Frequently ask question

Q. What is a Composite resin (white filling) and what are the advantages and disadvantages of composite? How long will a composite last? Is it costly?

A. A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used for restoring decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

Advantages: Esthetics are the main advantage, since dentists can blend shades to create a color nearly identical to that of the actual tooth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes.

Disadvantages: Along with the higher cost and the extra placement time, the patient can experience post-operative sensitivity. Also, the shade of the composite can change slightly if the patient drinks tea, coffee or other staining foods. The dentist can put a clear plastic coating over the composite to prevent the color from changing if a patient is particularly concerned about tooth color. Another drawback: composites tend to wear out sooner than silver fillings in larger cavities, al-though they hold up as well in small cavities.

Studies have shown that composites last 7-10 years, which is comparable to silver fillings except in very large restorations, where silver fillings last much longer than composites.

Hello Dr. Khan,

Thanks for wonderful article you wrote about sterilization in dental practice. I wonder how often could be maintain  the guideline you mentioned. I think the most important part is public awareness and strict government rule. Is gum disease contagious? I mean can it be spread from one person to another?  Do you suggest for using mouth freshener (mint spray) if some one has bad breath? 

Haider  

 

Thanks for your compliments about my article. I do agree with you that it is little bit difficult to maintain in underdeveloped countries but still it is easy to maintain in the dental clinic located in urban area. Yes I already mentioned about public awareness. Dental professionals who do not use proper infection control protocol on the transmission issue, they are doing crime and  playing with AIDS, Hepatitis B and C virus, and other deadly unknown germ, possibly threatening themselves, their staff, their patients and their families..  It is the duty of all dental professionals to use infection control guidelines. Any surgical instrument, once used, becomes a potential source of infection to another patient and to anyone handling the instrument. To minimize the potential risk, each instrument must be cleaned and sterilized as soon as possible after use, in a manner that is demonstrably effective.

Common methods of sterilization in dentistry are steam under pressure (autoclave). Please check whether they have  autoclave machine. You have every right to ask your dentist  about how they are doing sterilization.

When you go to any dental clinic what can you do in these circumstances? In order to ensure your safety, observe your dentist at work very carefully. But what should you be looking for? Note carefully whether your dentist observes basic mandatory cross infection control techniques such as obtaining complete medical histories, changing gloves routinely for every patient, being particular about personal hygiene and washing his hands regularly, most important  is whether the dentist uses sterilized instruments and disposable needles and suction tips.

Gum disease is not contagious means it can not spread from one patient to another. Yes you can use mint mouth wash.

I am 36 years old.The colour of my teeth is brownish

yellow. I really feel social embarrassment because of

my teeth. I visited many dentists regarding this

problem and they gave me two options (Porcelain cap or

Bonding filling). Making Porcelain cap is very

expensive, on the other hand I am not convinced with

the idea of bonding filling. Can you give me other

option instead of cap or bonding filling? What to do?

Please help me.

Jaglul Karar

 

49

Dear Dr Khan,

I've had a cavity in one of my lower jaw molars for a long time. However, I have not had it repaired by a dentist. It has not posed any serious problems, neither is it very painful or sensitive (only slight sensitivity when biting hard). The hole of the cavity isn't too big either. However, it seems that the cavity has spread to other teeth (if that is possible). I have noticed slight black marks on the top of the crown of some teeth, that do not go away with brushing. I try to maintain a good hygiene, brushing twice a day (sometimes missing to brush at night). What are the potential problems that I face from not having my teeth repaired? Are they likely to fall out? Also, I have noticed the same marks on an incisor on the lower jaw, and the tooth is sensitive (when tapped gently), and it seems to me that it is slightly tilting. I've never heard of anyone having their incisors filled! What can I do if I develop a cavity in the incisor? I am very worried, but unfortunately haven't taken any steps to correcting the problems. Could you also please suggest a diet healthy for teeth?

Thank you.

RM

 

Q. Please give me some information about braces. Why does some one need braces and are there any bad effects if some one uses them for long?

 

Orthodontics (Braces)

Orthodontics is the science of straightening and correcting teeth.

Who Needs Orthodontic Treatment?

Children as well as adults, are choosing to have orthodontic treatment for several reasons:

-malocclusion (bite or occlusion is off)

-tooth malalignment (crooked teeth)

-unhappy with appearance of teeth

During the preteen and teenage years, the jaws are growing and maturing, therefore it is easier to shift teeth at this stage rather than later on in adulthood.

Some Causes of Malocclusion?

Hereditary - for example, you may inherit your mother's small jaw, and your father's large teeth; if this is the case, your teeth would be too large to fit your jaw.

Trauma - if you lose a tooth due to an accident, then teeth may start to drift into the empty space.

Disease - you can lose a tooth early due to cavities or gum disease; this often leaves a space which other teeth drift towards.

Malnutrition - nutritional deficiencies can alter the growth of the jaws and teeth.

Habits - thumb-sucking can shift the teeth out of alignment.

How Do Braces Work?

Teeth can slowly be moved and shifted into proper position by applying pressure in certain directions. Bands, wires and elastics are placed on the teeth to move them in the right direction. This takes place slowly and carefully over an extended period of time.

Shifting teeth back into a functional position can take months to years, but eventually you'll have a new and improved mouth!

Retainers are often used after the braces, to hold the teeth in their new position until they are stable.

It is important to wear the braces or an appliance for however long it takes. If you quit at any point during treatment, the teeth can shift back into their old position.

Q. The baby teeth of my daughter started falling when she was only four year and two months old. When her permanent teeth appeared, they were all crooked and some of them were smaller than the others. She is now only six. Please advise what can be done about this problem?

 

A. It seems your daughter lost her milk teeth little earlier than usual. Sometimes a primary tooth is lost before the permanent tooth beneath it is ready to erupt. If the primary teeth are lost too early, nearby teeth can tip or move into the vacant space. When the permanent teeth are ready to come into the mouth, there may not be enough room. As a result, teeth may erupt out of their proper positions, leading to malocclusion. Early tooth loss due to dental decay can have a serious impact on your child’s self-esteem and self-confidence in their appearance. I think you should immediately consult with your family dentist.

Many Questions has been raised  regarding their  anxiousness to visit a dentist. I hope this topic will help those people having Dental Phobia!!

 

Dental Phobia

 

If you are anxious about dental treatment then you are not alone. In USA, between 6-14% (should be more in south east asia!!) of the population avoid attending the dentist because of anxiety about treatment. Between 45-55% of patients who attended the dentist are anxious in the dental environment.

The reasons people fear attending the dentist are varied and include pain, cost of treatment, lack of control while in the dental chair, embarrassment and fear of the unknown. The cause of dental anxiety is usually a previous bad experience, but can be caused indirectly through horror stories about dental treatment from family, friends and even the media. What do you fear most about going to the dentist? Just the thought of having a needle inserted into your cheek and a cavity removed from your tooth is enough to bring tears to the eyes. However, surprisingly it is not the actual dental procedure that most often terrifies patients. According to surveys, the site of a needle and the sound of the drill were the two most feared elements of dentistry.

 

 

Physiological Factors related to dental pain

Because of the oral cavity's proximity to the brain, as well as the complex nerve structure of the head and neck, dental pain is often more severe than pain in other parts of the body. One of the most troublesome biological factors that dentists must deal with is bacterial infection. In addition to the sensitivity caused by infections, the initial inability of oral infections in the teeth and bony structures to drain results in the build up of pressure. As bacteria quickly multiplies and produces gaseous toxins, pressure increases and pain results. If an infection is neglected for even a day or two, the pressure can become intolerable.

 

Controlling Dental anxiety

When you make the appointment to see the dentist, tell the receptionist you are nervous about treatment. This first appointment will usually be to discuss your fears about treatment and to do an initial examination of your teeth.

Behavior Management: This is the simplest method of treatment for nervous patients. It involves a careful and sympathetic approach from the dentist, with explanations of what is being done and allowing the patient control over the procedure. Some patients may want to bring a friend along for support. It may also be possible to play relaxing music or to watch a video while having treatment.

 

 

Dental Health Maintenance

Of course, the most important way to reduce the pain involved in maintaining oral health is by focusing on preventive care instead of the treatment of problems. If you've put off going to the dentist for years and have neglected regular flossing or brushing, you may be experiencing advanced stages of tooth decay or gum disease - both painful problems. The further decay spreads, the more radical the treatment required. This causes trauma to the tooth and gums that results in discomfort.

New Advances in Dentistry

Dentistry has come a long way over the last few years and many of you will be surprised on your next visit. Even if you have put off going to the dentist and are experiencing problems, your dentist has new ways to provide relatively painless treatment. For invasive procedures such as wisdom teeth extraction, biopsies and complex root canal surgery, nerve block are often administered. This involves the injection of an anesthetic to block sensation to the nerve that sends pain signals to the brain. By blocking the nerve with an anesthetic, the dentist can numb the area requiring treatment for a specific period of time. To eliminate the discomfort associated with injections, topical agents are applied to tissues prior to the injection A soothing atmosphere and a calm, reassuring dentist can make your next dental visit more pleasant. 

To

Dental Wise

Dear Doctor,

I can not drink cold water as it gives very abnormal sensation (a sort of pain) on my upper right jaw. Even I can not locate the exact teeth. I visited many dentist, but I am not satisfied with their explanation and line of treatment plan. Can you explain about abnormal sensation ? Why its happening?

Yakub molla

Tutpara

Khulna

Answer:

Dear Brother molla,

I will try to explain about the causes of abnormal sensation.

Abnormal sensation or Tooth Sensitivity

 

What is tooth sensitivity?

It can be defined as a painful reaction in one or more teeth triggered by hot, cold, sweet, or sour foods and drinks. This pain can be sharp, sudden and shoot deep into the nerve endings of your teeth.

Apart from a cavity or a missing filling, the most common cause of tooth sensitivity is exposed dentin on the roots of your teeth. Normally, the dentin (the second, more sensitive layer of the tooth) is surrounded and protected by your enamel, cementum(special root covering) and gums. The cause or mechanism of dentinal sensitivity is still not well understood. It is believed that the little tubes that connect the dentin to the nerve or pulp serve as sensory conductors. That sensation may be one of pain. OUCH!!!

Causes of exposed root surfaces which may result in dentinal sensitivity:

• Brushing too hard - Over a period of time, brushing too hard or using a hard-bristled toothbrush may wear away enamel or cementum and cause the dentin to be exposed.
• Recession of the gums - Movement of gums away from the tooth due to periodontal disease will expose the root surface.

 

• Gum disease - Inflamed and sore gum tissue may also cause sensitivity due to the loss of supporting ligaments which exposes root surface.

 

Other causes of sensitive teeth:

• Cracked teeth - Chipped or broken teeth may fill up with bacteria from plaque and enter the pulp causing an inflammatory reaction.
• Grinding your teeth - Grinding or clenching your teeth may wear down the enamel and expose underlying dentin.
• Plaque- The presence of plaque on the root surfaces can cause sensitivity.

 

What to do at home:

• Maintain good oral hygiene - Continue to clean all parts of your teeth and mouth thoroughly.
• Use a soft bristled toothbrush -This will result in less toothbrush abrasion of the tooth surface.
• Use desensitizing toothpaste - There are many on the market. With regular use you should feel a decreased sensitivity.
• Consider what you eat- If you frequently eat foods high in acids, such as citrus fruits (example: sucking on lemons), they can gradually dissolve the enamel over time, leading to dentin exposure. The citric acids may aggravate the hypersensitivity and initiate a painful reaction.
• Use fluoridated dental products - As an example,with a daily application of a fluoridated mouthrinse, hypersensitivity usually decreases.

 Professional Care:

Ask your oral health professional, about professional products that may be used to help reduce sensitivity. Some of the most common treatments are:

• white fillings (Glass inomer or composite filling) to cover exposed root surfaces
• fluoride varnish applied to the exposed root surface
• dentin sealer applied to the exposed root surface

You don’t have to suffer with sensitivity!!

Abfraction. This is a wearing of the tooth along the gumline caused by repeated clenching and grinding (bruxism), causing the enamel to "pop" off starting at the base of the tooth and it can expose the gumline of the tooth to excessive wear. Once the enamel is gone, then dentin is exposed and the teeth are more susceptible to decay, sensitivity and more wearing down.

Abrasion. A wearing down of the tooth structure, commonly caused by using a hard toothbrush and improper brushing technique along the gumline. Could also be from grinding or chewing hard objects or food.

Abscess. An infection of either the tooth, gums or bone. Commonly appears either clinically as a "gum boil" on the tissue, or it shows up on the x-ray, most often at the tip of the root or between the roots.

Abutement. These are the teeth on either side of a bridge. They support the bridge. A bridge is placed when a tooth is missing.

Age to bring in a child. Most children are brought in to see a dentist between age 3 and age 4. Younger than that, and they generally will not be able to sit for the visit. If you can bring the child in with you (if you are a parent) you can let them see you having your teeth cleaned and perhaps the dentist can count their teeth and let them have a pleasant first visit (instead of waiting until they have a toothache).

Air abrasion. A relatively new technique to the dental field in which a small high pressure spray of aluminum oxide is used to remove decay or drill out pieces of old fillings and even tooth structure. It cuts down the need for a drill in many cases and often can eliminate the need for anesthetic since there is less trauma to the tooth while it is being used. Advantages include: less vibration, less noise, less heat build-up. It acts like a mini sand blaster and works excellently in preparing teeth for sealants or conservative dental care. Sometimes it is referred to as Micro-Dentistryô or "Soft-Prepô".

Amalgams. Silver fillings have been used for dental filling material for about 100 years. They are the metal type of fillings (containing mercury - about 50%, tin, silver and other metals such as tin or zinc mixed together) and generally hold up for years and are an easily placed filling material. Now that newer, more aesthetic and conservative composite (white) fillings are coming out with stronger materials and quartz fillers for better wear, more people are getting those placed instead. Amalgams tend to have a higher rate of causing tooth stresses and fractures. However, since amalgams are the least expensive type of filling, most insurance companies only pay for amalgam fillings. ADA position on Amalgam.

Anesthesia. This is the method of "numbing" an area of the mouth, or putting an area "to sleep" or in the case of general anesthesia, putting the patient to sleep, for a brief time while the procedure is being done, to block the transmission of pain through the nerves.

Anterior Teeth. These are the front eight teeth on the upper or lower jaw. They include the incisors and the cuspids (canines).

Attrition. This is the loss of tooth structure over time, (or the loss of teeth over time.) Generally caused by wear, long term usage, heavy usage of the teeth.

Base. This is the material (typically a type of cement) that is placed under a filling, when a filling is getting close to the nerve to act as an insulator and sedative on the pulp of the tooth (where the nerve is.)

Bicuspids. These are the teeth just behind the pointed canines. They are the fourth and fifth tooth on either side from the midline. They typically have two cusps. They are used for chewing.

Base. Whenever a filling is getting close to the pulp chamber, we have to protect the nerve by putting something on top of it.

Bleaching. Teeth can often be whitened by the several new techniques of "bleaching" available today. The most common methods used are the "in-office" method where a strong bleaching agent is placed over the isolated teeth and a special light is used to assist the bleaching material lighten the teeth. This method is generally more controlled and probably better for people who have tetracycline stains or streaks on their teeth. The "at-home" technique involves making trays which fit into the mouth and these are then filled with bleaching materials. When worn for a few hours a day, noticeable results can be seen generally within a few days to a couple weeks. Results vary from individual to individual and it is probably best to check with your dentist to help decide which method works best for you. Some of the factors involved include the intensity of the stains, whether or not you have fillings or crowns on your front teeth as well as what may have caused the stains.

Braces. Braces are put on teeth to help correct rotated teeth, too large of spaces, crowding or misalignment of teeth. Newer techniques today allow for wire frames to be worn that can spread open the arch if it is too small, or pull one side of the jaw to correct for overlap on one side only. In addition, clear brackets and brackets that can be bonded inside the teeth are making braces a good option for many adults today.

Bridge. A permanently cemented appliance that replaces missing teeth. The side teeth are called abutements and the missing replacement tooth is called a pontic.

Bruxism. This is the grinding and clenching of the teeth. Often associated with flattening of the teeth surfaces.

Calculus. When the plaque hardens on your teeth, it gets calcified and is referred to as calculus.

Canines - The cuspids, the long pointy teeth that are the third tooth from the midline on each arch.

Caries. This is the dental term for a cavity (decay) on a tooth.

Composites. Composite or white plastic fillings, are used when esthetics is a concern. The currently available materials used for composites are showing some very strong wear potential and while they may not be quite as hard as silver fillings on the chewing surfaces, they do excellently in the grooves, and dramatically lower the development of cavities. (Some insurance companies will pay for the less expensive amalgams instead of composite fillings.) They are glass filled resin fillings. The benefit if this type of filling is that it is more conservative and aesthetic than the silver fillings.

Crowns. Crowns are placed over a tooth when a large portion of the tooth is lost ot decay or has broken off. Usually when a filling is more than half of the size of the tooth, the tooth is weakened. If the filling would comprise a significant portion of the tooth, often the tooth can fracture under the stresses of chewing and therefore, placing a crown over the tooth protects the chewing surface and prevents that from happening. Crowns that are white are made of porcelain and are usually placed in areas of esthetic concern. Gold crowns might be placed in the molar region or when there is heavy grinding that might damage the opposing teeth.

Curettage. This is the scraping of the soft tissue areas to remove the bacteria deep under the gums.

Cuspids. These are the canines, or fangs. They are the third tooth from the midline.

Deciduous Teeth. These are the children's first set of teeth. Also called the primary teeth. They are replaced later in life with permanent teeth. See also teeth numbering.

Dentures. Dentures are false teeth. They are typically made from impressions (molds) that are taken of the inside of the mouth and they are made of a type of plastic or porcelain that duplicates the shape, size and function of the teeth. They are a removable appliance to replace your teeth.

Emergencies. How do you decide if something is a true dental emergency? Generally, if you have swelling, an exposed tooth, bleeding, or sharp throbbing pain, that is a dental emergency. If you knock a tooth loose or out, attempt to gently rinse it off lightly with water and reposition it as soon as possible. A tooth that is knocked out and let dry in the air for over an hour has a poor prognosis, whereas a tooth that is reimplanted within twenty minutes, has a good prognosis. If you have spontaneous ongoing pain or swelling or have experienced trauma, you should make arrangements to see your dentist as soon as possible. CDA

Edentulous. Missing the teeth in either arch.

EMPRESS crowns and veneers. This is a type of veneer or laminate or crown that uses a technique in which a strong porcelain material is bonded to the tooth, rather than cemented, and it picks up a more natural color of the underlying tooth. These are becoming the standard of high esthetics for cosmetic dentistry. the material is similar to natural tooth structure in terms of brilliance and light reflection and it is similar to leucite in terms of strength, thereby giving a durable surface that looks very natural.

Endodontics. The specialty of dentistry that involves removing the disease in and around the root or nerve of a tooth. Generally referred to as a "root canal".

Gingiva. The dental term for the gums, or supporting soft tissue around the teeth.

Halitosis. This is the term for "bad breath". There are several causes of halitosis, including the foods that we eat, smoking, coffee, or it could be due to periodontal disease, infection or "ketosis" which is a nutritional imbalance. Brushing the tongue, swishing with rinses after eating, flossing, and brushing after meals, avoiding coffee, smoking and garlic are some of the best ways to prevent this.

Implants. Dental implants, simply put, are replacements for missing roots. Most implants are typically titanium posts that are imbedded into the jawbone and then plastic or porcelain teeth are placed over the portion of the implant that sticks out of the gums. They usually take several months to complete since the bone must fuse to the posts before any kind of pressure can be put on the implant itself.

Impaction. This typically refers to the wisdom teeth. When a tooth is impacted, it can either be partially impacted, soft tissue impacted or full bony impacted, depending upon how far into the tissue the tooth is.

Incisors. These are the front two teeth on either side of the midline. They are mainly used for biting.

Inlay. When a filling is large enough that a little more chewing support may be needed, an inlay may be used. These are typically lab-processed cases and are either porcelain or gold.

Insurance. Dental insurance is designed to be a benefit that typically an employer can offer to their employees to assist them with their health care costs. Unfortunately, often more than 35% of the fees go towards administering the plan, then most plans have limitations, deductibles, waivers, fee schedules, pre-authorizations, waiting periods, and maximums. In addition, it often adds unnecessary expenses to the dental office for preparing forms, submitting for pre-estimates, waiting for approvals and processing claims. This does not allow for the dental care to be done with the least amount of cost to the patient and the maximum benefit applied to the provider's fees, rather than to administrative paperwork. The American Dental Association has assisted in establishing a program that allows a patient to select their own dentist, have 95% of the fees be applied towards the dental work (as opposed to 30-45% being wasted on unnecessary insurance administrative costs) and is very cost effective for employers. It is referred to as Direct Reimbursement. This program is a cost-saving alternative that is quickly becoming the standard of care. If your employer is not using this, you should contact the ADA and encourage your employer to compare what you currently have to the Direct Reimbursement alternative. For info: ADA .

INVISALIGN. A relatively new process of straightening teeth using a series of thin hard plastic "aligners" in a series, to corrrect rotations, crowding or space problems. To date, ALIGN TECHNOLOGIES, located in Santa Clara County has created over one million of these invisible aligners.

Lasers. There are several different types of lasers currently in use for dentistry. Among these include lasers that can be used to assist with bleaching, gum therapy, decay removal, root canal therapy, desensitizing a tooth, and helping heal an ulcer. In addition, the latest laser in our arsenal is one that can be used to determine if a stained pit has decay or not. It is 98% effective in it's diagnosis (more accurate than an x-ray for smaller cases, and with much less radiation.)

Local Anesthetic - This is the most common form of anesthetic given for most dental procedures. The anesthetic is localized in one area and generally will last anywhere from 2-4 hours duration, although there may be lingering sensation for several hours longer. Either we give an infiltration or a block, depending upon the area we need to numb up.

Mandible. The lower arch (lower jaw).

Maxilla. The upper arch (upper jaw).

Molars. The larger back teeth, which are the 6th, 7th, and 8th tooth in the mouth from the front. They are used for most of the chewing.

Nightguard. This is a removable appliance that is fabricated to assist with grinding, bruxism, clenching and TMJ symptoms. It is often worn at night to prevent wearing down the teeth surfaces.

Nutrition and Dentistry. The more we learn about nutrition, the more that we believe that a good diet will promote a healthier lifestyle and healthier teeth. Especially if you are anticipating dental work, you might wish to increase your Vitamin C, since it aids with healing. During pregnancy, women should take extra care to eat right and brush regularly since the hormone changes can affect the susceptibility of the tissues to infection.

Occlusal - the top of the teeth on the back teeth (the chewing surface.)

Occlusal Guards - Bite splints or niteguards. If you have TMJ, it's worth worth looking into getting an occlusal guard. These can be used to help relief pressure, tension and anxiety.

Onlay - When a tooth has a large filling that doesn't quite need a crown for side wall support, but a filling might not be strong enough by itself or be aesthetically compromised, then an onlay is placed. Generally, these are either cast from gold, a strong pressed ceramic type material or made from porcelain and are quite strong. They are more esthetic and more durable than fillings. They are more conservative than crowns and leave as much possible tooth strructure as possible, while at the same time protecting the teeth.

Oral Surgery. One of the specialties of dentistry. It includes the removal of teeth, placing implants, and jaw surgery.

Orthodontics. One of the specialties of dentistry. It involves braces, for the straightening of teeth. Newer technologies may use pre-bent wires or mouth guards to assist in straightening teeth rather than applying braces to the teeth. Generally the procedures are done to straighten the alignment of the teeth for better form, esthetics, function and speech.

Panoramic x-ray. These are taken using a special machine that takes the x-ray of the jaws with the film outside of the mouth and it shows a larger area at a time- all the teeth on one film. It is generally good for looking for teeth, and for identifying cycts, infections, impacted teeth, or fractures. The resolution is generally not as good as the individual films to show cavities. To see a sample of several panoramic x-rays.

Pedodontics. A specialty of dentistry. Pediatric Dentistry - the treatment of children's teeth. More about this in our Pediatric Department.

Periodontal Disease. The irritation and swelling and bone loss that can occur if disease is let go around the supporting tissues of the teeth. This is one of the more common and also preventable diseases of mankind. See the Hygiene Department for more in.

Periodontal Pocket. The area of the gum tissue that attaches to the tooth at the top of the gums. Generally speaking, we have healthier gums when the pockets are 2-3 mm deep, because it is easier to clean with a brush. Pockets that are 4-6 mm or deeper, tend to trap food and bacteria easier and can lead to gum disease.

Permanent Teeth. The adult teeth, the second set of teeth that we get, starting around age six and ending when we get our third molars (wisdom teeth) around age 17-22. See also teeth numbering.

Plaque. Generally this is the film that develops on teeth which is sticky and can develop into a calcified mass called calculus if not removed. It is food that is broken down and bacteria that combine to produce it.

Porcelain Veneers. The thin pieces of porcelain that are used to change the shape, size or color or position of teeth, primarily used in the front teeth. See the Aesthetics Department for more info.

Posterior Teeth. The back teeth in the mouth beyond the canines.

Primary Teeth. This is the dental term for the first set of teeth. Also called baby teeth. See also teeth numbering.

Prophylaxis. Also called a prophy. This is the basic cleaning of the teeth done by the hygienist usually.

Root Canals. A root canal is typically done whenever the decay or injury to the tooth invades the inner part of the tooth where the pulp is. This is where the nerve and the blood supply are located. When a root canal is done, the inner portion of the pulp is removed, along with any infection that may have invaded the inside walls of the tooth. Then a sealer material is placed with a rubbery plastic to fill the hole so that new infection can't get into the tooth. Generally, by removing the root, it can potentially weaken a tooth and therefore, it is common to protect the integrity of the tooth by placing a crown over the tooth.

Sealants. Sealants used to be considered for children's teeth only. Now we are finding that adults too, can benefit from sealants. Sealants are plastic coatings that are placed on the etched surface in the grooves of teeth-typically on the back molars and sometimes on pre-molars. It helps prevent sugars and bacteria from getting into those deep fissures and cause decay. CDA.

Specialties of Dentistry. There are several recognized specialties of dentistry. Simply stated, these are the more common specialties: Endodontics is the treatment of root canals. Pedodontics is the treatment of children. Periodontics is the treatment of the gums. Orthodontics is the straightening of teeth. Oral Surgery is extracting teeth and jaw surgery.

Sjorgren's Syndrome. A condition resulting in dry mouth and dry eyes caused by an immune system malfunction. It affects 2-4 million people and 90% are women. For more details from a web site specifically designed for this topic, click here.

TMJ. The temporo-mandibular joint (TMJ) is a very unique and fragile joint. Because of the numbers of tendons, ligaments and muscles that are used to hold it in position, it is subject to trauma and stress. As a result, headaches, jaw soreness and and neckaches can all be related to problems related to the TMJ. Sometimes the small disc that separates the lower jawbone from the socket where it rests gets displaced and a bite splint may be used among other therapies to "reposition" the jaw into the proper alignment. More on the TMJ.

Toothbrushes. Brushing after each meal or snack is a great way to prevent cavities. If your toothbrush is frayed at the ends, you should consider replacing it. Let your toothbrush air-dry in between uses so you don't get bacteria growing in it. Keep it in the light, so the dark creepy bacteria can't do well. Bacteria like a dark wet environment to thrive in. Tap the water off and make sure you don't leave food or toothpaste on the brush. Never share a toothbrush with someone else and change it even more frequently if you have been sick. More on this in our Preventive Dentistry Section.

Veneers. Thin coverings on the teeth, typically made of porcelain, but can also apply to composite materials. Veneers generally refer to the conservative version of a crown. The procedure is similar and the technique is more critical, because we are working with thin layers of porcelain and we also have to concern ourselves with the underlying color of the teeth, since the veneers are basically translucent and pick up the core shade of the teeth. Visit our Aesthetic Department for more info.

Wisdom Teeth. These are the last teeth to come into your mouth. They are the 3rd molars and generally do not come out until around age 17-25 years of age. Most people either don't have room in their mouth for them, or they come in crooked, or are impacted and never fully erupt. They get decayed easily and therefore are most commonly removed on most patients.