In dentistry, no mouth is the exact same. In order for our professionals to assess your individual needs, X-ray imaging helps identify any underlying signs of bone loss or gum disease that can be undetectable with the naked eye. It is typical for new patients to undergo a full set of dental X-ray imaging for the dentist to get an idea of their oral health status. In order to help with future comparisons, we may request additional X-ray images be taken during follow-up visits in order to determine what treatment will be needed, as well as to identify any conditions that may require action.
Dental radiographs, or X-ray generated images, are necessary in receiving the highest standard of care. The diagnostic benefits far outweigh the minimal risks involved in the use of dental X-ray imaging. We are careful to limit the amount of radiation exposure for patients by using lead aprons and digital radiography, which reduces radiation substantially. Without the use of X-ray generated images, conditions like cavities, extra teeth, and diseases could go undetected. Digital X-rays have minimal radiation, detailed images, and remarkable speed. With digital X-rays, the patient’s images appear instantaneously on a nearby monitor, giving us a convenient chairside image to analyze and refer to throughout the dental visit. We are pleased to offer this dental technology.
If you wince with pain after sipping a hot cup of coffee or chewing a piece of ice, chances are that you may suffer from “dentin hypersensitivity,” or more commonly known as sensitive teeth.
Hot and cold temperature changes cause your teeth to expand and contract. Over time, your teeth can develop microscopic cracks that allow these sensations to seep through to the nerves. Exposed areas of the tooth can cause pain and even affect or change your eating, drinking, and breathing habits.
At least forty-five million adults in the United States suffer from sensitive teeth at some point.
Abrasive toothpastes are sometimes the culprit of sensitive teeth. Ingredients found in some whitening toothpastes that lighten and remove stains from enamel, and sodium pyrophosphate, the key ingredient in tartar-control toothpastes, may increase tooth sensitivity. In some cases, a desensitizing toothpaste, sealants, and filling materials including fluoride may alleviate some of the pain associated with sensitive teeth.
Sometimes, a sensitive tooth may be confused by a patient for a cavity or abscess that is not yet visible.
In any case, contact your dentist if you notice any change in your teeth’s sensitivity to temperature.
We proudly accept most PPOs. Call our friendly staff if you have any questions about financial policies.
For the convenience of our patients, the following office policy and financial agreement has been established for your review.
Cash / Check / Credit Card
Lasting Impressions Family Dental Care gladly accepts cash, check, or credit card payments.
We accept VISA, MASTERCARD, and DISCOVER. We offer these to allow you the most convenience in taking care of your account.
As a service to our patients, we will file your dental insurance via electronic claims. We work with your insurance company to provide the most accurate estimate of your co-pays. It is the patient’s responsibility to provide the correct insurance information at each visit. Payment in full is required at the time of service for all non-insured patients. Insured patients are responsible for, and should be prepared to pay all amounts not to be covered by the insurance estimate. With insurance plans paying only a portion of treatment cost, we can only estimate what your insurance company will pay. The maximum time allowed for an insurance payment is sixty days. After sixty days, the patient is responsible for the entire balance.
We have made arrangements with the Care Credit Company to provide payment plans. This allows you to complete your dental work without delay and make relatively small monthly payments. Care credit is used for treatment over $300. Applications are available and approval can be determined within ten minutes. For your convenience you can also apply online at www.carecredit.com
We also offer a financial option that requires a down payment followed by monthly payments automatically withdrawn from a bank account. Please ask about this option that can be tailored for your specific needs.
As a courtesy to all patients we ask that a forty-eight hour notice be given for a cancelled appointment. If we have not received sufficient notice, a charge may be applied to your account.
Plaque constantly forms on teeth. It is a clear film of bacteria that builds in hard to reach areas such as between your teeth and in the lines of your gums.
When allowed to accumulate, the plaque can irritate the gums and lead to certain gum diseases, such as gingivitis. Research has provided evidence that gum disease has been linked to many health problems including stroke, heart disease, pneumonia, and even pregnancy complications
Plaque can be removed with regular brushing and flossing along with professional cleanings from dental professional to help with tough tartar removal. Early stages of gum disease are often unnoticed. By the time you begin to feel pain or irritation, it may already be too late to focus on prevention. Regular checkups can assist in preventing plaque and tartar from building up,as well as prevent many other dental complications.
Bad breath can be caused by a variety of factors. In most cases, it is caused by food and/or bacteria remaining in the mouth for an extended period of time. Dead or dying bacterial cells release a sulfuric compound that gives off an unpleasant odor. This food gets absorbed into the bloodstream and can travel to the lungs, where it can and will be exhaled. Periodontal disease is a result of bacteria accumulating in the pockets around the teeth. This can lead to bad breath, thus if you have bad breath, there is a possibility that you might have periodontal disease (or gum disease).
In some situations, bad breath can be caused by certain medications and/or dry mouth. If you feel that this might be affecting you, ask your dentist and they will be able to help answer your questions.
Routine oral hygiene is the best way to prevent and maintain a clean and odor-free mouth. Daily brushing and flossing, and regular professional cleanings will take care of any unpleasant odors. One common area that everyone forgets is to brush their tongue. The tongue comes in contact with food and bacteria as much, if not more than, the teeth, thus a good brushing of the tongue can also help to prevent bad odors from arising.
If the odor is a result of gum disease (or periodontal disease), the dentist may recommend a deeper, more thorough cleaning, known as “scaling and root planing”. Periodontal disease results from an accumulation of bacteria in the gum pockets surrounding the teeth. This can lead to bone loss around the teeth and ultimately tooth mobility. Scaling and root planing is a process where the deep pockets are cleaned of and any all bacteria and the gum tissue is given a chance to re-connect to the tooth’s surface. If the situation is more severe, your dentist may refer you to a periodontist, who is a specialist in treating gum disease.
In some situations, a dentist may determine your mouth as healthy and that the odor is not being caused by anything contributing to the oral cavity. In this case, your dentist may refer to your family physician or a specialist to help determine the cause of the odor and any possible treatment that may be necessary.
An abscessed tooth is another name for an infected tooth. A tooth becomes infected when the pulp (or nerve of the tooth) is diseased or injured and cannot repair itself. In these situations, an infected tooth can lead to more serious problems associated with your overall health down the road as you have blood vessels running with the nerve through the tooth and that blood also travels throughout the body, to the brain, and to the heart.
The most common cause of an infected tooth is either a cracked tooth and/or a deep cavity. In either case, bacteria gains access to the pulp (inside of the tooth) and can compromise the nerve. Once the nerve is unable to repair itself, it will then die. If left untreated, the infection that has built up inside of the tooth can exit via the root tip in jawbone. At this point, a “pus-pocket” can form at the root tip and can also damage the surrounding supporting bone. This is defined as an abscessed tooth.
Baby Bottle Tooth Decay, or “early childhood caries”, is the rapid decay of baby teeth in an infant or child from exposure to sweetened liquids over a long period of time. This can be very detrimental to the teeth if left untreated. The upper front teeth are most commonly affected.
A majority of the time, the problem is usually caused by a baby falling asleep while nursing a bottle or while breast feeding. While the child is asleep, the sugary liquid pools around the front teeth. The bacteria living in every baby’s mouth then turns the sugars to acid which causes decay.
Ways to prevent Baby Bottle Syndrome:
- Cleaning your child’s teeth daily
- Not allowing your child to fall asleep with a bottle filled with juice, milk, or formula (instead put water in the bottle when a child is going to sleep)
- Not allowing your child to sip on a bottle filled with juice, milk, or formula for long periods of time as a pacifier
- Giving your child plain water when he or she is thirsty
- Making sure your child gets the fluoride needed to prevent decay
- Making regular dental appointments for your child beginning when their first tooth erupts
Baby bottle tooth decay can be detrimental if left untreated because if a baby tooth is lost too soon as a result of this, the neighboring teeth may drift into the empty space causing crowding in the erupting permanent teeth. This would result in crowded teeth in the adult life and potentially an increased risk for cavities later in life due to the crowding causing inability to adequately clean the teeth.
Sores can be a nuisance and can commonly occur in and around the oral cavity. The location of where the sore occurs can tell you what kind of sore it is. Canker sores and cold sores are two different types of sores.
Canker sores occur inside the mouth. This is a small ulcer with a white or gray base and a red border. These sores can be seen by themselves, or often in groups of multiple little ulcers. Canker sores are very common and can often recur. Like all ulcer, canker sores are difficult to treat. To date, there is no proven technique that can eliminate ulcers or improve recovery time. There are, however, a few medications out there that may provide temporary relief from the pain. These medications need to be started as soon as the symptoms are experienced in order to get the most efficient response to them. There is some over the counter topical anesthetics that can be applied to a canker sore for temporary relief. Canker sores will usually last anywhere from 10-14 days.
– Here are a few tips to prevent a Canker sore
– Vitamin B12 helps to prevent canker sores
– increase lysine in your diet (fish, chicken, eggs)
– eat yogurt or other cultured foods to keep healthy bacteria in the mouth
– REDUCE stress!!
– avoid intra-oral trauma (chew softer/slower, use soft bristle toothbrush)
– avoid toothpastes/mouthrinses with sodium lauryl sulfate
A cold sore, also known as a fever blister, usually will occur outside the mouth, on or around the lips. These sores are caused by the “herpes simplex” virus. Cold sores are comprised by groups of small, painful, fluid-filled blisters located on or around the lips, and can erupt causing discomfort. There are over the counter topical anesthetics the may provide temporary relief of the discomfort. There are also prescription anti-viral drugs that can reduce the occurrence or severity of these kinds of infections. Cold sores will usually last anywhere from 7-10 days.
Cavities are another name for the disease known as “caries,” or tooth decay. A cavity is the result of your tooth being demineralized (or damaged) over long-term exposure to harmful bacteria and other germs to the point that it cannot re-mineralize (repair) itself and a restoration is needed to prevent further decay.
Cavities may not be life threatening, but everybody, to some extent, will experience a cavity in his or her lifetime. Cavities are very preventable by simply performing good oral habits and routine dental visits. Tooth decay is caused by your teeth being frequently exposed to foods rich in carbohydrates (starches and sugars) like soda pop, candy, ice cream, milk, and cakes. Ironically, even fruits, vegetables, and juices can lead to tooth decay.
When these foods are left in contact with the teeth over an extended period of time, they are eventually broken down by bacteria to form a soft, sticky, colorless substance called “plaque”. Plaque then uses the acids from these foods and can begin to break down (or demineralize) the enamel structure of the tooth, or the outer covering of the tooth. This results in a weakening of the tooth structure and potentially tooth decay, or cavities.
There are many ways to maintain a healthy mouth. Routine brushing and flossing and regular professional cleanings are the #1 way to prevent cavities. Brushing twice a day is important in that brushing in the morning will remove and a substance that may have remained overnight and brushing in the evening is as important in that your salivary glands stop producing saliva when you sleep. Saliva, being the body’s first defense mechanism towards cavities, is decreased thus allowing substances to really affect the teeth while you sleep when you do not brush in the evening. Saliva acts as a buffer and re-mineralizing agent.
Fluoride, a natural substance which also helps re-mineralize the tooth structure, is used in community water systems and is a main ingredient of many types of toothpaste. If you are at medium to high risk for cavities, your dentist may recommend special high concentration fluoride gels, mouth rinses, or dietary fluoride supplements.
How do I know if I have a cavity?
- A painful toothache
- Higher sensitivity in your teeth to hot or cold temperatures, liquids, or food
- The presence of decay such as white spots
- Tooth discoloration
Often, people develop cavities without any pain or other symptoms. That is why it is so important to schedule regular, routine visits with your dentist so that they can potentially treat the cavity at its earliest stage.
Dry mouth, also referred to as “xerostomia”, is a result of improperly functioning salivary glands. Dry mouth can make it hard to eat, swallow, and speak. Other common symptoms of dry mouth include burning tongue, dry lips, or impaired taste.
Causes of Dry Mouth:
- Certain diseases (ie. Sjogren’s Syndrome)
- Medications (many decongestants, diuretics, anti-hypertensives, and anti-depressants)
- Cancer treatment (radiation damage the salivary glands)
Ways to Improve Dry Mouth:
- Frequently sip water
- Keep water at bedside at night
- Chew sugarless gum
- Avoid tobacco, alcohol and foods high in sugar
- Use a saliva substitute, which is a commercial product that “wets” the mouth like saliva does
- Establish a good plaque control program – since heavy plaque accumulations occur with oral dryness
- Use fluoride – toothpaste, rinse, or gel
In certain situations, we also may be able to prescribe medications to fight severe dry mouth.
Gum disease, also called periodontal disease or periodontitis, is an infection of the tissues surrounding and supporting the teeth. Bacteria has accumulated in the gum pockets around the teeth. This causes the gums to become irritated and inflamed. Inflamed gums will bleed easily and occasionally swell. This swelling leads to an increase in bacteria in the gum pocket, further advancing the disease and compromising the supporting structures around the teeth.
Early stages of gum disease are evident in the term, gingivitis. Gingivitis is the inflammation and bleeding of gums. At this early stage, if treated appropriately and effectively, the disease is reversible and further complications can be avoided by good brushing and flossing techniques with routine professional cleanings.
Gum disease is a “silent killer” for lack of a better term in the sense that the disease does not initially present with symptoms of discomfort. Only until the advances stages of the disease will it present with discomfort. At these stages, the options of treatment are limited and if untreated, severe bone loss can occur, and ultimately, tooth loss.
Early symptoms of gum disease:
- Gums that bleed when you brush your teeth
- Red, swollen or tender gums
- Gums that have pulled away from the teeth
- Persistent bad breath
- Pus between your teeth and gums
- Loose teeth
- A change in the way your teeth fit together when you bite
- Bad taste in your mouth
If gum disease is advanced to the point a normal cleaning will not suffice, periodontal therapy is indicated. Scaling and root planing is essentially a “deep cleaning”. The reason it is termed a “deep” cleaning is because the gum pockets around the teeth have been populated with bacteria to the point that the pockets are now deeper, thus a deeper cleaning is needed. Scaling and root planing is a technique in which all bacteria inside those pockets are removed from the root of the tooth, some antibiotic medications may be applied, and the gums are then allowed 3-4 weeks to heal before a re-evaluation of the gum tissue is completed to see how the tissues are responding to treatment.
Wisdom teeth are your third and most posterior teeth in the mouth. Normally, each individual will have 3 molars in each quadrant of the mouth: upper, lower, right, and left. The third molars are normally the last molars (and teeth) to erupt into the mouth and they do so around the ages of 16-18 years old. There are many times when these teeth become impacted and do not actually become visible in the mouth.
In most situations where there is an impacted tooth, that tooth has been forced into an awkward position and there isn’t enough room in the arch for the tooth to erupt properly.
Extraction is usually performed when the roots are approximately formed, or three-fourths developed. This is typically during the adolescent years, as early removal will help to eliminate problems such as an impacted tooth that destroys the second molar.
If a tooth is left impacted, there are many consequences that can be had. This tooth could become infected. Depending on the angulation of the tooth, it could be impinging on a neighboring tooth, thus increasing the likelihood of a cavity on the neighboring tooth. Lastly, if an impacted tooth is left untouched, there is a very good chance that it could cause crowding of the anterior teeth later in life.
Oral Cancer Facts
- Oral cancer is the sixth most common cancer, and accounts for about 3.6 percent of all cancers diagnosed, with roughly 42,000 new cases of oral cancer reported annually in the United States.
- The vast majority of oral cancers occur in people older than 45 years, with men being twice as likely as women to develop the disease. (More information visit The Oral Cancer Foundation)
- The tongue is the most frequent source of cancers in the mouth, followed by the floor of the mouth, soft palate tissues in the back of the tongue, lips, and finally, the gums.
- When tobacco and alcohol use are combined, the risk of oral cancer increases 15 times more than non-users of tobacco and alcohol products.
- If left untreated or not diagnosed early, oral cancer can spread, which may lead to chronic pain, loss of function, irreparable facial and oral disfigurement following surgery, and even death.
- According to the American Cancer Society, oral cancer affects more than 40,000 people in the U.S. each year.
Warning Signs of Oral Cancer
Red, white or discolored lesions, patches or lumps in or around the mouth are an early sign of oral cancer, which is typically painless in its early stages. As the cancer spreads, the lesions or lumps become noticeably painful.
- White patches on the cheeks, otherwise known as leukoplakia
- Red patches on the cheeks, otherwise known as erythroplakia
- Combined red and white patches, also known as erythroleukoplakia
- A sore that fails to heal and is present for over two weeks duration
- An abnormal lump or thickening of the tissues of the mouth
- Chronic sore throat or hoarseness
- Difficulty in chewing or swallowing
- A mass or lump in the neck
Oral Cancer Self-examination
To perform the oral cancer self-examination, follow these steps using a bright light and mirror:
- Cheek – examine the inside of your cheek by gently using your finger to pull/stretch the cheek out. Look for any red, white, or dark colored patches. Put your index finger on the inside of your cheek and your thumb on the outside. Gently squeeze and roll your cheek between your fingers to check for any lumps or areas of tenderness. Repeat this on the other cheek.
- Face – examine the skin on your face. Look for any color or size changes, sores, moles, or growths.
- Floor of the mouth and tongue – Examine your tongue by first sticking it out. Examine the top surface of your tongue for any color changes or unusual textures. Next, gently grab your tongue and move it side to side (right to left) inspecting the sides of the tongue for any swellings, sore spots, or color changes. Next, place the tip of your tongue on the roof of your mouth and inspect the lower side of the tongue and the floor of the mouth, again looking for any lumps, bumps, or color changes. Lastly, gently press your finger along the underside of your tongue to feel for any lumps or swelling.
**The most common sites for oral cancer are on the side of the tongue or the floor of the mouth.
- Head and neck – look at yourself in the mirror; examine any asymmetries in the head and neck; look for any lumps, bumps, or swellings that may be on one side that are not on the other
- Lips – inspect the lips inside and out; examine the inside for any color changes and/or sores that might be present for over 1 week in duration; use your fingers the slightly pinch the lip feeling for any internal lumps or bumps. Repeat this on both lips.
- Neck – use both hands to press along the sides and front of the neck feeling for any unusual lumps or bumps or even tenderness that might be present.
Questions For Child Treatment
Babies typically begin teething at six months of age. Usually, the bottom lower front teeth erupt first, followed by the two upper front teeth. Children have twenty teeth compared to adults that typically have thirty-two. In general, a child will have erupted all of his or her teeth by 2-3 years of age.
In general, checkups are recommended at a minimum of every six months in order to aid in the prevention of cavities and other dental problems. It is always better to diagnose a potential problem early on. Since every child has individual oral healthcare needs, the frequency of dental visits will vary as the situation necessitates. Regular visits keep children familiar with the dentist and dental professionals. These visits build confidence in children and are much more pleasant when the child is not forced to associate the dentist with emergency treatment due to tooth pain and dental neglect. Decay or breakdown of a tooth that is detected in the early stages is easier and less costly to treat.
“Baby” teeth – also known as primary teeth – have three main functions. First, they allow children to chew. The importance of pain-free feeding directly relates to your child’s diet, nutrition, and overall health. Second, baby teeth are important for speech development. Third, baby teeth provide a pathway for permanent teeth to erupt in a timely way. Premature tooth loss from cavities or infections allows for remaining teeth to move into the empty space and ultimately cause crowding. Cavities on baby teeth can cause permanent teeth to have higher cavity susceptibility.
The earlier a cavity is diagnosed and treated, the less invasive the overall treatment will be. Over time, cavities can spread if allowed and possibly lead to an infection. It is important to evaluate each situation on an individual basis to determine what is best for the child.
Dental sealants are hard plastic-like materials that are placed into the grooves of the chewing surfaces of teeth in order to help prevent cavities. They work by blocking out the sticky, sugary foods and liquids that tend to get caught in the teeth. The application is fast and pain-free. Dental sealants are recommended based on the child’s diet, history of cavities, and overall anatomy of the teeth.
Oral Healthcare At Home For Children
The use of a soft cloth, gauze or toothbrush for children 0-2 years will adequately remove plaque and bacteria that can lead to cavities. Caregivers should clean the teeth at least once a day (most importantly before bedtime following the last feeding). Infant non-fluoridated toothpaste can be used. Until your child is able to spit out the toothpaste without swallowing it, we recommend not to use fluoridated toothpaste.
First, rinse the irritated area with warm salt water. If swelling is present, place a cold pack on the area. Over the counter Children’s Tylenol or Ibuprofen (Motrin) are recommended for the pain. DO NOT place aspirin on the gums as this can cause harm to the tissue. Please, see a dentist or healthcare professional as soon as possible.
Use of fluoride for the prevention of cavities can be safe and effective in decreasing cavities when given in the correct dosage. If your water supply contains less than 0.6ppm (private wells), a dietary supplement may be recommended for your child (6 months to 16 years old). If your child is unable to spit out toothpaste, then toothpaste with fluoride should be avoided. It is acceptable to begin using toothpaste (pea-size amount) with children 2-3 years of age. Prior to that, parents should clean the child’s teeth with water and a soft-bristled toothbrush. It is important to contact a pediatric dentist to make sure your child is not receiving excessive or inadequate amounts of daily fluoride.
First, rinse the irritated area with warm salt water and if swelling is present place a cold pack on the area. Over the counter Children’s Tylenol or Ibuprofen (Motrin) are recommended for any pain. DO NOT place aspirin on the gums, this can cause harm to the tissue. Please, see a dentist or healthcare professional as soon as possible.
Many oral habits, such as thumb and pacifier sucking, only become problems if they persist for long periods of time. This is very normal in infants and young children. Most children stop these habits on their own by age three. Habit-breaking appliances can be used for children who want to stop but need an active reminder. Long-term oral habits such as thumb or finger sucking, mouth breathing, and tongue thrusting can produce dental and skeletal changes. The amount of change is directly related to frequency, duration, intensity, and direction of the forces applied.
First, remain calm. Second, locate the tooth. Always hold the tooth by the crown (not the root). Third (if possible), determine whether it is a baby tooth or a permanent tooth. If it is a baby tooth, do not replace the tooth in the socket. For permanent teeth, reimplant by applying mild finger pressure. If that is not possible, put the tooth in a glass of milk and take your child and the glass immediately to the pediatric dentist.