflame your gums, making them swell or bleed. This is called gingivitis, the early stage of gum disease. The good news is that gingivitis can be reversed with professional dental cleaning and good oral hygiene at home.

If gum disease is left untreated, it can cause your gums to pull away from the teeth. Pockets or spaces can form between the teeth and gums. These pockets can become infected. In advanced stages of gum disease, bone loss can occur and teeth may become loose, fall out or have to be pulled.

You can prevent both tooth decay and gum disease by always remembering to brush twice a day and floss daily. It is much easier and less expensive to prevent disease and decay than to treat them!

What are some tips for brushing teeth properly?

Brush twice a day with a fluoride toothpaste to help prevent tooth decay. Fluoride (FLOOR-ide) is a mineral that helps make tooth enamel stronger. There is more than one way to brush your teeth, so it’s a good idea to ask your dentist which one to use. Here are a few tips to help you start a good routine:

1) Place the toothbrush against your gumline at a 45-degree angle. Move the brush back and forth gently in short (tooth-wide) strokes.

3) Brush the inner tooth surfaces, still with the toothbrush at a 45-degree angle.

5) Use the top part of the brush to clean the inside surface of the top and bottom front teeth. Use a gentle up-and-down motion.

2) Brush the outer tooth surfaces, keeping the toothbrush at a 45-degree angle to the gums.

4) Brush the chewing surfaces.

6) Brush your tongue to remove bacteria and freshen your breath.

Why do I need to clean between my teeth?

Even if you brush twice a day, there are places your toothbrush bristles can’t reach. Flossing removes plaque and food particles from between teeth and under the gumline. Your dentist or hygienist can show you the right way to floss. It may feel clumsy at first, but don’t give up. It takes time to get the hang of it. The following suggestions may help:

1) Break off about 18 inches of floss and wind most of it around your middle or index finger. Wind the rest of the floss around a finger of the other hand. This finger will take up the used floss.

3) When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.

5) Repeat this method on the rest of your teeth. As you move from tooth to tooth, unwind the clean floss with one finger and take up the used floss with the finger on the other hand. Do not forget the back side of the last tooth.

2) Hold the floss tightly between your thumbs and forefingers. Guide the floss between your teeth, using a gentle rubbing motion. To avoid hurting your gums, never snap the floss into gum tissue.

4) Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.

There are so many dental products. How do I know what works best?

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  • Choose products with the American Dental Association Seal of Acceptance. The ADA Seal on a product is your assurance that it has met ADA standards for safety and effectiveness. Look for the ADA Seal on fluoride toothpaste, toothbrushes, floss, interdental cleaners, oral irrigators and mouth rinse.

  • Look for a toothpaste with fluoride. Fluoride helps keep tooth enamel strong and can aid in repairing the early stages of decay. If you have sensitive teeth, your dentist may suggest using special toothpaste.

  • Select a toothbrush that feels comfortable in your hand and in your mouth, and use it twice a day. All ADA-accepted toothbrushes – manual or powered – earned the ADA Seal because they can remove plaque above the gumline and reduce gingivitis. For children, choose a child-sized toothbrush.

  • Replace your toothbrush every three or four months, or sooner if the bristles become frayed. A worn toothbrush won’t clean your teeth properly. Children’s toothbrushes often need replacing more frequently because they can wear out sooner. If you have hand, arm, or shoulder problems that limit movement, you may find a powered toothbrush easier to use.

  • Oral irrigating devices use a stream of water to remove food particles around the teeth. They can be helpful for people who wear braces or dentures. However, an oral irrigator is meant to enhance, not replace, regular brushing and flossing.

  • Check mouthwash labels closely. Some mouthrinses just cover up odors; others actually kill germs and reduce plaque. Some mouthrinses have fluoride. If you are constantly using a breath freshener for bad breath, see your dentist. In some cases, bad breath may be a sign of poor health.

  • Ask your dentist or hygienist for product tips. People’s needs may differ, and your dental team can point you to products for your specific needs.

Tooth Extraction

A Few Simple Guidelines
Sometimes teeth need to be removed due to decay, disease or trauma. Having a tooth removed or “pulled” is called a tooth extraction.

When you have an extraction, it’s natural that changes will occur in your mouth afterward. Your dentist may give you instructions to follow after the extraction, and it’s important to talk to your dentist if you have any questions or problems. Here are some general guidelines to help promote healing, prevent complications, and make you more comfortable.

When to Call the Dentist

If you have any of the following issues, call your dentist immediately. If you cannot reach your dentist, go to a hospital emergency room.

  • fever, nausea or vomiting

  • ongoing or severe pain, swelling, or bleeding

  • pain that gets worse with time instead of better

Anesthetics

Before the extraction, you will be given an anesthetic to reduce your discomfort. Your mouth will remain numb for a few hours after the extraction. While your mouth is numb, you’ll want to be careful not to bite your cheek, lip or tongue. After the extraction, do not eat any foods that require chewing while your mouth is numb. The numbness should go away within a few hours. If it doesn’t, contact your dentist.

Bleeding

Your dentist may place a gauze pack on the extraction site to limit bleeding. This will also help a blood clot to form, which is necessary for normal healing. This gauze pack should be left in place for 30 to 45 minutes after you leave the dentist’s office. Do not chew on the pack. There may be some bleeding or oozing after the pack is removed. If so, here’s what to do:

  • Fold a piece of clean gauze into a pad thick enough to bite on. Dampen the pad with clean, warm water and place it directly on the extraction site.

  • Apply pressure by closing the teeth firmly over the pad. Maintain this pressure for about 30 minutes. If the pad becomes soaked with blood, replace it with a clean one.

  • Do not suck on the extraction site or disturb it with your tongue.

  • A slight amount of blood may leak from the extraction site until a clot forms. However, if heavy bleeding continues, call your dentist. (Remember, though, that a little bit of blood mixed with saliva can look like a lot of bleeding.)

Do Not Disturb!

The blood clot that forms in the tooth socket is an important part of the normal healing process. You should avoid doing things that might disturb the clot. Here’s how to protect it:

  • Do not smoke, or rinse your mouth vigorously, or drink through a straw for 24 hours. These activities create suction in the mouth, which could loosen the clot and delay healing.

  • Avoid alcoholic beverages or mouthwash containing alcohol for 24 hours.

  • Limit strenuous activity for 24 hours after the extraction. This will reduce bleeding and help the blood clot to form.

  • Sometimes the blood clot does not form in the first day or two after the extraction, or it forms but breaks down for some reason. The result is called dry socket. This can be very painful and should be reported to your dentist. A dressing may be placed in the socket to protect it until the socket heals and to reduce any pain.

Cleaning Your Mouth

Do not clean the teeth next to the healing tooth socket for the rest of the day. You should, however, brush and floss your other teeth well and begin cleaning the teeth next to the healing tooth socket the next day. You can also brush your tongue. This will help get rid of the bad breath and unpleasant taste that are common after an extraction.

The day after the extraction, gently rinse your mouth with warm salt water (half a teaspoon salt in an 8 oz. glass of warm water) after meals to keep food particles out of the extraction site. Try not to rinse your mouth vigorously, as this may loosen the blood clot. If you have hypertension, discuss with your dentist whether you should rinse with salt water. Avoid using a mouthwash during this early healing period unless your dentist advises you to do so.

Medication

If your dentist has prescribed medicine to control pain and inflammation, or to prevent infection, use it only as directed. If the pain medication prescribed does not seem to work for you, do not take more pills or take them more often than directed—call your dentist.

Swelling and Pain

After a tooth is removed, you may have some discomfort and notice some swelling. This is normal. To help reduce swelling and pain, try applying an ice bag or cold, moist cloth to your face. Your dentist may give you specific instructions on how long and how often to use a cold compress.

Eating and Drinking

alt tag

After the extraction, drink lots of liquids and eat soft, nutritious foods. Avoid hot liquids and alcoholic beverages. Do not use a straw. Begin eating solid foods the next day or as soon as you can chew comfortably. For the first few days, try to chew food on the side opposite the extraction site. When it feels comfortable, you should resume chewing on both sides of your mouth.

Follow-Up

If you have sutures that require removal, your dentist will tell you when to return to the office.

Root Canal Treatment

image

Your teeth are meant to last a lifetime. Years ago, diseased or injured teeth were usually pulled. But today, a tooth can often be saved through root canal (endodontic) treatment.
Endodontics (en-do-DON-tics) is the branch of dentistry that deals with treating diseases or injuries to the dental pulp. An endodontist is a dentist who specializes in root canal and other endodontic treatments.

What happens if the dental pulp is injured?
The pulp is soft tissue inside the tooth that contains blood vessels and nerves. When the pulp becomes inflamed or infected, treatment is needed. The most common causes of pulp inflammation or infection are a cracked or chipped tooth, a deep cavity or filling, or other serious injury to the tooth. All of these can allow bacteria to enter the pulp.

Diagram of a Healthy Tooth

Why should the pulp be removed?

If damaged or infected pulp is not removed, the tissues around the root of the tooth can become infected. Pain and swelling often result. Even if there is no pain, bacteria can damage the bone that holds the tooth in the jaw. Without treatment, the tooth may have to be removed.

Removing a tooth can create problems

When a tooth is removed and not replaced, the teeth around it may shift. This can make biting and chewing difficult and may make it harder to clean your teeth. Areas that are not cleaned well are more likely to get gum disease.

Root canal treatment can prevent these problems by saving your natural tooth. Also, root canal treatment usually is less expensive than a replacement tooth.

What does treatment involve?

Root canal treatment may involve one or more dental visits. Your dentist or endodontist will perform the necessary steps to save your tooth:

  • First, your tooth is numbed for your comfort. A thin sheet of latex rubber is placed over your tooth to keep it dry. An opening is made through the crown of the tooth into the pulp chamber.

  • The tooth’s nerve or pulp is removed from the pulp chamber and root canal (the space inside the root). Each root canal is cleaned and shaped so it can be filled.

  • Your dentist may place medicine in the pulp chamber and root canal to help get rid of bacteria.

  • The root canals are usually filled with a rubber-like material to seal them.

  • A temporary filling is then placed in the tooth to prevent contamination of the root canals. You might be given antibiotics if the infection has spread beyond the end of the root(s). If your dentist prescribes medicine, use it only as directed. If you have any problems with the medicine, call your dentist.

  • During the next stage of treatment, the dentist removes the temporary filling and restores the tooth with a crown or a filling to strengthen it and improve the way it looks. If an endodontist performs the root canal treatment, he or she usually recommends that you return to your general dentist for this step.

How long will the restored tooth last?

When properly restored, a tooth with a root canal filling can last for many years. But, like any other tooth, it can become decayed or fractured or the tissue around it can get gum disease. Daily cleanings and regular dental exams will help keep your mouth healthy, whether you’ve had root canal treatment or not.

Tooth decay can cause an abscess (infection).

The pulp is removed and the root canals are cleaned and shaped.

A metal or plastic rod or post may be placed in the root canal to help retain the core (filling) material, which supports the restoration (crown).

The decay is removed and an opening is made through the crown of the tooth into the pulp chamber.

The root canals and pulp chamber are filled.

The tooth is then restored with a crown or filling.

Improving Your Smile

A great smile can be the most attractive feature of your face. A smile helps you express health, success, youth and sincerity. It is a great asset in your personal, business and social contacts. So it’s important that you are happy with how your smile looks. But if you are like many people, you may not be.
Your dentist has many different techniques to shape, sculpt, and make your smile more beautiful. With a few simple steps, you can have a smile you feel great about. And treatment may be more affordable than you think.

First Steps to a New Smile

Once you decide to improve your smile, the first step is to visit your dentist. At this visit, you will talk about the best plan for you. If you have any signs of dental disease, your dentist may recommend treatment for this. It’s important to have a healthy mouth before starting cosmetic treatment.

Example of an Improved Smile

These treatments and others can help you have more natural-looking and attractive teeth. What are you waiting for? Talk to your dentist today about how to make your smile the best it can be.

Before-and-after photos courtesy of John R. Nosti, DMD, FAGD, FACE, FACOI, SmileDesignNYC.com.

Before

After

Smile Checklist

Look in the mirror.

  • Do you like the way your teeth look?

  • Do you dislike the color of any of your teeth?

  • Are there spaces between your teeth?

  • Do you have any chips or cracks on your teeth?

  • Are you missing any teeth?

  • Do you have any crooked teeth?

  • Do you feel your teeth are too long or too short?

  • Are you pleased with the shapes and position of your teeth?

If your answers show that you might want a change in your smile, talk to your dentist about Improving Your Smile.

Here are some popular treatment options:

Tooth-Colored Fillings

Your dentist can use natural-colored materials to restore teeth that have cavities. Options include composite materials, such as resin, as well as lab-made porcelain inlays, onlays and crowns.

Tooth Whitening

Teeth become stained for many reasons – drinking coffee, tea or wine; smoking; and even aging can discolor teeth. Tooth whitening is a process that makes discolored teeth whiter. The bleach used for in-office (chairside) whitening is stronger than the bleach found in at-home whitening kits. Keep in mind that not everyone’s teeth can become movie-star white. Your dentist can recommend the whitening treatment that is right for you.

Veneers

Veneers are thin, tooth-colored shells that are bonded, or cemented, to the front of your teeth. They are custom-made of ceramic or composite resin, and look like natural teeth. Veneers can be used to fill spaces between teeth and to cover teeth that are stained, poorly shaped, or a bit crooked.

Braces

Bracescan help correct crowded or crooked teeth or an uneven bite. Braces have become much smaller and less noticeable over the years. Brackets, the part of the braces that attach to each tooth, can sometimes be attached to the back of the tooth to make them less noticeable. Some brackets are clear or tooth colored—which help braces blend in.

In some cases, treatment may be done without using braces at all. A series of clear, removable aligners are used to move your teeth over time. These aligners are more discreet than traditional braces.

Enamel Shaping

Your dentist can “reshape” your teeth by contouring tooth enamel, the outer layer of the tooth. When teeth are a little crowded or uneven, or when teeth appear too long, your dentist can use enamel shaping to improve how the teeth look.

Crowns

If a tooth needs more a dramatic change than veneers or enamel shaping can provide, crowns are an option. The outer part of the tooth is removed and a crown is placed over it. The crown can be made to fit in with your other teeth. It’s like a fresh start for your tooth.

Taking Care of Your Teeth and Gums

Good oral care is part of a healthy lifestyle. It’s easy to keep your teeth and gums in good health. A simple routine of daily teeth cleaning, good eating habits and regular dental visits can help prevent tooth decay (cavities) and gum disease.

Healthy Smile Tips for Life

Healthy smiles make great impressions! To keep your mouth in good condition,

  • Always brush twice a day,

  • Clean between your teeth daily,

  • Eat a balanced diet and limit snacks, and

  • Visit your dentist regularly for a dental exam and professional teeth cleaning.

What causes tooth decay and gum disease?

Your teeth are covered with a sticky film of bacteria called plaque (sounds like PLAK). After a meal or snack, these bacteria convert the sugar in foods into acids. These acids attack the enamel, the tooth’s hard outer layer. Repeated attacks can cause the enamel to break down and lead to cavities.

If you brush twice a day and floss once a day, you can remove most of the harmful plaque and bacteria. But if plaque stays on the teeth, it will eventually harden into tartar. It is harder to brush and floss when tartar builds up near the gumline.

Plaque that is not removed can also irritate and inflame your gums, making them swell or bleed. This is called gingivitis, the early stage of gum disease. The good news is that gingivitis can be reversed with professional dental cleaning and good oral hygiene at home.

If gum disease is left untreated, it can cause your gums to pull away from the teeth. Pockets or spaces can form between the teeth and gums. These pockets can become infected. In advanced stages of gum disease, bone loss can occur and teeth may become loose, fall out or have to be pulled.

You can prevent both tooth decay and gum disease by always remembering to brush twice a day and floss daily. It is much easier and less expensive to prevent disease and decay than to treat them!

What are some tips for brushing teeth properly?

Brush twice a day with a fluoride toothpaste to help prevent tooth decay. Fluoride (FLOOR-ide) is a mineral that helps make tooth enamel stronger. There is more than one way to brush your teeth, so it’s a good idea to ask your dentist which one to use. Here are a few tips to help you start a good routine:

Preventing Periodontal Disease

Implants

Taking Care of Your Teeth and Gums

Windermere Family Dentistry

5590 S. Windermere St. Suite A
Littleton, CO 80120
Tel: Littleton Office Phone Number 303-798-4571

Littleton Dentist, Dr. Claire-Marie Ficsor, is dedicated to providing you with a pleasant visit and results that you're proud to show off. Call Littleton Office Phone Number 303-798-4571 with any questions or to make an appointment.