Dental Education

Fluoride Supplements

The most effective way for your child to get fluoride’s protection is by drinking water containing the right amount of the mineral… about one part fluoride per million parts water. This is of special benefit to children, because fluoride is incorporated into enamel as teeth form. Children who, from birth, drink water containing fluoride have up to 40% fewer cavities. Many of them remain cavity-free through their teens.

Fluoride is one of the most effective elements for preventing tooth decay. This mineral combines with tooth enamel to strengthen it against decay. Fluoride may also actually reverse microscopic cavities by enhancing the process by which minerals, including calcium, are incorporated into the teeth.
Even though your regular water supply may be fluoridated, it is still important to discuss with your dentist any additional fluoride needs your child may have. Look for fluoride toothpastes and over-the-counter fluoride mouth rinses that carry the ADA seal. They have been proven safe and effective for their intended use. The advertising claims for these products have been reviewed by the ADA so the claims are accurate and not misleading.Your dentist may recommend various ways to get fluoride protection, including:

– Drinking fluoridated water at school.

– Taking prescribed fluoride tablets or drops.

– Brushing with a pea-sized amount of fluoride toothpaste after age two.

– Using a fluoride mouth rinse for children over age six.

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People usually think of a newborn baby as having no teeth. But the 20 primary teeth that will erupt in the next two and a half years are already present at birth in the baby’s jawbones. At birth, the crowns of the primary teeth are almost complete and the chewing surfaces of the permanent molars have begun to form. The front four teeth usually erupt first, beginning as early as six months after birth.

Your infant depends totally on you for dental care. You should begin cleaning the baby’s mouth during the first few days after birth. After every feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. This establishes, at an early age, the importance of dental hygiene and the feeling of having clean teeth and gums.

To clean your child’s teeth, place the child in a comfortable position that will allow easy access to his or her mouth.

Remember: Your infant depends totally on you for dental care!

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Preparing for the First Dental Visit

Take you child to see the dentist by his or her first birthday. Your child’s first visit to the dentist can be a pleasant adventure. Talk about the visit in a positive matter-of-fact way, as you would any important new experience. Explain that the dentist is a friendly doctor who will help the child stay healthy.

During the first visit, the child’s mouth will be examined for tooth decay and other problems. The teeth may be cleaned by the dentist or dental hygienist. The dentist will explain how the child’s teeth should be cleaned at home, how diet and eating habits affect dental health and methods to ensure that your child gets sufficient fluoride.

Most children have a full set of 20 primary teeth by the time they are three years old. Primary teeth are just as important as permanent teeth, for chewing, speaking, and appearance. In addition, the primary teeth hold the space in the jaws for the permanent teeth.

You should start brushing the child’s teeth as soon as the first tooth erupts. Flossing should begin when all the primary teeth have erupted, usually by age 2 to 2 ½. By age 4 or 5, the child may be able to brush his or her own teeth under supervision.

The pre-school years are an important time to help your child establish good eating habits, since you can control your child’s diet successfully. At this age, many children need to eat snacks or “mini-meals”. They cannot always eat enough food at mealtimes to get all the nutrients and energy they need. Help your child choose sensible snacks – foods that don’t promote tooth decay.

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To prevent tooth decay and periodontal diseases, tooth brushing and flossing are needed daily to remove harmful plaque from your child’s teeth.

Look for a toothbrush that bears the ADA seal. They have been shown to be safe and effective for their intended use. The advertising claims for these products have been reviewed by the American Dental Association and the claims are accurate and not misleading.

Ask your dentist to recommend a toothbrush for your child. Children need smaller brushes, specially designed for them. Generally, a brush with soft, end-rounded or polished bristles is recommended, since it is less likely to injure gum tissue.

Check your child’s toothbrush often and replace it when it is worn out. Bent or frayed bristles will not clean plaque from your child’s teeth and they can damage gums. The ADA recommends replacing toothbrushes every 3 months.

Brushing removes plaque from the inner, outer, and chewing surfaces or the teeth. Select a fluoride toothpaste with the seal of the ADA.

Children under six years of age should clean their teeth with a pea-sized amount of fluoride toothpaste after every meal and at bedtime.

1. Holding the toothbrush bristles at a 45-degree angle against the gum line, move the brush back and forth with short strokes – half a tooth wide – in a gentle, scrubbing motion.

2. Brush the outer surfaces of all teeth in the upper and lower jaws. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth.

3. Finish by brushing the tongue to help freshen breath and remove bacteria.

4. Use about 18 inches of floss, wind most of it around the middle fingers of both hands. Hold the floss tightly between the thumbs and forefingers. Use a gentle, sawing motion to guide the floss between the teeth.

5. Curve the floss into a C shape and slide it into the space between the gum and the tooth until you feel resistance. Now, gently scrape the floss, in and up and down motion, against the side of the tooth.

6. Repeat this procedure on each tooth. Don’t forget the backs of the last four teeth.

Flossing removes plaque that hides between the teeth and under the gum line, areas where a toothbrush cannot reach. Supervising your child while he or she brushes and flosses will ensure that a proper job is done.

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Facts about Nutrition

Basic Dental Health Facts

Plaque is a sticky, colorless film of bacteria by-products that constantly forms on everyone’s teeth. Unless it is thoroughly removed daily, it can lead to dental cavities (tooth decay) and periodontal diseases (gum diseases).

Tooth Decay

Tooth decay is a major cause of tooth loss in children. Tooth decay, or dental caries is caused by bacteria. For a tooth to decay, three elements are needed: plaque, food containing sugars and starches, and a susceptible tooth. When foods containing sugars and starches are eaten, the bacteria in plaque produces acids that can dissolve tooth enamel. The sticky plaque holds these acids onto the teeth, where, if left, the acids can begin to attack the enamel. After repeated attacks, the enamel may break down, forming a cavity.

Periodontal DiseasePeriodontal diseases afflict the gums and bones that support the teeth. A recent survey stated that some form of periodontal disease affects 39 percent of children and 68 percent of teenagers in the United States alone. Furthermore, periodontal disease has proven to be a worldwide problem with all age groups. Studies show that many periodontal problems, which occur later in life, could be caused by the neglect of oral care during childhood and adolescence.An early sign of periodontal disease is swollen bums that bleed easily, especially when teeth are brushed or flossed. Toxins that are created by bacteria found in plaque cause periodontal diseases. If plaque is not removed by daily brushing and flossing, along with regular professional cleaning by a dentist or dental hygienist, these toxins can irritate the gums, making them tender and likely to bleed. If not treated at an early stage, bleeding gums can become progressively worse. Eventually, affecting the bone, which can cause teeth to become loose or to fall out.

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Types of Mouth Guards

You don’t have to be a football player to benefit from wearing a mouth protector. Any adult or child involved in a recreational activity that poses a risk of injury to the mouth can obtain smile protection with this important safety device.

There are basically two types of mouth protectors:

Pre-fabricated: A pre-fabricated mouth guard can be purchased at stores, these mouth guards are often only offered in a general size offerings.

Custom: Mouth guards can also be fabricated by your dentist using an exact model (impression) of your mouth. This type of mouth guard provides superior fit and protection.

Custom-made mouthguardsYour dentist can create a special mouth protector just for you – one that will provide comfort and proper fit. A custom-made mouth protector is individually designed and constructed in the dental office or according to your dentist’s specifications in a professional dental laboratory.

First, the dentist makes an impression of the patient’s teeth. Using a special material, the dentist constructs the mouth protectors over a model of the teeth.

Although custom-made mouth protectors are somewhat more expensive than stock mouth protectors purchased in stores, their exceptionally good fit, comfort, and overall quality make them worth it. A custom-made mouth protector is easily retained in the mouth and does not interfere with speech or breathing. For these reason, custom-made devices are often preferred by sports enthusiasts and recommended by dentists. So give your smile a sporting chance – ask you dentist about mouth protectors.

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Athletic Requirements

If you have dental appliances such as orthodontic braces or bridgework, you should wear a mouth protector that has been fitted by a dentist.

A mouth protector should be worn at all times during contact sports, in practice as well as during games.
Mishaps on the playing field, the basketball court, and while riding a bicycle or skateboard often involve blows to the head, face, and mouth.

Besides creating a painful emergency, injuries to the mouth can result in chipped or fractured teeth, nerve damage, and tooth loss. Wearing a mouth protector is a simple way to prevent many of these painful and costly injuries.

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Injuries from Non-Use

Recreation experts have long recommended a mouth protector as an important piece of safety equipment. Without one, an athlete on the playing field runs the risk of acquiring a toothless grin! You’ve probably seen mouth protectors used in contact sports, such as hockey, football, and boxing. Coaches and team members know that mouth protectors cushion blows that would otherwise cause broken teeth, injuries to the lips and face, and sometimes even jaw fractures.

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What Sealants Do for You

A sealant is a clear shaded plastic material that is applied to the chewing surfaces of the back teeth (premolars
and molars), where decay occurs most often. This sealant acts as a barrier, protecting the decay prone areas of the tooth from plaque and acid.

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How Sealants are Applied

Each tooth only takes a few minutes to seal. First, the teeth that will be sealed will be cleaned. The chewing surfaces are then etched (roughened) with a weak acidic solution to help the sealant adhere to the teeth. Finally, the sealant is placed onto the tooth enamel and hardened. Some sealants need a special curing light to help them harden, while others do not.


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Who Should Have Sealants

Although children receive significant benefits from sealants, adults can also be at risk for pit and fissure decay and thus be candidates for sealants. Your dentist can advise you about the need for sealants. Sealants are also recommended even for those who receive topical applications of fluoride and who live in communities with
fluoridated water. Fluoride helps fight decay on the smooth surfaces of the teeth but is least effective in pits and fissures.

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How Long Do Sealants Last

When the sealant is applied, finger-like strands penetrate the pits and fissures of the tooth enamel. Although the sealant cannot be seen with the naked eye, the protective effect of these strands continues. As a result, it may be several years before another application of sealant is needed. Reapplication of the sealants will continue the protection against decay and may save the time and expense of having a tooth restored. Sealants will be checked during regular dental visits to determine if reapplication is necessary.

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How Sealants Save Money

The American Dental Association recognizes that sealants can play a major role in the prevention of tooth decay.

When properly applied and maintained they can successfully protect the chewing surfaces of the tooth from decay. A total prevention program includes brushing twice a day, cleaning between teeth daily with floss or interdental cleaner, regular dental visits, and limiting the number of between-meal snacks. Ask your dentist how to obtain the right level of fluoride. If these measures are followed and sealants are used well, the risk of decay can be reduced or may even be eliminated.

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With the sealant deep within the pits and grooves of the enamel surface, normal eating habits can be maintained.

Twice a day brushing is very important to maximize the benefits of the sealants. Of course, sealants should be
checked during regular dental visits to determine if reapplication is necessary.

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Why do I need X-rays?
Dental X-rays are extremely valuable for helping to detect oral diseases of the teeth and surrounding tissues. An X-ray exam may reveal small cavities that can’t be seen by a visual exam, infections in the bone, abscesses, cysts, developmental abnormalities, such as extra or impacted teeth and some types of tumors. Just because such diseases, including early tooth decay, can’t be seen by a visual exam does not mean that treatment isn’t required.

Is it safe to have dental X-rays?
Yes. Numerous precautions and advances in X-ray equipment help protect patients from receiving unnecessary radiation. The amount of radiation received from a dental exam is extremely small compared to other naturally occurring sources of radiation, including minerals in the soil, radon, and cosmic radiation from outer space. A full-mouth series of films, using state-of-the-art technology, will deliver an effective dose that is equivalent to about 19 days of exposure to naturally occurring environmental radiation.

How often are they necessary?

This depends upon the patients individual health needs. If you are a new patient, the dentist may recommend X-rays to determine the current status of your mouth and to check for hidden problems. The need for radiographs varies according to your age, risk for disease, and your past dental history.

Children may need X-rays more often than adults because their teeth and jaws are still developing and they are more prone to tooth decay. X-rays help the dentist discover developmental problems as early as possible so preventative or treatment measures can be started.

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Fluoride is one of the most effective elements for preventing tooth decay. This mineral combines with tooth enamel to strengthen it against decay. Fluoride may also actually reverse microscopic cavities by enhancing the process by which minerals, including calcium, are incorporated into the teeth.

The most effective way for your child to get fluorides protection is by drinking water containing the right amount of the mineral… about one part fluoride per million parts water. This is of special benefit to children, because fluoride is incorporated into enamel as teeth form. Children who, from birth, drink water-containing fluoride have up to 40% fewer cavities. Many of them remain cavity-free through their teens.

Even though your regular water supply may be fluoride products such as toothpaste, and in some cases, mouthrinses. You may want to discuss with your dentist any special fluoride needs your child may have. Fluoride toothpastes and over-the-counter fluoride mouth rinses that carry the ADA seal have proven safe and effective.

Your dentist may recommend various ways to get fluoride protection including:

– Drinking fluoridated water at school.

– Taking prescribed fluoride tablets or drops

– Brushing with a pea-sized amount of fluoride toothpaste.

– Using a fluoride mouth rinse for children over age six.

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Parental Responsibility

With your help, in combination with their own efforts and regular professional care, your daughters and sons can grow up cavity-free and keep their teeth all their lives.

It’s not difficult to help your child maintain a healthy smile. Here are a few tips for good oral health:

– Make sure your child gets the fluoride needed for decay-resistant teeth. Ask your dentist how this should be done.

– Brush and floss your child’s teeth daily until the child can be taught to do this alone. Then encourage him or her to brush and floss.

– Take your child to see the dentist regularly, beginning at six months of age.

– Put only water in your child’s nap time or bedtime bottle.

– Start cleaning your child’s mouth daily.

– Start brushing as soon as the first tooth erupts.

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What is Bonding?

Bonding is a term used to describe a number of procedures that involve applying composite resins to the tooth. Regardless of its use, bonding can provide an attractive result.

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How Bonding is Performed

Bonding is often completed in one visit and often does not require the use of anesthesia or drilling. The process involves preparing the tooth surface with an etching solution that allow the composite resin to adhere. To match the color of your teeth, various colors of resins are carefully blended so the bonded tooth will look natural.

The resin is applied, contoured into the proper shape and hardened using a special light or chemical process. It is smoothed and polished to appear natural. Sometimes a follow-up appointment will be required for final polishing and finishing.

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Because bonding material is not as strong as natural tooth enamel, it can chip and may have to be replaced periodically. Bonded areas of the tooth are also prone to stain. For these reasons, bonding requires careful home and professional maintenance. You can help maintain your bonding by following these tips.

– Avoid acids (such as vinegar, tomatoes, or pineapples) and alcohol which can damage the resins.

– Avoid items that can stain bonding material such as cigarettes, coffee, tea, and berries.

– Do not put excess pressure on resins. Chewing ice, popcorn kernels and hard candy can cause damage.


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What Causes Discoloration?

While people have different colors of skin and hair, they also have genetic differences in tooth color. Some teeth are more yellow, while others yellow with aging. Natural tooth color can be discolored by a number of causes. The surface of the teeth can be stained by tobacco, coffee, tea, berries and other foods as well as by deposits of calculus (which is better known as tartar).

Discoloration of the tooth internally can also result from aging, injuries, excessive fluoride, certain illnesses and taking antibiotic tetracycline during early childhood. Although bleaching successfully lightens most discolorations, certain types (like those caused by tetracycline) are more difficult to remove.

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Chairside Bleaching

There are two types of bleaching procedures. Bleaching may be done completely in the dental office (known as “chairside bleaching”) or a system may be dispensed by the dentist to use at home (called “in-home bleaching”).

Chairside bleaching takes from 30 minutes to one hour per visit. It is not uncommon for the teeth to become slightly sensitive following bleaching treatments. To protect the mouth, a gel-like substance is applied to the gums and a rubber “shield” is placed around the necks of the teeth. A chemical solution, the oxidizing agent, is painted onto the teeth. A special light may be used to activate the agent.


To achieve the best results, teeth may be bleached a shade lighter than the desired since they will tend to darken slightly with time. Generally two to ten visits may be necessary to complete the process of chairside bleaching.(Back to top)

In-home Bleaching

With in-home bleaching, the dentist makes an impression for a model of the teeth, fabricates a custom-fitted tray and prescribes a bleaching agent that comes in the form of a bleaching gel. The gel is placed in the custom-fitted tray and worn up to two hours daily or at night for about two weeks. The amount of time the custom-fitted tray is worn and the duration may vary according to a person’s individual need and the recommendations of the dentist. The dentist will monitor the entire process of in-home bleaching to assure its effectiveness and safety.

Over the counter products that are self-administered are not recommended, although they may appear to cost less. Bleaching treatment should be done under the supervision of a dentist following a proper exam and diagnosis. Whiteners with the ADA Seal of Acceptance have proven to be safe and effective.

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Who Can Benefit?

Most bleaching procedures last one to three years, although in some situations it may last longer.

Some people, with certain dental conditions, may not be good candidates for this type of bleaching. People with gum recession, for example, may have exposed root surfaces that are highly sensitive and could be further irritated by the ingredients in the whiteners or bleaching components. In addition, these products are not recommended for habitual tobacco and alcohol users.

Brushing and flossing, twice a day, as well as regular professional cleanings, along with occasional touch-up treatments will help keep teeth white. An attractive smile increases self-confidence.

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How Long Whitening Lasts?

Whitening usually lasts between one and three years. However, it is important to:

– Brush twice a day

– Floss once a day

– Have regular cleanings at your dentist’s office

– Ask your dentist about any concerns you may have

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Types of Orthodontic Care

Before orthodontic treatment can begin, pre-treatment records are gathered (this is the key to successful diagnosis of orthodontic problems). Those records include medical/dental history, clinical examination, plaster study models of your teeth, photos of your face and teeth and x-rays of your head. This information will be used to decide on the best treatment for you.

Orthodontic treatment usually consists of applying braces to the teeth or using other appliances which gradually move the teeth or jaws into their correct position. Many of today’s braces are far less noticeable than those of the past.Braces consist primarily of brackets and interconnecting wires. Brackets (the part of the braces that hold the wires) are bonded to the teeth. Often, clear or tooth colored brackets are used for esthetics.

These braces may not be suitable for all types of orthodontic problems and, because they are more difficult to place and control and require frequent adjustments, they tend to be more costly. New white-colored elastics blend with the teeth. For the younger crowd, colored elastics are available.

When braces are removed, it is usually necessary to wear a retainer for a period of time. A retainer keeps the teeth in their new, correct position until the tissues surrounding them stabilize.

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Removable Dental Appliances

At the other end of orthodontic treatment, a special appliance is fabricated to hold the teeth in their new positions. This is called a “retainer”. Some retainers are cemented over teeth to hold the position and others that are removable.

Other removable appliances are very similar to the removable “retainer” in looks but provide a very different function. These can, in fact, create pressures on teeth in a specific way so as to cause the appropriate teeth to come into the correct position. This appliance can be used for active treatment as well as for post treatment retention.

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Types of Braces

Braces come in a variety of shapes, sizes, and colors. Some are the more traditional looking metal brackets that have been greatly reduced in size. Other brackets are clear plastic types and still other are made of ceramic materials. These last two types have been developed to aid in creating a greater cosmetic acceptance by patients in treatment.


Sometimes these brackets can be placed on the inside of the teeth. Brackets positioned in this way cannot be detected by others.

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Class 1 – Unilateral posterior cross bit, on the right side, slight anterior open bite.

Before After


Class 1 – crowding, deep bite

Before After


Class 2 division 1 – Crowding, deep bite, adult surgical case

Before After

Class 2 division 2 – Deep bite, severe crowding

Before After


Class 2 division 2 – Mandibular asymmetry, lateral open bite, posterior cross bite, crowding

Before After


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You would probably never dream of not bathing your body but give less thought to not brushing or flossing your teeth. When you have braces, it is incredibly important that you give as much attention to cleaning the braces as you do to cleaning the rest of your body.

The bands or bonded brackets on braces create small nooks and crannies where food and plaque (an invisible file of bacteria) can hide. If plaque is allowed to remain on the teeth for a long time, it can increase the likelihood of tooth decay. This same process can also cause permanent white lines and spots as enamel is dissolved by the acids.

Because of these problems, it is essential to brush after every meal and snack. You should also clean between your teeth and around each bracket daily. Brushing removes the food and plaque that forms on your teeth. When you brush, use a brush with soft and rounded bristles or a special orthodontic brush and also, use fluoride toothpaste. Look for the American Dental Association’s Seal of Acceptance. The Seal is awarded to products that have proven to be effective.

How should I brush?

A number of different tooth brushing methods are acceptable. Whichever method you use, take the time to brush thoroughly. Here’s an example of a method:

– Place a soft-bristled brush at a 45-degree angle against the gums.

– Move the brush back and forth in short strokes with a gentle scrubbing motion.

– Brush the inner, then outer, and finally the chewing surfaces of the teeth.

– Use the “toe” of the brush to reach the inner front tooth surfaces.

– Brush your tongue to help freshen your breath.

After brushing, rinse well. Then closely inspect your teeth and braces in a well-lighted mirror. You may have to brush and rinse several times before your teeth are clean.

Is flossing possible with braces?

Yes! But it can be a little tricky while wearing braces. A floss threader can help you slip the flow between the braces or under the arch-wire.

– Once the floss is in place, hold it between your forefingers, about an inch apart.

– Using a gentle sawing motion, guide the floss between your teeth. Do not snap it in place.

– When the floss reaches the gum-line, cure it against the tooth and gently slide it into the space between the gum and tooth.

– When you feel resistance, gently rub the side of the tooth moving the floss away from the gum.

– Rinse your teeth to wash away food or other particles that you removed with the floss.

Are there other products that can help me clean my mouth?

There are several dental aids that can be helpful. Specially shaped brushes, the other interdental cleaners and oral irrigating devices can often help clean some of those hard-to-reach areas. After brushing prior to bedtime, an ADA accepted fluoride mouth-rinse should be used for added protection of the enamel surfaces of the teeth.

Interdental Cleaners

Interdental cleaning devices with the ADA Seal of Acceptance are specially shaped brushes or other implements that help remove plaque. They are usually made of wood, plastic or rubber and shaped to help clean between the teeth. They can be particularly useful for people who wear braces or who have trouble handling floss. Discuss the proper use of these devices with your dentist to avoid injuring your gums.

Oral Irrigators

These devices create a focused stream of water to remove particles of food from the surfaces around and between the teeth. They are useful for cleaning hard-to-reach areas and may reduce gingivitis. They are especially helpful for people who have braces. Your dentist will tell you if you can benefit from using this device and provide instruction on proper use. Look for devices bearing the ADA Seal of Acceptance.

Fluoride Mouth Rinse

Fluoride with the ADA Seal of Acceptance provides extra protection for your teeth. Is an element that combines with tooth enamel, strengthening it against decay. Fluoride can even repair microscopic cavities by helping mineral incorporate into the teeth. You may want to discuss with your dentist the need for additional fluoride products such as non-prescription mouth rinses for children in your family over the age of 6.

Dental aids can play an important role in cleaning those hard-to-reach areas, but your diligence in daily cleaning is really the key to good oral health. By watching your diet, practicing good oral hygiene and following your dentist instructions, you can be assured that your orthodontic treatment will be a success. Remember, it is even more important that you visit your general dentist every six months for routine cleanings and examination while you have braces.

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When to Use Veneers?

Veneers are used to close gaps or cover teeth that are stained, poorly shaped, or slightly crooked. Even the most subtle change in your smile can make a dramatic difference in the way you look and feel. When you feel and look good, you project a confident self-image. So, make the most of your smile. Ask your dentist what veneers can do for you.

How Veneers Work


What is a Bridge?

A bridge is a replacement tooth that is supported and attached by a crown on either side of the space. The two side teeth or (anchor teeth) are prepared to provide support the bridge).

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Taking Care of Your Bridge

A bridge is made of very strong materials, but nothing as strong as natural tooth structure. If normal care and precautions and care are taken, a bridge can last for many years.

– Brush and floss with great care to clean where the crowns meet the tooth.

– Flossing must be accomplished underneath the bridge on a daily basis.

– Avoid eating or chewing on hard objects, food, or ice.

– Make regular visits to your dentist to evaluate the condition of the crowns.

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When are Bridges Needed?

To replace a missing tooth with a conventional three-unit bridge, teeth adjacent to the gap are prepared.(Back to top)
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Appearance immediately after a tooth is lost.(Back to top)
When a tooth is not replaced, the remaining teeth can drift out of position. This can lead to cavities and gum disease.(Back to top)

Types of Bridges

Bridges come in two main types. Fixed bridges or Removable bridges.(Back to top)
Some fixed bridges cement over a tooth, others cement to the outside surface of a tooth.(Back to top)


1. Must clean “under” as well as around the bridge
2. There are special tools to aid in cleaning
3. Floss once, and brush twice daily
4. Avoid chewing on hard objects, food and ice
5. Limit snacks

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What is a Crown?

Crowns are made of metal, ceramic, or a combination of the two and require very high temperatures in converting the carved was representation into the finished product. Crowns are fitted to a model of your mouth that is made at the time the teeth are prepared in your mouth. The crown is shaped and fitted to this model in the laboratory before the dentist tries it in your mouth. This process ensures that the crown will have a fit and appearance that will last for many years.

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When are Crowns Needed?

When a tooth is fractured, severely damaged by decay, or has a large old filing, a crown (also called a cap) is often placed. A crown strengthens the tooth, protects the remaining tooth structure and can improve appearance.

The location of the tooth, the intensity of the bite, and your requirements as a patient are some of the factors used in deciding which type of crown is best for you.

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Placement Process

Step 1The tooth is prepared to accept a crown. All odd fillings, decay, and unsupported tooth is removed to ensure a solid foundation for the new crown. An impression of the prepared tooth is made, and the appropriate shade of the crown is determined to match the patient’s tooth color.
Step 2A temporary crown is made, usually of tooth-colored plastic, to cover and protect the tooth until the crown is ready.



Step 3The crown is tried on for a fit, shape, and color. The bite is checked and adjusted. If all is satisfactory, the crown is bonded to the tooth.

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– Flossing and proper brushing is a must

– Brush gently but thoroughly where the crown meets the gum

– Avoid hard food or ice

– Limit snacks

– See your dentist regularly

– If continual discomfort is experienced after placement, contact your dentist

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Types of Implants

– Artificial substitutes for natural tooth roots

– Made from titanium, covered with material that can attach to the jaw bone

– Endosseous: placed within the jaw

– Sub-periosteal: attached under the gum but over the jaw

– Involves several visits

– Either bridges or dentures are made to cover the implants

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– Someone in good health

– Sufficient jaw bone to support the implant

– Lack of other medical complications

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Types of Gum Disease

While there are many forms of gingival and periodontal diseases, the most common type are gingivitis and adult periodontitis.

Gingivitis is the earliest stage and affects only the gum tissue. At this stage, the disease is still reversible. If not treated, however, it may lead to a more sever condition.

Periodontitis is the more advanced stage of periodontal diseases. The gums, bone and other structures that support the teeth become damaged. Teeth can become loose and fall out-or may have to be removed. At this stage, the disease may require more complex treatment to prevent tooth loss.

Here is a step-by-step illustration of the process of gingivitis and periodontitis:


1. Healthy gingival (gum tissue) and bone anchor the teeth firmly in place.
2. Gingivitis develops as toxins in plaque irritate the gums, making them red, tender, swollen and likely to bleed easily.
3. Periodontitis occurs when toxins destroy the tissues that anchor the teeth in the bone. Gums become detached from the teeth, forming pockets that fill with more plaque. Tooth roots are exposed to plaque and become susceptible to decay and sensitive to cold and touch.
4. Advanced periodontitis is present when the teeth lose more attachment because the supporting bone is destroyed. Unless treated, the affected teeth frequently become loose and may fall out or require removal by a dentist.
Although gum diseases are caused by plaque, a number of other factors can increase the risk, severity, and speed of development of the condition.

– People who smoke or chew tobacco are more likely to have gum diseases, and to have them more severely, than those who do not use any form of tobacco.

– Poorly fitting bridges, malocclusion (badly aligned teeth) or defective restorations (fillings), can all contribute to plaque retentions and increase the risk of developing gum diseases.

– Habits which place excessive biting forces on your teeth, such as clenching or grinding, may also accelerate the rate at which supporting bone is lost.

– Poor diet may cause gum diseases to progress more rapidly or increase the severity of the condition, according to some researchers. There is also some evidence than an unbalanced diet makes mouth tissues less resistant to infection.

– Pregnancy or use of oral contraceptives increases hormone levels which can cause gum tissues to react more sensitively to the toxins in plaque and accelerate growth or certain bacteria. The gums are more likely to become red, tender, and swollen and to bleed easily.

– Systemic diseases, such as AIDS or diabetes, can lower the tissues’ resistance to infection, making gum diseases more sever.

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Early Stages: Redness, tenderness, swelling, and bleeding gums
Late Stages: Shrinking of gums, loose teeth, bad mouth odors and pus

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How Gum Disease is Treated

– Depends on the stage you are in

– Dentist will recommend procedures, for example: thorough cleaning, adjustment of bite, antibiotics, or minor surgery

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How to Prevent Gum Disease

– Regular, professional cleaning of the mouth
– Meticulous attention to home care, flossing and brushing

– Don’t wait until it hurts

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Why Remove Wisdom Teeth?

Extraction of third molars can protect the overall health of the mouth. It is generally recommended when the following conditions occur:

Wisdom teeth only partially erupt. This leaves an opening for bacteria to enter around the tooth and cause an infection. Pain, swelling, jaw stiffness, and general illness can result.
Impacted wisdom teeth may continue growing without enough room, damaging adjacent teeth.A fluid-filled sac (cyst) or tumor forms, destroying surrounding structures such as bone or tooth roots.

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When to Remove Wisdom Teeth?

People between the ages of 16 and 19 should have their wisdom teeth evaluated. If they need to be removed, it should be considered before age 20 when generally fewer complications occur. At a younger age, tooth roots are not fully developed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures. There is also less surgical risk and healing is generally faster.

Extractions of wisdom teeth may be performed by a general dentist. If your dentist anticipates any special care will be needed, he or she may refer you to an oral or maxillofacial surgeon. An oral or maxillofacial surgeon is a dentist who specializes in surgery and the removal of wisdom teeth.

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What to Expect?

Before surgery, your dentist will explain what to expect, have you sign a consent form and give you personalized instructions to follow. Keep in mind these general items in order to help your surgery go smoothly.

Wear loose, comfortable clothing and arrange to have someone be with you after surgery. Extraction can be performed under local conscious sedation or general anesthesia. Following surgery, you may experience some swelling and mild discomfort, which is part of the normal healing process. Cold compresses can help decrease the swelling and medication prescribed by your dentist can help decrease the pain. You may be instructed to drink only clear liquids following surgery and later progress to soft foods.

Some patients experience numbness or tingling following surgery. Normal sensation usually returns in a short period of time. Occasionally, a dry socket occurs when the blood clot breaks down earlier than normal. A dressing placed in the socket protects it until the socket heals.

Talk with your dentist about any questions that you have. It is especially important to let your dentist know, before surgery, of any illness that you have and medications that you are taking. If your general dentist has referred you to a specialist, they will both work together to provide you with the best and most efficient care. Keeping your teeth healthy – to a wise old age – is your dentist’s primary concern.


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– Keep gauze in place, as instructed by your dentist

– Clear liquids, not hot, must be used in the diet for the first day

– Soft foods can be consumed as tolerated

– Brush all but the surgical site the first day, then all areas thereafter

– Brush your tongue

– Avoid rinsing and spitting the first day after surgery

– Follow all special instructions given by your dentist

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