Q. Can drinking milk prevent tooth decay?

A. Not by itself. Even the strongest milk (calcium) fed teeth may break down and decay unless there is consistently good dental hygiene and regular professional care.  Of course, drinking milk is obviously very important to provide calcium necessary to build the best teeth possible during the growth years.  After these years, it is still needed as a source of calcium, protein, vitamins and minerals to keep gums and jawbones healthy.


Q. My six-year-old son has a cavity in one of his baby molars.

A. This is one of the most commonly asked questions we hear.  The answer lies in understanding more about baby or primary teeth.  Baby teeth serve three major functions:  (1) appearance, (2) function – proper chewing and formation of words during speech, and (3) as space maintainers for the permanent teeth.  Baby teeth are naturally lost as the permanent tooth underneath erupts upward, causing the root to dissolve away.  After the baby tooth is out, the permanent tooth usually erupts within the next several weeks filling the space.  If the baby tooth is lost prematurely, due to decay or accident, the space will very often close before the permanent tooth erupts, causing it to erupt in a crooked or tipped manner or many times preventing eruption entirely.  Many avoidable (and expensive) orthodontic problems, as well as dental pain and infection, are caused by badly decayed or prematurely lost teeth.  While there are exceptions, baby teeth should usually be filled and maintained until they are lost naturally.


Q. Should I bother to have it fixed since he’s going to lose it anyway?

A.This is one of the most commonly asked questions we hear.  The answer lies in understanding more about baby or primary teeth.  Baby teeth serve three major functions:  (1) appearance, (2) function – proper chewing and formation of words during speech, and (3) as space maintainers for the permanent teeth.  Baby teeth are naturally lost as the permanent tooth underneath erupts upward, causing the root to dissolve away.  After the baby tooth is out, the permanent tooth usually erupts within the next several weeks filling the space.  If the baby tooth is lost prematurely, due to decay or accident, the space will very often close before the permanent tooth erupts, causing it to erupt in a crooked or tipped manner or many times preventing eruption entirely.  Many avoidable (and expensive) orthodontic problems, as well as dental pain and infection, are caused by badly decayed or prematurely lost teeth.  While there are exceptions, baby teeth should usually be filled and maintained until they are lost naturally.


Q. Is there any relationship between teeth and sinus problems?

A. Since the sinuses and upper teeth are close to one another, problems in one may be confused with (or contribute to) the other.  Pain in upper teeth may be attributed to a sinus infection and conversely a sinus infection may be the result of a severely infected upper back tooth.  Dental x-rays are helpful in determining this relationship.  If you have recurrent sinus problems, be sure to mention it to your dentist.  Proper dental care is an important element in your overall good health.


Q. What is a crown?

A. A natural crown is that portion of the tooth composed of enamel.  If a dentist suggests that you need a crown, he is referring to a synthetic crown that will restore the natural crown that has been lost to decay or abrasion. 

Since crowns are thimble-like in appearance and are placed on top of the tooth, they are sometimes referred to as “caps”.  Fabricating a synthetic crown, or cap, is a very precise procedure similar to that of producing fine jewelry.  Although this process is laborious and time consuming, it is necessary because a synthetic crown must duplicate the anatomy and function of the natural crown and fit so accurately that no leak can occur between the oral fluids and that part of the tooth which the synthetic crown covers.  Because crowns fit so accurately, they are readily held in place by a thin layer of cement (dental glue) spread between the synthetic crown and the tooth.

Crowns may be made of precious metal alloys (gold), non-precious metal alloys, porcelain veneered over a metal substructure, and all porcelain.


Q. Why do some teeth need fillings while others need crowns?

A. The decision to use a filling or a crown is generally based on the strength of the remaining tooth enamel.  For example, if a tooth has a small cavity and no prior filling it will be strong enough to hold a filling and still withstand the forces generated during chewing.  If on the other hand, a tooth has a large cavity, or if it has had a large filling, the remaining enamel may not be of sufficient strength to hold the hard, but brittle, silver filling.  In this instance, it is preferable to use a synthetic crown in order to acquire the added strength necessary to maintain the structure and function of the tooth.


Q. Is it always necessary to crown a tooth after a root canal?

A. Not always --- but first of all let’s define a root canal.  At the center of every vital tooth is living tissue called the pulp.  The pulp consists of several cellular elements to include blood vessels and nerve tissue.  When a person has a severe toothache or abscess, the pulp is usually infected and must be removed.  Since the pulp is removed from the central canal of each root, this procedure is often referred to as a root canal treatment.  More formally this procedure is referred to as an endodontic treatment. Now back to our original question.  It is quite common for dentists to crown the tooth following root canal therapy since the procedure does hollow the tooth and thus makes it more susceptible to fracture; however, this is not automatic.  The decision to use a crown or a filling depends once again on how much tooth structure remains and how much stress the tooth must bear.


Q. If a tooth needs a crown, do I have to have a root canal?

A. I’m sure that by now the answer to this question is an obvious, no. Any tooth may or may not need a crown, just as any tooth may or may not need a root canal treatment.  The decision for crown placement depends on the strength of the remaining tooth and decision regarding a root canal depends on the health of the pulp.  Therefore, crown placement and root canal treatment are independent of each other and one treatment does not necessitate the other.


Q. Are yellow teeth a sign of bad oral hygiene?

A. Though many people believe that teeth must be white in order to be clean, those with slightly yellow teeth can have equally good or better oral hygiene; yellow is simply the natural color of some people’s teeth.  Although it is not necessary for good dental health, some people prefer the esthetics of white teeth.  If this is your desire, you should investigate the most conservative treatment methods available before deciding on porcelain caps.  In many cases, tooth shade may be altered by bleaching or by veneering the teeth (bonding).  Both of these methods preserve the tooth enamel and require no anesthetic prior to treatment.  However, as is the case with any dental restoration, a necessary prerequisite to bleaching and veneering is good oral hygiene


Q. Are dental whiteners and polishers good for teeth?

A. Special whiteners or polishes may be all right for occasional use, but the extra-abrasive additives of these products could cause harm over prolonged periods of use.  The abrasive particles can scratch the enamel and root surfaces of teeth and cause the gums to recede, exposing the sensitive root surfaces to oral fluids.  In most cases, twice daily brushing with a standard fluoride dentifrice will keep teeth and gums healthy and looking good.  If persistent stains are a problem, it is best to consult with your dentist and find a solution for your particular situation, rather than using abrasive products.


Q. How much toothpaste per brushing is recommended?

A. According to dental research, one gram of fluoride toothpaste per brushing is the desirable quantity.  That equals approximately one-half an inch of toothpaste, depending on the size of the tube opening.  As for pumps, one spurt is plenty since this amount weighs 1.6 grams.  It is important to use at least one gram of toothpaste per brushing because if you use too little, saliva will dilute the fluoride concentration, resulting in less effective decay prevention.


Q. What is the difference between fluoride rinse and fluoride tablets?

A. Fluoride protects your teeth by two separate methods, which can be described as topical or systemic.  Topical fluoride protection occurs when you coat your teeth with a fluoride-containing product.  This could include a fluoride rinse, fluoride toothpaste, or fluoride application in the dental office.  These all help to harden the tooth enamel but they wear off and the fluoride needs to be replaced by frequent applications.  Systemic fluoride protection occurs when the fluoride product is swallowed and the body uses it to construct tooth enamel.  This method is permanent and most effective, but it is not possible to achieve this type of protection after the teeth are formed, which occurs for the most part by age 12.  Taking fluoride tablets and using fluoridated water are the only way to obtain this life-long fluoride benefit.  Since Roseburg does not have fluoridated water, our children must swallow fluoride tablets to obtain permanent tooth protection.  All the fluoride rinses combined cannot give permanent protection because they provide only topical protection, not systemic protection.


Q. What is a tooth abscess?

A. A tooth abscess is a puss-filled sac at the tip of the tooth’s root within the jaw bone.  The abscess usually forms when extensive decay or tooth trauma causes the nerve and blood vessels to die.  In the acute phase, an abscessed tooth aches or throbs and is extremely painful when biting or chewing.  In addition, the glands in the neck may swell and become tender.  If the abscess spreads, the side of the face may become swollen and the patient may experience fever.

Often the acute stage ends when the abscess has destroyed enough jaw bone to create a small opening through which it can “leak out” into the mouth.  A foul smell or taste is usually noticeable at this time and the pain subsides.  However, if the tooth is left untreated bone destruction and pain will return.  Treatment for an abscessed tooth normally consists of antibiotics, drainage and root canal therapy.


Q. Why are "sealants" sometimes recommended for children’s teeth and how do they work?

A. Sealants are recommended to provide protection against decay during the early growth years when newly erupted 6-year-old molars are deeply grooved and can easily trap food particles which cause decay.  Compounding the problem is the fact that some children have not developed the dexterity necessary for proper oral hygiene.  Sealant application is quick and painless, requiring no anesthetic.  The tooth grooves are first prepared with a bonding agent.  A clear liquid resin is then flowed into the grooves and allowed to harden.  Most dentists today use a blue light to speed up the curing time of the resin.  You can expect sealant protection to last up to five years, though occasional touch ups may be needed.  Experts at the National Institutes of Health recommend that the sealant be used in conjunction with fluorides, ideally at age 6 or 7, when the first permanent molars come in, and again at age 13, when the second molars erupt.  The combination is said to give almost 100 percent protection against dental decay.


Q. Dental Health During Pregnancy

A. Even though your baby has not arrived yet, you are building the foundation for his/her healthy teeth.  The baby’s first set of teeth begin to form when you are about four months pregnant.  Remember:

     Eat a balanced diet.  Your baby’s teeth need the right foods to grow properly.  Limit sweet snacks and drink plenty of water.
     Brush and floss daily.
     See your dentist to have your teeth cleaned and checked.  A mother’s healthy mouth is the first step to keeping her baby’s mouth healthy.


Q. Mouth Injuries

A. If your child participates in sports such as basketball, baseball, skateboarding or soccer, there is always risk for injury.  Would you know what to do if your child knocked out a permanent tooth?  With this type of injury, time is critical.  You will only have about thirty minutes to save the tooth:

Locate the tooth and replant immediately, if possible.  The tooth should only be picked up by the crown NOT the root.
If the tooth is dirty, rinse with cool water.  Do NOT scrub or remove any tissue.
If replanting is not possible, place the tooth in a cup of milk or cool water.
Contact your dentist immediately or go to the emergency room if your dentist is not available.
Stay calm, knowing what to do can mean the difference between losing and saving a tooth.


Q. Dental Do’s - Birth to 3 Years

Do Hold baby while feeding.  Do Not prop the bottle.
Do feed baby before putting to bed.  Do Not put baby in bed with a bottle.
Do wipe the inside of the baby’s mouth daily.
Do begin brushing baby’s teeth daily, as soon as they come in.
Do use a small pea-size dab of fluoride toothpaste to brush.
Do Lift the baby’s lip monthly to check for white or brown spots on front teeth.  If you see any, take your child to the dentist.
Do ask your doctor or dentist about fluoride toothpaste to brush.
Do begin to give liquids in a cup when your baby is 6 months old.
Do wean your child from the bottle at 12 to 14 months of age.
Do take your child for a first dental visit at one year of age.  Ask your dentist about topical fluoride treatments.