What is Good Oral Hygiene?

Good oral hygiene results in a mouth that looks and smells healthy. This means:

  • Your teeth are clean and free of debris
  • Gums are pink and do not hurt or bleed when you brush or floss
  • Bad breath is not a constant problem

If your gums do hurt or bleed while brushing or flossing, or you are experiencing persistent bad breath, see your dentist. Any of these conditions may indicate a problem.

Your dentist or hygienist can help you learn good oral hygiene techniques and can help point out areas of your mouth that may require extra attention during brushing and flossing.

How is Good Oral Hygiene Practiced?

Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being.

Daily preventive care, including proper brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress.

In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:

  • Brushing thoroughly twice a day and flossing daily
  • Eating a balanced diet and limiting snacks between meals
  • Using dental products that contain fluoride, including toothpaste
  • Rinsing with a fluoride mouth rinse if your dentist tells you to
  • Making sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area.

Illustrations: How A Tooth Decays

Healthy Tooth
White Spots

Bacteria that are exposed to sugars or carbohydrates can make acid, which attacks the crystal-like substance in the tooth's outer surface. This process is known as demineralization. The first sign of this is a chalky white spot. At this stage, the decay process can be reversed. Using fluorides at home and in the dental office can help the tooth repair itself.

Enamel Decay
Dentin Decay
Pulp Involvement

Keys to Controlling Bad Breath

If you're serious about learning what's causing your bad breath, consider scheduling an appointment with your dental professional. Given your full medical and dental history along with an oral examination, your dentist should be able to identify the culprit. The causes of bad breath are numerous and include certain foods, alcohol or cigarettes, poor oral hygiene, periodontal disease, diabetes, dry mouth, sinus or throat infections, lung infections or abscesses, kidney/liver failure, gastrointestinal issues and severe dieting.

Treatment of Bad Breath

It is important to conduct thorough oral hygiene at home twice daily utilizing tooth brushing with a fluoride antibacterial toothpaste and flossing to remove food debris and plaque on teeth, bridgework and implants, and brushing the tongue to remove odor-causing bacteria. A published study reported that tongue and tooth brushing in combination with dental flossing significantly decreased bleeding of the gum tissue over a two week period of time as well as reduced bad breath1. Another clinical study conducted by the University of Buffalo dental researchers confirmed that brushing twice a day with an antibacterial toothpaste and using a tooth brush with a tongue cleaner can eliminate bad breath 2.

Tongue Cleaning is the Key to Fresher, Cleaner Breath

Cleaning your tongue is very important. You can purchase a Colgate 360 toothbrush with the tongue cleaner on the back of the toothbrush for cleaning both your teeth and tongue. After tooth brushing your upper and lower teeth with an antibacterial toothpaste, flip the toothbrush over to the tongue cleaner and place the tongue cleaner in the posterior region of the tongue and move it forward to the anterior section of the tongue. After you have scraped that portion of the tongue, rinse the tongue brush off with warm water to remove any odor causing bacteria. Then replace the tongue brush in the next posterior section again and repeat as described above again.

Consult your dentist or dental hygienist when choosing oral hygiene aids to help you eliminate plaque and odor causing bacteria and review the techniques that should be utilized at home. Also, ask your dental professional what oral hygiene care products they would consider you use to help eliminate bad breath (antibacterial toothpaste, antiseptic mouth rinse, tongue brushes or scrapers and inter proximal cleaning devices).

The key to a clean, fresh mouth is optimal oral hygiene conducted at home on a regular basis and professional recommendations discussed with you by your dental professional.

What are the Stages of Gum Disease?

Gum disease is an inflammation of the gums that can progress to affect the bone that surrounds and supports your teeth. It is caused by the bacteria in plaque, a sticky, colorless film that constantly forms on your teeth. If not removed through daily brushing and flossing, plaque can build up and the bacteria infect not only your gums and teeth, but eventually the gum tissue and bone that support the teeth. This can cause them to become loose, fall out or have to be removed by a dentist.

There are three stages of gum disease:

Gingivitis : This is the earliest stage of gum disease, an inflammation of the gums caused by plaque buildup at the gum line. If daily brushing and flossing do not remove the plaque, it produces toxins (poisons) that can irritate the gumtissue, causing gingivitis. You may notice some bleeding during brushing and flossing. At this early stage in gum disease, damage can be reversed, since the bone and connective tissue that hold the teeth in place are not yet affected.

Periodontitis : At this stage, the supporting bone and fibers that hold your teeth in place are irreversibly damaged. Your gums may begin to form a pocket below the gum line, which traps food and plaque. Proper dental treatment and improved home care can usually help prevent further damage.

Periodontitis : At this stage, the supporting bone and fibers that hold your teeth in place are irreversibly damaged. Your gums may begin to form a pocket below the gum line, which traps food and plaque. Proper dental treatment and improved home care can usually help prevent further damage.

Advanced Periodontitis : In this final stage of gum disease, the fibers and bone supporting your teeth are destroyed, which can cause your teeth to shift or loosen. This can affect your bite and, if aggressive treatment can't save them, teeth may need to be removed.

How do I Know if I Have Gum Disease?

Gum disease can occur at any age, but it is most common among adults. If detected in its early stages, gum disease can be reversed so see your dentist if you notice any of the following symptoms:

  • Gums that are red, puffy or swollen, or tender
  • Gums that bleed during brushing or flossing
  • Teeth that look longer because your gums have receded
  • Gums that have separated, or pulled away, from your teeth, creating a pocket
  • Changes in the way your teeth fit together when you bite
  • Pus coming from between your teeth and gums
  • Constant bad breath or a bad taste in your mouth

How is Gum Disease Treated?

The early stages of gum disease can often be reversed with proper brushing and flossing. Good oral health will help keep plaque from building up.

A professional cleaning by your dentist or hygienist is the only way to remove plaque that has built up and hardened into tartar. Your dentist or hygienist will clean or "scale" your teeth to remove the tartar above and below the gumline. If your condition is more severe, a root planing procedure may be performed. Root planing helps to smooth irregularities on the roots of the teeth making it more difficult for plaque to deposit there.

By scheduling regular checkups, early stage gum disease can be treated before it leads to a much more serious condition. If your condition is more advanced, treatment in the dental office will be required.

Healthy Gums - healthy gums are firm and don't bleed. They fit snugly around the teeth.

Gingivitis - gums are mildly inflamed, may appear red or swollen and may bleed during brushing.

Periodontitis - gums begin to separate and recede from the teeth. This allows plaque to move toward the roots, supporting fibers and bone.

Advanced Periodontitis - supporting fibers and bone are destroyed. Teeth become loose and may need to be removed.


Oral Health for Children

How Do I Help My Children Care for Their Teeth and Prevent Cavities?

Teaching your child proper oral care at a young age is an investment in his or her health that will pay lifelong dividends. You can start by setting an example; taking good care of your own teeth sends a message that oral health is something to be valued. And anything that makes taking care of teeth fun, like brushing along with your child or letting them choose their own toothbrush, encourages proper oral care.

To help your children protect their teeth and gums and greatly reduce their risk of getting cavities, teach them to follow these simple steps:

  • - Brush twice a day with an ADA — accepted fluoride toothpaste to remove plaque-the sticky film on teeth that's the main cause of tooth decay.
  • - Floss daily to remove plaque from between your teeth and under the gumline, before it can harden into tartar. Once tartar has formed, it can only be removed by a professional cleaning.
  • - Eat a well-balanced diet that limits starchy or sugary foods, which produce plaque acids that cause tooth decay. When you do eat these foods, try to eat them with your meal instead of as a snack-the extra saliva produced during a meal helps rinse food from the mouth.
  • - Use dental products that contain fluoride, including toothpaste.
  • - Make sure that your children's drinking water is fluoridated. If your water supply; municipal, well or bottled does not contain fluoride, your dentist or pediatrician may prescribe daily fluoride supplements.
  • - Take your child to the dentist for regular checkups.

What Brushing Techniques Can I Show My Child?

You may want to supervise your children until they get the hang of these simple steps:

  • - Use a pea-sized dab of an ADA-accepted fluoride toothpaste. Take care that your child does not swallow the toothpaste.
  • - Using a soft-bristled toothbrush, brush the inside surface of each tooth first, where plaque may accumulate most. Brush gently back and forth.
  • - Clean the outer surfaces of each tooth. Angle the brush along the outer gumline. Gently brush back and forth.
  • - Brush the chewing surface of each tooth. Gently brush back and forth.
  • - Use the tip of the brush to clean behind each front tooth, both top and bottom.
  • - It's always fun to brush the tongue!

When Should My Child Begin Flossing?

Because flossing removes food particles and plaque between teeth that brushing misses, you should floss for your children beginning at age 4. By the time they reach age 8, most kids can begin flossing for themselves.

What are Dental Sealants and How Do I Know if My Child Needs Them?

A dental sealant creates a highly-effective barrier against decay. Sealants are thin plastic coatings applied to the chewing surfaces of a child's permanent back teeth, where most cavities form. Applying a sealant is not painful and can be performed in one dental visit. Your dentist can tell you whether your child might benefit from a dental sealant.

What is Fluoride and How Do I Know if My Child is Getting the Right Amount?

Fluoride is one of the best ways to help prevent against tooth decay. A naturally occurring mineral, fluoride combines with the tooth's enamel to strengthen it. In many municipal water supplies, the right amount of fluoride is added for proper tooth development. To find out whether your water contains fluoride, and how much, call your local water district. If your water supply does not contain any (or enough) fluoride, your child's pediatrician or dentist may suggest using fluoride drops or a mouthrinse in addition to a fluoride toothpaste.

How Important is Diet to My Child's Oral Health?

A balanced diet is necessary for your child to develop strong, decay-resistant teeth. In addition to a full range of vitamins and minerals, a child's diet should include plenty of calcium, phosphorous, and proper levels of fluoride.

If fluoride is your child's greatest protection against tooth decay, then frequent snacking may be the biggest enemy. The sugars and starches found in many foods and snacks like cookies, candies, dried fruit, soft drinks, pretzels and potato chips combine with plaque on teeth to create acids. These acids attack the tooth enamel and may lead to cavities.

Each "plaque attack" can last up to 20 minutes after a meal or snack has been finished. Even a little nibble can create plaque acids. So it's best to limit snacking between meals.

What Should I Do if My Child Chips, Breaks or Knocks Out a Tooth?

With any injury to your child's mouth, you should contact your dentist immediately. The dentist will want to examine the affected area and determine appropriate treatment.

If your child is in pain from a broken, cracked or chipped tooth, you should visit the dentist immediately. You may want to give an over-the-counter pain reliever to your child until his/her appointment. If possible, keep any part of the tooth that has broken off and take this with you to the dentist.

If a tooth is completely knocked out of the mouth by an injury, take the tooth to your dentist as soon as possible. Handle the tooth as little as possible — do not wipe or otherwise clean the tooth. Store the tooth in water or milk until you get to a dentist. It may be possible for the tooth to be placed back into your child's mouth, a procedure called reimplantation.

Early Orthodontics May Mean Less Treatment Later

Look at yearbook or prom pictures from the 1950s or '60s and you'll see many smiles framed with heavy metal braces, a sight that's increasingly rare on today's high school campuses. Why the change? Children today tend to get braces at a much earlier age. It's not uncommon for a patient as young as 7 or earlier to begin orthodontic treatment.

"The American Association of Orthodontics (AAO) recommends that all children receive an orthodontic screening by age 7," says Thomas Cangialosi, D.D.S., chairman of the Section of Growth and Development and director of the Division of Orthodontics at Columbia University College of Dental Medicine. "Permanent teeth generally begin to com in at age 6 or 7, and it is at this point in a child's oral development that orthodontic problems become apparent.

"Because bones are still growing, it's an ideal time to evaluate a child and determine what orthodontic treatment, if any, may be needed either now or in the future," Dr. Cangialosi says.

Making Braces Hip

To make braces more acceptable to young people, manufacturers have made brightly colored elastics, the tiny rubber bands that hold the wires to the braces. Children can choose elastics with their school colors or a holiday color scheme, such as orange and black for Halloween.

"When patients are given the opportunity to choose the color of the elastics at every orthodontic visit, they tend to feel that they are more involved in their treatment," Dr. Cangialosi says.

Still Take Getting Used to

Braces today tend to be less uncomfortable and less visible than they used to be, but they still take some getting used to. Food can get caught in the wires, flossing and brushing can take more time, and after the monthly adjustments sometimes the teeth are a little sore. Tooth discomfort can be controlled by taking an analgesic, such as ibuprofen (Advil, Motrin and others) or aspirin if necessary. The use of lighter and more flexible wires has greatly lessened the amount of soreness or discomfort during treatment.

"I got braces when I was in fifth grade and I beyond hated them," recalls Jessica Claflin, 18, a freshman at the University of North Carolina at Wilmington. "I looked ridiculous."

Beyond Braces

Orthodontic treatment in young children is known as interceptive orthodontics, in which intervention begins before the child starts first grade. At this age, tooth development and jaw growth have not been completed, so certain conditions, like crowding, are easier to address.

Before permanent teeth have come in, it may be possible to help teeth to erupt (emerge through the gums) into the proper positions. It's common, for example, for the dental arch to be too small to accommodate all of the teeth. A few decades ago, the solution for crowding was to extract some of the adult teeth, then use fixed braces to position the teeth properly. Early intervention takes advantage of the fact that a child's jaw is still growing. For example, a device called a palatal expander may be used to expand the child's upper arch. Once the arch is the proper size, there's a better chance that the adult teeth will emerge naturally where they should. If all teeth have erupted and there is still a great deal of crowding, some permanent teeth may have to be extracted to align the teeth properly.

"It is important to note that children who receive interceptive orthodontics may still need braces or other orthodontic appliances later," Dr. Cangialosi says. "However, this early treatment may shorten and simplify future treatment and may eliminate the need for more drastic measures such as the need to extract permanent teeth in the future."

Treatment Options for Tooth Sensitivity

Tooth Sensitivity– Overview

Tooth sensitivity is due to the exposure of dentin, the part of the tooth which covers the nerve, either through loss of the enamel layer or recession of the gums. Temperature changes and certain foods (acidic or sweet) can cause the tooth or teeth to be painful. The pain usually subsides after a short period of time.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When the dentin is exposed, these tubes can be stimulated by changes in temperature or certain foods. Here is an image of what the dentin tubes look like under the microscope:

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When the dentin is exposed, these tubes can be stimulated by changes in temperature or certain foods. Here is an image of what the dentin tubes look like under the microscope:

The best way to find out why a tooth is sensitive is to have dental professional examine you. They can look for the signs of dentin exposure, and run tests to determine what the true cause of the sensitivity is. Sometimes, the sensitivity is due to a cavity or gum disease – these can be treated to address the sensitivity. Other times, the cause of the sensitivity is because the enamel has been lost through abrasion or erosion, or the gums have receded, causing the roots to be exposed.

What Can Be Done?

If the sensitivity is due to a cavity, a restoration can be placed. If gum disease is the cause, the dental professional can perform a thorough cleaning of the area.

However, if the cause is from dentin being exposed, then there are a number of professional and at home treatments that can be used to reduce the sensitivity.

In Office Procedures

  • Fluoride varnish can be applied to exposed areas, strengthening the enamel and dentin
  • Fluoride foam or gel can be placed into a mouth tray; you then sit with this in your mouth for 3-5 minutes, providing the teeth with a high concentration of fluoride to strengthen the areas
  • Bonding agent, the material used to stick tooth colored restorations to teeth, can be used to seal the dentin surface and provide a barrier to the stimuli that cause sensitivity

At Home

  • Use a very soft bristle tooth brush, with low abrasive tooth paste
  • Brush correctly and do not over brush
  • Use a tooth paste specially formulated to soothe the nerve endings in the tooth
  • Use a high concentration fluoride toothpaste (given to you by the dental professional) to strengthen the tooth surface

There are a number of treatments available, and your dental professional can help you find those that will work best, depending on your situation. Always seek a dental professional's help – do not try to diagnose this problem yourself. It may be the sign of something more serious, and only a dental professional can tell you what it really is.

Tooth Whitening

What Is It?

Tooth whitening is a procedure that lightens teeth and helps to remove stains and discoloration. Whitening is among the most popular cosmetic dental procedures because it can significantly improve the appearance of your teeth at much less cost and inconvenience than other techniques. The majority of dentists perform tooth whitening.

Every day, a thin coating forms on your teeth and it picks up stains. Also, the outer layer of each tooth, called the enamel, contains pores that can hold stains. Whitening is not a one-time solution. It will need to be repeated periodically if you want to maintain the brighter color.

What It's Used For

The most common reasons for yellowing or stained teeth are aging, tobacco, tea and coffee, which can stain the surface of the teeth.

It is also possible to have stains that are inside the tooth. These are called intrinsic stains. For example, intrinsic stains can be caused by exposure to too much fluoride as a child while teeth are developing. Other causes include tetracycline antibiotics taken during the second half of pregnancy or given to children 8 years old or younger when the teeth are still developing.

Tooth whitening is most effective on surface stains caused by age, foods or drinks.

Preparation

Cavities need to be treated before teeth are whitened because the whitening solution can penetrate decay and reach inner areas of the tooth, which can cause sensitivity. Also, whitening will not work on exposed tooth roots, because roots do not have an enamel layer. Receding gums can cause roots to become exposed. Whitening also does not work on crowns or veneers.

Whitening can be done in the dental office or at home. For in-office whitening, your dentist probably will photograph your teeth, which will help him or her to monitor how the treatment is progressing. Whitening in the office may involve two to six visits of approximately 45 minutes each. He or she also will examine your teeth and ask you questions to determine the type and severity of staining.

When the examination is complete, the dentist or a dental hygienist will clean your teeth. Once this is completed, the whitening procedure begins.

For whitening at home, your dentist will direct you to use custom trays that are made in the dental office and fit your teeth precisely. Home whitening usually takes two to three weeks. Over-the-counter kits also are widely available for home use. You should talk to your dentist about using these products, and use them according to directions to avoid overuse and possible damage to your teeth and mouth.

How It's Done

There are two main types of whitening procedures. When whitening is done on a tooth that has had root-canal treatment and no longer has a live nerve, the process is called non-vital whitening. Vital whitening means that the procedure is being done on teeth that have live nerves.

Non-Vital Whitening

Vital whitening may not improve the appearance of a tooth that has had root-canal treatment. If this is the case, your dentist will use a different procedure that whitens the tooth from the inside. He or she will place a whitening agent inside the tooth and will place a temporary filling. It will be left this way for several days. You may need this done only once, or it can be repeated until the tooth reaches the desired shade.

Vital Whitening

The most common type of vital tooth whitening involves placing a gel-like whitening solution, which usually contains hydrogen peroxides, in a tray that resembles a night guard or mouth guard. The tray is then placed over the teeth for a certain period of time — anywhere from an hour or two to overnight.

Tooth whitening can be done in the dentist's office or at home. In-office whitening (also called chairside whitening) has the advantage of allowing your dentist to supervise the process — and your progress — more closely.

In-office whitening usually takes between 30 and 90 minutes and can require up to three appointments with your dentist. The number of visits required will depend on the type of discoloration and how white you want your teeth to be.

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Your dentist will start by asking about your medical history to learn how your teeth became discolored. Different types of stains will respond differently to the treatment.

Your dentist will apply a special gel to the gums to protect them from the whitening agent. Then the whitening agent is applied. The most common substance used for chairside whitening is hydrogen peroxide.

Some whitening agents are activated by special lights or by heat. After the whitening agent is applied, the dentist will shine the light on your teeth for a short time. Some dentists have started to use lasers as a high-speed alternative to conventional whitening procedures. Consumers like the high-tech aspects of laser treatments, but the technology is still too new — and too expensive — to justify its general use. The American Dental Association states that while the technique may be safe, it has not seen published data on the safety or effectiveness of using lasers for tooth whitening.

If your teeth are badly discolored, you may need more extensive whitening than can be done in the office. Or you may decide you would prefer to whiten your teeth at home.

For in-home whitening, your dentist will take impressions of your teeth and will make one or two custom mouthpieces to fit you, depending on if you are having both upper and lower teeth whitened. It is important that the mouthpiece fit well so that the whitening agent remains in contact with your teeth and doesn't irritate your gums. Over-the-counter mouthpieces are unlikely to fit correctly and can cause gum irritation if the whitening agent seeps out.

At home, you will fill each mouthpiece with a whitening gel your dentist provides, and wear the mouthpiece for several hours every day. Many people achieve the amount of whitening they want within a week or two, but you may need to wear the mouthpiece for four weeks or longer.

Follow-Up

Your dentist may want to see you a few days after in-office whitening to check your gums. If your gums were exposed to the whitening agent, they can become irritated. If you are whitening your teeth at home, your dentist will want to check to make sure the process is working properly, usually after a week.

Whitening is not a permanent solution. The stains will come back. People who expose their teeth to a lot of staining may see the whiteness start to fade in as little as one month. Those who avoid staining foods and drinks may be able to wait six to 12 months before another whitening treatment is needed.

Re-whitening can be done in the dentist's office or at home. If you have a custom-made mouthpiece and whitening agent at home, you can whiten your teeth as frequently as you want to. You should discuss your whitening schedule with your dentist, and talk about what whitening products would work best for you.

Risks

Whitening is unlikely to cause serious side effects, although some people;'s teeth may become more sensitive temporarily. There may be mild gum irritation as well. Whitening procedures should not be done while a woman is pregnant because the effect of the whitening materials on the development of the fetus is not known. Since the procedure is cosmetic and option, it should be postponed until after delivery.

When To Call a Professional

If you feel your teeth would benefit from whitening, contact your dentist to discuss the procedure.

How Often Should You Go to the Dentist?

Fifty years ago, examinations of people entering the military showed that the average American's teeth were in pretty bad shape and few people took good care of their teeth. There were no guidelines for how often you should see a dentist, and many dental professionals focused on fixing problems rather than preventing them. Dental and health organizations trying to set standards for preventive dentistry settled on a "best guess" recommendation of twice-yearly visits to the dentist for checkups and cleaning.

The recommendation proved to be a useful rule of thumb and has remained common. Even if you take excellent care of your teeth and gums at home, you need to see your dentist regularly so he or she can check for problems that you may not see or feel. Tooth decay generally doesn't become visible or cause pain until it is in more advanced stages.

Regular visits allow your dentist to find early signs of decay and disease and treat problems at a manageable stage. Ask your dentist the best schedule for your routine dental visits.

On average, seeing a dentist twice a year works well for most people. A few people can get away with fewer visits; others may need more frequent visits. People with very little risk of cavities or gum disease can do fine seeing their dentist just once a year. People with high risk of periodontal disease(because of current gum disease, a weak immune response to bacterial infection or a predisposition to plaque buildup or cavities) might need to see the dentist every three or four months, or even more frequently, for the best care.

The schedule for any person may change during a lifetime. In times of stress or illness, it may be necessary to see the dentist more frequently than usual to help fight off a temporary infection or treat changes in your mouth. If you take good care of your teeth and gums at home and your dentist doesn't find any cavities or gum disease for a few years, he or she may choose to lengthen the time between visits.

What is a Filling?

A filling is a way to restore a tooth damaged by decay back to its normal function and shape. When a dentist gives you a filling, he or she first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a filling material.

By closing off spaces where bacteria can enter, a filling also helps prevent further decay. Materials used for fillings include gold, porcelain, a composite resin (tooth-colored fillings), and an amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).

Which Type of Filling is Best?

No one type of filling is best for everyone. What's right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost. Considerations for different materials include:

Gold fillings are made to order in a laboratory and then cemented into place. Gold inlays are well tolerated by gum tissues, and may last more than 20 years. For these reasons, many authorities consider gold the best filling material. However, it is often the most expensive choice and requires multiple visits.

Amalgam (silver) fillings are resistant to wear and relatively inexpensive. However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth.

Composite (plastic) resins are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The ingredients are mixed and placed directly into the cavity, where they harden. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of fillings generally from three to 10 years.

Porcelain fillings are called inlays or onlays and are produced to order in a lab and then bonded to the tooth. They can be matched to the color of the tooth and resist staining. A porcelain restoration generally covers most of the tooth. Their cost is similar to gold.

If decay or a fracture has damaged a large portion of the tooth, a crown, or cap, may be recommended. Decay that has reached the nerve may be treated in two ways: through root canal therapy (in which nerve damaged nerve is removed) or through a procedure called pulp capping (which attempts to keep the nerve alive).

What Happens When You get a Filling?

If your dentist decides to fill a cavity, he or she will first remove the decay and clean the affected area. The cleaned-out cavity will then be filled with any of the variety of materials described above.

How Do I Know if I Need a Filling?

Only your dentist can detect whether you have a cavity that needs to be filled. During a checkup, your dentist will use a small mirror to examine the surfaces of each tooth.

Anything that looks abnormal will then be closely checked with special instruments. Your dentist may also X-ray your entire mouth or a section of it. The type of treatment your dentist chooses will depend on the extent of damage caused by decay.

Silver Amalgam
Gold filling
White filling(composite)

What are Dental Crowns and Tooth Bridges?

What are Dental Crowns and Tooth Bridges?

Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

How do Crowns Work?

A crown is used to entirely cover or "cap" a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

Your dentist may recommend a crown to:

  • Replace a large filling when there isn't enough tooth remaining
  • Protect a weak tooth from fracturing
  • Restore a fractured tooth
  • Attach a bridge
  • Cover a dental implant
  • Cover a discolored or poorly shaped tooth
  • Cover a tooth that has had root canal treatment

How do Bridges Work?

A bridge may be recommended if you're missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.

Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.

How are Crowns and Bridges Made?

Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.

Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

How Long do Crowns and Bridges Last?

While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by Brushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings.

To prevent damage to your new crown or bridge, avoid chewing hard foods, ice or other hard objects.