Q: I went to a dental office in the past, and I left without any information about my mouth and also got stuck with a huge treatment plan that I don’t know anything about. Is this normal at all offices?
A: We hope that this is not normal, but unfortunately some people have told us that they have had this experience. We strive to educate and be a part of the decision making process alongside our patients. First appointments involve diagnostics such as viewing recent x-rays and a thorough exam. Our dentists then enter a conversation to educate you and answer any questions along the way. All options are discussed for each problem, along with pros and cons given. All final decisions for a patient’s treatments are in the hands of the patient, although the dentists will give recommendations for the best course of action as well. We pride ourselves in the fact that we communicate well with our patients to help develop a reasonable and comfortable plan.
Q: Can all of my dental problems be fixed in your office?
A: Here at Narita Family Dental, we definitely try our best to take care of our pediatric, teenage, adult and geriatric patients as much as possible. However some problems or concerns may arise that go beyond the scope of what our dentists have studied and require consultation or treatment with a specialist. Our decisions to refer to a specialist for certain problems are made with the best interest of the patient in mind. We do have two specialists that work in our office, a periodontist (gum & bone specialist) and an endodontist (root canal & nerve specialist). For other problems, we may refer out to our trusted network of specialists. We have great relationships and communication with our specialist doctors, so our patients can be assured that all parties will be aware of all findings and treatments rendered.
Q: Are x-rays really necessary if nothing hurts? Can’t you just look in my mouth to check for problems?
A: Dental radiographs, commonly known as “x-rays,” are an essential diagnostic tool for dentists. By looking in the mouth only, dentists can get a general idea of big problems such as large swellings in the gums and cavities that are on visible surfaces of the teeth. However, dentists can not see cavities in the hidden areas such in flossing areas, between the teeth, under the gums, in the bone and on roots. X-rays also allow us to find early problems such as problems with infections in the bone, bone loss below the gums, roots and problems in teeth that have root canal treatments and typically feel no pain. Usually if pain or a large swelling are present, the problem has already progressed far enough that a simple filling or a regular teeth cleaning can no longer be the solution. By allowing us to take radiographs at the recommended time frame, we hope to detect problems early to help conserve your teeth, gums, and bone.
Q: How often do I need to take x-rays?
A: Every person is different, so our recommendations can vary depending on age, history of problems, patient comfort level, and other factors. Typically a set of full mouth x-rays is recommended every 3-5 years. The full set of x-rays allows the dentist to view all aspects of the teeth as well as the bone levels and root health. Between the large sets of x-rays, we may ask for a smaller check up set of x-rays that is typically ⅓ the size of a full set. The check up x-ray set allows us to see major and common areas, but do not allow us to see all the small details. On average, most patients are recommended to have yearly check up x-rays. Some patients who have very little history of cavities and healthy hygiene may be recommended x-rays every 18 months, while others who have rampant levels of bacteria causing cavities and gum disease may be recommended x-rays more often than yearly.
Q: Are x-rays safe?
A: It is true that taking x-rays does expose each of us to a small amount of radiation. It is important to keep in mind that living our daily lives exposes us to radiation as well. In fact we at Narita Family Dental are very aware of the radiation exposure concerns of our patients and use digital dental x-rays which are about 80-90% less radiation exposure than the older conventional x-rays taken with film. We also ask our patients to wear a leaded apron with a neck collar to minimize exposure to the abdomen and the thyroid. Dental x-rays give very little exposure of radiation; for a comparison, eight dental x-rays is equal to one cross country flight from Los Angeles to New York City. As dental professionals we feel that the very small risk of dental x-rays is outweighed by the benefits of important diagnostic information to help keep your teeth and gums free of disease. If you do have further concerns or would like to set limitations on your dental x-rays, we are willing to answer questions and work with you to meet your personal goals.
Caring for Hypersensitivity
Q: Lately my teeth are really sensitive when I drink cold water or touch certain areas with my toothbrush or fingernail. Do I have a cavity or need a root canal?
A: If you have not recently had an exam or check up at a dental office, we would advise scheduling an appointment as it is possible that a cavity has formed or one of the nerves in your teeth has a problem and firing pain signals. If you have recently come to see us or another dentist and the sensitivity is more generalized across multiple teeth, it may be possible that the sensitivity is caused by gum recession and root exposure. We can help answer your questions about your specific circumstances on your next visit. Until that visit, the use of sensitivity toothpastes such as Sensodyne™, or any toothpaste with Potassium Nitrate, can be effective in helping with the sensitivity. It does take about two to four weeks for these toothpastes to build a layer to help block sensitive root surfaces from feeling cold sensations and touch. If you have tried a sensitivity toothpaste and it has been longer than 1 month without any relief or if you have been feeling increasing pain over any amount of time, please call us to assist you.
Teeth Grinding & Clenching
Q: I’ve been told by someone that I make grinding noises when I sleep. What’s going on?
A: A high percentage of people grind their teeth in their sleep. Some people go through phases of grinding their teeth especially with day to day stress, but others grind their teeth due to brain activity that occurs during sleep which may not be related to stress. Still other possible causes of grinding at night may be due to sleep disorders or an abnormal bite due to crooked or missing teeth. Some common symptoms include dull headaches, jaw soreness, chipped, fractured, or flattened teeth, and teeth that are starting to feel loose. Gum recession can also be caused by grinding. A visit to our office will help determine what treatment options are best for you. It is likely that a night guard will be recommended for you to wear at night. A night guard is a custom fit piece of plastic/acrylic/silicone that fits over your teeth to create a protective barrier and help to keep your teeth stable and minimize the damage caused by the excessive chewing or grinding forces that can occur during sleep.
Q: I think I clench my teeth during the day, especially when I’m concentrating on something or when I’m stressed. Is this a problem?
A: Clenching during the day is also problematic. Although the forces of clenching may not be as strong as nighttime grinding, damage can still be caused to the teeth and also nerves with repetitive constant pressure applied over time. Some patients find it helpful to wear their night guard while doing their work, commuting in traffic, or playing sports involving concentration such as golf. If you don’t have a night guard or a protective mouthpiece appliance, please make an appointment to discuss your options.
Q: Can I just buy a mouthguard from the sporting goods store or one from the drugstore dental aisle to use?
A: Protective devices for sports are highly recommended when used for labeled use, but may not be the best fit for use for clenching and grinding at night. They tend to be bulky, are not discreet, and can prove to be uncomfortable. Drugstore nightguards are less bulky, but most store-bought items are not a good fit due to lack of customization for your individual and unique bite. Custom-made night guards and sports guards ensure a good fit, comfortable size, and are also adjusted and balanced chair-side by your dentist to make sure that your grinding patterns are translated into a smooth motion to avoid stress to your jaw joints. If you choose to wear a store-bought guard, please be aware that they can stress muscles and joints if not fitting properly. Please discontinue use if soreness or pain persists with use.
Q: I want my teeth to look whiter and remove stains. What are my options?
A: Several options are available to help achieve better esthetics. It can be as simple as coming in for a regular cleaning, as some stains do build up on the surface due to coffee, tea, or smoking. A regular cleaning helps to improve your oral health but has the added benefit of improving the look of your teeth if there are surface stains. For stains that are deeper, use of a peroxide bleaching gel can be effective. Over-the-counter trays and whitening strips are available at mass market stores, however the strength of the whitening gel is less than professional grade, so the effect may be more subtle. In the office, we can make custom bleaching trays for home bleaching. We also have Zoom™ bleaching available, an in-office system that yields results in a 3 hour appointment. For our patients that have deep developmental staining due to antibiotics, peroxide bleaching may not be give a satisfactory result– porcelain veneers or crowns would be best to mask these darker, grey type banded stains.
Cleanings and Regular Maintenance
Q: I was told that I need a deep cleaning. How is this different than a regular basic cleaning?
A: Scaling and root planing, or a “deep cleaning,” may be part of the recommendation given by your dentist to benefit your oral health if there is hard build up called calculus, or “tartar,” on your teeth or under your gums. A regular maintenance type cleaning is best for those that are free of gum disease, have only mild or moderate inflammation, and have adequate bone conditions. A regular cleaning can only clean the surface of the tooth above the gumline and slightly below, about 1-3 mm. When hard build-up is present deeper under the gumline, a deep cleaning is necessary. Local anesthesia, or numbing of the gums, is done to insure patient comfort and allow for the best cleaning possible below the gums and on the root surfaces. If not removed, the hard build up creates a continued inflammatory process that can lead to infection and bone loss, essentially what we call periodontal disease or gum disease.
Q: I only want to have my cleaning done. Do I really need to do the x-rays and the exam?
A: We recommend a yearly exam which involves a thorough check of the mouth. During the exam we look for any signs of problems including cavities, swellings, and infections. We also do an oral cancer screening and record your gumline health in an assessment called periodontal probing. We also check for recession, any loosening of teeth, and areas of gum bleeding. These readings are essential in tracking potential problems and reduce the risks for gum disease. X-rays assist the doctors with their diagnosis of cavities, infections, and to monitor root health and bone levels. X-rays may or may not be recommended on a yearly basis depending on your individualized needs and history with problems or lack of problems.
Q: Does getting an implant hurt?
A: Like all dental procedures, we make every attempt to avoid pain for our patients. We use good local anesthesia or numbing techniques and are responsive to our patients if they express concern or discomfort. For our more anxious patients we can also provide general anesthesia or sedation services for implants or in fact, any other dental procedure.
Q: Is it true that implants are very expensive?
A: Implants are more expensive than getting fillings or dentures, but if considering bridges to replace multiple teeth, implants may be comparable after all considerations are made. Insurance plans vary as to coverage with implants and we would be happy to assist in requesting pre-estimates from your insurance prior to treatment if desired. For our cash patients, we do offer discounts and also have in-house payment plans available.
Q: If I get an implant, will it last forever?
A: Implants are not guaranteed to last forever as it depends on many factors including bone condition, hygiene care at home, timeliness of recommended maintenance visits, grinding and clenching, etc. They can last a very long time with the proper care. We take the time to go over all the factors that affect the success of your implant and make recommendations specifically for your situation.
Q: I was told that I can get an implant for my denture. I thought implants only used to replace a single missing tooth?
A: Implants are popularly known as a single tooth replacement with a post in the bone and a crown that sits above the gums. Implants can also be used successfully to replace multiple teeth with splinted or bridge units. Also increasingly popular is the use of attachments on top of implants to stabilize dentures that may be replacing more teeth or in situations where little bone remains to support and retain a denture well.