819 East Franklin

Greencastle, IN
765.653.5501

Frequently Asked Questions

Do you do white fillings?

I’m always having cavities. What can I do to prevent decay?

Can you whiten my teeth in one visit?

Can I whiten my teeth with Crest White strips or other over the counter methods?

How does the take home whitening process work?

Will whitening my teeth make them sensitive?

Can you whiten teeth that were darkened by antibiotics?

What are my options for replacing missing teeth?

My jaw popped and now it hurts. Could I have TMJ?

 

Do you do white fillings?

Yes, whether it is a new cavity or replacement of an older silver amalgam, most of the fillings we do are with a tooth colored composite, which works very well for small to medium size restorations. Tooth colored composite can work for larger fillings too, but in some situations may not be strong enough. Teeth with large fillings are weaker and can fracture, so tooth colored ceramic fillings or crowns would be a stronger option.

I’m always having cavities. What can I do to prevent decay?

Diet might be the most important factor. I know most people expect to hear that brushing and flossing, blah, blah, blah is the answer. They are both important, but consider that very little evidence of decay is found in pre-historic human teeth. They may have used sticks to clean their teeth, we don't really know, but we do know they that didn't have toothbrushes, toothpaste, floss and regular professional cleanings. They didn't have a lot of sugar in their diet or foods that digest readily to sugars or foods that were sticky.

Today, we consume massive quantities of sugar and it is hidden in products that you wouldn't think contain sugar. Soft drinks are the number one problem and even lower sugar drinks like Gatorade too, because they are consumed so frequently. We have generations of kids who would never think of getting a glass of water from the faucet to quench their thirst and it isn't uncommon to see one or two cases of Mt. Dew or Coke on the family shopping cart. Doritos, chips, and crackers have sugar and form sticky goo on the teeth when digestion begins in the mouth. White breads stick to the teeth and begin to digest down to simple sugars while in the mouth. Sugary breakfast cereals do the same.

If you frequently have cavities, it will be frustrating to learn that there are people who never have decay. I see them daily. These people often brush very well and maybe floss occasionally, but the big factor is what they eat. I'm not saying these people never have sweets; it just isn't a big part of their diet or something they consume very often. No one is going to get a cavity from one piece of candy, a Coke or a handful of chips, but you will if you're chewing sugared gum all day long or sipping half a dozen soft drinks. The bacteria in your mouth love to turn sugar into acid and if you're constantly consuming sugar, you're constantly exposing your teeth to an acid that destroys enamel. If you drink Mt. Dew, it is best to consume it fairly quickly, so your teeth aren't exposed to acid for very long. If you nurse it, your mouth stays acidic longer.

Time for some tough love. Stop buying soft drinks. This could cause a major revolt among children and teenagers, but the impact on decay and on obesity will be immediate. Someone once told me they didn't think they could do this because they didn't like the taste of water. Since water doesn't have a taste (or shouldn't), I think what they meant is that they couldn't drink something unless it had a sweet taste. This probably won't be easy in the beginning. It's hard to go bland, but if you truly want to quite having cavities, this is where you start.

And Soft Drinks are like Acid. You might remember the ph scale from your high school science class. Tap water has a ph near 7 and battery acid has a ph of 1. Tooth structure can begin dissolving with food or drinks that have a ph of about 5, but things get much worse with food and drink as the ph gets closer to 1. Soft drinks and sports drinks have a ph of 2.3-4.4, sour candy 1.9, and lemon juice 2-2.6. Surprisingly, commercially bottled iced teas (2.9), coffee (2.4-3.3) and diet soft drinks (3) are also acidic. Remember, a cup or two of coffee per day or a diet soft drink isn’t going to destroy your enamel, but six diet soft drinks sipped throughout the day could cause some trouble. Uncontrolled gastric reflux disease, frequent vomiting and bulimia expose the mouth to a very strong stomach acid, ph of 1-2, that rapidly destroys enamel. You should consult with your physician for evaluation.

Some helpful tips for eating acidic foods can be found at Pronamel.us and here:

  • Soda is a major cause of acid erosion. If it's your main beverage, consider cutting back and substituting water or another non-acidic drink. Or you could alternate between drinking soda and water.
  • Swallow acidic beverages quickly to limit the time your teeth are exposed to the acid.
  • Combine the consumption of acidic foods with other foods that can help neutralize their effects (e.g. milk, cheese, yogurts)
  • Use a straw to keep the acid in beverages away from your teeth.
  • Waiting at least an hour before you brush is easier on your teeth since your enamel remains soft for a while after you eat or drink something acidic.

What should I eat?

My undergraduate degree was in Foods & Nutrition and I know how bewildering it can be to figure out how to eat healthy. The good news is that changing your diet to decrease the incidence of decay is also going to help you lose weight and will probably improve your overall health. The best advice I've seen recently comes from Michael Pollan in his book, "In Defense of Food": Eat food, Not too much, Mostly plants. Sounds obvious I know, but this simple bit of advice is powerful if you understand that we now consider food to be something that has an ingredient list and comes in a package.

If you go to the Internet for help, try to find sites that are backed by good evidence based science. Two I have found helpful are: Cspinet.org and Nutritiondiva.quickanddirtytips.com.

Brushing and Flossing, Blah, Blah, Blah

You would think a dentist would list this first, but if I did your eyes would glaze over. I see it all the time. However, this is the other important part of the equation. We have bacteria in our guts, our skin, our nose, our mouths and some scientists see us as nothing more than a host for bacteria. There are more bacterial cells in and on your body than human cells. You don't really want to get rid of all the bacteria in your body, just the bad ones. Brushing and flossing is nothing more than an attempt to reduce the bad bacteria in your mouth, the bad ones that cause decay and gum disease.

But I Brush

Maybe you need to brush longer. Some studies show that people spend less than 30 seconds brushing. If you ask people how long they brush, they always estimate that they spend much longer. Spend at least two minutes. Get a timer or get a timer app for your phone. You can also find an electric brush like a Sonicaire or an Oral-B that have timers built in. These brushes help people do a better job than a manual brush. Electric brushes are more expensive, but are worth it if you consider the long-term benefit to your overall health.

You should brush at least twice a day, in the morning and before bed, but if you've been developing decay then you should consider putting a toothbrush in the lunchbox.



Flossing

I won't say too much here because I don't want to lose you, but if you frequently have decay between your teeth, you need to floss. Gum specialists (periodontists) will tell you that brushing alone isn’t enough and that flossing is the only way to clean thoroughly to prevent gum disease. Our hygienists can show you how. There are flossing gadgets available that can help too. I think it is easier to do it in front of a mirror, but some people save time by doing it in the shower.

Rinses

Fluoride rinses can help enamel that has been attacked and weakened by acids. ACT Restoring rinse has fluoride and an anti-microbial to help kill bacteria. You can put a cap full in your mouth and swish it around for at least one minute. Look at a timer. If you just spit it out after 10 seconds, you aren’t doing much good. You can also pour some into cup and dip a toothbrush into it and apply it like it was toothpaste. Go ahead and brush first and then use the rinse. Once a day before bed.

Decay Magnifiers

There are other factors that contribute to tooth decay. If you have a problem with your salivary glands or are taking medications that reduce the flow of saliva, you will have what is known as a dry mouth. Saliva has natural acid buffers that can help neutralize acidity in your mouth, but if you aren’t making enough saliva, you can’t make acid buffers. The problem is that many medications cause dry mouth as a side effect. This can be an especially vexing problem for elderly patients who might be taking multiple medications that cause a loss of salivary gland function.

Anything that increases the acidity in the mouth is a problem. Gastric reflux disease that isn’t controlled can destroy enamel very quickly. Bulimia and frequent vomiting can also cause serious decay.

Can you whiten my teeth in one visit?

There are techniques available that claim you can whiten teeth in one hour or in one visit. This involves shining a bright light on the teeth while the teeth are coated with a bleaching gel. The light is supposed to speed up the whitening process. Studies have shown that the light doesn’t really do much except dehydrate the teeth, which is a temporary effect. This is why most patients who have had this done are also given the same home-whitening system we use. The primary reason we use the take home system from Discus Dental is because it is very effective and is a third to a quarter the cost ($125) compared to “one visit” techniques.

Can I whiten my teeth with Crest White strips or other over the counter methods?

I’ve had a few patients tell me they thought their teeth got whiter with the strips, but a lot of patients have been disappointed because they had trouble keeping the strips on their teeth. Toothpastes or rinses that claim to whiten teeth probably don’t. The whitening solution has to be held against the enamel for at least several hours to do anything. Pastes and rinses aren’t on the teeth long enough and any active ingredients are immediately diluted with water.

How does the take home whitening process work?

We make models of your teeth and then create clear custom-made trays that fit over your teeth. The whitening gel is placed inside the trays and worn over the teeth during sleep, which is why the product is called Nite/White. You aren’t doing anything while you are sleeping, so why not whiten your teeth at the same time.

Many patients find this process convenient, but some don’t like wearing the trays all night. It is possible to wear the trays at times other than nighttime and it has been shown that you can get results with only two hours of daily wear. Depending on how often and how long your wear the trays and depending on your unique tooth enamel, the process takes anywhere from one to three weeks.

Will whitening my teeth make my teeth sensitive?

It’s true, even though the material has a neutral ph and desensitizers; some patients get very sensitive while they are whitening. This goes away once the process is stopped. If someone has sensitive teeth prior to whitening, they should apply a desensitizing solution for a week before they start whitening. You can also modify the process by wearing the trays for fewer hours per day or wearing them every other day.

Can you whiten teeth that were darkened by antibiotics?

Maybe, but no one can predict ahead of time with any certainty. I’ve had a few patients who did the take home process for almost six months and got amazing results. Since the only other option would have been complex and costly crowns or veneers, these patients were highly motivated to stick with the process for so long.

What are my options for replacing missing teeth?

Implants have become the best choice to replace a single tooth because the result is as close to a real tooth as we can get. A bridge is still a good option too, but has to be supported by teeth on either side of the space. Implants or bridges are anchored in place solidly and don’t move around. A partial denture is an economical option to replace many missing teeth, but it is removable and some designs with few supporting teeth tend to move around. Partial dentures are bulky and have to be removed to clean. Depending on the situation, some partial dentures are made of acrylic, nylon or acrylic and metal.

My jaw popped and now it hurts. Could I have TMJ?

TMJ or temporomandibular joint disorder is pain originating from the jaw joint and any muscles associated with this joint. Opening wide, laughing or yawning have been known to trigger joint pain. I’ve compared it to a sprained ankle or back pain in that many times the pain will go away. It helps to give the joint a rest so you have to be careful not to open too wide and try not to eat tough foods. A soft diet, a heating pad applied to face and mild muscle relaxers can help too. If the pain doesn’t go away after two or three weeks or if you have had the pain for quite a while, then you may have a more chronic problem that requires more extensive therapy. For these patients I refer to dentists who specialize in the treatment of TMJ.

Sometimes the pain can be due to jaw clenching due to stress in your life and there are some simple appliances that can be made to control the clenching.

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