Q. I've seen advertisements on TV about over the counter teeth whitening products. Do they work?

A. The phrase “your results may vary” comes to mind. The short answer is yes, many can make your teeth lighter, but some don't work at all. The questions with these products are; how well do they work, how long does it take and do they last very long?

Since these products are sold and used without any supervision by a dentist they are of necessity not as strong as whitening gel used in dental offices. This means it will take longer to see results and the results may not last very long.

The other issue with over the counter whiteners is safety. These products do not come with a customized bleaching tray. This may mean that the bleaching gel could come into contact with delicate gum tissue. This can cause pain and redness.

Trays produced in a dental office are specific to your bite and therefore will fit better than other trays. And because dental office bleaching gel is typically three or more times stronger than anything you can get over the counter, the results are better, faster and last much longer.

Q. I have a mouth full of silver amalgam fillings. Amalgams contain mercury. Should I have these removed?

A. Research about mercury in amalgam fillings has to date not shown any concrete data to suggest that amalgams are harmful to your health. However, we find that most people want their fillings replaced with so called “white fillings” because they look much better.

But aside from the cosmetic appeal there are other reasons to consider having your metal fillings replaced. We all know that mercury expands and contracts depending on the temperature. That's why mercury is used in thermometers. Hot or cold foods and liquids entering the mouth can cause the tooth to get weaker and weaker because of the constant expansion and contraction of the filling. This can cause cracks in the tooth. This in turn can make it much easier for bacteria to invade the tooth root. As this continues the chances that you will need a root canal go way up.

Q. I've heard about having your teeth straightened without metal braces. I've had crooked teeth for years. Will this method work for me?

A. You're probably talking about clear aligners. Instead of the traditional metal braces the patient is fitted with a series of clear plastic aligners that rapidly move the teeth into the correct position. With this method we can achieve straight teeth in less than half the time of traditional braces. Since the aligners are clear they are nearly invisible and they can easily be removed for brushing and flossing.

You may be a candidate for clear aligners. Not everyone is. If your teeth are severely crooked you may require metal braces. We can easily determine if clear aligners will work for you.

Q. I've neglected my teeth for years. I'm afraid to go to the dentist because of the pain but I also don't want to be scolded for letting my teeth get so bad.

A. Many patients have the same concern. I can only speak for my practice – we won't belittle you or give you any finger wagging lectures. On the contrary we are very happy to see you! I think you will be amazed at how different things are today. Modern dentistry can be virtually painless and your time in the dental chair is probably less than half of what you experienced as a child. This is definitely not your father's dentistry!

Q. Is there any reason to be concerned about radiation exposure from dental x-rays?

A. The short answer is “no.” The amount of radiation you are exposed to in the dental office is microscopic when compared to what you receive from just being outside. However, we know that some people are still anxious about this so we utilize an amazing new technology that replaces traditional x-rays. It's called digital x-ray and it reduces the already low radiation dose by as much as 80%. Digital x-rays are also much clearer and more accurate than traditional x-rays. Other advantages are you won't have to spend any time waiting while the film develops (because there is no film), your x-rays can be stored in the computer indefinitely and the quality will never deteriorate.

Q. I've heard about a laser than can find cavities that regular x-rays miss. Is this true?

A. Yes. It's called a Laser Scanner. It can “see” through the tooth with much more clarity than an x-ray. It can tell us if there's any decay within the tooth so we can repair it while it's still very small. The Laser Scanner can find problems YEARS before they show up on an x-ray. This will save you time, money and reduce the need for root canals!

Q. My 12 year old son likes to chew ice. Is this harmful?

A. Tooth enamel is very hard but that doesn’t mean you can’t break it.

Try to avoid eating “hard foods” such as popcorn. Don’t crack nut shells with your teeth or chew on ice. Opening packages with your teeth can also damage the enamel.

Q. Why are soft drinks bad for your teeth?

A. Sugar and acids are your teeth’s worst enemies. What are we talking about? Soft drinks, energy drinks, fruit juices, and candy.

Because of the acid content, Mountain Dew seems to be the worst of the worst. Dentists even have a name for the damage it does – they call it “Dew Mouth.”

These soften the tooth enamel, making it highly susceptible to decay. Parents, watch your kid’s consumption of these because young children’s enamel hasn’t developed fully. This makes these drinks even more damaging for kids.

As well as eliminating the above (or at least reducing their consumption), use a sugar-free xylitol chewing gum after meal. Also rinse your mouth with a high quality dental mouthwash.

Q. Tongue piercings seem to be a very bad idea. How bad?

A. Yes, they can look cool but they can also fracture your teeth as well as make it much easier to get a nasty infection of the tongue and lips. Dentists have estimated that up to 40% of people who have metal rings or other oral piercings have had big problems from tooth fractures and infection.

Q. I think I grind my teeth at night. What can I do about this?

A. Do you wake up with pain in your jaws or a persistent headache? If so you may be grinding (called bruxing) while you sleep.

Persistent bruxing can damage teeth and cause them to get shorter and shorter. It can also damage your temporomandibular (jaw) joints and even affect your hearing. If you suspect that you are a bruxer, tell your dentist. He or she may recommend a night guard or other oral appliance.

Q. What’s so bad about losing a tooth?

A. Teeth can be lost due to an accident or other trauma but the most common reason people lose a tooth is because of gum disease and/or decay.

So, is it a big deal to lose a tooth? I mean you can’t die from it, right?

No, you can’t but losing even a single tooth can cause the other teeth to shift and move around – not good. This can affect chewing and your ability to absorb nutrients from your food. Other bad things can happen; your face will change shape, often looking “sunken.” This can make you look much older than you really are. Your speech can be affected. Because it’s harder to chew with missing teeth you may find yourself favoring softer foods and more carbohydrates, which can cause you to gain weight.

The best way to treat a missing tooth (or missing teeth) is with dental implants. An implant can replace one tooth or many. They can be made to look so natural that even a dentist has to look hard to tell the difference.

Q. I’ve read that gum disease can contribute to heart disease and even stroke. Is this true?

A. Yes. Recent medical research has caused many doctors to reach a startling conclusion: gum disease, stroke and heart disease are linked. Since heart disease is usually fatal, it is clear that gum disease is a serious matter.

The American Dental Association estimates that 8 out of 10 Americans have periodontal (gum) disease. If this were any other affliction, such as AIDS or tuberculosis, it would be considered epidemic! Most dentists think it is just that.

They also knew that gum disease would never be labeled epidemic because, “no one ever dies from it.” The worst is that you lose your teeth. Not pleasant - but certainly not life threatening.

But that’s all changed.

The American Academy of Periodontology reports: “studies found periodontal infection may contribute to the development of heart disease, increase the risk of premature, underweight births, and pose a serious threat to people whose health is already compromised due to diabetes and respiratory diseases.”

Periodontal disease is characterized by bacterial infection of the gums. These bacteria can travel into the bloodstream – straight to the heart. Now the Good News

With advanced periodontal disease, the treatment is surgical. Gum surgery is never fun, but it is almost always successful in controlling the condition, and it’s usually covered by common insurance plans.

With mild periodontal disease, there are very effective NON-surgical procedures which, coupled with improved dental hygiene, can virtually halt the spread of the disease. This, too, is usually covered under most dental insurance plans.