|Dental disease will affect all of us at some point in our lives.
Listed below are many common dental problems that our patients have brought to Port Jefferson Dental Group.
We believe you will find this advice useful. If you are experiencing a dental problem or have
any additional questions, please use our online form and we will advise you as to the proper treatment.
||Patients too fearful to go to the dentist.
Educate patients that dentistry has changed
The American Dental Association studies indicate that 50% of the
population in the United States donít see a dentist on a regular basis.
Fear is one of the most common reasons we hear for this lack of care.
Patients often tell us of bad experiences going to the dentist as a child.
Many patients donít realize how much dentistry has changed. First of all,
the anesthetics are much improved,
they act more quickly, last longer, and do a much better job of eliminating all feeling in the tooth. We use a topical anesthetic
to numb the area before the shot, and with smaller and thinner needles,
the shots are virtually painless. Drill techniques have also improved greatly.
While it is still necessary to sometimes use the "drill", they are so much
improved that the drilling time is greatly reduced. Many patients use
tape or CD players with headphones to further relax during a dental
procedure. If a patient says " I hate dentists ", let him or her know how
much dentistry has changed, and is no longer a need for fear.
||Accidental tooth loss by injury
If the tooth is loose, even extremely so, but is still attached in any
way, leave it in place; do not remove it. If it is out of the socket completely and unattached, but is still in
the victimís mouth, it is best to have the person hold it there, if
possible, until a dentist can attempt re-implantation. If it is out of the mouth, do not let it dry out. Handle it as little as
possible. Do not attempt to disinfect the tooth or scrub it, or remove
any tissue attached to it. If it is recovered from the ground or other soiled area, rinse it off in
lukewarm water. Preserve it in milk until a dentist is available. If
milk is not available, lukewarm water will suffice. Time out of the socket is critical in the long term success of
re-implantation. After 30 minutes, the success potential begins to
decline. However, re-implantation is still possible after several hours,
so the attempt can still be made even if the tooth has been out for a
||Dental decay - "cavities"
Prevention through the use of sealants
Fluoride has been a great benefit to patients of all ages in helping
prevent dental decay. Regular brushing and flossing lowers the chance of
developing "cavities". However, the most decay-prone areas of the teeth
are the grooves and depressions on the chewing surfaces of the back teeth
which require further preventive care. To prevent decay, a plastic-like coating called a sealant should be
painted on the chewing surfaces of all the back teeth. Studies have shown
that sealants can reduce tooth decay by as much as 90% to 100%. The
American Dental Association recommends sealants be placed as soon as the
first adult teeth come in at age 6 or 7. Sealants should continue to be
used as each adult back tooth comes into the mouth. All back teeth that
need to be sealed are present by age 13. Sealant application is simple,
fast and painless.
||Gum disease - THE SILENT KILLER OF TEETH
Detecting early symptoms
The American Dental Association says that over 75% of all adults have or
will have some form of gum disease. With statistics like this, it is
important that all health providers are aware of the signs and can make
the proper recommendations to the patient. Gum disease, or more commonly called "periodontal disease", is a bacterial
infection in the gums and supporting structures of the teeth. It can be
divided into several categories.
The first stage is called "gingivitis" and is characterized by gum tissue
that is red, puffy, and bleeds easily when touched with a toothbrush,
floss or dental instrument. The second, third, and fourth stages are initial, moderate, and advanced
"periodontal disease", respectively. These stages are different from
gingivitis because the infection has destroyed the bone supporting the
teeth, causing eventual tooth loss. Additional signs of advanced gum
disease are swelling of the gums, pus oozing around the teeth, bad breath,
receding gums and looseness of the teeth. The treatment is more involved
at these stages, usually consisting of a special cleaning with anesthetic
and sometimes gum surgery.
||Patient concern about AIDS
Modern infection control
A recent survey of dental patients showed that infection control was #1 on
their list of concerns about dental care. Some patients have even stopped
going to the dentist because of their fears. Fortunately, trips to the dentist have never been safer. The case in
Florida where the patient was apparently infected with the AIDS virus by
her dentist is the only such case out of tens of millions of dental
treatments performed since the introduction of the virus. The Center for
Disease Control still does not know the method of infection. Even one case is too many. The dental profession has responded by adopting
"universal precautions". These involve sterilizing all instruments in
dry-heat ovens or steam autoclaves to kill any bacteria or viruses.
Disposable items are used whenever possible. The chance of contracting an
infection in the dental chair is extremely remote, but the chance of
losing oneís teeth because of lack of proper dental care is extremely
likely. We should not let our patientsí unfounded fears lead them into
For over 100 years, dentistry has restored teeth primarily with a material
made of mercury and silver. It has done itís job well, although we have
had to live with itís weaknesses. Those weaknesses consist of cracking
teeth due to the expansion of the material, and restorations turning black
as the silver material corrodes. Now in 1997, we have many ways to provide tooth-colored restorations. We
can use adhesives to bond tooth parts that look and act like teeth. We can
provide a bright, healthy and strong smile with these exciting new
techniques in adhesive dentistry.
||Medications causing dry mouth create an increase in cavities in the
Topical fluoride rinses
Many seniors today have retained their own teeth, avoiding the trauma of
removable dentures. Many are on medications creating dryness of the
mouth as a side effect. Without the natural benefit of saliva to decrease
bacterial action, we see an increase of cavities on the root surfaces of
these patients. Anyone on a medication causing a dry mouth effect should be encouraged to
see their dentist for regular dental cleanings and topical fluoride
||Dental disease associated with pregnancy
A dental evaluation and preventive dental care
Many mothers have experienced gum disease, dental pain and/or tooth
extraction during or shortly after pregnancy. This is often seen as being
a "normal" side effect of being pregnant. Dental disease, which is an
infection of the teeth and/or gums, is not "normal" for any patient.
There are three basic things that happen during pregnancy which make the
patient more susceptible to dental disease. First, hormonal changes may
make the gums more susceptible to gum disease. Second, pregnant women
to eat smaller, more frequent meals, exposing their teeth and gums to
tend sugar and acids more often. Third, the cravings for "junk foods" and
inadequate oral hygiene pose an increased threat to the teeth and gums.
Pregnant women should be advised to schedule a dental evaluation and
receive preventive dental care. Personalized oral hygiene instruction
should also be given to fight disease and promote overall good health for
the mother and her baby.
"Well, you know Doc, itís only a back tooth. No one will see it so Iíll
just get rid of it. Itís not going to make a difference". The plain truth is that it will make a difference. The loss of just a
single tooth can set a course that can destroy the entire mouth. "Well, if
thatís true, tell me more. I sure donít want to lose the front ones that I
smile with". Teeth will drift and tip into a space that is created by missing teeth.
Just like two gears of a car that are not properly aligned, pretty soon
youíve got a whole lot of problems. "Well I donít like that. What can I do?" If it sounds like Iíve heard this
conversation a few times, youíre right. If Iím going to keep a patient
happy, I need to provide options at this point. One of the options would be an implant. This is the replacement of a tooth
with a false root that is surgically placed. It is often followed by the
careful construction of a crown which replaces the missing tooth, to
prevent teeth from shifting and thereby avoiding further tooth loss.
||Bad breath (halitosis)
Dental evaluation and treatment of probable tooth decay and gum disease
While bad breath might be a symptom of some other disorder, it most likely
stems from dental decay and periodontitis (gum disease). Periodontitis is a disease affecting gums and bone that support the teeth,
and it results from inadequate tooth brushing and flossing. In this
disease, the irritated gums pull away from the teeth and form pockets
between the teeth and the gums. These pockets fill with bacteria and pus
and give off a foul odor.
Patients with bad breath should be referred for a complete dental evaluation. If gum disease and/or dental decay is diagnosed, it can be
treated readily. The patient will no longer have an infection in his or
her mouth, and he or she will no longer have the embarrassment of bad