Scott W. Arndt, DDS writes an article every week for the North Ridgeville Press and Light Newspaper called "Ask Dr. Arndt". Below are some of the most frequently asked questions patients have about dentistry and oral health issues. If you have any other questions, or would like to schedule an appointment, we would love to hear from you.
Click on a question below to see the answer.
Q:
Do I need to see a dentist if my mouth feels fine and my teeth look great?
A:
Those are two good reasons why you should see a dentist regularly – at least twice a year. If you’ve got a good thing going, why not keep it that way? Catching a problem in your mouth, whether it’s decay or the even more common malady of gum disease, gives you a much better chance of resolving it before it becomes critical. And a strictly financial consideration is that addressing a problem early is most likely going to be less expensive than addressing it later.
Over the years, with the advances in dental care and education, the incidence of decay is down. But the incidence of gum disease, also called periodontal disease, is up. Even if your teeth are sound, if your gums are diseased you have a problem. As the disease progresses, it can erode both the tissue and the bone that support the teeth. Your casual glances at your gums at home will not detect gum disease when it’s in its early stage. It takes a dental exam to detect gum disease. A rule of thumb – rule of gum? – for visiting a dentist is every six months. Dr. Arndt can determine what the right schedule is for you. So visit us soon, even if your mouth feels fine.
Q:
I want to start the New Year off right for my dental health. What should i do?
A:
If you've been remiss about your oral hygiene, start off with a visit to the dentist. It's generally recommended that you visit the dentist at least twice a year for a checkup and for a professional cleaning. You simply can't reach all the places where plaque can build up on your own, so a cleaning by a dentist or hygienist is recommended for ridding your teeth of plaque. Regular visits to the dentist also reduce the likelihood of a potentially serious problem going undetected. Gum disease, for instance, is the leading cause of tooth loss among adults.
In addition to checking your teeth for cavities, Dr. Arndt will give you a periodontal screening and recording. This establishes a baseline for the health of your gums and the supportive bones of your mouth. After you've made that first visit, set a regular appointment schedule. Another reason for regular visits is that problems caught early are also less expensive to correct. Between visits, practice good oral hygiene at home, including regular brushing and flossing.
Q:
As an adult, am I less likely to have dental problems than when I was younger?
A:
Unfortunately, the possibility of having dental problems doesn't necessarily diminish as we age. Although the baby boomer generation has benefited from water fluoridation programs and fluoride toothpaste, problems can still crop up in the adult's mouth.
Some 14 percent of adults, aged 45 to 54 have severe gum disease. Signs and symptoms from soft-tissue diseases like cold sores are common in adults. According to the U.S. Center for Disease Control, about 19 percent of adults aged 25 to 44 are affected by such soft-tissue ailments.
Every year more than 400,000 cancer patients undergoing chemotherapy are afflicted with oral problems like painful mouth ulcers, loss of taste and dry mouth as a result of malfunctioning salivary glands. The CDC reports that employed adults lose more than 164 million hours of work each year because of oral health problems. So the message is KEEP brushing, flossing and visiting your dentist regularly. Don't sit back and relax.
Q:
What is the process for proper flossing?
A:
Wind 18 inches of floss around the middle fingers of each hand, leaving about five inches between the hands. Pinch the floss between the thumb and index finders and leave about 1 inch in between to work with. Gently guide the floss down between the teeth using a side to side motion. If the teeth are too tight to floss, or is it catches or tears, the dentist should be notified. Pull the floss tightly in a "C" shape around the side of the tooth and slide it under the gumline. Clean the surface of the tooth by using an up and down motion, not side to side, until the surface is clean. When all the plaque has been removed a person will hear the floss start to squeak. Wind the floss to a fresh section. Gradually work the way around the mouth cleaning both sides of every tooth.
Q:
What is the process for proper brushing?
A:
Angle the bristles of the brush along the gumline at a 45 degree angle. Apply firm pressure so the bristles slide under the gumline. Vibrate the brush while moving it in short back and forth strokes and in small circular motions. Brush two or three teeth at a time, then move to the next teeth, allowing some overlap. Tilt the brush and use the tip to brush the backs of the front teeth. It’s fine to brush in any regular pattern a person chooses, but since the insides of the teeth tend to get less attention, a person might start with the insides of the upper teeth, then go to the insides of the lower teeth. Switch to the outsides of the upper teeth, and then the outsides of the lower teeth. Brush the chewing surfaces of the upper teeth, then the lower teeth. End by gently brushing the tongue and the roof of the mouth. This removes germs and keeps the breath fresh.
Q:
What is the benefit of Tooth Colored Restorations?
A:
They match the natural color of the teeth. They contain no mercury. They can be bonded to the teeth, which adds strength to the teeth.
Q:
How does an All-Porcelain Crown solve the problem of a dark blue line at the gumline?
A:
After a period of time, as the gumline shrinks back, the metal core of the porcelain-fused-to-metal begins to show at the gumline. All-Porcelain crowns contain no metal and are bonded directly to the tooth. Without metal, the problem of a dark line at the edge of the gums is eliminated. They can be bonded to the teeth, which adds strength to the teeth.
Q:
What is the problem with postponing treatment?
A:
The problem with postponing treatment is that a cavity will never go away on its own. It just gets bigger and bigger. It grows slowly while it’s still in the hard outer enamel. If the cavity is allowed to reach the softer inner dentin, it grows much more quickly. It is important to fill the cavity before it reaches the pulp chamber. If it gets into the pulp chamber, a root canal will be needed.
Q:
What do I need to know about toothpaste?
A:
The first thing to know is to buy toothpaste that displays the ADA seal of acceptance. This means the American Dental Association has cleared the product both for safety and effectiveness. You want to make sure the toothpaste has fluoride, which remains the number one anti-cavity ingredient for both children and adults.
Approved toothpaste will also contain a mild abrasive to help remove plaque. Some toothpaste is labeled for tartar control, which can help prevent tartar from forming above the gumline. Look on the label for triclosan, which can help combat gingiviitis that is the early stage of gum disease.
If your gums have already receded a bit, you might look for toothpaste that contains a desensitizing ingredient, namely potassium nitrate, it will reduce any pain you might feel when your teeth are exposed to hot or cold food or liquid. Approved toothpaste might also include a whitening agent.
Talk to Dr. Arndt about choosing the toothpaste that is right for your needs.
Q:
How often should a person have dental x-rays taken?
A:
The answer depends on you individual condition and needs. If you are a new patient, Dr. Ardnt may very well recommend a complete x-ray, or radiograph, examination of your mouth and jaws to determine your current status and to make sure there are no undetected problems developing.
A set of x-rays also gives the dentist a baseline against which to compare future oral health developments. The schedule for x-rays will not likely be the same for any two patients. Your schedule will vary according to your age, your risk of disease and any signs or symptoms of a problem that you display.
Children need x-rays more frequently than adults because their teeth and jaws are still developing and because their teeth are more likely to be affected by tooth decay than those of adults. X-rays are particularly useful in detecting the start of new cavities and in determining the extent of gum disease, which may not be visible to the naked eye.
Talk to Dr. Arndt about any concerns or questions you have about x-rays.
Q:
Lately my teeth have been sensitive to cold. What could this be?
A:
If you started using a tartar-control toothpaste, that might be the culprit. The tartar-control agent in some toothpastes can cause sensitivity. What happens is that it touches the root surfaces that have been exposed by gum recession. Your best bet is to try another toothpaste for several weeks to see if the sensitivity subsides.
It may not be the toothpaste, however. Anytime the dentin (the layer just below the surface of the teeth) and roots are exposed, it can result in sensitivity. It can be caused by worn enamel, small cracks in the tooth or overly ambitious brushing. If you suspect it’s the brushing, switch to a soft-bristle brush and brush with a gentle circular motion.
Most sensitivity will go away in time. The pulp lays down some hard tissue from inside the tooth to protect itself. If the sensitivity persists, see Dr. Ardnt.
Q:
What should I do if I knock out a tooth?
A:
You have a better than 80 percent change of saving a tooth if you can get to a dentist with the tooth within a half hour.
Here are some things to remember:
- Rinse the tooth off with warm water.
- Do not scrub the tooth, you might scrub off fibers on the root that are important in re-planting the tooth in its socket.
- Keep the tooth moist by wrapping it in either gauze or tissue dampened in warm water.
- If you can easily replace the tooth into the socket, do that.
- Some experts recommend just putting the tooth back in your mouth under the tongue during the ride to the dentist. That’s fine, too. Just don’t swallow the tooth.
- Your pharmacy may also carry one of the liquid media that are available for just such an emergency.
- You won’t have time for a trip to the pharmacy, so you might consider keeping one of these liquid media on hand.
- It’s likely that you got a laceration with this injury. Press a cold damp cloth with moderated pressure over the cut lip.
Q:
Are there special things i should know about my kids' oral health?
A:
Until they are old enough to understand the importance of oral health and to take full responsibility for it, like scheduling their own visits to the dentist, your children will depend on you to safeguard their oral well being. The American Dental Association recommends a checkup every six months, beginning with the third birthday. According to the U.S. Surgeon General's Report on Oral Health, more than half of children ages 6 to 19 have untreated tooth decay. Dr. Arndt can guide you on the care of new teeth, or baby teeth. Adolescence, of course, is a challenging period for young people on any number of fronts. Good nutrition and oral hygiene practiced at home are particularly important during the teen years. Teens are busy and they snack a lot. Getting them into the routine of healthy snacking-fruits and nuts, for instance, instead of chips and candy-will be doing them a huge favor. If they wear braces, urge them to keep the spaces between the teeth and wires clean. And talk with Dr. Arndt about a mouth guard if your son or daughter is involved in sports.
Q:
What, if any, impact does chewing tobacco have on teeth?
A:
At least one study concluded that chewing tobacco users are four times more likely to develop tooth decay than non-users. The study, overseen by an epidemiologist and dental officer at the Centers for Disease Control and Prevention, compared men who use chewing tobacco and compared them with men who used other forms of tobacco and those who used no tobacco products. The study included roughly 14,000 males aged 18 and above. Researchers interviewed them about tobacco use, dentists examined them and then calculated the number of decayed or filled teeth among them. They found that men who used only chewing tobacco had a higher adjusted average number of decayed or filled permanent teeth than did those who used only snuff. It was also true when chewing tobacco users were compared with those who used only cigarettes or more than one form of tobacco and with those who had never used tobacco. The study also showed that men who use chewing tobacco were four times more likely to have a decayed or filled root surface than those who never used tobacco. Talk with Dr. Arndt about the dangers of tobacco.
Q:
Do you have any suggestions for the care of dentures?
A:
Sure. Your dentures require your careful attention. First of all, just like natural teeth, dentures need daily brushing to remove food particles and deposits of plaque. Not only will daily brushing keep the dentures from getting stained, it will help keep your mouth healthy and fresh. Check your pharmacy for, or ask a dentist about brushes specially designed for dentures. If you can't find a special brush, then a regular toothbrush with soft bristles will do the job. Also talk to a dentist about a cleaning agent. Some denture wearers use hand soap or mild dishwashing liquid.Stay away from powdered household cleaners, though, which may be too abrasive. Also keep in mind that dentures are fragile and could break if dropped even a short distance. When you're handling your dentures, do so over a bowl of water, or your bed or some folded towels. Keep them away children and pets. For some reason, dogs find dentures irresistible. Dr. Arndt can give you lots of information that will in turn give you years of service from your dentures.
Q:
What is a prosthodontist?
A:
A prosthodontist is a dentist who specializes in the restorations that go into a person's mouth. They can be as simple as a single crown or as complicated as a full-mouth restoration that could require a combination of tooth implants and bridges. Prosthodontistry is one of several specialties that some dentists may pursue. An orthodontist, for instance, specializes in the straightening of teeth using bands, wires, elastics, and braces. A prosthodontist is an expert in the application of crowns, bridges, dentures, implants and any combination thereof. A prosthodontist's work sometimes will encompass the majority of a patient's remaining teeth. A prosthodontist also does restorative work after the removal of a cancerous portion of the mouth. These specialists usually have three or more years of further education after graduating dental school. They also usually will limit their practice to prosthodontics as opposed to general dentistry. Talk with Dr. Arndt about the various areas of specialty that are available to you should you need them.
Q:
Is there a connection between gum disease and blood clots?
A:
Yes. Studies have shown a strong connection between gum disease, also, called periodontal disease, and an increased risk for developing blood clots, which in turn can lead to heart attack and stroke. Therefore, keeping your gums healthy may reduce the risk of cardiovascular problems. Bacteria from gum infections can increase the development of fatty plaques that cause heart attacks and strokes. It's a problem that affects older people in particular. About 730, 000 strokes occur in the United States every year. Elderly people are also at risk for developing pneumonia from aspirating bacteria from gum infections. It's also possible for these bacteria to get into the bloodstream and settle in other parts of the body, including the blood vessels of the heart. This is a potentially fatal infection that is called endocarditis. Incidentally, dental X-rays have been known to detect clogged carotid arteries, the arteries on each side of the neck that carry blood to the brain. In those cases, dentists have been known to make potentially life-saving referrals. So talk with Dr. Arndt about your overall health concerns.
Q:
What can i expect after a tooth extraction?
A:
Tooth extraction is serious business and you can generally expect some bleeding, pain, and swelling after. A small amount of bleeding and oozing for about 24 hours after the procedure is not unusual. A pinkish tinge to saliva can be expected. Prying with your tongue in the area can contribute to the bleeding, so avoid that. One first aid tip is to moisten a tea bag-black or green tea, containing tannins-and compress that over the area. For at least 24 hours, don't rinse the area directly. That can wash away any blood clot that's forming and create an uncomfortable condition called `dry socket'. If heavy bleeding persists, contact a dentist. For pain, your dentist will usually prescribe some sort of medication. Don't take aspirin to ease the pain after an extraction. Aspirin thins the blood and can increase bleeding. Acetaminophen, as contained in Tylenol, or ibuprofen, like in Advil, are good for pain relief. For swelling, a cold pack-15 to 20 minutes on and 15 to 20 minutes off -periodically over the first 24 hours will help. Always talk before the procedure about what to expect afterwards.
Q:
What's good treatment for a burn in the mouth?
A:
A burn inside the mouth, from, say, a hot piece of pizza or that first spoonful of piping hot soup, can be painful and annoying. Usually, though, it's not serious because tissue in the mouth has amazing recuperative power. The first thing is to get ice or ice water on the burn to ease the pain and minimize tissue damage. The sooner you get ice or cold liquid on the spot, the less damage you'll have. The next day, start rinsing the mouth gently with a half-teaspoon of table salt dissolved in warm water. Rinse four or five times daily for a few days and the area should heal nicely. Be patient when eating and make sure food and beverages are cool enough to not pose a problem. Talk with Dr. Arndt about items you should keep in the house by way of dental first-aid kit. There are steps you can take to minimize discomfort and damage, as in the case of a burn.
Q:
Is a powered toothbrush better than manual a brush?
A:
It's hard to say if one is better than the other. The American Dental Association(ADA) says manual brushes can be as effective as powered brushes. However, a study published in the March 2000 issue of the Journal of the ADA gave a favorable report to the powered model used in the study. In more than 16,000 patients who participated in the study, more than 80 percent experienced a `positive effect', according to the assessment of the dentists and hygienists involved in the study. Thorough work with a manual brush will certainly keep your teeth clean. Powered brushes can be very helpful, however, to a person who has arthritis, say, or some other condition that impairs motor skills. Also, children or adults who are fond of gadgets may become more regular brushers if they use a powered toothbrush. Whatever the type, the ADA recommends replacing your toothbrush every three to four months, or sooner if bristles are frayed. Frayed bristles can damage gums. So check the quality of your brush periodically.
Q:
What are the common misconceptions about dentures?
A:
Dentures obviously are a major benefit to people whose teeth are beyond saving. But some misconceptions about them have worked their way into accepted wisdom. Though they are long lasting, a set of dentures does not last forever. If mishandled or dropped, they can break. Also, a person's mouth changes as he or she ages and dentures may need to be refitted. It is also not true that once you have been fitted for dentures your days of visiting a dentist are over. Denture wearers, like everyone else, should visit a dentist at least twice a year. Whether you wear dentures or have all your teeth, the possibility of developing oral cancer remains real. Another myth is that if you are wearing dentures it will be obvious that you are wearing them. With the advances in materal and techniques over the years, properly fitted and manufactured dentures are not readily recognizable as dentures. They look natural and allow you to eat and speak with ease. Talk with Dr. Arndt about dentures and any assumptions you may have made about them.
Q:
The athlete in our family is our daughter. Only boys need mouth guards, right?
A:
Wrong. Anybody who plays a sport, particularly a contact sport, is susceptible to above-the-neck injury ranging from a fat lip to a concussion. In between, there are possible broken teeth, bitten tongues and other injuries to the face and jaws. Mouth guards are effective in preventing and/or minimizing damage from those injuries. And girls are just as much at risk as boys. Mouth guards cushion blows that might otherwise result in chipped or broken teeth and severe lacerations to the lips, tongue, or face. By serving as a shock absorber of sorts, it is believed that mouth guards may reduce the severity and incidence of concussions. In obvious contact sports like football and rugby, mouth guards are standard. But watch the actions in a traditional non-contact sport like basketball, soccer, or field hockey, and you'll see the potential value of a mouth guard for a young athlete, boy or girl. Mouth guards come in various versions. Talk to Dr. Arndt about the right kind for your young athlete.
Q:
What is an oral irrigating device?
A:
An oral irrigating device uses pulsating jets of water to help clean around the gum line and between teeth. It's an excellent supplement to brushing and flossing and helps clean spots neither of those two methods reaches. Although they are not recommended for children under 12, oral irrigators can benefit both teenagers and older patients. For youngsters-or adults-with braces, the strong streams of water are extremely helpful in flushing food particles. For older patients who may have gum problems, the water provides a massage and stimulates circulation.
The devices come in two types: the electric-powered and the type that attaches to a faucet. With the electric model, most dentists agree, it is easier to regulate water pressure and temperature.
Irrigating does not take the place of brushing and flossing. But after you're done brushing and flossing, irrigating is an excellent way to flush out any remaining debris. At your next exam, ask about oral irrigating devices. Dr. Arndt can give you more infomation.
Q:
Should expectant mothers take any special precautions with their teeth?
A:
regnant women need to be extra careful about all aspects of their health. Obviously this is a special time when there are some specific oral health concerns. Pregnant women have lots of things on their minds. Sometimes they don’t have the time or energy to devote to their personal needs. That can lead to neglect of important daily oral health steps like brushing and flossing.
Expectant mothers also tend to snack more than the average person. They should avoid sugary, sticky snacks. Those foods don’t offer much in the way of nutrition. They’re not good for your teeth either. The longer any sort of food stays against the tooth, the greater the opportunity for decay.
Maintaining a well-balanced diet will be good for your teeth and for the overall health of both you and your baby. Hormonal changes during pregnancy can leave gums susceptible to swelling and bleeding. Should gum trouble develop, it’s important for the mother-to-be to see a dentist.
Prior to delivery, the expectant mother should visit the dentist for an exam. Since it may be difficult to fit in an appointment once the baby is born, it is advisable to have any dental problems addressed before the baby’s birth.
Q:
What is trismus?
A:
Trismus is the term used to describe any restriction to mouth opening, including those caused by trauma, surgery, radiation and TMJ (temperomandibular joint) problems. The limitation in opening can be caused by, among other things, damage to facial muscles and nerves, scar tissue, infection and damage to the TMJ. A lack of mobility in the mouth can cause problems. Speech, for instance is difficult when the mouth doesn't open properly. Oral hygiene can also be impeded. The inability to chew properly can impact a patient's nutrition. With cancer patients, trismus most often is a result of scar tissue that accumulates from radiation or surgery, nerve damage, or a combination of those factors. Early treatment of trismus can minimize some of the conditions. Gentle movement of the jaws several times a day is more effective than extreme stretching in reducing inflammation and pain. Talk with Dr. Arndt about any difficulty you have in opening your mouth completely.
Q:
Are dental implants really a practical option for a person missing teeth?
A:
Dental implants are definitely a practical option. They are not, however, suitable for everyone. Healthy gums and bone are necessary to support implants, which are metal posts that are surgically placed in the bone under your gums. Also, because the placement of implants is a surgical procedure, a candidate must be in good overall health. Since good periodontal health is key to the sucess of an implant, smokers and diabetics may not be candidates for implants. After a period of healing, during which the bone grows around the post, a replacement tooth, or crown, is attached to the post. Implants also can be used to secure a bridge or dentures when more than one tooth is missing. Placing implants is not a dental specialty. So a team of dentists may be involved in placing an implant. One dentist, for instance, may do the surgery to put the implant in the bone and another may place the crown on the post. Talk with Dr. Arndt about whether you are a candidate for dental implants.