Cosmetic Dentistry

Question: My teeth are crooked and crowded. Is there a faster way than braces to make them more attractive?
Answer: There are many alternative cosmetic solutions such as resin bonding, porcelain veneers and crowns that might apply. Each individual would have to be evaluated to the best course of treatment.

Question: If I'm missing a tooth, do I really need to replace it?
Answer: Yes. Replacing missing teeth restores both function and esthetics and will prevent future problems. If a space is left untreated, adjacent or opposing teeth may tip, drift or over erupt leading to bite problems, periodontal disease and/or tooth decay.

Question: How can I make my teeth look whiter?
Answer: There are several alternatives. They may be bleached to reverse discolorations of the enamel [outer layer of tooth crown], bonded with a tooth-colored resin to cover stains or restored with porcelain veneers.

Question: Will my teeth become sensitive if I have them bleached?
Answer: Sensitivity may result in only 10% of all patients who have their teeth bleached. In these instances, there are other agents that can be utilized to desensitize their teeth.

Question: What causes teeth to discolor?
Answer: Teeth tend to darken as we age. However what we eat and drink play an important role. Red wine, tea, coffee, various berries, cranberry juice, soy sauce and soda are all contributing factors.

Question: Are home whitening kits effective?
Answer: Yes, depending on the type of staining or discoloring. Use commercial products that contain 10%, 16%, or 22% hydrogen peroxide or carbamide peroxide. Laser teeth whitening technology is available in the dental office and utilizes a stronger bleaching agent.

Question: What is the difference between porcelain and gold as a restorative material?
Answer: While gold is stronger than porcelain, it is not very cosmetic and cannot be bonded to the tooth. Porcelain can simulate tooth color and by bonding it to a tooth, it becomes strong enough to resist normal chewing forces.

Question: What is the difference between a cap and a crown?
Answer: They both refer to the same type of full-coverage restoration. If a tooth is severely broken down, a crown [cap] is fabricated that will cover the entire tooth and restore it to its natural shape and function. When esthetics is important porcelain will be used.

Question: What are porcelain veneers?
Answer: They are thin shells of tooth-colored porcelain that are bonded to the front surface and biting edge of your upper or lower teeth. Minimal tooth reduction is necessary, and they can be used to close spaces, straighten teeth, cover stained teeth and/or create better-proportioned teeth.

Question: Can I change the old silver fillings in my teeth?
Answer: Yes. There have been revolutionary changes in tooth-colored resins and porcelain materials. There are many alternative restorations that provide both cosmetics and the strength of amalgam fillings, especially in back teeth.

Question: What can be done about my chipped teeth?
Answer: There are several alternative available treatments including resin bonding to reform the tooth, porcelain veneers and/or porcelain crowns. Factors that are important in determining the treatment are the vitality of the tooth, the size of the chip and the patient's bite.

Question: Can my youthful smile be recreated even though my teeth have worn down over the years?
Answer: In many instances, the answer is yes, even if there is a combination of broken, missing, shifted and worn teeth. However, situations like this will need full-mouth reconstruction to restore function, comfort and a your original smile.

General

Question: If I'm pregnant, should I go to the dentist?
Answer: Yes, it is important to get any major dental work completed before your last trimester [best in the 4th to 6th month]. Also, hygiene appointments are very important to minimize the risk of developing "pregnancy gingivitis" [inflammation of your gums]. Postpone all elective procedures until after you give birth.

Question: Is it necessary to update my x-rays once a year?
Answer: Yes. But only the necessary x-rays. X-rays can discover breakdown between teeth and infections in the gums and bone. Annual monitoring with x-rays may prevent root canal treatment, excessive loss of tooth structure and bone loss.

Question: Why can't I just wait until I have pain before I visit the dentist?
Answer: Many people do just that. However, by the time pain has arrived, the treatment may be much more extensive and expensive. Regular hygiene and examination visits may save you time, money and aggravation.

Question: Should my tooth be sensitive to hot or cold after I have had a filling?
Answer: A protective base is placed under most fillings to prevent sensitivity. However, depending on the size and deepness of the cavity, it is not unusual to have some sensitivity that will decrease day-by-day. If it is sensitive on biting down or if it lasts more than a couple of weeks, have your dentist check it out.

Dental Implants

Question: Is there something, other than a removable appliance to replace my missing back teeth?
Answer: Yes. You can have dental implants that will support fixed artificial teeth. The implants are titanium root-like structures that are placed in your jaw and become attached to the bone; these teeth do not have to be removed and will function like your original natural teeth.

Question: How successful are dental implants?
Answer: Most published studies indicate 90-98% success when the patient has favorable conditions. These include being in good health, a lack of systemic problems such as uncontrolled diabetes or heavy smoking, proper implant placement and prosthetic design, appropriate bite adjustments and good maintenance and home care.

Question: Is age a deterrent to having implant therapy?
Answer: Not in itself. More important is the health of the patient. A 70 or 80 year-old patient in good health may be a better candidate than a younger patient with systemic problems, especially a person that is motivated to improve their quality of life and is willing to maintain good oral hygiene.

Question: How many implants will I need?
Answer: As a general rule, each missing tooth should be replaced with one implant. However, often due to financial or anatomical limitations, this may not be possible and compromises will have to be made. Before proceeding, proper diagnosis from clinical examination, x-rays and models will help determine the outcome.

Question: Are implants covered by dental insurance?
Answer: Unfortunately, at this point most dental insurance companies do not cover implant treatment. The prosthetic restoration, supported by the implant, may have coverage depending on the company, and sometimes, medical insurance covers part of the surgical placement. Patients must set their own priorities and measure a lack of insurance coverage against an improved quality of life.

Question: How do I know if I am a candidate for dental implants?
Answer: There are two basic criteria for people who desire dental implants.

You must be relatively healthy, meaning no uncontrolled medical problems, such as uncontrolled diabetes, uncontrolled hypertension, or immunosuppressive diseases.
You must have enough bone to be able to place something in to it.

Question: What are dental implants?
Answer: Another name would be tooth-replacement therapy. Dental implants are titanium fixtures that take the place of the missing tooth's root.. They are used to attach a single tooth, multiple teeth or even to stabilize a denture so it does not move around.

Question: Are the procedures painful?
Answer: Most people relate that the implant placement procedure is similar to a simple or easier extraction. You are slightly sore, but not debilitated. Many state that following the procedure that if they knew what the surgery was going to be like, they would have done it a long time ago. Everyone is different, however, so our patients are provided the proper pain medications, as necessary.

Question: How long do implants last?
Answer: Modern dental implants have been successful for over 30 years. Dental implants are intended to be permanent, however, many things contribute to their long- term success including home care and regular maintenance. Cigarette smoking can cause problems with implant healing. Engineering is an important part of the success of the dental implant reconstruction. Placing the correct type and number of implants is important.

Question: What is the cost of dental implant therapy?
Answer: The investment made in proper and comprehensive implant therapy is an investment in your overall health and quality of life. Appearance is improved and facial structures are preserved. There are many factors involved in cost including the number of implants and the type of teeth placed over them. A thorough consultation is required to determine final cost, but all fees are presented prior to any commitment for treatment.

Question: Do implants require special care?
Answer: No, regular maintenance visits is important as is daily home care.

Question: How long does the entire process take?
Answer: This depends on the position that the implants are placed and what we are intending to with our restoration. The implants are placed and sutures are usually removed in about one week. Following a proper healing time (usually 4-5 months), the implants are uncovered and impressions are made for the final teeth. This may take a month or so, depending on the complexity of the situation.

Question: Will I leave your office without teeth?
Answer: We will always try to provide you with some type of transitional or temporary restoration.

Question: Are dental implants experimental?
Answer: Absolutely not. Implants have been thoroughly researched and the current technology results in an outstanding success rate in the hands of the well-trained and experienced clinician.

Question: Can implants be placed the same day as an extraction?
Answer: Whether an implant can be placed on the same day as an extraction depends on the amount of bone that is available and whether there is any infection around the existing tooth. When teeth are lost, bone will shrink in several dimensions. Placing an implant immediately can reduce this bone loss and provide a better esthetic result.

Question: What are some of the benefits to dental implants?
Answer: Increased confidence when smiling, speaking and eating, especially if dentures or partials are replaced or retained with dental implants. Other advantages include: Elimination of denture adhesives; Improved comfort, speech and appearance; Preservation of the integrity of facial structures; Adjacent teeth are not ground down for a bridge; Implants can be easier and maintain since they are cleaned like natural teeth; Improved ability to taste food; Looking and feeling younger; Restored self esteem; and Improved Quality of life.

Children Dentistry

Question: Are fluoride drops necessary?
Answer: Incorporation of fluoride into the tooth structure is a highly effective method of preventing tooth decay. If it is determined that fluoride is not added to you municipal drinking water, then check with your pediatrician or your dentist about the age and dosage of fluoride supplementation.

Question: Is taking care of baby [primary] teeth important?
Answer: Yes. Primary teeth are necessary for speaking properly, chewing food, and smiling [good self esteem]. They hold the space in the jaw for the permanent teeth to erupt correctly. Premature loss can be painful and cause developmental problems. Good oral hygiene and regular check-ups for children are extremely essential.

Question: What are sealants?
Answer: A sealant is a plastic coating applied to the biting surface of a tooth to produce a physical barrier to the bacterial plaque and acids that cause tooth decay. Children, under the age of 12, get most new cavities on the biting surfaces of their back teeth. Sealants will prevent this and can be applied in one visit.

Question: When should a child have their first dental visit?
Answer: It should be about age 2 1/2 - 3 years, when all their primary [baby] teeth have erupted, unless there is an emergency or observable problem prior to that. Usually, the first visit is more educational than anything.

Oral Hygiene

Question: Is flossing necessary?
Answer: Yes. Toxins and acids produced by bacteria that stick to your teeth cause gum disease and tooth decay. Flossing is necessary to remove the plaque and bacteria between your teeth where brushing will miss. The bacterial plaque will reattach to your teeth every 24 hours, so you need to floss daily.

Question: Which is the best toothbrush?
Answer: Use a toothbrush with soft, rounded bristles, and be sure to replace it at least every 3 months. Power brushes or manual brushes are both acceptable, as long as you use them properly to remove all of the plaque.

Question: How often should I have a cleaning?
Answer: It is recommended to have a professional prophylaxis [cleaning] twice a year. If you have had gum problems, cleanings should be performed quarterly or as recommended by your treating dentist.

Anxiety-Free Dentistry

Question: Will I really be totally relaxed?
Answer: You'll receive just enough medication so that you'll be completely relaxed during treatment.

Question: Will I remember anything?
Answer: At the end of the treatment, you'll have little or no memory of your dental visit.

Question: Will I fell any pain?
Answer: Most patients feel no discomfort whatsoever during their treatment and feel surprisingly good afterwards.

Question: Will I be groggy after my treatment is over?
Answer: You will feel just fine. For your safety, we do require that you have a family member or friend drive you home and stay with you for a few hours.

Question: Is Anxiety free dentistry safe for me?
Answer: Before starting any treatments, we review your medical history and we monitor you very closely while you're relaxed and anxiety-free.

Question: Will my insurance cover treatment?
Answer: We'll review your insurance coverage then, if necessary, make financial arrangements to insure you get the dental care you need.

We will be happy to explain the details and benefits of Anxiety-free Dentistry.  Just call our office for an appointment at (914) 761-5500.