Healthy Mouth and a Healthier You

Best of Ask the Dentist 2010

Dentist Steven E. Roth, DMD, answers your additional questions about dental care, oral hygiene, orthodontics, and cosmetic dentistry from 2010.

Question:

I am 36 years old with seven children and no insurance. I am having a problem with a broken wisdom tooth. What are my chances of successfully extracting it myself?

Answer:

There is no chance that you will successfully extract the tooth, but there is a strong possibility that you will seriously hurt yourself. Call your local dental society for a referral to a public assistance oral surgeon or clinic. Good luck!

Question:

What are signs of oral cancer?

Answer:

The following are the more common signs and symptoms of oral cancer:

• Swelling, thickenings, lumps, bumps, rough spots, crusts, or erosion on the lips, gums, or other areas inside the mouth
• The development of velvety white, red, or speckled (white and red) patches in the mouth
• Unexplained bleeding in the mouth
• Unexplained numbness, loss of feeling, pain, or tenderness in any area of the face, mouth, or neck
• Persistent sores on the face, neck, or mouth that bleed easily and do not heal within two weeks
• A soreness or feeling that something is caught in the back of the throat
• Difficulty chewing, swallowing, speaking, or moving the jaw or tongue
• Hoarseness, chronic sore throat, or changes in the voice
• Ear pains
• A change in the way your teeth or dentures fit together -- a change in your "bite"
• Dramatic weight loss

If you notice any of these changes, contact your dentist immediately for a professional examination.

Question:

What’s the difference between a cap and a veneer? Which is safer for your mouth?

Answer:

A cap, or a crown, is a dental restoration that covers an entire tooth, like a new coat of enamel. A porcelain veneer covers the outside or visible face of the tooth. They are equally safe when used in the proper situations. For example, if a tooth is badly broken down by decay and has no remaining support, it needs a crown. If there is severe discoloration, or chipping, or misalignment of a front tooth a veneer may be the most appropriate treatment.

Question:

I haven’t been to the dentist in a long time. The last time I remember was when I was a little girl and I’m 28 years old now. I bleed from my gums every time I brush my teeth. Is this a problem?

Answer:

My stock answer: Would you be concerned if your hair was bleeding when you brushed it? It is NOT normal. It is a sign of an infection! Get to the dentist immediately. Most adults need a professional cleaning every 3-6 months with a rigorous home care program. There is even some evidence that inflammation of the gums may play some part in heart disease.

Question:

I had a wisdom tooth removed yesterday and was wondering how I could help it heal faster.

Answer:

By following your doctor’s instructions. No smoking, no sucking on a straw, follow the dietary recommendations, and return to the office for the post-op treatment. Take your antibiotics. Use ice when you need to, etc.

Question:

What are the symptoms that tell you when or if you need dentures?

Answer:

There are no specific symptoms, and dentures are a treatment choice. Before a person loses all of their teeth, they have probably had gum and/or decay problems. There are many levels of treatment for these conditions. If all of your teeth have to be removed, there are other options. Dental implants, for instance, are root-shaped titanium fake teeth that can be placed in the jawbone so dentures do not have to be worn. See your local dentist a soon as possible for a diagnosis and treatment plan.

Question:

What over-the-counter or home remedies can be used to maintain white teeth?

Answer:

Every pharmacy in America has white strips and whitening toothpastes that can give you a whitening result. However, the best results are always attained when a professional is guiding the treatment. There may be reasons that you aren’t a good candidate for whitening, and only a dentist can tell you.

Question:

Is 54 years old too late for braces?

Answer:

It is never too late for braces, as long as the teeth, gums, and underlying bone are healthy. Straighter teeth can give you a more comfortable bite, more cleanable teeth, less chance of decay, and a better-looking smile.

Question:

What is the cause of halitosis and what can be used to cure it?

Answer:

Halitosis, or “bad breath,” has a number of causes. Food odors, gum disease, tooth decay, stomach problems, sinus problems, and even certain diseases can all cause halitosis. The cures vary. To knock out any possible dental causes, I always advise my patients to have a good cleaning and examination, followed by a review of your at-home oral hygiene regimen. Your dentist can help you figure out the exact cause and treatment. Most mouth rinses can help, but the results will be temporary.

Question:

How do diabetics care for their dental health?

Answer:

Diabetics should see their dentists regularly. The most common oral health problems associated with diabetes are tooth decay, periodontal (gum) disease, salivary gland dysfunction, fungal infections, lichen planus and lichenoid reactions (inflammatory skin disease), infection and delayed healing, and taste impairment. Diabetics should carefully review their medical history with their dentists and have a comprehensive dental examination. Great preventive home care and regular scaling are essential for the diabetic.

Question:

What is the recommended age for a child's first visit to the dentist? Does it have to be a pediatric dentist?

Answer:

In order to prevent dental problems, your child should see a pediatric dentist when the first tooth appears or no later than his/her first birthday. This is the recommendation of the American Academy of Pediatric Dentistry. The purpose is to begin a thorough prevention program. Dental problems can begin early. A big concern is early childhood caries (formerly known as baby bottle tooth decay, or nursing caries). Once a child’s diet includes anything besides breast milk, erupted teeth are at risk for decay. The earlier you start dental visits, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

Question:

How do I know if my child has bottle rot?

Answer:

Bottle rot is indicated by dark stains around the teeth. But if you are concerned, see your local pediatric dentist as soon as possible. The risk of potentially devastating nursing-pattern dental decay exists for the breastfed child just as it does for the bottle-fed child. This kind of decay is caused by extended and repetitive feedings, with prolonged exposure of erupted teeth to fermentable carbohydrates.

Some general recommendations:

1. Infants should not be put to sleep with a bottle. Nocturnal breastfeeding should be avoided after the first primary tooth begins to erupt.
2. Parents are encouraged to transition infants into drinking from a cup as they approach their first birthday. Infants should be weaned from the bottle between 12 and 14 months of age.
3. Consumption of juices from a bottle should be avoided.
4. Oral hygiene measures should be implemented by the time of eruption of the first primary tooth.
5. An oral health consultation visit within six months of the eruption of the first tooth is recommended to educate parents and provide anticipatory guidance for prevention of dental disease.

 

Question:

If my baby sucks her thumb, will she need braces?

Answer:

Not necessarily. Frequently, when thumb-sucking stops, any teeth that have shifted will go back into their proper place. I would see the pediatric dentist for an evaluation and for help with stopping the habit.

Question:

Can you get cavities under your braces? What happens then?

Answer:

With braces, teeth can decay just as easily as they would without them. Your oral hygiene, including frequent brushing, water picking, fluoride rinses and supplements, and frequent cleanings during orthodontics treatment is imperative. Usually cavities can be fixed while braces are still on. But sometimes, they do have to be removed first.

Question:

What is the right age for children to get braces?

Answer:

Age 7 or 8 is a good time to have an orthodontic screening exam. Frequently, younger children can wear retainer-type appliances, which will mold the jaws properly and make it possible for braces to be worn for a shorter amount of time.

Question:

Should I have X-rays taken every six months when I get my teeth cleaned? I’ve heard the radiation is bad for you.

Answer:

The ADA recommendation is every 6-12 months for a child or adolescent with a history of decay. But it could be as infrequent as every 12-24 months for an adult with no history of decay. So I would discuss it with your dentist.

Question:

Do vegetarians have more or less cavities because they don’t eat meat?

Answer:

Vegetarians will not have fewer cavities just because they don’t eat meat. Eating vegetables or meat does not matter in this process.

Question:

I have a fear of the dentist. What do you suggest I do to calm my anxiety?

Answer:

Speak to the dentist about various anxiety-reducing methods, such as hypnosis, therapy, medication, or nitrous oxide. Sometimes, just becoming more familiar with the procedures will help a lot.

Question:

My dad said I got my bad teeth from him. Do you really inherit bad teeth?

Answer:

Genetics definitely play a part in susceptibility to gum disease and tooth decay. But ... you can change the course of your family’s dental health history by discussing the situation with your dentist and taking the proper preventive measures.

Question:

I’m confused by all the different types of floss. Is any one kind better than the others? Or is it all a matter of preference?

Answer:

Some dentists feel that unwaxed floss may remove more plaque. I have always felt that whichever product works the best and is the easiest for you to use is the best. If floss gets shredded, stuck, or torn in half in your teeth, it’s probably a sign that a dental procedure is needed.

Question:

Hello! I'm wondering how far a dentist would recommend you keep your toothbrush away from your toilet.

Answer:

That’s a good one! Obviously the further away, the better. There is also the option of a toothbrush head cover, the medicine cabinet, or placing it in a drawer. Most importantly, I tell my patients to change their brush every six weeks.

Question:

I like to chew on ice and I heard that crunching ice will make your teeth crack off. Is that true?

Answer:

It can be true at times. If you have strong, healthy teeth, you shouldn’t have a problem from chewing ice. But teeth that are weakened by old fillings, cracks, or enamel loss are at a much higher risk of getting damaged by chewing ice.

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