Frequently Asked Questions

• Which toothpaste should I use?

  Arm & Hammer Dental Care® is a good toothpaste, and because it has about four times more baking soda than most other toothpastes, it’ll leave your teeth looking and feeling squeaky clean. The other one I’d recommend is Crest Regular Paste (the one we all grew up with). It’s nothing fancy, but it’s still a great toothpaste. If you’re looking for a toothpaste without fluoride, you still have a lot of options. A doctor friend of mine brought a new one for me to try called Nano Silver Standard, which is a colloidal silver toothpaste that seems to work well.

  While we’re on the topic of oral hygiene, let’s talk floss. Mathematically speaking, brushing your teeth cleans only about 60% of the surfaces in your mouth. By neglecting to floss, you have a 100% chance of developing problems in the other 40% of your mouth! We dentists usually recommend using plain, unwaxed floss, as it tends to be more absorbent and less slippery than waxed varieties, but the kind of floss you use isn’t nearly as important as how often you use it: once a day, every day.

• When I floss, my gums bleed. If they don’t hurt and my teeth look fine, is it really a big deal?

  Bleeding gums can be an indicator of gingivitis or even gum disease. Gingivitis is characterized by swollen, bleeding gums, is usually painless, and unlike full-blown gum disease, can be treated and even reversed. Our first lines of treatment for gingivitis are simple lifestyle changes. Flossing daily not only removes the plaque and bacteria your toothbrush can’t reach, but also strengthens gums and keeps them clean. Using a toothbrush with soft bristles can ease gum damage, too, and regular dental cleanings will control plaque and tooth decay.

  It's important to stop gingivitis before it progresses into gum disease. Recent studies have linked a number of serious illnesses to gum disease, from heart disease and strokes to diabetes, osteoporosis, and even inflammatory diseases such as Rheumatoid Arthritis. If we suspect that you are suffering from moderate to severe gum disease, we will most likely recommend a deep cleaning, also known as root planing, to remove the tartar that floss can’t reach. Root planing goes below the gumline to clean out areas of the gums that have pulled away from the root and become susceptible to infection. By monitoring these “pockets” with deep cleanings and more frequent checkups, we can prevent many of the serious health complications associated with gum disease—and most likely save your teeth, too!

  Though not a likely culprit for mild gum irritation, severely swollen, receded, or bleeding gums could be a symptom of oral cancer. Oral cancer can be difficult to diagnose because many of its symptoms are associated with other medical conditions. They include sores, difficulty swallowing or moving the jaw, bleeding gums or cheeks, and a continuous pain in the mouth. If Dr. Hastings and our team can find no other cause for your bleeding gums, we may recommend a visit to a specialist.

• I seem to build up a lot of tartar on the tongue side of my lower front teeth. Am I brushing often enough?

  When my patients ask me how often they should brush, I usually recommend three times a day—whether you think you need to or not! Tartar build-up is most commonly related to a pH problem, as bacteria thrive in an acidic environment. Acids are present in a number of different foods, some of which may surprise you: sodas, breath mints, gum, sports drinks, coffee or tea (especially when sweetened with sugar), candy, and carbonated flavored water are just a few common causes of acidic pH. Eliminating these foods from your diet and being more diligent about brushing and flossing the affected area should noticeably reduce the tartar build-up on those teeth. However, if you change your habits and still don’t see a difference, call or stop by our office so we can ensure there is no underlying condition affecting the pH of your mouth.

• Is it safe to get my teeth cleaned while I’m expecting?

  Regular dental cleanings during pregnancy are completely safe, and they’re good for you and your baby, too. Gum disease has been associated with a number of health problems, including heart disease, diabetes, and strokes, but gum disease can be particularly dangerous for women who are expecting. Certain hormone fluctuations that occur during pregnancy can cause gums to swell and bleed more easily, making them more susceptible to bacteria and infection. Recent studies have linked gum disease during pregnancy to such complications as gestational diabetes, premature birth, and low birth weight.

  Just one basic dental cleaning each trimester can help keep you and your baby healthy, and many insurance companies will reimburse you for these cleanings if you contact them and tell them you’re expecting. Unless it is an emergency, we recommend postponing more invasive dental treatment (such as crowns, root canals, or teeth whitening) until after your pregnancy.

• I don't have a toothache, and I brush and floss regularly. Do I really need a check-up?

  Biannual teeth cleanings performed by a skilled dental hygienist are central to keeping teeth and gums looking, feeling, and functioning well. If you have gum disease, more frequent visits to the dentist will probably be recommended for your oral and overall health.

  During cleanings, plaque and calculus (more commonly known as tartar) are removed from teeth. Plaque is a sticky deposit on teeth in which bacteria grow, and tartar is basically calcified or hardened plaque, so it is more difficult to remove. When tartar builds up under the gumline, causing gum disease, more extensive treatment than a standard cleaning is needed to remove it and help ensure healthier gums. Hygienists also polish teeth, floss (partly to test the condition of gums, to see if they bleed), and they document any bleeding along with stains they noted during the cleaning in a patient's file.

  Dental exams with a dentist make it so problems can be diagnosed and treated before they grow to be big, often painful and expensive. A typical exam includes a visual assessment of teeth and occlusion (bite), along with an appraisal of current restorations. When x-rays have been taken, the dentist will carefully review them to identify areas of decay and other possible areas of concern for cysts, tumors, and other disorders of the mouth. Panoramic x-rays are especially revealing and beneficial to this process. The dentist will perform a general screening for early detection of gum disease and oral cancer, as well.

  In between cleanings and exams at a dental office, brushing teeth at least twice a day (in the morning and at night) is the most important thing you can do to take care of your teeth. Brushing after every meal is even better, if you can. If not, chewing sugar-free gum after meals can get food particles out of teeth. Additionally, clean between teeth daily with floss or interdental cleaners, and remember to brush your tongue. Brushing your tongue, especially the back areas, can make a big difference in how clean your mouth feels and smells, and how clean it actually is. Restorations, such as bridges and partial dentures, should be cleaned thoroughly, too, just like natural teeth. Toothbrushes should be replaced every two to three months.

• How can I tell if I'm at risk for gum disease?

  According to MedlinePlus, a service of the U.S. National Library of Medicine and National Institutes of Health, about 80 percent of U.S. adults currently have some form of gum disease, ranging from gingivitis to serious periodontal disease. The prevalence of gum disease increases with age, because as we age, our teeth wear down, our gums naturally recede, teeth can become more sensitive, and medications can affect some oral changes. If your gums feel tender or sore, or if they look red and swollen, you may be at risk for gum disease. Other signs include bleeding and/or receding gums, pain or sensitivity in your teeth (and even loose teeth, caused by weakening gum fibers and/or bone loss), and persistent bad breath. If left untreated, gum disease can lead to tooth loss as well as various other health problems. More and more life-threatening illnesses are being linked to the presence of dental diseases.

  The first thing to do is get a thorough dental evaluation. If you have any degree of periodontal disease, Dr. Hastings can help. He strongly believes in and focuses on the importance of healthy gums for a healthy mouth and body. Gum disease used to require surgery more often than not. While surgery is still an option and sometimes needed, many cases are now treated with less invasive techniques first, such as deep cleanings, local antibiotics, and special rinses. Please come in and let Dr. Hastings help you achieve and maintain healthier gums for a healthier you.

• How can cosmetic dentistry improve my life?

  A more beautiful smile can make life more beautiful. Studies have shown that a healthy and attractive smile can raise self-esteem, increase confidence, improve your personal as well as your professional life, and help you make better first impressions on others. Sometimes it doesn’t take much treatment for you to feel better about your smile, and there are a variety of subtle, yet noticeable ways that smiles can be enhanced. There are also more significant and dramatic treatment procedures (and combinations of procedures), often called “smile makeovers,” that can totally change teeth and smile appearance, to give you the smile of your dreams.

  While there is no true “specialist” association with cosmetic dentistry, there are a number of organizations with advanced training and awards associated with cosmetic dentistry. Some dentists place greater emphasis on cosmetic dentistry treatments, especially when they have an exceptionally artistic eye and/or particular enjoyment for cosmetic procedures.

  Advancements in dental technology have made it possible for dentists to address a wide variety of issues affecting smile appearance. Some common cosmetic dentistry treatments include teeth whitening, cosmetic bonding and enamel shaping, porcelain veneers, bridges, and orthodontic solutions (including braces and aligner therapy). Replacing old, amalgam (silver) fillings with tooth-colored fillings can also be considered cosmetic in nature, as it is done to improve both the health and structure, and the appearance of teeth. Really, all dental treatment aimed to improve the appearance of your teeth, gum shape, and smile can be considered cosmetic in nature.

• Is professional teeth whitening safe?

  Bleaching is a safe and effective way to brighten your smile. The most common side-effect is tooth sensitivity, and that usually occurs as a result of the rapid or same-day whitening procedures. If you’re worried about having an adverse reaction to bleaching, try a take-home whitening kit. These custom-made trays let you control the amount of bleach you use and the length of time you use it. If you do experience some sensitivity, stop using the bleach until it goes away, then continue the whitening process. Also, always brush your teeth before and after bleaching with a basic white toothpaste (such as Arm & Hammer Dental Care®, which I mentioned earlier). With take-home kits, you can expect to see a brighter smile in about two weeks.

• Doc, I’ve always had sensitive teeth. Any suggestions for how I can stop the pain?

  If you’ve been avoiding that ice cream cone or cup of coffee because of sensitive teeth, you don't have to! Sensitivity is a common complaint, and can be the result of a number of factors. Involuntary grinding, jaw clenching, gum recession, and enamel loss can all cause teeth to become extra sensitive, because the usually-protected layer of dentin--the nerve-packed surface beneath the enamel--is exposed to external stimuli. Surface irritants such as braces and teeth whitening can also cause temporary sensitivity.

  I usually recommend that patients with sensitive teeth try brushing with a toothpaste specially formulated to reduce sensitivity. In addition to the variety on the shelves these days, there’s also an old stand-by called Pearl Drops (the liquid, not the paste) that seems to work pretty well. You can order it online. There are also over-the-counter fluoride rinses you can use to prevent further damage to your enamel, and we can even provide an in-office procedure to coat your teeth with a protective agent.

• What is "comprehensive dentistry"?

  Our aim is to have all concerns and issues known – to us and to you – and hopefully resolved before an emergency. We want everyone to have healthy, attractive, and stable teeth and smiles. (Nobody likes a toothache or broken tooth, especially since they never happen at convenient times.) This means that we see patients for many reasons with many different needs. Our services range from routine preventive care to life changing restorative and cosmetic treatment, so we have something to offer everyone to address their personal chief concern and needs.

  The second half of this equation is the development and fulfillment of ongoing maintenance plans. This minimizes the chance of original problems reoccurring. We will do everything we can to customize your maintenance plan based on your individual situation.

  Maintaining good oral hygiene at home is important, but man cannot live by toothbrush alone. In-office exams are critical to keeping your smile clean and healthy. Your dental team has the ability to remove plaque your toothbrush can’t, which reduces your risk of tooth decay and gum disease. They can also use panoramic x-rays and intraoral cameras to monitor structures that aren’t so obvious to the naked eye.

  Although preventive dentistry is fairly predictable, our goal is to have all issues and concerns known – to us and to you – in order to reduce your risk of dental emergencies. We want you to have a healthy and stable smile, but we also know that accidents happen. In a way, "comprehensive" care really refers to our commitment to the present and the future of your smile. Not only do we want to keep it healthy, we want to make it beautiful, and make it last.

• A couple of my teeth have been worn down and need to be replaced. Should I opt for crowns?

  Crowns, often called "caps," cover teeth to restore them to their appropriate shape and size after large fillings, fractures, and/or weakening forces such as intense grinding. In all of these cases, crowns not only cover teeth but provide added support as well. Crowns can also be used to attach bridges, cover dental implants, restore seriously discolored or misshapen teeth, and even as a preventive measure to protect a tooth in danger of breaking. Crowns can be made of all-porcelain (ceramic) material, porcelain fused to metal (for added strength), gold alloys (high noble), or base metal alloys (non-noble). Each of these restorative materials has its advantages and disadvantages. All-porcelain restorations most closely mimic natural tooth appearance. Their strength depends on adequate porcelain thickness, thus this material requires more extensive preparation. Porcelain fused to metal alloy restorations are tooth-colored and stronger than all-porcelain crowns. Gold alloy crowns are very strong and wear resistant. They are well tolerated in terms of biocompatibility, but metal colors do not match natural teeth. Base metal alloy crowns are similar to gold for strength and durability. However, allergy to the non-noble base metals may be an issue with some patients.

  Crowns can be placed in as few as two appointments. For porcelain crowns, properly matching the aesthetics of teeth can take more visits but the natural looking cosmetic results are worth it to most patients. Crowns in general are very strong restorations, and they help to protect teeth. If a crown is placed before the tooth is so badly decayed or so weak that it fractures, the necessity of a root canal can often be preempted. This can also help prevent a broken tooth from becoming so bad that it needs to be removed, which would require a bridge or implant for restoration.

  In light of their excellent restorative capabilities, crowns have few disadvantages. As they are more extensive restorations than fillings, their relative cost is higher. However, if our doctors recommend a crown it is because we want to help you keep your teeth healthy and looking good for years to come. The problems crowns help to prevent and repair offset the cost.

  Also, while crowns are highly resistant, due to normal wear they will eventually need to be re-cemented or replaced. Six to nine percent of teeth that are damaged enough to need a crown may someday need a root canal.

• Do you place mercury-containing silver fillings?

  No, I quit placing them years ago for personal reasons. I love the color of natural teeth, and I felt that I should start using tooth-colored materials that better mimic your tooth’s natural shape and color.

• I had a tooth-colored filling that lasted for years. Recently, my dentist replaced it and it keeps coming off. What’s the matter?

  Most of the time the tooth that was protecting that filling has worn down, making the filling act as an interference. Constant pressure from chewing, grinding and/or clenching can also cause dental fillings to wear away, chip, or crack. If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to deeply infect the tooth and even cause an abscess and/or eventual loss of the tooth. Again, regular dental checkups enable us to monitor areas of concern and help keep you in optimal oral health.

  When restorations are large, or if recurrent decay is extensive, there might not be enough remaining tooth structure to support a replacement filling. In these cases, we may need to replace the filling with a natural looking porcelain crown.

• I’ve been told I need root canal therapy. What should I know before my appointment?

  Beneath the top layer of your tooth (the enamel) and the second layer (the dentin), there is a pulp, or nerve, which delivers sensations such as heat, cold, and pain to the brain. Whether from excessive decay or physical trauma, this nerve can become damaged, causing an abscess to form at the root of the tooth. Your dentist has recommended root canal therapy, a procedure in which the diseased pulp is removed from an infected tooth, to prevent further damage and tooth loss, and most importantly, to relieve your pain.

  Symptoms of an infected root include severe toothaches, sensitivity, discoloration, and upraised lesions on your gums. X-rays and a thorough dental examination determines whether a root canal your best option. Though root canal therapy has a reputation for being painful, the toothaches associated with an infected root are most likely causing you more pain than the treatment will. In addition, there are a number of ways to relieve pain and discomfort, including nitrous oxide and oral sedation.

  The nerve is not vitally important for day-to-day function, so removing it will not affect your tooth—unless you count saving the tooth from total loss! In fact, allowing it to decay further can lead to more pain and bone loss. Usually, an over the counter pain medication takes care of immediate post-operative discomfort, and most patients return to normal activities the very next day. Root canal therapy is highly successful, but hopefully, as dental technology progresses, we’ll find ways to more effectively combat bacteria and prevent the need for root canals altogether. Until then, a root canal is your tooth’s best chance.

• Are there any specific oral health concerns associated with diabetes?

  While having diabetes does not automatically put your dental health at risk, it does make a person more susceptible to certain conditions. Uncontrolled diabetes causes high glucose levels in saliva, which can promote the growth of bacteria in the mouth and increase the risk of cavities. Diabetes also reduces the body’s resistance to infection, which can make an individual more likely to develop illnesses such as gingivitis or even gum disease. Symptoms of gingivitis, which is an early form of periodontal disease, are red, sore, receding, or bleeding gums; if you notice these to any degree, be sure to make an appointment with your dentist. Other, less serious, problems that can occur include thrush (a treatable infection in the tongue and cheeks), ulcers, and dry mouth.

  Interestingly enough, this connection is a two-way street. For patients with severe gum disease, the infection in the gums can affect the blood glucose levels and the immune system, actually increasing the overall risk of developing diabetes. If you have diabetes, you know the importance of a healthy lifestyle. Smoking can be particularly damaging to diabetics, as it causes excess dryness and damage to the gum tissue. Ultimately, the most important factor is blood sugar. If you keep your diabetes under control with a healthy lifestyle and maintain good oral hygiene through regular check-ups, diabetes won't get the best of your smile.

• What should I do in case of a dental emergency?

  Let's face the facts: accidents happen, and especially when it comes to our teeth and mouths, they can be pretty frightening. Being careful is good prevention, but being prepared promises reassurance in any oral health emergency. It's important to know when home care will suffice and when a trip to the dentist is necessary, so here are some guidelines to help you through common situations:

  Toothache/Sore Gums. Rinse with warm water to remove any food or debris; if you notice anything lodged between teeth, floss to remove it. Take an over the counter pain medication (but never apply the medication directly to tooth or gums), and see your dentist if the pain persists.

  Chipped Tooth. Save the pieces, if you can, and rinse them thoroughly. Apply an ice pack or a cold compress to the swollen lip or gum tissue near the chipped tooth to prevent swelling. If the area is bleeding, apply gauze for ten minutes, or until the bleeding has stopped. See your dentist as soon as possible.

  Broken Tooth. With recent advancements in restorative and cosmetic dentistry, you might not lose your tooth. If there’s enough remaining healthy tooth structure, a dentist can create a crown that will “grab onto” your natural tooth, eliminating the need for root removal. While the success of this process, known as “crown lengthening,” depends on the severity of the break, it’s worth asking about options other than complete removal.

  Knocked Out Tooth. Depending on the situation, find the tooth and, holding it by the crown only, rinse it briefly with warm water. If possible, gently reinsert the tooth into the socket and bite down on gauze or cloth to keep it in place. If you cannot reinsert it, place it in a container of milk or salt-water. See your dentist as soon as possible—if treated within 2 hours, the tooth may be salvaged.

  Soft Tissue Injuries. Soft tissues such as gums, cheeks, lips, and the tongue tend to bleed heavily, only because the tissue contains a great deal of blood flow. To control the bleeding, first rinse with a warm, mild salt water solution. Apply pressure with gauze or a moistened towel for 15 to 20 minutes. Afterwards, to reduce swelling and help stop residual bleeding, apply a cold compress to the outside of your mouth. In the event of a serious soft tissue injury, in which the bleeding is profuse or the damage is visibly traumatic, it's best to stay calm, keep applying pressure, and go to the emergency room.

• Am I candidate for dental implant restorations?

  Dr. Hastings and our team work hard to stay on the leading-edge of restorative dentistry. If you or someone you love struggles with ill-fitting, uncomfortable dentures or a retainer with false teeth, we have a permanent solution. Quickly becoming the preferred method of dental replacement, implants can give your smile a second chance. They are useful in denture stabilization, but they can also be used in conjunction with crowns, bridges, and in single-tooth replacements.

  Permanent implants are not only more durable and long-lasting than traditional tooth replacements, they also look and feel more like natural teeth. Most importantly, they function like natural teeth, so you can chew, talk, and smile with confidence again. Because the implant procedure allows for more of your healthy tooth structure to be saved, fixed implants can even prevent bone loss.

  Many patients suffering from advanced tooth decay, root canal failure, trauma to the mouth, or just extreme natural wear and tear on teeth are benefiting from this revolutionary option in restorative dentistry. However, there are still some things to consider before you decide on dental implants. For example, they are best performed after adolescence, when the teeth and jaw bone are fully developed. Additionally, the implant procedure can be more complicated for individuals with periodontal (gum) disease, active diabetes, immune deficiencies, and for patients who smoke. To ensure that you get the treatment that’s right for you, keep our team at Discovery Park Dental informed and up-to-date about your entire medical history and dental habits.

• I have a recurring pain where my jaw meets my temple, and sometimes my jaw clicks when I chew. What's the problem?

  You could be suffering from temporomandibular joint disorder, or TMJ, which affects the flexibility and function of the temporal jaw joint and surrounding muscles. Because this area controls bite, speech, chewing, and all other jaw movements, the pain can be severe.

  TMJ has been attributed to a number of different causes, but the most common factor is the bite itself. A misaligned bite can place pressure on the jaw joint, forcing the muscles to work overtime in an effort to correctly align the upper and lower jaws. This not only compromises the function of your jaw, but it can cause a good deal of fatigue and pain in the facial muscles. Headaches, toothaches, and jaw clenching, popping, or locking are all common symptoms of TMJ. TMJ can also occur after a jolting face injury which causes a normally aligned jaw joint to become damaged or repositioned. For more information and on TMJ dysfunction, I suggest you watch the video on our TMJ page, then call our office about your treatment options.

  Professional treatment of TMJ ranges from minor fixes to surgical options. If we determine that the main cause of your TMJ is an irregular bite, we might create a MAGO splint (Maxillary Anterior Guided Orthosis) to help even out your bite and reposition your jaw. Another option is to reshape the actual surfaces of your teeth, thereby changing the way they fit together and the way your upper and lower jaws meet. If your TMJ is a structural issue in your jaw bone (as is usually the case with facial injuries), you may benefit from surgery. When it comes to TMJ treatment, it's important to choose the most conservative plan for your individual needs.

  In the meantime, alleviating pain through treating the symptoms can provide some relief. Heating pads or cold compresses can reduce swelling, and limiting your jaw movement (for example, cutting especially chewy foods out of your diet) can stop the clicking or popping. Massages can temporarily relieve muscle tension, and painkillers (medicated or over the counter) can reduce inflammation and make you more comfortable.

• What are the benefits of a dental radiograph (x-ray) examination?

  X-rays, also known as radiographs, are commonly used in dental exams of patients of all ages. Panoramic x-rays, which are taken every five to seven years and show the entire mouth, are particularly useful diagnostic tools. Panoramic x-rays are taken with a machine that circles your head providing a complete overview of all the teeth as well as the roots, upper and lower jawbones, the sinuses, and other hard surfaces in the mouth. Many problems with teeth and the surrounding tissues cannot be seen when we visually examine your mouth. An x-ray examination is needed to reveal:

  Small areas of decay between teeth or below existing restorations (fillings)
  Deep cavities
  Infections that can develop in the mouth bones
  Periodontal (gum) disease
  Abscesses or cysts
  Developmental abnormalities
  Some types of tumors
  TMJ dysfunction

  Detecting and treating dental problems at an early stage can spare you unnecessary discomfort, cost, and time. In cases where x-rays help us detect oral cancer and periodontal disease early, radiographs can also help save your life!

• What could be causing my dry mouth, and what can I do about it?

  Symptoms of dry mouth can include a sticky, dry, or burning sensation in the mouth, chronic bad breath, an altered sense of taste, and insufficient saliva. Dry mouth is particularly common in the elderly and the very young, but it can affect anyone at any given time, and there are a number of common causes.

  Dry mouth is a known side effect of many medications, from prescriptions to antihistamines. Medical conditions such as diabetes can also cause recurrent dry mouth, Cancer treatment (chemotherapy, radiation), hormone changes during pregnancy or menopause, and high levels of stress are other conditions that can lead to dry mouth.

  Dry mouth can be uncomfortable, and is one of the leading causes of chronic bad breath, but it can also make teeth more prone to decay and soft tissue more susceptible to infection. Because insufficient saliva endangers the health of your entire mouth, it’s important to ask your dentist about oral sprays, prescription drugs, or simple lifestyle changes that can provide relief.