Frequently Asked Dental Questions

Periodontal Treatment and Prevention FAQs

What procedures are used to help me get healthy gums?

What are the 3 most common types of gum problems?

Gingivitis – inflammation of the gum with no bone loss.
Periodontal disease – a deeper condition in which loss of the bone surrounding the teeth has occurred, and deeper spaces (called pockets), filled with bacteria, are present between the gum and teeth.

Receding gums – can be caused by periodontal disease, and also by an inadequate thickness of the gingival (pink) band of tissue at the edge of your gums. If this tissue is too narrow, then muscle fibers in the mucous membrane can pull the gum, causing it to recede. Also, orthodontics sometimes weakens the bone under the gum, leading to recession.

What is the treatment for the above?
For periodontal disease, root planing and scaling is the most frequently used procedure, following your first cleaning. In the root planing procedures, which may be done under local anesthesia, deposits of calculus (tarter) are removed from the surface of the roots under the gum. This permits healing of the lining of the gum , and often results in shrinkage of the inflamed tissue. Another benefit is reduction of pocket depth.

Each condition is different. Some are treated with non-surgical methods, and some require surgery. Dr. Marshall has over 30 years of experience with Periodontics, and will explain to you both the cause of your problem and the treatment.

If I need surgery, will it hurt?
During the procedure you will feel no discomfort, because you will be numb from a local anesthetic. The affected area may be tender or sore. Minor swelling may occur. We will prescribe antibiotics and a pain medication. It takes about 1 week to heal. If you take your medications as directed and follow post-operative instructions, you will probably only experience minor discomfort. Usually, you may resume your normal daily activities within a few hours.

Will I be able to speak and eat normally?
You should be able to speak normally after the local anesthetic wears off. It is important to eat a nutritious but soft diet after treatment. You may wish to chew on the side of the mouth that didn’t have surgery. Avoid smoking and minimize drinking alcoholic beverages and caffeinated beverages during this time. For a few months following some types of periodontal treatment, the teeth may be more sensitive to cold. This sensitivity will diminish over time.

When will I need to return following the surgery?
Usually , 1 or 2 weeks later. At that time, it may be necessary to remove the dressing and any stitches that did not dissolve. Additional appointments may be required to evaluate your healing and review proper oral hygiene procedures.

How will I prevent future periodontal disease?
Seeing Dr. Marshall four times a year for periodontal maintenance cleanings and under his guidance, using the PerioProtect System to prevent return of the bad bacteria that causes the disease.

FAQs About Dental Implants:

What Is A Dental Implant?
A dental implant is actually an artificial root and stump, made of titanium, which is used as a support for a crown that can be used to replace as few as one missing tooth many missing teeth.

Thus, implants are a man-made replacement for natural teeth which allows the person to return to fixed teeth. It is not a transplant, which is taken from another person or animal. Prior to having the implant placed, you may require a special x-ray to evaluate the amount of bone available into which to place the implant. Study casts of your upper and lower jaws are also taken to help plan your treatment.

The teeth that attach to the implant can be either removable (removed by you, the patient), or fixed (non-removable), depending on your preference and the number of implants needed.

What Is A Sinus Lift?
If sinuses are very large and in the way, and implants cannot be placed, bone grafting is done first underneath the sinus. The width and height of the bone is expanded thereby creating the necessary bone for the implant. A 7 month period allows the bone graft to mature. Then, the implants are placed. A variety of graft materials can be used in these procedures. Success rate is generally very high with sinus lift procedures.

How Long Does It Take?
To perform the surgery it may take somewhere between 45 min. to 90 min. depending on the number and location of the dental implant(s). It takes 3 months in the lower jaw and 5 months in the upper jaw for the implant to integrate with the bone. This longer if bone grafting was done. A sinus lift case can take one year before teeth are placed over implants.

When are my teeth placed on the implants?
After the implants have been in enough time to integrate to the bone (3 months on the lower jaw, 5 months on the upper jaw), you will receive either a fixed bridge, or a crown, or crowns, or a large replacement for many teeth called a fixed-removable appliance. Usually, we provide you with temporary teeth during this time frame. At no time are you without teeth unless you elect to do so. Dr. Marshall will help you decide what would be best for you, and he will give estimates of the cost of the tooth replacements. You can work out a payment plan with the office.

Does It Hurt?
A gentle surgical procedure is performed under local anesthesia to place the dental implant. Generally, there is very little postoperative pain. Often, single implant patients can return to work immediately and multiple implant cases can return in a day! We will prescribe medications to ease any discomfort that you may experience, although often, Tylenol or Advil is enough.


Frequently Asked Questions about Porcelain Veneers:

What is the difference between resin (bonding veneers) and porcelain veneers?
Bonded veneers are composed of a plastic resin which is not as durable as the lab processed porcelain veneers. They do tend to stain/darken over time. Porcelain veneers are lab processed and are custom made to fit perfectly over the existing tooth. Both procedures require some reduction of the enamel to make room for the veneer or bonding. The porcelain veneers require two visits since lab work is involved; whereas the resin bonded veneers may be performed in one visit.

Do porcelain veneers last longer than the resin veneers?
Yes, porcelain veneers are much stronger than the resin veneers and have a lifespan comparable to crowns, which is usually 5-10 years and in many cases longer.

Can I change the color or shape of my teeth with veneers?
Yes, veneers can be made to perfect the shape and color of teeth.

What are Lumineers?
Super thin veneers which often require no drilling (or very little), no anesthesia, and can whiten your teeth, reshape and beautify your smile, all in 2 visits, 10 days apart.


FAQs About Teeth Bleaching:

Should I bleach my teeth before I have other restorations performed?
Yes. Bleaching is advised before any cosmetic restorations to help obtain a perfect shade match.

Will it harm my gums and teeth?
No. Great care is taken to protect your gums and any sensitive areas on the teeth.

How long will the effects last and do I have to do it again?
The bleaching results vary. Results depend on your brushing habits, the toothpaste used, as well as stains from smoking, wine, food, tea, coffee, etc. Usually the results last 2-3 years and if touch ups are necessary they may be performed at any time.

Can I get the same results with the over the counter products?
Most of the whitening products on the market will either take much longer (3 weeks) to obtain less or similar results. Often, the whitening toothpastes or gels are just not effective. Many whitening toothpastes are abrasive and are meant to just get rid of surface stains and do not actually bleach the teeth.


FAQs About Tooth Colored Fillings

What are tooth colored fillings made of?
Tooth colored/white fillings are made of a light cured plastic, which is initially a soft glass reinforced plastic that gets hardened in the mouth with a blue (curing) light.

Do tooth colored fillings last as long as silver fillings?
Some tooth colored fillings may last as long as silver fillings if they are not too large. Once the total size in volume is too large, the filling may shrink. That can lead to sensitivity, and sometimes decay under the filling. The compression and bonding strength of resin materials has improved dramatically over the years thereby increasing their life span.

Should I change all my silver fillings to tooth colored fillings?
Unless there is a cavity underneath or a breakdown of the old silver fillings, it is not usually necessary to change all the silver fillings to tooth colored replacements. Because of this, when the filling is larger, inlays are recommended, to avoid problems.


FAQs About Onlays

Why should I get an onlay instead of a tooth colored filling?
When there is insufficient tooth structure left to sustain a regular filling, an onlay is recommended. When there are cavities in between teeth, the best and most conservative restoration is an onlay. An onlay seals the tooth better than any conventional filling and is less likely to cause food to be caught between teeth.

How long do onlays last?
An onlay may last as long as crowns do with proper dental maintenance (i.e flossing and regular check ups and cleanings). The life span of an onlay depends on diet and hygiene. They can last as long as 15 or 20 years.

Should I just get a crown instead of an onlay?
An onlay is more conservative than a crown. The tooth structure is preserved and only the part that is missing from the tooth (i.e. the cavity) is restored with the onlay. The rest of the tooth is not drilled down. There are several dental variables, and only careful evaluation of the tooth and the x-rays of that tooth will allow a proper decision by the dentist.


FAQs About Crowns

When do I need a crown?
Crowns are performed in order to avoid root canals by preventing further fracture of a tooth or filling and preventing leakage of an existing filling, when large fillings are being replaced, when there is extensive decay following root canals and post placement, when a missing tooth or teeth are being replaced, when the bite is being rebuilt, and, for cosmetic purposes, with porcelain crowns.

Is a crown permanent or does it come out?
A crown is permanent. It is permanently cemented onto the tooth.

How long will crowns last?
Crowns may last anywhere from 5 to 20 years if the patient maintains proper dental hygiene and has a relatively sweet-free diet.

What if I need a root canal after?
If the crown cannot be removed, the root canal may still be performed by drilling a small hole into top of the crown. Because it is permanently cemented, when the root canal is finished, a permanent filling is placed in the entry hole. Sometimes, for various reasons, the nerve may die.

Is a crown harder to take care of?
With proper flossing, brushing and dietary control, patients usually have no problem taking care of their crowns.

Do crowns look like real teeth?
Yes, crowns are custom made to match your own tooth color.


FAQ’s About Root Canals:

Do root canals hurt?
You will always receive anesthesia prior to the root canal to numb the tooth. The root canal procedure removes the nerve and cleans out the infection. Root canal treatment usually removes the pain initially felt when the nerve dies.

How many visits are necessary for a root canal?
Usually 1-2 visits may be necessary to complete a root canal.

What treatment is needed after the root canal?
To strengthen the tooth which is now filled with a rubber filling, a post and a crown should generally be placed.

Will I be able to go back to work?
Yes, following the root canal procedure the tooth will be numb; and getting back to work is not a problem.

Does that mean that I keep my tooth?

Why shouldn’t I just extract the tooth?
When a tooth is extracted, the adjacent teeth start to shift and this may cause periodontal problems and chewing or joint problems. Replacing that tooth will also be more costly than performing the root canal.


FAQs About Bridges and Implants:

Are bridges harder to maintain than natural teeth or implant teeth?
Slightly. However, if the bite needs to be rebuilt, often bridgework is a better choice than an implant. Special dental floss devices will be given to the patient for proper maintenance of bridges.

When are implants better than bridges?
In many cases implants are better restorations than bridges because implants are easier to maintain than bridges: however, not all patients are able to receive implants. Sometimes not enough bone is present. With today’s new techniques, we can rebuild bone in many situations and later, place the implant.

How soon after an extraction should a bridge be made?
A temporary bridge can be started immediately after the extraction to replace the missing tooth. The final bridge should be cemented 3-5 weeks after the gum tissue has regrown and finished remodeling.

How long do bridges and implants last?
If maintained properly, bridges and implants last about 5 to 20 years and sometimes longer, depending on many factors, as discussed above.