Dr. Frank Dentremont, DMD

You don't mention the size of the decay in your question. Tooth decay - to use a simple analogy - is like rust on a car. You can wax or wash it as much as you want but unless you physically remove the rust (or the decay) eventually your muffler falls off, or your floor rots out, or worse.
Decay must be stopped to stop the progress of deterioration of the tooth. Otherwise symptoms of pain begin, infection can occur, and the tooth can cause general systemic problems from cellulitis (a severe infection which spreads to other parts of your body and even death if left untreated. I've seen tooth roots of teeth lost to decay after many years - which is rare and at first seems contrary to what I've just stated - become infected and patients hospitalized. So visit your dentist and get their professional advice to whether the tooth can be fixed or removed.

That's a good question. I'm going to assume you are getting a tooth-colored filling, and not the old-fashioned silver amalgam filling. Modern tooth-colored fillings are made of a composite material, which quite literally means it's made of several compounds. It's hardened chemically by the interaction of a catalyst in the filling material with blue-violet light which has a high energy level which causes the chemical to react and form the hard filling you use to chew on.
So the short answer to your question is that when you leave the dental office the filling is already hard- it is as hard as it is ever going to be. Dentists recommend that you defer from eating anything hard that you would have to chew not because the filling is still soft but because the "Novocain" may still be numbing your lip or tongue or cheeks and you could lacerate these while numb and not know it. So wait until the numbness is gone before you chew anything. Swallowing liquids or liquid foods like soup are preferable to eating hard foods that need to be chewed.

A dental crown - also colloquially called a "cap" or "casting" - Is a wonderful restoration for prolonging the lifespan of a tooth. A crown used to be made of gold alloy, or porcelain baked over gold. Our current technology uses zirconium, which is harder than a tooth. On average, a crown should have a lifespan of about 20 years... longer or shorter depending on various factors such as type of material, quality of the tooth structure underneath, quality of the workmanship of the dental lab and the dentist, and your own factors such as your oral hygiene, the types of foods you eat, whether you grind your teeth, etc. I've seen crowns last as long as 30-40 years on patients, and as short as weeks or months. Most reputable dentists will warranty their work for at least 1-5 years in some form or other. It's always a good idea to ask your dentist about this.

Sensitivity to hot and cold drinks is one probable sign of tooth decay. We especially perk up our ears when we hear about heat sensitivity. Tooth infections rarely just "turn on." They ramp up from simple cold sensitivity to heat sensitivity to unprovoked pain (i.e., waking you up at night or throbbing during the day). Further delay can cause the presence of swelling and infection and, in rare cases, death. See your dentist ASAP and nip this in the bud before you have to have a root canal or an extraction.

Dental caries is a bacterial disease, plain and simple. The bacteria feed on table sugar. It's their favorite food... what's yours? In dental science, we refer to the exposure of a tooth to sugar as an "event". If you're watching your weight, do you stick to just fruits and vegetables, or do you hit the local buffet? In other words, it's the length of time a tooth is exposed to the sugars and not just the exposure. It's much better, for example, to eat a quick candy bar than suckle on sugar-filled breath mints or hard candy. In summary, you can minimize tooth decay by 1) reducing the amount of table sugar you eat and 2) reducing the amount of bacteria in your mouth. Watch your intake of sweets - both the type and amount. Keep up with your oral hygiene: brush, rinse, and floss as you were taught. Feel free to ask your dentist or hygienist to review your oral hygiene regimen. They are trained to teach you the proper way to clean your teeth and reduce bacteria. Do this and you can prevent cavities almost 100%!!!!

A Mini tooth implant - as the name so describes - is designed to be a "scaled down" version of an implant. Hailed as a Utopian solution to expensive implants a decade ago, they are one-piece dental implants which are about 1/8 inch wide and about an inch long tip to tip. Experience has shown that these mini-implants don't hold up well in poor density bone or high-chewing locations in the mouth, so they are principally relegated now to holding down lower dentures in a sort of ball-and-socket fashion. They do have an advantage in narrow missing tooth areas, but overall their use is limited and traditional sized implants are a better option for replacing missing teeth.

An irritated tooth is analogous to an engine light on your dashboard. It is warning you of an impending problem with your tooth. Ignoring this important sign will undoubtedly lead to a severe tooth problem in no time. See your local dentist ASAP. In the meantime, use pain relievers such as Tylenol, Motrin, or Aspirin as directed on the label. These medications work to block pain receptors in the brain. They do NOT work at the site of the pain; ie, do NOT grind them up and put it in your tooth. Aspirin, especially, is actually a strong acid, (Acetylsalicylic Acid, abbreviated ASA), and will cause a chemical burn on your cheeks and tongue if you try this old wives' tale.

Asking which are the best dental implants is a lot like asking which is the best car. Using cars as an analogy, there are multiple manufacturers of dental implants. Like cars over the decades, the weaker and less popular implant systems have merged with others or been discontinued. There are now different price ranges of implants: "Chevy" implants, "Buick" implants, and "Cadillac" implants to fit your budget and needs.

So, which is the best dental implant? The "Gold Standard" in implant dentistry has been Nobel Biocare for many years, but there are equally successful - and less expensive - brands. Is Nobel the best? Is a Mercedes Benz the best car? Truly, it is in the eye - and skill - of the beholder, or owner. Even "Chevy" implants can function adequately if they're purposed for the right reason and the surgeon picks the right technique. The short answer to your question: implants have to function in the human jaw and have only the patient to answer to. The density, size, depth, width, and length of the jaw bone plays a critical answer to that question. And... are you a smoker? Modern consensus is that the failure rate for smokers is very high, to the point where many dentists just won't place implants in a smoker. Sorry, but that's just the truth. So truly, the best dental implant is one that is properly picked out for the task it is used for, placed properly and the patient is a compliant non-smoker. There are other issues such as systemic diseases or conditions which may also be a factor.

Your information given doesn't say whether you are seeking dental implants. I'm going to infer that you are indeed looking for an oral surgeon who places dental implants. Dental implants are a multi-procedure process, including the surgical anchor (endosteal implant) which holds the abutment, the peg or post (dental abutment) which holds the tooth, and the artificial tooth (crown or cap). This is my recommendation:
Oral surgeons are likely the best dental professionals to place the surgical portion of an implant into your maxilla (upper jaw). Their training in this is incredible and the standard of care these days is very high for oral surgeons. That being said, they are NOT restorative dentists. I would prefer to think that you have a "home" dentist, someone you see and trust for your dental needs on a routine basis. Restoring two lost front teeth is more than just a trip to the oral surgeon and popping in two implants. What type of accident occurred? Is the jaw bone sound enough to handle two implanted teeth? What color (shade) are your teeth? Is the oral surgeon colorblind? Do you want these two teeth the same color as your existing teeth or want a complete smile makeover and improve ALL of your front teeth? Oral surgeons are NOT the first dentists to see for restoring your smile, but are a vital part of an important group solution to your lost teeth. Seek out a licensed and experienced general dentist, and then work with him to get your front teeth fixed properly. In my office I work in conjunction with an oral surgeon to surgically place the implants into the bone and then allow them adequate (4-6 months) to integrate (lock) into the bone before placing any permanent crowns. In the interim there are different techniques to give you a temporary smile until your permanent crowned implants are fabricated. Go online and seek out implant information to get a better idea of how they work and what makes them successful. Best wishes.

It IS prudent to consider a pain reliever ("analgesic" as we call them) before oral surgery. Before you do so, please consult the Oral Surgeon's office and ask them for their recommendation and consider that the final answer. Generally, it is best to avoid any pain reliever that may potentially thin the blood and cause more bleeding than normal. We typically tell you to avoid aspirin-based analgesics before oral surgery. Aspirin is part of a larger family called "Non-steroidal Anti-inflammatory Drugs"... Huh? Well you may know them as NSAID's. So, that being said, Ibuprofen (and by other names may be called "Advil", "Motrin", etc.) is also an NSAID and probably should NOT be used before oral surgery. I can suggest Tylenol (acetaminophen) products if you can safely take those prior to oral surgery. Again, please consult with your oral surgeon before taking any pain reliever prior to your appointment.

Tooth-whitening products normally contain an organic bleach chemical called Carbamate Peroxide. Like household bleach, it is diluted to different strengths for safety and efficacy. If you want quick, snow-white teeth, you have to use a stronger concentration of bleach, which opens the possibility of creating sensitivity to your teeth. I don't understand from your statement whether you have been using the same concentration of bleach for the "past years", but by simply "dialing down" the concentration from say 34% to 19% you can significantly reduce post-bleaching sensitivity. 34%, by the way, is extremely strong and I have long ago discontinued its use in my office because of the results you indicate. I would recommend having your dentist issue you a home-bleaching kit with a lower concentration to get you satisfactory results with less sensitivity. It's also commonly known among dental professionals, btw, to pre-rinse with a fluoride rinse which protects the tooth nerves from the bleach and lowers post-operative sensitivity. Your dentist can prescribe a fluoride Rx toothpaste called Prevident Sensitivity toothpaste which will help your teeth recuperate from your latest bleaching treatment. You can also use it just before you bleach as I indicated before.

I've never - quite honestly - heard of a dentist recommending a 3 month recall of children to their office. There would have to be extenuating circumstances for this to occur. Also, are you meaning to use the word "whitened", or are you intending to mean the children's prophylaxis (cleaning)? We do not recommend bleaching on children, though there is some leeway in the discussion for high school children. I would certainly never recommend bleaching a 10 year old's teeth. As an aside, there is a program in place by some dental professionals to use peroxide in a gel form daily from age 5 to discourage the formation anaerobic bacteria which is potentially linked to systemic diseases. You can google a program called "Perio Protect" to learn more about it. I think the science is sound but the dental community is divided about its true potential. To conclude, don't bleach a young child's teeth and there has to be a significant reason that your child is seeing a dentist every 3 months.

Your statement doesn't indicate the severity of the crack. Cracked teeth can have a range of severity and therefore a range of options. Remember, though, you dentist is a trained professional at restoring damaged teeth. We have all kinds of options to repair a cracked tooth. If the crack is nominal (barely cracked or hardly noticeable) it may just be the best treatment to keep an eye on it for further deterioration. You may opt to fill in the crack with a bonding procedure. On the other end of the spectrum, a full crack might possibly need a crown or a veneer to successfully restore the tooth. In a further scenario, the crack might go down to the nerve of the tooth and require a root canal and then a crown. In a worse-case scenario, the crack might lead into the root, which normally requires the removal of the tooth and then something (implant, bridge, partial, etc.) to replace the lost tooth. Go see your dental professional and get his expert opinion.

There ARE toothpastes which can statistically lower tooth sensitivity. The standard of the industry is the "Sensodyne" brand of toothpaste. Their most recent product is called "Rapid" and my patients say it works. That being said, tooth hot or cold symptoms are just that: symptoms of a problem with a tooth or teeth. The simplest problem here would be a cavity which can be fixed. Dentists always perk up their ears when the patient says their teeth are "hot" sensitive. Heat sensitivity is frequently related to nerve damage. My advice is to 1) get the "Rapid" toothpaste product to lessen your symptoms, and 2) make an appointment with your dentist to rule out cavities or dental disease. Cavities are like rust... it only gets worse by ignoring it.

There could certainly be a cause and effect relationship between your bad cavity and headaches. A headache can certainly be triggered by an event such as a toothache. More importantly, unprovoked pain from a tooth such as you describe indicate that the tooth may be inflamed or infected already. If that's the case then root canal or removal may be the only solution. Fully describe your pain to your dentist and I'm sure he will help you discover the best solution for you.

Plaque buildup is a function of biological processes which we don't need to detail, but is essentially the accretion of your salivary fluids, certain bacteria, certain biochemical elements of your body, and food particle retention. These groups combine to form plaque buildup over time, sort of in an "incubator" type of fashion. As you see in nature, all living things "incubate" (read "form) at a different rate. Some people get plaque buildup immediately after their dental cleaning, while some people get plaque buildup after weeks have gone by. To answer your question directly: The best defense is a good offense, or so goes the saying. Offensively minded, you can opt to brush and floss more than the average bear, so to speak. Not a frequent flosser? Floss more. An average brusher? Brush more. Professionally, you can opt to go to your dental hygienist more than twice a year. Be forewarned, however, that dental insurances only pay for cleanings twice a year at best. Your 3rd, 4th, and more dental cleanings will have be paid for "out of pocket". A tip here: for those extra dental cleanings: ask your dental professional for ONLY a dental cleaning. NO exam, NO x-rays on those 3rd, 4th, or 5th cleanings. That should significantly lower your out-of-pocket expenses. Your dentist will be happy to have his hygienist's chair time filled and her payroll covered, and you'll save $$$ on those extra cleaning appointments. Like I said however, be more aggressive at home to lower plaque buildup between dental visits.

Tooth loss is a natural biological function of almost all vertebrate species on this earth, and should be explained as such. Teach your son this fact and explain that he has been given a great opportunity to replace any baby teeth that may be decayed or missing. Children are not born with fear, it is a learned behavior, often emanating from family members. Someone has terrified this child needlessly, plain and simple. The opposite of fear is faith, and your child must be taught to have faith, and not fear.

"Gapping" is a condition whereby the jaws are physically bigger than the teeth they support. There is only one true answer for a large anterior gap: braces to close the gap and bring the anterior teeth together. At some point more posteriorly a larger gap will develop by necessity on both sides. A decision will need to be made to either 1) leave that gap there, or 2) fill it with either an implant or a bridge. If orthodontics is not available, and the gap is not too large, you can alternately consider veneers or crowns to close he spacing. With this type of orthodontic consideration, you will always have to consider having a retainer afterwards to prevent drifting of the teeth.

A "white layer" on the tongue can be obtained by several sources. We call these "white lesions" in dental pathology and it's impossible to determine a specific cause without a visit to your dentist. Most white lesions are symptoms of an underlying systemic condition so you may want to seek out your physician as well. An example of such a condition would be "Thrush", or a Vitamin deficiency. Seek professional help to determine this cause.

Bad breath normally occurs from a buildup of bacteria, often from the Sulfur producing variety. While dentists often find bad breath coming from periodontal (gum) disease or tooth infections, in fact bad breath can often arise from any connection to the mouth, such as sinus drainage, tonsillitis, adenoids, stomach disorders, or lung disorders. A visit to your dentist will rule out purely dental origins, and if your teeth and jaws are normal, then you will need to seek out a physician to rule out other areas of the head and neck.