Dr. Ramesh Kianfar, DMD

Invisalign is a great product, it all depends on the level that your front teeth are misaligned or protruded. A certified Invisalign dental provider can simply collected necessary impressions, pictures and information from you and after submitting it to Invisalign, a complete result can be obtained via Clincheck that would let you and your dentist know what are the reasonable result you should expect at the end of your treatment.

The best treatment for replacing a single tooth is always IMPLANT. The reason are:A bridge requires reduction of adj teeth. This is never a good plan, especially if they are perfectly in a good condition. Sometimes adj. teeth are small therefore a reduction may result in root canal therapy.If in the future one of those teeth require further treatment you will have to replace three teeth involved in the bridge; the two adj teeth and the missing teeth. Many patient rely on insurance coverage which at most is 50 to 80%, with maximum allowance of $1500 to $2000, you may reach your max prior to coverage for the bridge and your copay may increase. For a bridge, your payment is for three or more crowns depending on the number of the teeth involved in the bridge; hence your payment is very close to the implant cost. The most important issue for replacement of a single front tooth is cosmetic factor. Matching a single tooth requires expertise in cosmetic dentistry.

There are different types of cavity very small proximal cavities, not crossing the first layer of the tooth known as enamel are sometimes reversible by fluoride treatment. However, larger cavities ranging from crossing the enamel layer to close proximation to the nerve require restoration prior to becoming a bigger problem resulting in root canal or even extraction. 

Wisdom teeth are not just some extra teeth that are mandatory to be removed. Some wisdom teeth are perfect and function as other molars. Taking out wisdom teeth are only require if: they are causing pain or damage to soft tissue (gum), hard tissue (bone), other teeth, and misalignments of other teeth ordered by an orthodontist, oral surgeon, or your general dentist. They are always exceptions, but visiting your dentist would be the first step in evaluation of your wisdom teeth status and condition.

If I had a penny every time a patient asked me that.Tooth pain doesn’t not necessary mean cavity.First of all it has to be determine if the origin of the pain is the soft tissue such as gum related or hard tissue such as tooth and bone. A tooth pain requires X-rays, oral exam and review of symptoms.Some cavities may not show in the X-ray or in oral exam and only a competent dentist would be able to distinguish when a tooth has a cavity. Sometimes it is extremely difficult to diagnose the original of the pain, but the key is talking to your dentist.
Is the tooth sensitive to temperature, is it dull or severe, is it spontaneous (hurts all the time), does it hurt when you are eating? Drinking? What temperature: hot or cold? Does it hurt more at night? When did it started? Did it happen in the past? Is the tooth moving? Does the tooth have a filling and what kind of filling (metal vs. white)? How did it start? Did you have any recent extraction? Do you suffer from TMJ? And then follow-up questions. Find an experienced dentist that takes time to speak to you. A correct diagnosis by an expert dentist is worth every penny. Misdiagnosis can  cost much more than a pay out of pocket consultation exam. I know I did not give you a definite answer, but there are many reasons for tooth pain and a cavity is only one of them.
Best of luck. 

Unlike other treatments, dental implants are like your own teeth. You may have to change it due to periodontal problem eventually. Please keep in mind your implant is a combination of implant, crown and abutment. Crown and abutment could get damaged or loosened. They can be replaced very easily and does not require replacement of the entire implant component. A simple visit to the dentist would be the best way to find out if your implant needs to be replaced.

Hello,

There is not one simple answer for this question. Sometimes even experts can misdiagnose this. Tooth infection may show the following symptoms: spontaneous pain, severe lingering pain, severe pain to hot and cold, swelling of your face, warmth to touch, and more. On the other hand, I have seen infected teeth with none of these symptoms. Gum infection is normally due to lack of dental care, especially brushing, flossing, and professional cleaning. There may be bleeding and the pain is general area and not as severe as tooth infection. To properly diagnose either problem I recommend you to see a dentist, either problems won’t go away without proper care and can have Severe consequences.I hope this help to answer your question.

Dr. Kianfar

Absolutely. Depending on the level of sensitivity, you can use over-the-counter toothpastes for sensitivity or your dentist may recommend a prescription toothpaste for higher level of sensitivity which also reduces caries index.

Ramesh Kianfarr-Taheri, DMD

This is from me as a mother and a Dentist. I had to have root canal when I was 7 months pregnant and it was fine. But first you must check with your OB/GYN to clear use of None Epinephrine anesthetic. And let the Dentist know you are pregnant. They both should communicate in advance. Unfortunately infection is not a pregnancy with a time line no one can tell you how much time you have but if you are in pain due to infection you should see a dentist and possibly take antibiotics. Good luck, hope you feel better.

Unless necessary it is not required to replace all fillings. Necessary means presence of cavity, possible leakage which could cause cavity, sensitivity, discoloration and esthetic according to patients feeling regarding discoloration, cracked, broken and such. If you’re front restorations changing color you may want to use hydrogen peroxide for human consumption ( health stores have it) at night after eating and brushing. Maintenance is better than replacement, every replacement requires further tooth structure removal and additional issues in future. Keep in mind I am also very conservative. Replacing a filling may only require extremly little reduction of the previous restoration not the entire filling, the back can always be sanded and polished.

Extra pressure could damage soft tissue I am not affiliated with Phillips so I can freely tell you that Airfloss by Phillips is a great product. Always consult your dentist prior to purchasing dental products.

Anesthetic can be use at any time pending the procedure, patient pain threshold, medical history. At my office we recommend nitrous oxide for cleaning to avoid introducing chemicals into a patients body. You must always remember some anesthetic have chemicals that may have a negative effect due to unknown underlying medical issues.

I really would like to know the circumstances you were told that because technically the infection wouldn’t pass to the next tooth however if you have an abcess it could get large enough to effect other teeth. An abcess is a pocket of infection forming at the end of the root that is distroying the bone and this bone distruction can effect adj. teeth.

I can not tell you why your Dentist didn’t mention anything, but there are few reasons for loosing tooth structure at the gym line; brushing hard or Abrasion and a process called Abfraction. Abfraction is due to grinding or any stress or habit related excessive pressure on the teeth. I always use this example if you try to break a branch you can see splints breaking and fly off of it in the highest stress point: in the middle. The same things happens a to your teeth at the gum level. Although I do not like to prescribe anything unnecessary for my patient in either case I recommend Prevident 5000 which is a prescription fluoride tooth paste.
To avoid further damage you and your Dentist need to explore the reason behind your issue, resolve the problem (electronic tooth brush that automatically stop if excessive pressure is applied during brushing), a guard or what your dentist recommends. Remember you and your Dentist should be team working together.

There are many more permanent options such as crowns or veneers. But front teeth are extremely technique sebsetive. Your dentist must evaluate your bite (occlusion) in every possible position and movement and if necessary obtain a diagnostic model. Breaking front veneers or crowns can have bad consequence that surpasses time and money wasted. Color and shape harmony matching with your natural teeth is always another issue to consider. I strongly recommend if you decided to go that route make sure your Dentist is experienced in front teeth restoration and esthetic.

Of course, some dentists do offer services. In my office, the patients are offered fees with discount and payment plans. This is good for dentist and patient on personal, dental, financial and many other levels. My patients appreciate the discount and have even more trust in me as their dentist for understanding their circumstances and having compassion. It’s a win win situation.

There is always possibility of infection becoming larger and extend to adjacent teeth. The bone loss due to infection can make teeth loose and if not treated you may loose teeth. In case of tooth infection you should take antibiotics according to severity of infection and your allergy history.Always remember tooth infection always comes back even after taking antibiotics if it is not treated accordingly.

old metal fillings do not have a chemical bond with the tooth but a mechanical retention connection. when a metal filling falls out it is mostly due to: 1. cavity , 2. broken tooth, 3. filling is too old.
Either case a section of your tooth called Dentin is now exposed. Dentin is the layer before your nerve therefor you feel sensitivity. Unfortunately dentin is much more pron to cavity and if not covered it will cause further problems. Fill or Crown it according to the size of old filling or remaining tooth structure, and always remember if your tooth has more filling than tooth...crown is more logical treatment to avoid root canal and etc....

I prefer in my practice not to numb patients with understanding that I work very gently and slowly. the issue of getting numb prior to dental work depends on your pain trash hold, the depth of the cavity, your medical condition and most of all mutual respect and trust between you and your dentist. As a dentist who hates needle personally I have learned to listen and respect my patient's concerns and fears of dentistry. if you can trust your dentist listen to his advise about getting numb based on your treatment.

Bad Breath, bleeding gum, pain and discomfort, red gum, teeth mobility and sensitivity, and receding gum. Get into habit of looking inside your children's mouth and detect and possible issues in advance. take your children for dental exam, many problems only will be detected by xrays.