expert type icon EXPERT

Dr. Keith S. Tang, DDS

Dentist

Dr. Keith Tang is a Dentist practicing in Irvine, CA. Dr. Tang specializes in preventing, diagnosing, and treating diseases and conditions associated with the mouth and overall dental health. Dentists are trained to carry out such treatment as professional cleaning, restorative, prosthodontic, and endodontic procedures, and performing examinations, among many others.
27 years Experience
Dr. Keith S. Tang, DDS
  • Irvine, CA
  • UCLA School of Dentistry
  • Accepting new patients

Brushing too hard?

When you brush, it is best to confine your brushing to your teeth, but make sure you are cleaning all surfaces of your tooth effectively. Brushing should also be passive and READ MORE
When you brush, it is best to confine your brushing to your teeth, but make sure you are cleaning all surfaces of your tooth effectively. Brushing should also be passive and light especially at the gumline. This means that ideally people that with gum recession should look at their teeth when they brush, not use toothpaste at the gumline for greater visibility, and have the brush hug the tooth from all different angles without a lot of pressure. It is ok to use a fluoride toothpaste on the chewing surface and the areas where the brushing won't touch your gums.

It is not possible to brush your teeth well with a manual toothbrush without brushing your gums at the same time . However, it is possible to accomplish this goal without hurting your gums with a Braun Professional Toothbrush. There are only 3 brush heads that I recommend using. Please see my video on Youtube at the link below for a more detailed explanation of how to use a Braun toothbrush and don't forget to floss twice a day.

https://www.youtube.com/watch?v=SfrVFe37V1Y

Do dentists offer services to the uninsured?

Yes, most dentist treat patients without dental insurance. Many offices offer payment plans or work with other companies like Care Credit to help their patients get the treatment READ MORE
Yes, most dentist treat patients without dental insurance. Many offices offer payment plans or work with other companies like Care Credit to help their patients get the treatment they need. It is a good idea to keep up with your cleanings and checkups even if you don't have dental insurance.

If there is a dental issue, treat it early. I have seen too many patients who waited to get dental insurance and a tooth that could have been a simple filling turned into major treatment that maxed out their insurance with that one tooth. Then they had other teeth with dental issues that they had to pay out of pocket because the cavity spread to adjacent teeth.

Front tooth cavity

Composite fillings do chip, wear, and discolor over time which will require replacement to keep them looking good. Porcelain veneers or crowns are another option to consider depending READ MORE
Composite fillings do chip, wear, and discolor over time which will require replacement to keep them looking good. Porcelain veneers or crowns are another option to consider depending on the size of the defect, the length of time the filling looks good, and biting forces on the restoration. Talk to your dentist to review your options and discuss the advantages and disadvantages of each choice.

How can I stop pushing on my front teeth when I swallow?

What you describe is called a tongue thrusting habit. You may need tongue physical therapy to retrain your tongue muscles to swallow without pushing on your front teeth. There READ MORE
What you describe is called a tongue thrusting habit. You may need tongue physical therapy to retrain your tongue muscles to swallow without pushing on your front teeth. There are physical therapists who specialize in this field. Talk to your dentist or orthodontist for a referral.

Pain after a filling?

I would advise you to contact the dentist who did the filling. There are several possible causes. An X-ray and an exam with testing are needed to determine the cause of your issue. READ MORE
I would advise you to contact the dentist who did the filling. There are several possible causes. An X-ray and an exam with testing are needed to determine the cause of your issue. Hopefully, it's something simple like a filling adjustment.

Can a gum infection pass to other parts of the body?

Gums have a blood supply that is connected to other parts of one's body. Therefore the bacteria in one's mouth can be disseminated wherever there are blood vessels including the READ MORE
Gums have a blood supply that is connected to other parts of one's body. Therefore the bacteria in one's mouth can be disseminated wherever there are blood vessels including the heart, lungs, liver, kidneys, and other organs.

It is hypothesized that this will at least cause an inflammatory response in that area which can contribute to systemic diseases such as heart disease, cancer, osteoporosis, or even affect a pregnancy.

See the link below for more information about periodontal disease and how to treat or prevent it.

https://www.irvinedds.com/dental-services/periodontics.html

How can I close the gap between my frontal teeth?

We often have patients in our office who have cosmetic concerns such as yours. Possible treatment options include 1. Clear Aligner Therapy using Invisalign- a series of clear READ MORE
We often have patients in our office who have cosmetic concerns such as yours. Possible treatment options include

1. Clear Aligner Therapy using Invisalign- a series of clear plastic trays that gently move teeth to the desired position.
2. Porcelain Veneers- thin porcelain shells that are bonded to the front of one's teeth to reshape, change the shade, or close spaces.
3. Composite bonding-this is a cheaper and temporary solution similar to porcelain veneers but does not look as good. The composite filling material is bonded to one's teeth but is not as smooth as porcelain and therefore tends to stain, discolor, and chip more readily over time.

I would recommend an evaluation by a cosmetic dentist with a photo simulation to see which option is best for you.

For more information on Invisalign see the link below.
https://www.irvinedds.com/dental-services/orthodontics/invisalign.html

What are the most visible signs and symptoms of a gum disease?

Periodontitis or Periodontal Disease is gum and bone infection that is caused by the build-up of bacteria around one's teeth above and below the gumline. This accumulation of bacteria READ MORE
Periodontitis or Periodontal Disease is gum and bone infection that is caused by the build-up of bacteria around one's teeth above and below the gumline. This accumulation of bacteria in the form of plaque (soft) or tartar (hard stone like material) causes the body’s immune system to attack one's gums and bone, leading to inflammation of one's gums and the alveolar bone dissolving away.

Signs and symptoms are related to the stage of periodontal disease and can include bad breath or taste, swollen or bleeding gums, and eventually tooth mobility. Please see my website at the link below for a more detailed explanation of periodontal disease and the sign/symptoms associated with each stage.

https://www.irvinedds.com/dental-services/periodontics.html

What is gingivitis and its risk factors?

Please see my website for an explanation of the stages of periodontal disease at https://www.irvinedds.com/dental-services/periodontics.html Prevention is aimed at minimizing READ MORE
Please see my website for an explanation of the stages of periodontal disease at https://www.irvinedds.com/dental-services/periodontics.html

Prevention is aimed at minimizing the harmful bacteria causing the disease including
1. Properly brushing and flossing your teeth at least after breakfast AND at night before bed. Mouthwashes are not helpful if your teeth are not clean because they won't reach the areas covered in debris.
2.Visiting your dentist as recommended for cleaning and check ups. The frequency is based on your level of oral health and your gum measurements (periodontal charting). This will also allow your dentist the opportunity to identify the condition in the early stages and treat it before bone loss occurs.

Is a root canal during pregnancy safe?

If you are in pain and/or have an infection of the tooth, it is best to have the root canal done. The dentist doing the root canal should be using a lead apron which will shield READ MORE
If you are in pain and/or have an infection of the tooth, it is best to have the root canal done. The dentist doing the root canal should be using a lead apron which will shield your baby when he or she takes x-rays to check the progress of the root canal. The actual procedure of the root canal should not have any effect on your baby and the amount of radiation from dental x-rays is very small as the films have improved over time.

See http://www.ada.org/en/member-center/oral-health-topics/x-rays for more information about dental x-rays.

Is it bad if a piece of an old filling falls out?

It depends on the size/depth of the resulting defect, if the defect will trap food causing decay, and what part of the tooth is affected . Ex. A defect between the teeth should READ MORE
It depends on the size/depth of the resulting defect, if the defect will trap food causing decay, and what part of the tooth is affected . Ex. A defect between the teeth should be replaced as soon as possible, but a very small chipped area on the chewing surface that does not have decay and is cleansible with a toothbrush may not be as much of a priority to replace. Please see your dentist to determine if the filling needs replacement.

I don't understand how I got Periodontal disease

While there are genetic factors that predispose people to periodontal disease, the key to managing or preventing it is to keep one’s mouth impeccably clean for the vast majority READ MORE
While there are genetic factors that predispose people to periodontal disease, the key to managing or preventing it is to keep one’s mouth impeccably clean for the vast majority of a 24 hr. day. As part of the treatment for this disease, we use a pink food coloring to show our patients where they may be missing with their brush and floss. People are often surprised how much plaque (mixture of food, debris, and bacteria) there is on and between their teeth.

To treat periodontal disease, I recommend the following
1. Deep cleaning to remove the calculus/tartar (hard stone like material) stuck on one’s teeth, both above and under the gumline. This is a step that must be done by a dental professional because brushing alone will not remove it.
2. Use of a Oral B Braun motorized toothbrush with instructions and coaching on how to use it optimally. I minimally suggest brushing with a Braun motorized brush and flossing after breakfast in the morning AND at night before bed to remove the soft bacterial plaque. Note that most people brush their teeth before breakfast and go through the entire day with their teeth dirty.
3. Maintenance cleanings by a dentist or hygienist with the frequency determined by the severity of one’s disease.

For more information about periodontal disease, visit my website at https://www.irvinedds.com/dental-services/periodontics.html

How to get rid of mouth ulcers

Mouth ulcers are usually caused by viruses or localized soft tissue trauma. As long as there isn't anything that is contributing to them staying around, they unfortunately have READ MORE
Mouth ulcers are usually caused by viruses or localized soft tissue trauma. As long as there isn't anything that is contributing to them staying around, they unfortunately have to run their course to heal on their own. Taking vitamin C, reducing salty and spicy foods, and using Kanka or Orajel (for pallative relief) can be helpful to make sure they heal quickly.

For answers to common dental question, please visit my website at Irvinedds.com

Food getting stuck behind wisdom teeth

It sounds like the wisdom teeth are creating a hygiene issue. This means that you can't really access them to clean them well. Generally, this will lead to a bigger problems READ MORE
It sounds like the wisdom teeth are creating a hygiene issue. This means that you can't really access them to clean them well. Generally, this will lead to a bigger problems eventually. Unless there is a major reason to not remove them, it is better to have them taken out in the long run.

For answers to common dental questions, please visit my website at Irvinedds.com

Is reflux giving me bad breath?

If oral health and diet are not a factor, then a systemic condition like acid reflux could be the cause of mouth odors. Mouth rinses, breath mints or other oral hygiene aids READ MORE
If oral health and diet are not a factor, then a systemic condition like acid reflux could be the cause of mouth odors. Mouth rinses, breath mints or other oral hygiene aids won't be helpful. It would be the best for you to consult your physician regarding recommendations to treat acid reflux or GERD.

For patients with GERD, we also recommend that they use Proenamel toothpaste. It is especially formulated for acidic mouths which are more prone to erosion and accelerated wear.

Did my dental x-rays harm my baby? (first trimester)

This should not be a concern especially if you had a lead apron on and they use F speed film or digital x-rays. Also the amount of radiation is very low compared to other health READ MORE
This should not be a concern especially if you had a lead apron on and they use F speed film or digital x-rays. Also the amount of radiation is very low compared to other health related x-rays. Please see the link below from the American Dental Association regarding "Radiation Exposure in Dentistry" and their statement on "Dental Radiography and Pregnancy."

http://www.ada.org/en/member-center/oral-health-topics/x-rays

I wear my retainer, so why are my teeth still shifting?

It sounds like the retainer is not working properly. Identifying the type of movement occurring will help in deciding the best type of retainer or design to stop that movement. READ MORE
It sounds like the retainer is not working properly. Identifying the type of movement occurring will help in deciding the best type of retainer or design to stop that movement. If the retainer is a clear plastic retainer, the retainer will naturally distort over time. If is a traditional hawley retainer, maybe it can be adjusted or have accessories added to control the movment. You should see the dentist or orthodontist who delivered the retainer to see what they can do.

Also depending on how much movement has occurred, you may have to do some minor orthodontic movement with something like Invisalign. See the link below if you would like more information about clear aligner therapy.

https://www.irvinedds.com/dental-services/orthodontics/invisalign.html

What if only one tooth is crooked?

If the crooked tooth doesn't have the space to put it in the proper alignment (crowding), you will need orthodontics to move the other teeth to provide the space. Orthodontics READ MORE
If the crooked tooth doesn't have the space to put it in the proper alignment (crowding), you will need orthodontics to move the other teeth to provide the space. Orthodontics could be clear aligner therapy (like Invisalign), braces, or removable appliances depending on the amount and type of movement needed. Click on the link below at my website for more explanation abput orthodontics.

https://www.irvinedds.com/dental-services/orthodontics.html

Is water-flossing as effective as regular flossing?

Most dental diseases are caused by bacteria. To prevent these dental issues, reducing the amount of bacteria is very important. This is why, we recommend that our patients READ MORE
Most dental diseases are caused by bacteria. To prevent these dental issues, reducing the amount of bacteria is very important. This is why, we recommend that our patients brush and floss well at least after breakfast and before bed.

A Water flosser may be helpful for people who find it difficult to floss and won’t floss, such as patients with braces. However, it not as good at preventing dental diseases as regular flossing.

As an analog, lets say you have a really dirty plate and you take it to the sink and spray it off. Does it look clean afterwards? Most people would say No. To get it clean, you have to take a scrubber and physically touch the surface to remove the debri from it. The Water flosser is like the water spray from the facet. It reduces the amount of debri but leaves a lot behind.

We have seen multiple patients over the years, who use a Water Flosser thinking it will prevent cavities and periodontal disease. Unfortunately, it does not. See the link below for more explanation about periodontal disease. https://www.irvinedds.com/dental-services/periodontics.html

What can I eat or avoid eating to reduce plaque?

If there is still a good amount of plaque on your teeth after brushing and flossing, it means that you may not be doing it properly or long enough. If you are using a regular READ MORE
If there is still a good amount of plaque on your teeth after brushing and flossing, it means that you may not be doing it properly or long enough. If you are using a regular toothbrush, the bristles may not be touching all areas of the tooth to remove the debri. See my Youtube channel for a recommendation on the motorized brush and instructions on usage at https://www.youtube.com/watch?v=SfrVFe37V1Y

It is good that you already avoid sugary foods when possible. As a general recommendation, it's best to limit the length of time sweets and carbohydrates (that turn to sugar) are in contact with your teeth. Sticky foods are worst because they will take longer to dissolve or clear from your teeth and gums.