Frequently Asked Questions   I don't have a toothache and my mouth feels healthy.  Do I still need a check up?   Biannual teeth cleaning performed by a skilled dental hygienist are central to keeping teeth and gums looking, feeling, and functioning well.  If you have gum disease, more frequent visits to the dentist will probably be recommended for your oral and overall health.    If my filling is still in place and my tooth does not hurt, why does my dentist want to replace the filling? Constant pressure from chewing, grinding and/or clenching can cause dental fillings to wear away, chip, and even crack.  If the seal between the tooth enamel and filling breaks down, food particles and decay-causing bacteria can work their way under the filling.  You then run the risk of developing additional decay in that tooth.  Decay that is left untreated can progress to deeply infect the tooth and even cause an abscess and/or eventual loss of the tooth.  Regular dental checkups enable us to monitor areas of concern and help keep you in optimal oral health.  When restorations are large, or if recurrent decay is extensive, there might not be enough remaining tooth structure to support and replace filling.  In these cases, we may need to replace the filling with a natural looking porcelain crown.    Is there anything that can calm my nerves during an exam? Nitrous oxide is one of the safest anestetics used in dentistry.  Nitrous oxide is a colorless blend of oxygen and nitrous oxide gases with a pleasant, sweet smell and taste.  It is also known as "laughing gas."  Inhaling nitrous oxide creates a sense of well-being and relaxation, and it is  used effectively to help individuals who experience anxiety or fear about dental treatment feel more comfortable and at ease.  Nitrous oxide increases a patient's pain threshold and, when necessary, makes the administration of anesthetic injections more comfortable.  Combined with a caring dental staff, nitrous oxide has proven to be especially beneficial for children and adolescents who experience dental anxiety.  Nitrous oxide can help make visits to the dental office less difficult for individuals with mental or physical disabilities, as well.    How can cosmetic dentistry improve my life?  A more beautiful smile can make life more beautiful.  Studies have shown that a healthy and attractive smile can raise self-esteem, increase confidence, improve your personal as well as your professional life, and help you make better first impressions.  Sometimes it doesn't take much treatment for you to feel better about your smile, and there are a variety of subtle, yet noticeable ways that smiles can be enhanced.  There are also more significant and dramatic treatment procedures, often called "smile makeovers," that can totally change teeth and smile appearance, to give you the smile of your dreams.    A couple of my teeth have been worn down and need to be replaced.  Should I opt for crowns? Crowns, often called "caps," cover teeth to restore them to their appropriate shape and size after large fillings, fractures, and/or weakening forces such as intense grinding.  In all of these cases, crowns not only cover teeth but provide added support as well.  Crowns can also be used to attach bridges, cover dental implants, restore seriously discolored or misshapen teeth, and even as a preventive measure to protect a tooth in danger of breaking.  If a crown is placed before the tooth is so badly decayed or so weak that it fractures, the necessity of a root canal can often be preempted.  This can also help prevent a broken tooth from becoming so bad that it needs to be removed, which would require a bridge or implant for restoration.  In light of their excellent restorative capabilities, crowns have few disadvantages.  As they are more extensive restorations than fillings, their relative cost is higher.  However, if our doctors recommend a crown it is because we want to help you keep our teeth healthy and looking good for years to come.  The problems crowns help to prevent and repair offset the cost.  Also, while crowns are highly resistant, due to normal wear they will eventually need to be re-cemented or replaced.  Six to nine percent of teeth that are damaged enough to need a crown may someday need a root canal.      I have a recurring pain where my jaw meets my temple, and sometimes my jaw clicks when I chew.  Whats the problem? You could be suffering from temporomandibular disorder, or TMJ Disorder, wchich affects the flexibility and function of the temporal jow joint and surrounding muscles.  Because this area controls bite, speech, chewing, and all other jaw movements, the pain can be severe.  TMJ Disorder has been associated with a number of different causes, but the most common factor is the bite itself.  A misaligned bite can place pressure on the jaw joint, forcing the muscels to work overtime in effort to correctly align the upper and lower jaws.  This not only compromises the function of your jaw, but it can cause a good deal of fatigue and pain in the facial muscles.  Headaches, toothaches, and jaw clenching, popping, or locking, are all common symptoms of TMJ disorder.  TMJ can also occur after a jolting face injury which causes a normally aligned jaw joint to become damaged or repositioned.  Professional treatment of TMJ Disorder ranges from minor fixes to surgical options.  If our dentists determine that the main cause of your TMJ pain is an irregular bit, he may recommend a retainer-style mouthguard, or even a reshaping of the biting surfaces of your teeth, to subtly change the way your upper and lower jaws meet.  If it's a structural issue occurring in your jaw bone (especially if your TMJ is a result of injury), you may benefit from surgery.  In the meantime, alleviating the pain through treating the symptoms can give you some relief.  Heating pads or cold compresses can reduce swelling.  Limiting your jaw movement (for example, cutting especially chewy foods out of your diet) can stop the clicking or popping.  Massages can temporarily relieve muscle tension, and painkillers (medicated or over the counter) can reduce inflammation and make you more comfortable.      When I floss, my gums bleed.  If they don't hurt and my teeth look fine, is it really a big deal? If your gums are not sore, it's safe to assume your bleeding gums are not the result of hard brushing or flossing  Bleeding gums that apparently have no cause are always a warning sign, often indicating such conditions as gigivitis or even gum disease.  Gingivitis is not a one-way ticket to gum disease; in fact, if it's caught early enough, gingivitis can be treated and even reversed.  The first lines of treatment when it comes to gingivitis are lifestyle changes.  Poor oral hygiene, smoking, uncontrolled diabetes, and high levels of stress can all contribute to gingivitis.  Choosing a toothbrush with soft bristles can ease gum damage, too, and getting regular dental cleanings will control plaque and tooth decay.  It's important to stop gingivitis before it progresses, as studies have shown more and more serious illnesses are associated with gum disease.  Heart disease, strokes, diabetes, even osteoporosis and inflammatory diseases such as Rheumatoid Arthritis have been linked to poor oval health.  Though not the first suspect in a simple case of bleeding gums, oral cancer is also a possibility.  Oral cancer can be difficult to diagnose because many of its symptoms are associated with other medical conditions.  They include sores, difficulty swallowing or moving the jaw, bleeding gums or cheeks, and a continuous pain in the mouth.  If your dentist finds no other causes for your bleeding gums, he or she may recommend a visit to a specialist.  Regular check-ups are vital to cancer prevention, as are good oral hygiene, avoiding tobacco, and maintaining a balanced diet.  If you experience any of the above symptoms call us.  You'd go to the doctor if a cut on your hand were infected-do your gums the same service.  They'll thank you later.      Hot or cold my teeth hate both!  Why are they so sensitive and how can I stop the pain? If you've been avoiding that ice cream cone or cup of coffee because of sensitive teeth, you don't have to!  Sensitivity is a common complaint, and can be the result of a number of factors.  Involuntary grinding, jaw clenching, gum recession, and enamel loss can all cause teeth to become extra sensitive, because the usually-protected layer of dentin is exposed to external stimuli.   Surface irritants such as braces and teeth whitening can also cause temporary sensitivity.  Because the causes of sensitivity are so diverse, and because sensitive gum tissue can indicate more serious problem, it's important to ask our doctors which treatment is best for you.  A softer toothbrush is usually the first step, and special toothpastes can reduce sensitivity over time.  There are also over the counter fluoride rinses to protect your enamel against further damage.   Why is flouride good for my teeth?  Each day, foods and acids feed bacteria in your mouth, which can accumulate on your teeth to form plaque.  Plaque wears away at a tooth's enamel in a process known as demineralization.  Fluoride is a naturally-occurring mineral that can promote the remineralization of enamel, replacing important minerals that strengthen your teeth and can protect them from decay.  Fluoride can also help reverse early stages of decay.  Children with newly-erupted permanent teeth benefit a great deal from fluoride exposure, but adults should make sure their teeth come into contact with it too.  The safe and easy way to ensure your teeth are getting enough fluoride is to use fluoride toothepaste, available at drugstores in a variety of types and flavors.  If a more intense fluoride treatment is recommended, there are a number of gels, rinses, or even in-office procedures that can do the trick.  Though the most fluoride is absorbed from direct contact with the teeth, many public drinking water systems contain small, safe amounts of fluoride that can have positive health effects.