Answers for Your Important Questions
When it comes to your teeth, pain can pop up out of nowhere. What might that pain be? Well, it could be just about anything. Creative Smile Designs has compiled the answers to many frequently asked questions below.
Q: What can be done for a toothache?
A: A toothache can be one of the most difficult problems someone can encounter in dentistry. The first thing that may help with a toothache would be an OTC (over-the-counter) pain medication. Aspirin increases bleeding and should be the last drug to use, unless it is the only OTC medication you can use. You should NEVER place aspirin on the tooth or gums because aspirin is very acidic and will burn the tissues. The most common causes of a toothache include; Broken tooth, broken filling, abscessed tooth and loose tooth.
A short term solution may be to get temporary filling material or orthodontic wax (used with braces) at a pharmacy. Either of these will cover the broken tooth or filling to decrease sensitivity to temperature or sweets. It is important to contact our office to get something more definitive done or a small problem can become much larger.
Abscessed tooth means the nerve has died and there is an infection. Often the pain caused by these teeth keeps coming and going, and eventually it will keep on hurting and will never get better. It is much easier for you to take care of the problem before it “subsides.” Some people take “a couple” antibiotic pills to reduce the pain. This can be very dangerous, since the antibiotic will kill the easiest “bugs” first and leave the tougher “bugs” if only taken for a short time. This will make it much more difficult to control the infection later! Contact our office to determine the best course of treatment for your problem.
A loose tooth is usually due to periodontal (gum) disease. Gum disease usually doesn’t hurt until it is very severe. At this point it is important to see our office to diagnose and treat the problem.
Q: Why are my dentures loose?
A: Dentures generally get looser with time. Bone resorbs when there are no teeth or dentures to put pressure on it. As the bone resorbs the dentures get loose. Relining the dentures (adding a layer of plastic) can help for a while, but eventually there will be so little bone that even relines will not be of much help.
Most complaints are centered on the lower dentures. Lower dentures are mostly held in by your tongue and lips, unlike upper dentures that get some suction on the roof of the mouth.
can help retain dentures. In addition, implants help “exercise” and maintain the bone.
Q: What can I do for a broken tooth?
A: A short term solution may be to get temporary filling material or orthodontic wax (used with braces) at a pharmacy. Either of these will cover the broken tooth or filling to decrease sensitivity to temperature or sweets. It is important to contact our office to get something more definitive done or a small problem can become much complicated.
Q: What is cosmetic dentistry?
Q: Why are my gums bleeding?
A: Gum disease
/ Periodontal disease is a probable cause. It could be a mild form known as Gingivitis that is reversible, or it could be a more severe form requiring treatment to return your mouth to a healthy condition.
Q: Can a missing tooth be replaced?
A: There are three major ways to replace a missing tooth. First would be with a dental implant
that replaces the root(s) of a missing tooth and allows a naturally feeling and appearing replacement of the tooth. A bridge
replaces a missing tooth by putting a crown on the tooth on either side and a “fake tooth” between, this is cemented into the mouth. A partial denture
has a metal framework and is a removable replacement for the missing tooth.
What is a denture?
Q: What is a partial denture?
Q: What is a root canal?
Q: What's the difference between silver fillings and tooth colored fillings?
A: Silver fillings
are and has been the “work horse” of dentistry for years. Their ease of use and relatively inexpensive cost have made these ideal for many people for many years. Tooth colored fillings
are preferred by many because they look more like natural teeth. These plastic fillings are bonded to the existing tooth structure.
Q: Are silver fillings safe?
A. There has been a very small number of dentists and individuals that have tried to convince the public that silver fillings are dangerous. Scientific data DO NOT support these allegations. ADA.org has more information on amalgam.
Q: Do you accept insurance?
A: We are happy to file claims and accept most insurance. We will make every effort to help you get the most out of your insurance. Our business coordinator can help you with your specific insurance. Click for more information!
Q: Are oral piercings safe?
A: Oral piercings of the tongue, lips or cheek are very popular. There are many risks associated with oral piercings. Anyone considering oral piercings should seriously weigh the benefits and risks.
Oral piercings are usually done without anesthetic. Lip and cheek piercings are done by placing a cork inside the mouth to support the tissue as it is pierced with a needle. A stud or hoop is then placed and healing time ranges from weeks to months. When the tongue is pierced, a needle is used to insert a barbell-shaped piece of jewelry. Healing generally takes four to six weeks.
Serious infections, such as hepatitis B and HIV, can be transmitted if instruments are not properly sterilized. Other risks include:
Pain and bleeding: Major blood vessels in the tongue can lead to prolonged bleeding. Nerves in your tongue and lips can cause severe pain.
Infection: Infections are common because the mouth is full of bacteria. It is possible for the tongue to swell as a result of piercing, which may lead to a compromise in swallowing or breathing.
Dental Problems: Oral jewelry can interfere with x-rays complicating the diagnosis of dental problems. Teeth and fillings can be broken or chipped, and gums can be eroded by oral jewelry. Trauma to the teeth can cause damage to the nerve resulting in the need for root canals and crowns.
Heart Problems: Nearly 1 of 4 patients with congenital heart disease developed a heart infection after body piercing. There are even cases of healthy patients suffering heart damage after oral piercings.
Injury: Jewelry can be swallowed or inhaled into the lungs if they become loose. Surgery may be necessary to recover pieces of the jewelry. It is possible to have permanent numbness in your tongue.
Embarrassment: Increased salivary flow can lead to drooling. Eating, drinking and speech can be negatively affected.
Other Problems: Food may taste different. Bad breath can result from food and plaque building up around the jewelry. Poor quality jewelry can lead to allergic reactions.
Q: What if I still choose to have an oral piercing?
A: Despite the many negative effects some people still choose to pierce their tongue, lips or cheek. Significant lifestyle and hygiene changes are necessary to minimize the chance of infections and other complications.
Following these guidelines are important:
Brush your tongue and irrigate the hole with antiseptic after eating, chewing gum or smoking for the first two months.
Brush your tongue and irrigate the hole with water daily.
Keep jewelry clean.
Regular jewelry cleaners may be toxic.
Rinse with an antimicrobial / antibacterial mouthwash daily.
Know how to remove your jewelry for dental exams and x-rays.
Q: Why is orthodontics needed?
A: Orthodontics (braces) isn't just used to make someone's teeth straighter. They can also improve self-esteem and make it easier to clean teeth, decreasing the potential for cavities and gum disease. Braces are capable of correcting facial form for esthetics and improved speech. An improved bite will make it easier to chew food.
Q: My whole family has dentures. Will I have to get dentures?
A. NO! Decay (cavities) or periodontal (gum) disease are the two major reasons that people get dentures. Both of these causes are preventable or may be treatable if they are taken care of early enough.
Dental decay can be controlled with proper diet, home care, fluoride and restoring (fixing) teeth that already have cavities. Periodontal (gum) disease
can also be treated and maintained with the help of our professional team and your diligent home care.
Q: It doesn’t hurt, why should I fix it?
A: A broken tooth, filling or partial denture leave areas that are rough and tough to keep clean, may leave areas that catch food, or may trap plaque that will all lead to decay (cavities) and / or periodontal (gum) disease. Repairing a broken tooth, filling or partial denture early will usually save money, pain and infection. If you wait until it hurts, in most cases treatment will be more difficult and expensive.
Many people delay treatment because of fear, prior negative experiences or cost. Sedation dentistry
can be a great help with the fear of dental treatment. Improved techniques, anesthetics, sedation dentistry and early intervention can help decrease negative experiences. There are now options that can help make dental treatment fit into your budget so it is more financially affordable for you.
Q: My insurance doesn’t pay for it. What if I want to only do the work that insurance pays for?
A: That choice is yours! Each of us has the freedom to place a different value on our health. Ultimately good health is about personal responsibility.
Dental plans are typically business arrangements between an insurance company and an employer. While an insurance company or other third party may be helpful, be careful. Plans typically only pay a portion of your dental expenses. Dental plans may exclude or discourage certain treatments because of cost, not because they are not needed or poor treatments.
Many times patients ask us to try to explain to the insurance company why a certain treatment option would be better in their case, “maybe they will change their mind and pay for it.” Our business coordinator will always assist you in getting the most from your insurance company. Remember, insurance companies pay based on the contract they have made with the employer. The contract sets forth certain items that will be covered, won’t be covered, and the amounts they will pay.
Most dental insurance maximums are between $1000 - $1500. These have changed very little, if any, since dental insurance was first started in the 1970’s. Dental insurance is not like medical insurance. Medical insurance is most often a “major or catastrophic” coverage; dental insurance on the other hand is not intended for major or catastrophic needs.
Q: What can I do if my treatment isn’t covered by insurance?
A: Insurance generally pays for a certain percentage of treatment up to a yearly maximum. They also have exclusions based on their contract with your employer. In any case, insurance will generally never pay for all treatment.
If you have necessary treatment that is not covered by your insurance, our business coordinator can work with you to help make the remainder of your treatment affordable. Click for more information!
Q: Why doesn’t my insurance pay for this?
A: Insurance companies make their decision to pay or not, based on a contractual agreement with your employer. Insurance companies often make the decision based on what is least expensive, and not necessarily what is “best.” There are several issues you should be familiar with:
UCR (Usual, Customary and Reasonable)
Under a UCR plan, patients are usually free to see whoever they choose for treatment. These plans pay an established percentage of the dentist’s fee or the plan sponsor’s “customary” or “reasonable” fee limit. Although these limits are called “customary” or “reasonable” they may not reflect the fees that dentists in the area charge.
There is no regulation as to how insurance companies determine reimbursement levels and insurance companies are not required to disclose how they determine these levels. The language and lack of regulation can make it difficult to understand reimbursement levels and allow for great variations in those levels.
Your employer makes the final decision on the annual maximum through the contract with the insurance company. Even though the cost of dental treatment has increased over the years, most yearly maximums are $1,000 – 1,500, similar to what they were
in the 1970’s when most dental insurance plans started.
Least Expensive Alternative Treatment
Many dental plans have a provision that they will only pay for the least expensive treatment for a condition. For example, we may recommend a crown to protect a tooth, but your insurance may only allow for a large filling. As with many things in life, the least expensive alternative may not be the best.
Some dental plans do not cover conditions that existed before you were covered. For example, your insurance may say it pays for a bridge, but if the tooth was missing before you were covered on the insurance plan, they may not pay for it. Even though your plan may not cover certain conditions, they may still be necessary.
Many dental plans have certain procedures or treatments that are not covered. Some plans do not cover sealants
that can prevent or reduce problems and save you money later. Dental implants
may not be covered as a matter of cost but may still be the best option for you. We can help you understand the differences in treatment options so you can decide what is best for you.
Our business coordinator will help you understand your insurance to the best of our abilities. It may not be possible for us to predict the level of coverage or specific language of a policy. It is possible that plans offered by the same employer or insurance carrier can be different because of specific contracts involved. It is important to understand that the contract for insurance is between your employer and the insurance company. Patients usually have more influence than our office with their employer and insurance company than we do.
Each of us has the freedom to place a different value on our health. Ultimately good health is about personal responsibility. While an insurance company or other third party may be helpful, be careful. You should make any decisions about what is best for you, in your situation, and based on your budget after you have discussed the options as well as the pro’s and con’s about those options. We are always glad to explain this with you. Some patients have complicated needs and it is best to have this discussion privately at a separate appointment, where we can take the time necessary to explain in detail.
Q: Are you a participating dentist with my plan?
A: If you have a true insurance plan there generally are not “lists of providers.” When an insurance company has a list of providers they have created a PPO (Preferred Provider Organization). Providers agree to reductions in payment in order to see more patients. Since expenses are the same regardless of PPO agreements, it is necessary to significantly increase the number of patients or procedures in the same amount of time. This could lead to working so fast that quality could be compromised.
PPO’s will generally reimburse a different set amount or percentage. Be sure to check what those differences in reimbursement and determine if the quality of care is worth that difference. If your PPO pays at a different percentage, remember they usually don’t pay a different total amount (maximum). This means you will still get the same total amount of benefit when your treatment reaches the yearly maximum. If you have a $1000 yearly maximum you will still get $1000 in benefits, it will just take a little longer to get there.
70% of Tx 80% of Tx
Treatment Plan $1,500 $1,050 $1,200
Yearly Maximum $1,000 $1,000 $1,000
Patient Pays $500 $500
Our office is committed to providing the highest quality of care available for all our patients. Our business coordinator will assist you in receiving the maximum possible amount from your insurance, regardless of what kind of plan you have.
Q: What if I don’t have an insurance?
Q: Why do I need X-rays?
A: X-rays are used to check between the teeth for cavities, check bone for infections or other kinds of abnormalities, find foreign bodies or broken roots or check for quantity of bone for implants. Many patients are concerned about the amount of radiation they get from x-rays. So are we!
We want to assure you that our staff takes a 16-hour training course on radiation safety with hands on training to improve their techniques. In addition, the staff takes yearly continuing education to keep their skills honed and their knowledge up-to-date.
Using conventional x-rays to take a “full mouth series” of x-rays (usually 15-20 films) the amount of radiation you receive would be approximately comparable to being in the sun for 1-2 hours. Most importantly we have invested in the latest technology to reduce the radiation you receive when we have to take x-rays. Our office uses digital x-rays (ScanX system) for both our intra-oral films and extra-oral Panorex films. Digital x-rays can decrease radiation by 80-90%. With conventional x-rays, if a film is not exposed correctly, developing chemicals are old, or films not processed right, it is often necessary to retake the x-ray. Digital x-rays allow us to manipulate the films on the computer if the film is not exactly the way we want it, this minimizes the number of x-rays that must be retaken.
Q: When should I bring my child for their first dental visit? What will you do at that visit?
A: It is recommended that children be seen by a dentist by the age of one to detect potential problems early, and to get the youngster familiar with a dental office. We generally try to make this visit easy and with very little stress. We go as far as the child will reasonably let us. If a child’s first dental visit is due to a dental abscess, toothache, etc. it is likely to be a “loose – loose” situation. Early visits are highly important.
Q: Why are baby teeth important?
A: Baby teeth are important for chewing, speaking, and appearance. Both baby and adult teeth help give the face its shape and form. Baby teeth help hold space for the adult teeth. If a baby tooth is lost too early the adjacent teeth may tip or shift into the space and block the adult tooth. The adult tooth may emerge into an abnormal position or may not be able to erupt at all.
Q: How do I take care of my baby’s teeth?
A: As soon as teeth appear they can get cavities. When teeth appear you should brush them with a baby sized toothbrush and water. At 2 years old you can use fluoride toothpaste. Check the manufacturer’s label as some toothpastes are not recommended for children under 6 years old.
Q: Can I put my baby to bed with a bottle?
A: Severe tooth decay can occur when a baby is put to bed with a bottle, sometimes called “baby bottle tooth decay.” Liquids remain on the teeth for an extended period of time as the baby suckles and falls asleep multiple times a day. Any liquid containing sugar, including milk, breast milk, formula and fruit juice. Infants should finish their bedtime and naptime bottle before going to bed. If you use a pacifier, never dip it in sugar or honey before giving it to your baby.
Q: Is spit tobacco safe?
A: NO! Spit tobacco, smokeless tobacco, snuff, dip or chew are all names for the same costly and ugly form of nicotine. Smokeless tobacco is the term used by the tobacco industry. Remember, Smokeless doesn’t mean harmless!
There are many strong health reasons to avoid smokeless tobacco. If these don’t convince you, consider:
Cost- multiply the amount you spend in one week by 52 weeks!
Dirty, stained teeth that won’t clean up with brushing
Receding gums with tobacco stains on the teeth
Exposed roots that are susceptible to decay (cavities) and often more sensitive to temperatures
Bone loss that can lead to teeth being lost
Leathery white patches, called leukoplakia (loo-ko-play-kia), and red sores are common
Regular use of tobacco, spit tobacco or cigarettes, by people of any age leads to a both physical and psychological dependence. Spit tobacco is known to cause mouth, lip and tongue cancers. Each year, more than 30,000 new cases of oral cancer are diagnosed. Only half of those diagnosed will live five years or more! Are you sure it’s worth it?
Q: Why do I have to take antibiotics before a dental appointment?
A: There are two major reasons to take antibiotics before a dental appointment; heart problems or artificial joints.
Bacterial endocarditis is a serious inflammation of the heart valves or tissues. During dental treatment bacteria gets into the bloodstream and works its way to the heart. In susceptible people bacterial endocarditis can occur. If you get endocarditis, the least that will happen is that you will spend 6 weeks in the hospital!
Certain heart conditions are more often associated with bacterial endocarditis. We need your complete health information to determine if an existing heart condition poses a risk. Make sure you let us know if any of the following conditions applies to you:
- Heart conditions within the last 6 months
- Bypass / vascular surgery within the last 6 months
- Artificial heart valve
- History of rheumatic fever
- Heart murmur of any kind, including mitral valve prolapse
- Previous bacterial endocarditis
- Systemic pulmonary shunt
- Congenital heart defect
- Acquired valvular dysfunction
The American Heart Association routinely publishes guidelines for physicians and dentists to protect their patients at risk of developing bacterial endocarditis. If you have any of the conditions above, or if you were diagnosed with any other kind of heart problem it is important that you inform our staff.
After surgery on the bones or artificial joints it is possible to get an infection. To prevent this infection and prevent damage to the bone and / or artificial joints it is important for susceptible patients to take an antibiotic premedication before any dental appointment.
In most cases your orthopedic surgeon will inform you of the need for this premedication, but please inform us of any kind of bone surgery or artificial joints or pins. This will allow us to determine the need for an antibiotic.