expert type icon EXPERT

WIlliam F. Scott, DMD

Dentist

Dr. William Scott is a Cosmetic, Implant & Family Dentist practicing in Warren, NJ at Deluxe Dental Group. Dr. Scott specializes in preventing, diagnosing, and treating diseases and conditions associated with the mouth and overall dental health. He is trained to carry out such treatment as professional cleaning, restorative, prosthodontic, and endodontic procedures, and performing examinations, among many others.
10 years Experience
WIlliam F. Scott, DMD
Specializes in:
  • Implant Dentistry
  • Cosmetic Dentistry
  • Family Dentistry
  • Warren, New Jersey
  • Temple Dental School
  • Accepting new patients

How much tooth should be left for a crown?

Hello, Wow, this is an incredibly astute question! Dentists can do some amazing things with teeth. Most people see teeth as being small and when they get drilled there is nothing READ MORE
Hello,

Wow, this is an incredibly astute question! Dentists can do some amazing things with teeth. Most people see teeth as being small and when they get drilled there is nothing left. However, dentists see a lot more than that. As a matter of fact, putting a crown on a tooth today is more a matter of convenience and desire than how much tooth is left.
Yes, there are rules to how much tooth needs to be there for a crown, i.e., 4mm of height is usually quoted in text books, but there are a lot of other factors that go into this. Textbooks will also talk about the ferrule of a tooth needing to be at least 1.5mm as well. However, there are plenty of times that a tooth is broken off at the gum line and we can still put a crown on it. It is a matter of knowing the rules and knowing what is important. Speaking of "knowing what is important"; just because we can put a crown on a tooth does not mean that we should. There are plenty of situations where we can create more tooth (crown lengthening procedure), do a root canal, put a post in the tooth, build it up, then put a crown on it. However, with the success of implants, more people are choosing to remove the tooth and put an implant in (implants are titanium and porcelain, they don't get cavities). The implant is usually the same cost or cheaper and it does not decay. If a dentist is suggesting a crown, there is usually enough tooth left to have a crown. Otherwise, the crown won't be able to go in. This also relies on the dentist abilities as well.
Hope this helps.

My best to you!

William F. Scott IV, DMD

Are black spots on teeth cavities?

Hello, This is a great question to be asking! Unfortunately, the answer is not so straightforward. Black spots on teeth cavities or staining. To distinguish between staining READ MORE
Hello,

This is a great question to be asking! Unfortunately, the answer is not so straightforward. Black spots on teeth cavities or staining. To distinguish between staining and cavity a good dentist has to take a few things into consideration, including: the area of the tooth it is on, hardness of the area, dietary habits, cavity susceptibility, etc. Certain areas of the tooth are more susceptible to cavities than others. If the black spot is soft (under careful exploration), it is likely to be a cavity. If it is hard, it could be staining. Dietary habits of the patient will suggest if staining is likely. If the person has never had a cavity before, it is unlikely that they started now unless some other factor has intervened. However, it is easier to say that black area is a cavity; so make sure it is a good dentist that does the exam.
Hope this helps.

My best to you!

William F. Scott IV, DMD

How do I know if my dental implant is healing correctly?

Hello, Good for you for taking interest in the process of your implant. There are two areas of concern with an implant healing. The initial placement of the implant and the READ MORE
Hello,

Good for you for taking interest in the process of your implant. There are two areas of concern with an implant healing. The initial placement of the implant and the gums around it. This usually heals without the person knowing about it. The person who places the implant will usually schedule a follow up visit to make sure the healing is going well. Finally, after a few months (usually 3-4) the person who placed the implant will schedule another follow up to check the long-term healing of the implant (osseous integration of the bone around the implant). This means the bone is going to heal around the implant and stabilize it. Unfortunately, there is no way to know during those few months if how the implant is healing. After the prescribed amount of time, the person who placed the implant will use a few different methods to check the stability. There is a machine that they can place on it, although some studies have shown that tapping on it is just as effective. It is noteworthy that even the best implants only get up to 60% of their surface area integrated with bone.
Hope this helps.

My best to you!

William F. Scott IV, DMD

How soon after a root canal can I get a crown?

Hello, Usually, a crown procedure is started 2 weeks after a root canal is finished. This gives the tooth some time to heal and any infection that might have been there to clear READ MORE
Hello,

Usually, a crown procedure is started 2 weeks after a root canal is finished. This gives the tooth some time to heal and any infection that might have been there to clear up. Leaving it this way gives the dentist access in case there is a need to go back and do further cleaning. After the tooth has been asymptomatic (pain free) for two weeks, the dentist will usually build the center of the tooth back up (the access for the root canal), then start preparing the tooth for a crown. Of course, there are some other times where this 2-week rule does not apply. If a person is traveling, the doctors may decide it is best to start the crown right away or to postpone and wait a few months. Health related issues may pop up and change the timing of the crown as well. Even pandemics have changed things. Plenty of people got root canals prior to the covid-19 pandemic, but cannot go back to the get the crown due to health related issues, or doctors retiring.
Hope this helps

My best to you!

William F. Scott IV, DMD

Are porcelain crowns stronger than teeth?

Hello, What a great question to ask! Of course the answer to this depends on the type of porcelain. Yes, there are different types of crowns with different types of porcelains. READ MORE
Hello,

What a great question to ask! Of course the answer to this depends on the type of porcelain. Yes, there are different types of crowns with different types of porcelains. Porcelain itself is very strong; however, its weakness comes when it is bound to metal. Porcelain is more likely to chip off when it is layered vs. solid porcelain. Right now zirconia is one of strongest crown materials currently. Even when talking about zirconia, crowns in the back of mouth are much stronger than crowns in front. The reason for this is because the aesthetics needed to make the crown do not allow for the stronger material. Hope this helps.

My best to you!

William F. Scott IV, DMD

Do sealants really prevent cavities?

Hello, Yes, properly placed and monitored sealants do prevent cavities. A sealant is a material that flows into the tiny pits and fissures of a tooth. It seals off this area READ MORE
Hello,

Yes, properly placed and monitored sealants do prevent cavities. A sealant is a material that flows into the tiny pits and fissures of a tooth. It seals off this area and does not allow bacteria to get in. If bacteria does get into the pits or fissures of the teeth, a toothbrush bristle is way too big to get them out. By sealing off the pits and fissures it keeps these areas clean.
It is important to know that sealants do fall out occasionally and need to be put back in. If they are not examined regularly, cavities can still develop.
Lastly, it is worth mentioning the history of sealants. For almost 5 decades insurance companies did not want to pay for them. Eventually even the insurance companies realized that sealants would prevent cavities and other more expensive dentistry. Now almost all insurances pay for sealants. Hope this helps

My best to you!

William F. Scott IV, DMD

Straightening one tooth?

Hello, People tend to look at orthodontics differently when it is their second time around. This time it is important to consider where the teeth are and where we want them READ MORE
Hello,

People tend to look at orthodontics differently when it is their second time around. This time it is important to consider where the teeth are and where we want them to go; as there are always a few different ways to treat the same case. It is often the case that it is only one or a few teeth the second time around. However, even if it is one tooth, something is going to have to go on the teeth to align them. This would normally be a good situation for Invisalign or some other clear aligner system.

In this case, we are looking at just the lower (mandibular) teeth, but the upper (maxillary) teeth need some consideration as well. If the upper teeth are aligned we generally want to leave them alone and only worry about the bottom. In this case, interproximal reduction (IPR) would be considered so that way only the lower front teeth would be straightened and treatment time would be 6 months or less.

At age 19 most would not consider an expander as this would mostly tip the teeth and it does not seem necessary. Lastly it is important to have a full orthodontic consultation especially with a connective tissue disease like Ehlers Danlos Syndrome. This will also check for any issues that might have arisen from the first round of orthodontics. I hope this helps.

My best to you,

William F. Scott IV, DMD

Deluxe Dental Group

How many teeth can an implant hold?

Hello, This is such a great question that is often overlooked! Ideally, one implant supports one tooth. This is what is done about 90-95% of the time. This situation has a READ MORE
Hello,

This is such a great question that is often overlooked! Ideally, one implant supports one tooth. This is what is done about 90-95% of the time. This situation has a nice high success rate (which is an important factor) over 90%. However, in the other 5-10% one implant will support two teeth. This depends on which teeth the implant is supporting. Usually, the implant will support a tooth and the second tooth will hang off the side of that tooth (cantilever system). This only works if the second tooth is smaller then the first tooth. It is not a good idea as it weakens the implant because the forces pull it to the side. Sometimes due to the shape and amount of bone available this is the only option. Finally, when a full arch is being reconstructed with implants between 10 and 14 teeth are replaced on 4-6 implants. Other than extreme cases, this is really the only time multiple teeth are supported by one implant. I hope this helps.

My best to you!

William F. Scott IV, DMD

Deluxe Dental Group

Why do gums recede around implants?

Hello, Gums (gingiva) can recede around an implant for a few different reasons including; 1) something stuck in the gums around the implant tooth, 2) periodontal disease (periodontitis), READ MORE
Hello,

Gums (gingiva) can recede around an implant for a few different reasons including; 1) something stuck in the gums around the implant tooth, 2) periodontal disease (periodontitis), or 3) natural order of events.
First, anything stuck in the gums around the implant tooth will make the gums bleed, maybe puss, and eventually recede. This could be food continually getting impacted between the teeth or something as a little bit of extra cement from the crown being put on. The cement can be cleaned our; however, if there is a food trap (small gap between the teeth), the gap will have to be closed to stop the recession.
Secondly, when an implant is put in, no one is worried about a cavity as titanium, porcelain, or zirconia do not grow cavities. However, an implant can still get periodontitis only in this case it is called peri-implantitis. The gums around the implant need to be kept clean just like any other tooth; otherwise they will recede.
Finally, Titanium and titanium alloys are used for implants because they have what is known as bio compatibility. This means that they are the most compatible with a persons biological tissues (the do not cause a reaction and go undetected by the body's immune system). This is why hip implants, rods and screws used in the body are made out of titanium. However, in some cases the body will reject the implant and the gums around it will recede. Hope this helps.

My best to you

William F. Scott IV, DMD

Can I get a dental implant years after extraction?

Hello, Dental implants are the most natural way to replace teeth; so we try to put them in when we can which would include a tooth that was extracted year ago. However, there READ MORE
Hello,

Dental implants are the most natural way to replace teeth; so we try to put them in when we can which would include a tooth that was extracted year ago. However, there are several factors that come into play when a tooth has been extracted years ago that make the process more difficult.
the biggest problem with placing dental implants is having enough jaw bone and having it in the right place. A carpenter can put a screw into a piece of wood because he/she knows how big the wood is and what it is shaped like. The shape of a person's jaw bone is curvy and when a tooth has been missing for a few years the jaw bone tends to atrophy (shrink). This means there is even less bone to hold the implant.
Complicating factors even more there are other anatomic structures that can get in the way, such as; sinus cavity in the upper jaw (maxilla) or the nerve bundle in the lower jaw (mandible). Since the implant can not be placed in these structures, the loss of bone is more critical. Not to worry though. There have been procedures that have been developed to deal with these structures; such as a sinus lift (moving the sinus cavity upwards and adding more jaw bone for the implant).
Since there has been so much development of implants and procedures around them, there are very few cases where implants can not be placed. It just may require an extra procedure. Hope this helps

My Best to you!

William F. Scott IV, DMD

Can an infected dental implant be saved?

Hello, Infection of an implant is the first line of concern and the biggest issue we try to protect against. Yes, infection of an implant can mean that the implant needs to be READ MORE
Hello,

Infection of an implant is the first line of concern and the biggest issue we try to protect against. Yes, infection of an implant can mean that the implant needs to be removed (explant); however, it all depends on the size and location of the infection.
Technically speaking, the very early stages of peri-implantitis is an infection. If caught early and cared for appropriately the infection can be stopped. However, as the infection gets bigger and spreads around the implant, it can affect the amount of bone there is to stabilize the implant. Think about it as a house with a crumbling foundation. When the foundation starts crumbling, it is only a little area on one side of the house; but, if it is let go, it will eventually crumble all around until it needs to be replaced.
Worry not, even when an implant is removed, the infection can usually be healed, and another implant be placed in the area. Hope this helps.

My Best to you!

William F. Scott IV, DMD

How do you fill a cavity between two front teeth?

Hello, What a great question! Filling a cavity between two front teeth has a greater emphasis on aesthetics then in other areas of the mouth. How it is done depends on the location READ MORE
Hello,

What a great question! Filling a cavity between two front teeth has a greater emphasis on aesthetics then in other areas of the mouth. How it is done depends on the location of the cavity.
If the cavity is directly on the side of a tooth, then the access to the cavity is made from inside the mouth (by the palate) on the edge of the tooth. The decay is removed in the direction from the palate to the lips; keeping the front of the tooth intact as much as possible.
If the cavity has wrapped around the front of the tooth, then the infected part on the front of the tooth will have to be removed as well. Care will be taken to only remove what is needed and then again with the filling to match the rest of the tooth as best as possible.
If the teeth are crooked, over-lapping, or crowded then access to the cavity from the front may be the only option. At this point, a hole only large enough to remove the decay is made and then special attention is given to the filling material to make it match the rest of the tooth. Hope this helps.

My Best to you!

William F. Scott IV, DMD

Is it bad to have a gap between your teeth?

Hello, Gaps (diastemas) between teeth are not usually a good thing; however, it depends on the size of the gap and the location of the gap. The size of the gap between teeth READ MORE
Hello,

Gaps (diastemas) between teeth are not usually a good thing; however, it depends on the size of the gap and the location of the gap.
The size of the gap between teeth matters as small gaps become what is known as "food traps". Teeth are shaped to allow food to flow to the sides as we eat. However, a gap will allow food to flow between teeth.
A gap between two back allows food to flow between the teeth, but due to the way teeth are shaped, it does not come out so easy. Food stuck between teeth causes 2 problems. First, food that is prolonged between teeth will cause cavites. Secondly, anything that is between the teeth for a prolonged time will cause recession and mobility of the teeth.
A larger gap will not allow the food to stay between the teeth. If a tooth was missing, that would be a large gap. But food particles are too small to get stuck there.
The location of the gap matters because we do most of our chewing on the back tooth. If the gap is in the front, it is more of a cosmetic concern then then a food trap. Hope this helps.

My best to you!

William F. Scott IV, DMD

Why is there a gap between my gum and the bridge?

Hello, There could be a few different reasons for a gap between the gums (gingiva) and a bridge; but two are most common. First, when a tooth is extracted the jaw bone and gum READ MORE
Hello,

There could be a few different reasons for a gap between the gums (gingiva) and a bridge; but two are most common.
First, when a tooth is extracted the jaw bone and gum tissue tends to atrophy (shrink). The body does not have to support a tooth anymore so there is no need to have that much bone or gums anymore. This means, since the bridge was done right away, the gums may move away from the bridge (this does not happen in all people).
Secondly, the bridge could have been made that way. If the bridge is in the back some dentist make it with a small gap between the gums and the bridge to try to promote hygiene and keep the area clean. However, this type of practice is rarely done anymore and could be the work of a low quality office. Hope this helps.

My best to you!

William F. Scott IV, DMD

Should there be a gap between my crown and gum?

Hello, Should there be a gap between a crown and the gums is a very interesting question that can be answered both yes and no. If the tooth is in the front, for aesthetic reasons, READ MORE
Hello,

Should there be a gap between a crown and the gums is a very interesting question that can be answered both yes and no.
If the tooth is in the front, for aesthetic reasons, the crown edge is usually placed underneath the gum line. This does not mean it will stay there. For a variety of reasons (inadequate brushing or flossing, tooth thick of a crown, edge not low enough to name a few) the gums can recede a little and show the edge of the crown. If all else is alright, this is only a cosmetic problem.
If the crown is out of the smile zone (in the back of the mouth); having a gap between the crown and the gum is perfectly fine. In fact, it could have been designed that way. When the edge of the crown is placed above the gum (causing a gap) it is cleaned when the tooth is brushed and flossed. When it is placed below the gum line it does not get cleaned. Cleaned crown edges promote health and prevent cavities. If it can not been seen then it is not that big of a cosmetic problem either. It is important to note that recession can happen here as well and expose the edge of the crown. As we get older, most crown edges become visible for one reason or another. Hope this helps.

My best to you!

William F. Scott IV, DMD

Can you replace a crown with a veneer?

Hello, Interesting question, but no, a crown cannot be replaced with a veneer. When a crown gets made the tooth gets reduced (shaved) down on all sides to make room for the READ MORE
Hello,

Interesting question, but no, a crown cannot be replaced with a veneer. When a crown gets made the tooth gets reduced (shaved) down on all sides to make room for the crown. When a veneer gets made the the tooth gets reduced on all sides except the inside (the side by the tongue). Since the inside of the tooth was reduced on the inside for the crown, there would be no covering for the inside when the veneer is made. The desire to have a veneer over a crown may not be a good thing either. A crown is usually stronger, with aesthetics that can be made better than a veneer, and does not tend to come off nearly as much. So, the only pro to having a veneer over a crown (the one surface of the tooth not reduced) is no longer valid.
Hope this helps.

My best to you!

William F. Scott IV, DMD

Do veneers ruin your teeth?

Hello, Ruin your teeth is a relative term. Sometimes filling cavities can be part of the reason for doing veneers; however, veneers are usually done for cosmetic reasons. Most READ MORE
Hello,

Ruin your teeth is a relative term. Sometimes filling cavities can be part of the reason for doing veneers; however, veneers are usually done for cosmetic reasons. Most veneers involve reducing (shaving) down the front, edge, and part of the sides of the tooth to get the best looking result. This reduction can be considered by some as ruining the teeth. These people would rather have their natural teeth. However, others want their natural teeth to look better, and they do not consider veneers as ruining them only enhancing them.
Hope this helps.

My best to you!

William F. Scott IV, DMD

Why do I have ridges on my tongue?

Hello, There are several reasons someone can have ridges on their tongue. Some of them are not too bad and some are not too good. Because of this it is highly recommended to READ MORE
Hello,

There are several reasons someone can have ridges on their tongue. Some of them are not too bad and some are not too good. Because of this it is highly recommended to have a professional examine the ridges (a lot of people out there do a free consultation). Location, type of ridges, and color are important to diagnosing. Sometimes people get malformations on their tongue because they have a habit of chewing on their tongue during times of stress or boredom. Oftentimes, people are unaware of it until they are asked about it. Other times, people get ridges on their tongue that are evenly spaced. These normally coincide with where their lower teeth are as the tongue sits against them. Sometimes there are lines on the top of the tongue. This is usually changes in the taste buds along the tongue's surface. However, there are more serious reasons for changes in tongue appearance which is why it is highly recommended to have a professional exam it.
Hope this helps and hope the ridges are nothing bad.

My best to you!

William F. Scott IV, DMD

Can a high filling cause any problems?

Hello, Yes, a high filling can cause some problems. Usually a high filling will only bother the person when they bite down. It is important to know that teeth only touch when READ MORE
Hello,

Yes, a high filling can cause some problems. Usually a high filling will only bother the person when they bite down. It is important to know that teeth only touch when the person is eating or speaking ('s' sounds cause teeth to slightly touch). If there is a para-functional habit like grinding (bruxism), this will cause a steady pain from a high filling.
In the short term, a high filling is more of a nuisance. It then usually turns into jaw aching because the tooth it self is taking more of the force from chewing. Finally, if it is left along for a while, the additional trauma to the tooth gets translated to the nerve and blood vessels inside the tooth and they die off (more rare cases can cause a fracture in the tooth). In this cause the tooth would need a root canal at the very least; so it is best to take care of as soon as possible. Hope this helps.

My best to you!

William F. Scott IV, DMD

How long will my mouth be numb after a filling?

Hello, The amount of time the numbness lasts after a filling depends on a couple of factors. First of all, there are a number of different anesthetics that can be used. These READ MORE
Hello,

The amount of time the numbness lasts after a filling depends on a couple of factors. First of all, there are a number of different anesthetics that can be used. These anesthetics have differences, but one of the main differences is the amount of time they are in effect. Some of them can last only 20 minutes or so; which others can last up to 8 hours. Usually the dentist doing the filling will use lidocaine (or something with the same amount of time of activation). Lidocaine will usually last 1-2 hours from the time it is given.
Secondly, the person's metabolism for anesthetics plays a large role. The reason for the range for lidocaine lasting 1 to 2 hours is an average. Some people it will only last an hour while others it will last 2 hours (some people it only lasts 20 minutes!).
The final aspect to consider is the amount of time it takes to do the filling. The doctor may give the anesthesia, leave, comes back 20 minutes later and do a couple of fillings for 40 minutes. That is 1 hour after the anesthesia was given. If the anesthesia only lasts one hour in that person, it will start to wear off as they are leaving the office (or they can still have the numbness for another hour). Hope this helps.

My best to you!

William F. Scott IV, DMD