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Mouth-Healthy Eating

Mouth-Healthy Eating

If you want to prevent cavities, how often you eat can be just as important as what you eat. That’s because food affects your teeth and mouth long after you swallow. Eating cookies with dinner will do less harm to your teeth than eating them as a separate snack. Of course, overall poor nutrition can contribute to periodontal (gum) disease. It also can have other long-term effects on your mouth. Learning how food affects your oral health is the first step toward mouth-healthy eating.

Immediate Effects of Food
Changes begin in your mouth the minute you start to eat certain foods. Bacteria in your mouth make acids. The acids start the process that can lead to cavities.

How does this happen?

All carbohydrate foods eventually break down into simple sugars: glucose, fructose, maltose and lactose. Fermentable carbohydrates break down in the mouth. Other foods don’t break down until they move further down the digestive tract.

It’s the fermentable carbohydrates that work with bacteria to form acids that begin the decay process and eventually destroy teeth. They include the obvious sugary foods, such as cookies, cakes, soft drinks and candy. But they also include less obvious foods, such as bread, crackers, bananas and breakfast cereals.

Certain bacteria on your teeth use the sugars from these foods and produce acids. The acids dissolve minerals inside the tooth enamel. The process is called demineralization. Teeth also can regain minerals. This natural process is calledremineralization. Saliva helps minerals to build back up in teeth. So do fluoride and some foods.

Dental decay begins inside the tooth enamel when minerals are being lost faster than they are being regained.

The longer food stays near the bacteria on the tooth, the more acids will be produced. So sticky carbohydrates, such as raisins, can do more acid damage. But other foods that pack into crevices in the tooth also can cause decay. Potato chips are a terrific example. Eat a handful of chips and see how long you have to work to get all the stuck bits out from between your teeth. Teeth with a lot of nooks and crannies, such asmolars, are more likely to trap food. That’s why they tend to have more decay.

To make matters worse, many of the foods that are unhealthy for teeth don’t just create acids while they are being eaten. The acids stick around for the next half-hour.

Depending on your eating and drinking patterns, it’s possible for the bacteria to produce acid almost constantly. This can happen if you sip soft drinks or sweetened coffee throughout the day. Eating many small sweet or starchy snacks can produce the same effect. The resulting acid damage adds up, so decay is more likely. Studies have shown that people who eat sweets as snacks between meals have higher rates of decay than people who eat the same amount of sweets with their meals.

On the brighter side, some foods actually help to protect teeth from decay. That’s because they increase saliva flow and neutralize the acids produced by bacteria. This makes it less likely that the enamel will lose minerals. For example, aged cheese eaten immediately after other food helps to buffer the acid.

Chewing sugarless gums also can help protect your teeth against cavities. Xylitol is an ingredient in some sugarless gums. This sweetener has been shown to reduce the amount of bacteria in the mouth. It also helps to buffer the teeth against the effect of acid. Most sugarless gums and sugarless candies increase the flow of saliva, which helps to protect your teeth against bacteria.

Long-Term Effects
Like the rest of your body, your mouth depends on overall good nutrition to stay healthy. In fact, your mouth is highly sensitive to poor nutrition. It can lead to tooth loss, serious periodontal (gum) disease and bad breath.

What To Eat
The current and best advice for overall good nutrition is found in the Dietary Guidelines for Americans. This document was developed by the U.S. Department of Agriculture (USDA) and the Department of Health and Human Services.

The guidelines are simple in concept:

  • Eat whole grains daily instead of refined grains. Whole grains include brown rice, oatmeal and whole wheat bread. Refined grains include white bread and white rice.
  • Eat healthier vegetables, including dark green and orange vegetables.
  • Eat a variety of fruits.
  • Choose a diet with plenty of grain products, fruits and vegetables.
  • Choose fish, beans, nuts and seeds for some of your protein needs.
  • Choose beverages and foods to moderate your intake of sugars.
  • Choose and prepare foods with less salt.
  • If you drink alcoholic beverages, do so in moderation.
  • Aim for a healthy weight and be physically active each day.

To help people understand these guidelines, the USDA has replaced the old Food Guide Pyramid. The new guide is an interactive tool called MyPyramid. It is actually many different pyramids, depending on a person’s age, gender and physical activity. The tool can be found at www.mypyramid.gov.

Your diet, like the pyramid, should have:

  • A strong base of grains
  • At least 2½ cups of vegetables a day
  • At least 2 cups of fruits a day
  • At least 3 cups of calcium-containing milk, yogurt and cheese
  • Proteins such as meats, beans, eggs and nuts

Eat fats and sweets sparingly.

To prevent tooth decay, you should follow a few additional guidelines. This can help to keep the amount of acid created by the bacteria on your teeth to a minimum. Here are some tips:

  1. Limit between-meal snacking. Fewer snacks mean less acid exposure for your teeth. If you snack, choose foods that are not fermentable carbohydrates.
    • Best choices — Cheese, chicken or other meats, or nuts. These foods actually may help protect tooth enamel. They do this by neutralizing acids or by providing the calcium and phosphorus needed to put minerals back in the teeth.
    • Moderate choices — Firm fruits such as apples and pears and vegetables. Firm fruits contain natural sugars. However, their high water content dilutes the effects of the sugars. These fruits also stimulate the flow of saliva, which fights bacteria and helps protect against decay. Vegetables do not contain enough carbohydrates to be dangerous.
    • Worst choices — Candy, cookies, cakes, crackers, breads, muffins, potato chips, french fries, pretzels, bananas, raisins and other dried fruits. These foods provide a source of sugar that certain bacteria can use to produce acid. The problem can be worse if the foods stick to teeth or get caught between them.
  2. Limit the amount of soft drinks or any other drinks that contain sugar. These include coffee or tea with added sugar, cocoa and lemonade. Fruit juices contain natural sugars that also can cause decay. Limit the amount of time you take to drink any of these drinks. Avoid sipping them throughout the day. A can of soda that you finish with a meal exposes your teeth to acids for a shorter time than a soda that takes you two hours to drink.
    • Better choices — Unsweetened tea and water, especially fluoridated water. Tea also has fluoride, which can strengthen tooth enamel. Water helps flush away bits of food. It also can dilute the sugar acids.
  3. Avoid sucking on hard candies or mints, even the tiny ones. They have enough sugar to increase the acid produced by bacteria to decay levels. If you need a mint, use the sugarless varieties.
  4. Limit very acidic foods (such as citrus fruits) because they can make the mouth more acidic. This may contribute to a loss of minerals in the teeth. The effects of acid exposure add up over time. Every little bit counts.
  5. Brush your teeth after eating and after drinking sugary drinks, to remove the plaquebacteria that create the destructive acids. If you cannot brush after every meal, brush at least twice a day.
  6. Chew sugarless gum that contains xylitol. This can help reduce the risk of cavities. The gum helps dislodge some of the food stuck to your teeth. It also increases saliva flow to help neutralize the acids.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Eight Steps to Dental Health

Eight Steps to Dental Health

Step 1: Understand your own oral health needs.
Step 2: Commit to a daily oral health routine.
Step 3: Use fluoride products.
Step 4: Brush and floss to remove plaque.
Step 5: Limit snacks, particularly those high in simple sugars, and eat a balanced diet.
Step 6: If you use tobacco in any form, quit.
Step 7: Examine your mouth regularly.
Step 8: Visit the dental office regularly.

It takes more than just brushing.
OK, so you know about brushing and flossing. But there are other steps you should take if you want to keep your teeth for a lifetime. Some people assume they will lose their teeth as they age. That doesn’t have to happen. David A. Albert, D.D.S., M.P.H., suggests these steps to keep your teeth and your mouth healthy. Dr. Albert is an associate professor of clinical dentistry at the Columbia University College of Dental Medicine.

Step 1: Understand your own oral-health needs.
“Your oral health depends on many factors,” Dr. Albert said. “These include what you eat, the type and amount of saliva in your mouth, your habits, your overall health and your oral hygiene routine.”

Changes in your overall health status often result in changes in your oral health. “For example, many medicines, including more than 300 common drugs, can reduce the amount of saliva in your mouth, resulting in dry mouth,” he said.

“Women who are pregnant go through oral changes. This often includes inflammation of the gums, which is called pregnancy gingivitis. Patients with asthma often breathe through their mouths, particularly when sleeping. This can result in dry mouth and increased plaque formation and gingivitis.”

Step 2: Commit to a daily oral-health routine.
Talk to your dentist or dental hygienist about your oral health practices. Based on the discussion, come up with an effective routine. It should be easy to follow and should take your situation into account. For example, if you are taking medicine that dries your mouth, it is important to use fluorides every day. Fluorides can be prescribed for home use. They come in several forms — rinses, toothpastes and gels. The gels are either brushed on or applied using a tray. Pregnant women, people with health conditions such as diabetes, and people with braces also need special daily oral health care.

Step 3: Use fluoride products.
Everyone can benefit from fluoride, not just children. Fluoride strengthens developing teeth in children. It also helps prevent decay in adults and children. Toothpastes and mouthwashes are good sources of fluoride. Your dentist can prescribe a stronger concentration of fluoride in a gel, toothpaste or rinse if you need it.

Step 4: Brush and floss to remove plaque.
Everyone should brush at least twice a day. It’s even better to brush three times a day or after every meal. In addition, you should floss at least once a day. These activities remove plaque, which is a complex mass of bacteria that constantly forms on your teeth. If plaque isn’t removed every day, it can turn the sugars found in most foods and drinks into acids that lead to decay. Bacteria in plaque also cause gingivitis and other periodontal diseases. It’s important to brush and floss correctly and thoroughly. You need to remove plaque from all sides of the tooth and where the tooth meets the gums. If plaque is not removed, it can lead to gum problems and cavities.

Step 5: Limit snacks, particularly those high in simple sugars, and eat a balanced diet.
Every time you eat, bits of food become lodged in and around your teeth. This food provides fuel for the bacteria in plaque. The bacteria produce acid. Each time you eat food containing sugars or starches (complex sugars), your teeth are exposed to these acids for 20 minutes or more. This occurs more often if you eat snacks and the food stays on your teeth for a while. These repeated acid attacks can break down the enamelsurface of your teeth, leading to a cavity. If you must snack, brush your teeth or chew sugarless gum afterward.

A balanced diet is also important. Not getting enough minerals and vitamins can affect your oral health, as well as your general health.

Step 6: If you use tobacco in any form, quit.
Smoking or using smokeless tobacco increases your risk of oral cancer, gingivitis,periodontitis and tooth decay. Using tobacco also contributes to bad breath and stains on your teeth.

Step 7: Examine your mouth regularly.
Even if you visit your dentist regularly, you are in the best position to notice changes in your mouth. Your dentist and dental hygienist see you only a few times a year, but you can examine your mouth weekly to look for changes that might be of concern. Changes in your mouth that you should look for include:

  • Swollen gums
  • Chipped teeth
  • Discolored teeth
  • Sores or lesions on your gums, cheeks or tongue

A regular examination is particularly important for tobacco users, who are at increased risk of developing oral cancer. If you smoke or use smokeless tobacco, your dentist or dental hygienist can show you where a sore, spot, patch or lump is most likely to appear.

Step 8: Visit the dental office regularly.
Talk to your dentist about how often you should visit. If you have a history of cavities or crown and bridge work, or are wearing braces, you should visit the dentist more often. Some people, such as diabetics or smokers, have more gum disease than the general population. They also should visit the dentist more often. People with suppressed immune systems also are more likely to have dental problems. Examples include people who are infected with HIV or are receiving cancer treatment. More frequent visits for these groups are important to maintain good oral health.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Good Oral Hygiene

What is Good Oral Hygiene?
Good oral hygiene results in a mouth that looks and smells healthy. This means:

  • Your teeth are clean and free of debris
  • Gums are pink and do not hurt or bleed when you brush or floss
  • Bad breath is not a constant problem

If your gums do hurt or bleed while brushing or flossing, or you are experiencing persistent bad breath, see your dentist. Any of these conditions may indicate a problem.

Your dentist or hygienist can help you learn good oral hygiene techniques and can help point out areas of your mouth that may require extra attention during brushing and flossing.

How is Good Oral Hygiene Practiced?
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being.

Daily preventive care, including proper brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress.

In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:

  • Brushing thoroughly twice a day and flossing daily
  • Eating a balanced diet and limiting snacks between meals
  • Using dental products that contain fluoride, including toothpaste
  • Rinsing with a fluoride mouthrinse if your dentist tells you to
  • Making sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area.
Proper Brushing Technique
brush1 brush2 brush3
Tilt the brush at a 45° angle against the gumline and sweep or roll the brush away from the gumline. Gently brush the outside, inside and chewing surface of eachtooth using short back-and-forth strokes. Gently brush your tongue to remove bacteria and freshen breath.
Proper Flossing Technique
floss1 floss2 floss3
Use about 18″ of floss, leaving an inch or two to work with. Gently follow the curves of your teeth. Be sure to clean beneath the gumline, but avoid snapping the floss on the gums.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Root Canal – Start to Finish

DeepInfection

1.  A Deep Infection

Root canal treatment is needed when an injury or a large cavity damages the tooth’s root. The root becomes infected or inflamed.

Route2Root
2.  A Route to the Root
The dentist numbs the tooth. An opening is made through the crown of the tooth to the pulp chamber.
Inflamed
3.  Removing the Infected/Inflamed Tissue

Special files are used to clean the infection and unhealthy pulp out of the canals. Then they shape the canals for the filling material. Irrigation is used to help clean the canals and remove debris.

Filling
4.  Filling the Canals

The canals are filled with a permanent material. Typically this is done with a material known as gutta-percha. This helps to keep the canals free of infection or contamination.

Rebuilding
5.  Rebuilding the Tooth

A temporary filling material is placed on top of the gutta-percha to seal the opening. The filling remains until the tooth receives a permanent filling or a crown. A crown, sometimes called a cap, looks like a natural tooth. It is placed over the top of the tooth.

ExtraSupport
6.  Extra Support

In some cases, a post is placed into the root next to the gutta-percha. This gives the crown more support.

Crown
7.  The Crowning Touch

The crown is cemented into place.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Failed Root Canal

The Second Time Around: Possible Retreatment or Surgery

A  root canal can fail for several reasons. If the bacteria were not completely removed from the canals, they can grow and cause pain. Bacteria can also get inside a tooth if a permanent filling was not placed soon enough. Temporary fillings or poorly placed permanent fillings can break down or leak. This allows bacteria back into the canal.

Sometimes the problem is not in the root canal that was filled, but in another canal that the dentist did not find. The bacteria in this unfilled canal will grow and cause pain.

A repeat root canal treatment tends to be more involved and take more time than the first one. Your dentist must remove the crown, post and core, and filling material before doing the second root canal. Some people who need another treatment may have infections that are difficult to destroy. Because they take more time and can be complicated, second root canals also usually cost more.

Sometimes a second root canal can be hard to do. For example, it may be too risky to remove a post and core. The post that is in the tooth may be cemented or set in very tightly. If that is the case, the tooth may be injured in the process. So your dentist may decide to do endodontic surgery instead.

This surgery allows the dentist to get inside a tooth’s root from the bottom of the tooth, rather than the top. Your dentist will not touch the crown of the tooth. The retreatment of the root canal will occur through the bottom of the root.

Endodontic surgery is done in the dentist’s office. An endodontist, general dentist or oral surgeon can perform this procedure. First, you will receive a shot to numb the area. Then your dentist will make a small cut (incision) in the gum near the base of the tooth. He or she will clean out the infected tissue around the tip (apex) of the root and shave off the tip. This procedure is called an apicoectomy. The endodontist will clean the inside of the canal from the root end, and then put a filling in the end of the root. The incision is then stitched.

Endodontic surgery is successful about 85% of the time. If the surgery does not get rid of the infection, the tooth will have to be extracted.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Gingivitis

Signs and SymptomsEarly stage of Gingivitis

What is Gingivitis?
Gingivitis — an inflammation of the gums — is the initial stage of gum disease and the easiest to treat. The direct cause of gingivitis is plaque – the soft, sticky, colorless film of bacteria that forms constantly on the teeth and gums.

If the plaque is not removed by daily brushing and flossing, it produces toxins (poisons) that can irritate the gum tissue, causing gingivitis. At this early stage in gum disease, damage can be reversed, since the bone and connective tissue that hold the teeth in place are not yet affected. Left untreated, however, gingivitis can become periodontitisand cause permanent damage to your teeth and jaw.

Gingivitis.

How do I Know if I Have Gingivitis?
Classic signs and symptoms of gingivitis include red, swollen, tender gums that may bleed when you brush. Another sign of gum disease is gums that have receded or pulled away from your teeth, giving your teeth an elongated appearance. Gum disease can cause pockets to form between the teeth and gums, where plaque and food debris collect. Some people may experience recurring bad breath or a bad taste in their mouth, even if the disease is not advanced.

How can I Prevent Gingivitis?
Good oral hygiene is essential. Professional cleanings are also extremely important because once plaque has hardened and built up, or become tartar, only a dentist or dental hygienist can remove it.

You can help stop gingivitis before it develops by:

  • Proper brushing and flossing to remove plaque and debris and control tartar buildup
  • Eating right to ensure proper nutrition for your jawbone and teeth
  • Avoiding cigarettes and other forms of tobacco
  • Scheduling regular checkups with your dentist

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Dental Crowns and Tooth Bridges

Dental Crowns and Tooth Bridges?

What are Dental Crowns and Tooth Bridges?
Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

How do Crowns Work?
A crown is used to entirely cover or “cap” a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

Your dentist may recommend a crown to:

  • Replace a large filling when there isn’t enough tooth remaining
  • Protect a weak tooth from fracturing
  • Restore a fractured tooth
  • Attach a bridge
  • Cover a dental implant
  • Cover a discolored or poorly shaped tooth
  • Cover a tooth that has had root canal treatment

How do Bridges Work?
A bridge may be recommended if you’re missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.

Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.

How are Crowns and Bridges Made?
Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.

Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

How Long do Crowns and Bridges Last?
While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy byBrushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings.

To prevent damage to your new crown or bridge, avoid chewing hard foods, ice or other hard objects.

Crowns
Porcelain Gold
Full porcelain fused to metal. Full cast goldcrown.
Bridges
Space Bridge Cemented
Teeth around the space are prepared. The bridge is mounted and adjusted for fit and comfort. The bridge is cemented into position.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Fillings

Determining If You Need a Filling

Your dentist may use several methods to determine if you have tooth decay, including:

  • Observation — Some discolored spots on your teeth may indicate decay, but not all of them. Your dentist may use an explorer, a metal instrument with a sharp tip, to probe for possible decay. Healthy tooth enamel is hard and will resist pressure by the explorer. Decayed enamel is softer. The instrument will stick in it slightly. Explorers must be used with caution. Pressing too hard with an explorer can damage a healthy tooth.
  • Cavity-detecting dye — This can be rinsed over your tooth. It will stick to decayed areas and rinse cleanly from healthy ones.
  • X-rays — X-rays can help your dentist see decay that doesn’t show on the surface. However, X-rays are often not accurate in detecting smaller cavities on occlusal (top) surfaces. Current fillings or other restorations also may block the view of decay.
  • Laser fluorescence cavity detection aids — These small wands measure changes caused by caries (tooth decay). They are especially useful for pit and fissure areas.

Decay is not the only reason you may need a filling. Other reasons include:

  • Cracked or broken teeth
  • Teeth that are worn from unusual use, such as:
    • Nail-biting
    • Tooth grinding (bruxism)
    • Using your teeth to open things

Steps to a Filling

When you visit your dentist to get a filling, you may be given local anesthesia to numb the area if necessary. Next, your dentist will remove decay from the tooth, using hand instruments or a drill. Air abrasion and lasers also can be used to remove decay.

A drill, which dentists call a handpiece, uses metal cones called burs to cut through the enamel and remove the decay. Burs come in many shapes and sizes. Your dentist will choose the ones that are right for the size and location of your decay.

At first, your dentist will use a high speed drill (the one with the familiar whining sound) to remove the decay and unsupported enamel of the tooth. Once the drill reaches thedentin, or second layer of the tooth, the dentist may use a lower speed drill. That’s because dentin is softer than enamel.

Once all the decay is removed, your dentist will shape the space to prepare it for the filling. Different types of fillings require different shaping procedures to make sure they will stay in place. Your dentist may put in a base or a liner to protect the tooth’s pulp(where the nerves are). The base or liner can be made of composite resin, glass ionomer, zinc oxide and eugenol, or another material.

Some of these materials release fluoride to protect the tooth from further decay.

If your dentist is placing a bonded filling, he or she will etch (prepare) the tooth with an acid gel before placing the filling. Etching makes tiny holes in the tooth’s enamel surface. This allows the filling to bond tightly to the tooth. Bonded fillings can reduce the risk of leakage or decay under the filling. That’s because the etched surface of the tooth and the filling material form a mechanical bond. Bonding is generally done with composite fillings.

Certain types of fillings get hardened by a special light. With these fillings, your dentist will stop several times to shine a bright light on the resin. This cures (hardens) the material and makes it strong.

Finally, after the filling is placed, your dentist will use burs to finish and polish the tooth.

After a Filling

Some people feel sensitivity after they receive a filling. The tooth may be sensitive to pressure, air, sweet foods or cold. Composite fillings often cause sensitivity, but other types of filling materials can, too.

In most cases, the sensitivity will subside over one to two weeks. Until then, try to avoid anything that causes it. If your tooth is extremely sensitive or your sensitivity does not decrease after two weeks, contact your dentist’s office.

It’s important to let your dentist know about any sensitivity you are feeling. The next time you need a filling, he or she may be able to use a different material and make changes to reduce sensitivity. People vary in their response to different materials. Your dentist has no way of predicting if your tooth will react to a particular material.

When you talk to your dentist about the sensitivity, try to describe it as precisely as possible. This information will help decide what should be done next. Your dentist may take out the filling and put in a new one. He or she may add a base, liner or desensitizing agent on the tooth as well. If the filling was very deep, you could need aroot canal treatment to solve the problem.

Besides sensitivity, some people feel discomfort when they bite down. There are two types of pain, each with a different cause.

  • The first type occurs when you bite, and worsens over time. This is caused by a filling that is too high and interferes with your bite. Once your anesthetic wears off, you would notice this right away. Contact your dentist. You will need to return to the office to have the filling reshaped.
  • The second type of discomfort is a very sharp shock that appears only when your teeth touch. This is called galvanic shock. It is caused by two metals (one in the newly filled tooth and one in the tooth it’s touching) producing an electric current in your mouth. This would happen, for example, if you had a new amalgam filling in a bottom tooth and had a gold crown in the tooth above it.

Your dentist polishes the filling after it is placed, but occasionally sharp edges may remain. You can’t detect this at first because of the anesthesia. If you find one, contact your dentist and arrange to have it smoothed as soon as possible to avoid injury to your tongue or mouth.

Temporary Fillings

You may receive a temporary filling (usually white, off-white or gray) if:

  • Your treatment requires more than one appointment.
  • Your dentist wants to wait a short period of time for the tooth to heal.
  • You have a deep cavity and the pulp (containing the nerve and blood vessels) becomes exposed during treatment.
  • You need emergency dental treatment.

A temporary filling may make your tooth feel better. This is because the filling seals the tooth, protecting the pulp from bacteria and reducing sensitivity.

Temporary fillings often contain eugenol, an ingredient in over-the-counter toothache remedies. Eugenol is also a component of oil of cloves, which people use for toothache pain.

Temporary fillings are not meant to last. Usually, they fall out, fracture or wear out within a month or two. If you get a temporary filling, make sure you visit your dentist to get a permanent one. If you don’t, your tooth could become infected or you could have other problems.

Why Replace a Filling?

Fillings don’t last forever. They can become discolored. Composite, tooth-colored fillings pick up stains, and yellow or darken over time. When you chew, your teeth and any fillings in them are subjected to tremendous pressures. Even if no other problems develop, some fillings will wear out over time and will need to be replaced. A filling will need to be replaced earlier if it falls out, leaks or cracks.

Food debris and bacteria can seep down under a filling that is cracked or leaking. Since you can’t clean there, the bacteria feed on the food debris and form the acid that causes tooth decay. Decay under a filling can become extensive before you notice it or it causes you pain. This is why you should have your fillings checked regularly and get them replaced when problems are found.

Fillings That Fall Out
Fillings can fall out for several reasons:

  • You bite down too hard on a tooth that has a large filling, and break the filling or the tooth.
  • The filling material that was used cannot withstand the forces placed upon it. For example, if you have broken a large piece of your front tooth, a porcelain (tooth-colored) crown is probably a good treatment choice. In some cases, a dentist may place a composite filling instead. This may look good or acceptable. However, if the composite is too large, a strong biting motion may break the plastic material.
  • The cavity is contaminated with saliva when the filling is placed. For composite resins, this will disrupt the bonding of the material. As a result, the bond will not stick well to the tooth and it may fall out.

Cracked Fillings
Both amalgam and composite fillings can crack, either soon after they are placed or after the fillings have been in place for some time.

Cracks can occur soon after a filling is placed if the filling is higher than the rest of the tooth surface, and must bear most of the force of biting. Cracks also can occur over time, as the forces from chewing and biting affect the filling.

Small cracks also can occur at the edges of a filling. These usually are caused by wear over time. These cracks often can be repaired.

Leaking Fillings
A filling is said to be leaking when the side of the filling doesn’t fit tightly against the tooth. Debris and saliva can seep down between the filling and the tooth. This can lead to decay, discoloration or sensitivity.

Both amalgam and composite fillings can leak. An amalgam filling sometimes leaks slightly after it is placed. You would notice this as sensitivity to cold. This sensitivity decreases for the next two to three weeks. Then it disappears altogether. Over that period, the amalgam filling naturally corrodes. The corrosion seals the edges of the filling and stops any leaks.

A composite filling could be contaminated with saliva. This would weaken the bond between the filling and the tooth and allow for leaks. Other times, there may be small gaps where the tooth and filling meet. These gaps are caused by shrinkage when your dentist places the filling. Sensitivity after receiving a composite filling may disappear over time. If it doesn’t, the filling may need to be replaced.

Fillings also can leak as a result of wear over time. These fillings should be replaced.

Worn-Out Fillings
Some fillings can last for 15 years or longer. Others, however, will have to be replaced in as little as five years. Your dentist can determine if your fillings are worn enough that they need to be replaced.

Clenching and Grinding
If you clench or grind your teeth, you may have more problems with your fillings. The forces placed on your teeth can lead to tooth sensitivity and extra wear on your fillings. Clenching or grinding also can cause your teeth and fillings to crack or develop small craze lines. These are fine cracks you can see if you shine a light on your tooth.

Keeping Your Fillings
Although some fillings can last for many years, the average life of an amalgam filling is about 12 years. Composite fillings may not last this long.

Your dentist will examine your fillings at your checkup visits. You may need X-rays if your dentist thinks a filling might be cracked or leaking, or to see whether decay is occurring under the filling. Make an appointment with your dentist:

  • If a tooth is sensitive
  • If you see a crack
  • If part of a filling appears to be missing

You should visit your dentist regularly for cleanings, brush with a fluoride toothpaste, and floss once a day. If you have many fillings or very large fillings, your dentist may prescribe a fluoride gel you can use at home. The fluoride will help strengthen the enamel of your teeth and help to prevent future cavities. Your dentist or hygienist also can apply a fluoride varnish around the edges of these teeth at your checkup visits.

Replacing a Filling
Before removing your old filling, your dentist will discuss treatment options with you. It is often possible to repair an old filling instead of removing it and replacing it completely. However, if the entire filling has to be replaced, the dentist may reevaluate what filling material to use. Talk with your dentist about how you would like the filling to look. Then he or she can select the material that is best for you.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Severe Pain

Any injury to the gums or teeth can be very painful. In some cases, however, the cause of severe dental pain is not obvious. For example, pain that comes on suddenly may be caused by particles of food that got lodged in a cavity and have started to irritate the nerve inside the tooth. If you lose a filling or a crown, the nerve inside the tooth may be exposed, and you may feel severe pain when air or hot or cold substances touch the uncovered part of the tooth.

Pain that becomes more severe over a period of time is commonly caused by debris lodged under the gum. Popcorn is a common offender. Because the hard cellulose fibers of the popcorn kernel don’t break down, it can remain stuck between your gum and your tooth. The longer a food particle stays trapped between the gum and tooth, the greater the chance the gum will become irritated and infected and the pain will get worse. If you develop an infection, called an abscess, it can become a serious health problem if left untreated.

Pain when you bite or chew, especially if it is accompanied by a foul odor and a bad taste, can be a sign of an abscess that needs immediate treatment.

What You Can Do

First, call your dentist and make an appointment – Dr. Jeffrey Fester in Roswell, GA, 770.587.4202

In the meantime, here are a few steps you can take at home to try to relieve some of the pain:

  • Take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). However, be aware that you need to see your dentist. If you mask the pain with a painkiller and ignore it, the infection can spread and could become life threatening.
  • Rinse your mouth with warm water every hour or as needed to ease the pain.
  • If the pain is caused by debris lodged in a cavity, washing the area may relieve the problem.
  • Floss your teeth, then run a toothpick around the gum line. This may remove debris that’s lodged under the gum.
  • If you’ve lost a filling or crown, dip a cotton swab in clove oil and apply it to the exposed part of the tooth. Clove oil, available in pharmacies and supermarkets, works well to relieve tooth pain. You also can use a topical anesthetic, such as Anbesol, also available in pharmacies and supermarkets.
  • Putting an ice pack on your face over the area that hurts also may relieve the pain. Apply the ice for 10 to 20 minutes of every hour, as necessary.
  • If you will be traveling in an airplane, the change in pressure when the plane takes off or lands may make you feel more uncomfortable. You should get dental treatment before traveling by air.

What Your Dentist Will Do

Even when dental problems cause a lot of pain, the problems — and the treatments — often are relatively simple if you seek help right away.

If you have a cavity, your dentist will clean out any debris, remove the decayed part of the tooth, and place a filling. Once the inner part of the tooth is protected, the pain will usually disappear immediately.

If your problem is related to debris under your gums, your dentist will use special instruments to remove the debris. If you have an infection, you may be given a prescription for antibiotics and pain medicine. If an antibiotic is prescribed, it is important that you take it as directed until you have finished all the medication.

An abscess in the tooth or gum may require more extensive treatment, such as drainage of the abscess, root canal treatment or tooth extraction.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Lodged Foreign Bodies

Lodged Foreign Bodies??

Small pieces of food ? especially things like popcorn hulls ? can get under your gums. If these pieces aren’t removed, the area can get irritated, and even infected.

What You Can Do

If you feel something wedged under the gum, try using dental floss to remove it. If this doesn’t help, take a toothpick and gently run it around the gum line. Be careful that you don’t hurt your gum with the toothpick or accidentally push anything deeper under your gum.

What Your Dentist Will Do

If you can’t remove a foreign body yourself, see your dentist as soon as possible. Your dentist has special that allow him or her to see into your mouth and find whatever is trapped under your gum. Your dentist will check for infection.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.