What should I do if I have bad breath?

Bad breath (halitosis) can be an unpleasant and embarrassing condition.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What may cause bad breath?

  • Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
  • Certain foods – Garlic, onions, etc.  Foods containing odor-causing compounds enter the blood stream; they are transferred to the lungs, where they are exhaled.
  • Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
  • Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
  • Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
  • Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
  • Tobacco products – Dry the mouth, causing bad breath.
  • Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
  • Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
  • Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath.  Also, review your current medications, recent surgeries, or illnesses with you dentist.

What can I do to prevent bad breath?

  • Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush.  Floss daily to remove food debris and plaque from in between the teeth and under the gumline.  Brush or use a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months.  If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
  • See your dentist regularly – Get a check-up and cleaning at least twice a year.  If you have or have had periodontal disease, your dentist will recommend more frequent visits.
  • Stop smoking/chewing tobacco – Ask your dentist what they recommend to help break the habit.
  • Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
  • Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor.  Ask your dentist about antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem.

In most cases, your dentist can treat the cause of bad breath.  If it is determined that your mouth is healthy, but bad breath is persistent, your dentist may refer you to your physician to determine the cause of the odor and an appropriate treatment plan.

How often should I brush and floss?

Brushing and flossing help control the plaque and bacteria that cause dental disease.

Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums.  The bacteria in plaque convert certain food particles into acids that cause tooth decay.  Also, if plaque is not removed, it turns into calculus (tartar).  If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.

  • Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
  • Brush the outer, inner, and biting surfaces of each tooth.
  • Use the tip of the brush head to clean the inside front teeth.
  • Brush your tongue to remove bacteria and freshen your breath.

Electric toothbrushes are also recommended.  They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.

FlossingDaily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

  • Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
  • Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
  • Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush.  If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.

How often should I have a dental exam and cleaning?

You should have your teeth checked and cleaned at least twice a year, though your dentist or dental hygienist may recommend more frequent visits.

Regular dental exams and cleaning visits are essential in preventing dental problems and maintaining the health of your teeth and gums.  At these visits, your teeth are cleaned and checked for cavities.  Additionally, there are many other things that are checked and monitored to help detect, prevent, and maintain your dental health.  These include:

  • Medical history review: Knowing the status of any current medical conditions, new medications, and illnesses, gives us insight to your overall health and also your dental health.
  • Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
  • Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
  • Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
  • Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
  • Examination of existing restorations: Check current fillings, crowns, etc.
  • Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for sometime and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line, and can only be removed with special dental instruments.
  • Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
  • Teeth polishing: Removes stain and plaque that is not otherwise removed during toothbrushing and scaling.
  • Oral hygiene recommendations: Review and recommend oral hygiene aids as needed (electric dental toothbrushes, special cleaning aids, fluorides, rinses, etc.).
  • Review dietary habits: Your eating habits play a very important role in your dental health.

As you can see, a good dental exam and cleaning involves quite a lot more than just checking for cavities and polishing your teeth.  We are committed to providing you with the best possible care, and to do so will require regular check-ups and cleanings.

How can I tell if I have gingivitis or periodontitis (gum disease)?

Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.  Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

  • Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
  • Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
  • Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives.  Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
  • Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
  • Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
  • Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis.  Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

  • Red and puffy gums – Gums should never be red or swollen.
  • Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
  • Persistent bad breath – Caused by bacteria in the mouth.
  • New spacing between teeth – Caused by bone loss.
  • Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
  • Pus around the teeth and gums – Sign that there is an infection present.
  • Receding gums – Loss of gum around a tooth.
  • Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

Why is it important to use dental floss?

Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth.  Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.

Daily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums.  Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar).  This will further irritate and inflame the gums and also slowly destroy the bone.  This is the beginning of periodontal disease.

How to floss properly:

  • Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
  • Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
  • Curve the floss into a “C” shape around each tooth and under the gumline.  Gently move the floss up and down, cleaning the side of each tooth.

Floss holders are recommended if you have difficulty using conventional floss.

Daily flossing will help you keep a healthy, beautiful smile for life!

How can cosmetic dentistry help improve the appearance of my smile?

If you’re feeling somewhat self-conscious about your teeth, or just want to improve your smile, cosmetic dental treatments may be the answer to a more beautiful, confident smile.

Cosmetic dentistry has become very popular in the last several years, not only due to the many advances in cosmetic dental procedures and materials available today, but also because patients are becoming more and more focused on improving their overall health.  This includes dental prevention and having a healthier, whiter, more radiant smile.

There are many cosmetic dental procedures available to improve your teeth and enhance your smile.  Depending on your particular needs, cosmetic dental treatments can change your smile dramatically, from restoring a single tooth to having a full mouth make-over.  Ask your dentist how you can improve the health and beauty of your smile with cosmetic dentistry.

Cosmetic Procedures:

Teeth Whitening: Bleaching lightens teeth that have been stained or discolored by age, food, drink, and smoking.  Teeth darkened as a result of injury or taking certain medications can also be bleached, but the effectiveness depends on the degree of staining present.

Composite (tooth-colored) Fillings: Also known as “bonding”, composite fillings are now widely used instead of amalgam (silver) fillings to repair teeth with cavities, and also to replace old defective fillings.  Tooth-colored fillings are also used to repair chipped, broken, or discolored teeth.  This type of filling is also very useful to fill in gaps and to protect sensitive, exposed root surfaces caused by gum recession.

Porcelain Veneers: Veneers are thin custom-made, tooth-colored shells that are bonded onto the fronts of teeth to create a beautiful individual smile.  They can help restore or camouflage damaged, discolored, poorly shaped, or misaligned teeth.  Unlike crowns, veneers require minimal tooth structure to be removed from the surface of the tooth.

Porcelain Crowns (caps): A crown is a tooth-colored, custom-made covering that encases the entire tooth surface restoring it to its original shape and size.  Crowns protect and strengthen teeth that cannot be restored with fillings or other types of restorations.  They are ideal for teeth that have large, fractured or broken fillings and also for those that are badly decayed.

Dental Implants: Dental implants are artificial roots that are surgically placed into the jaw to replace one or more missing teeth.  Porcelain crowns, bridges, and dentures can be made specifically to fit and attach to implants, giving a patient a strong, stable, and durable solution to removable dental appliances.

Orthodontics: Less visible and more effective brackets and wires are making straightening teeth with orthodontics much more appealing to adult patients.  Also, in some cases, teeth may be straightened with custom-made, clear, removable aligners that require no braces.

Thanks to the advances in modern dentistry, cosmetic treatments can make a difference in making your smile shine!

What are porcelain veneers and how can they improve my smile?

Porcelain veneers are very thin shells of tooth-shaped porcelain that are individually crafted to cover the fronts of teeth.  They are very durable and will not stain, making them a very popular solution for those seeking to restore or enhance the beauty of their smile.

Veneers may be used to restore or correct the following dental conditions:

  • Severely discolored or stained teeth
  • Unwanted or uneven spaces
  • Worn or chipped teeth
  • Slight tooth crowding
  • Misshapen teeth
  • Teeth that are too small or large

Getting veneers usually requires two visits.  Veneers are created from an impression (mold) of your teeth that is then sent to a professional dental laboratory where each veneer is custom-made (for shape and color) for your individual smile.

With little or no anesthesia, teeth are prepared by lightly buffing and shaping the front surface of the teeth to allow for the small thickness of veneers.  The veneers are carefully fitted and bonded onto the tooth surface with special bonding cements and occasionally a specialized light may be used to harden and set the bond.

Veneers are an excellent dental treatment that can dramatically improve your teeth and give you a natural, beautiful smile.

What can I do about stained or discolored teeth?

Since teeth whitening has now become the number one aesthetic concern of many patients, there are many products and methods available to achieve a brighter smile.

Professional teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel, and is an ideal way to enhance the beauty of your smile.  Over-the-counter products are also available, but they are much less effective than professional treatments and may not be approved by the American Dental Association (ADA).

As we age, the outer layer of tooth enamel wears away, eventually revealing a darker or yellow shade.  The color of our teeth also comes from the inside of the tooth, which may become darker over time.  Smoking, drinking coffee, tea, and wine may also contribute to tooth discoloration, making our teeth yellow and dull.  Sometimes, teeth can become discolored from taking certain medications as a child, such as tetracycline.  Excessive fluoridation (fluorosis) during tooth development can also cause teeth to become discolored.

It’s important to have your teeth evaluated by your dentist to determine if you’re a good candidate for bleaching.  Occasionally, tetracycline and fluorosis stains are difficult to bleach and your dentist may offer other options, such as veneers or crowns to cover up such stains.  Since teeth whitening only works on natural tooth enamel, it is also important to evaluate replacement of any old fillings, crowns, etc. before bleaching begins.  Once the bleaching is done, your dentist can match the new restorations to the shade of the newly whitened teeth.

Since teeth whitening is not permanent, a touch-up may be needed every several years to keep your smile looking bright.

The most widely used professional teeth whitening systems:

Home teeth whitening systems: At-home products usually come in a gel form that is placed in a custom-fitted mouthguard (tray), created from a mold of your teeth.  The trays are worn either twice a day for approximately 30 minutes, or overnight while you sleep.  It usually takes several weeks to achieve the desired results depending on the degree of staining and the desired level of whitening.

In office teeth whitening: This treatment is done in the dental office and you will see results immediately.  It may require more than one visit, with each visit lasting 30 to 60 minutes.  While your gums are protected, a bleaching solution is applied to the teeth.  A special light may be used to enhance the action of the agent while the teeth are whitened.

Some patients may experience tooth sensitivity after having their teeth whitened.  This sensation is temporary and subsides shortly after you complete the bleaching process, usually within a few days to one week.

Teeth whitening can be very effective and can give you a brighter, whiter, more confident smile!

What are my options if I have missing teeth?

With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth.  When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function.  Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced. Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen.  Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth.  If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.

When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth.  Also, the tooth above or below the open space will start to move toward the open space because there is no opposing tooth to bite on.  These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems.  These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.

Options for replacement of missing teeth:

Removable bridges - This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.

Fixed bridges - This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.

Dentures - This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.

Implants - Are a great way to replace one or more missing teeth. They may also be great to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.

What can be done about old, unattractive, or discolored fillings?

Most of us have fillings in our mouths that date back many years and some may have even been placed during our childhood. These fillings may now be old, dark, and unattractive, making us feel self-conscious when we smile, laugh, and talk. Old fillings are not only unattractive, they may also be defective. When a filling is old, the margins (space between the tooth and filling) may eventually open and allow bacteria and food debris to enter, potentially causing dental decay.

Your dentist can check your fillings and evaluate if they are defective and need replacement. Also, if you simply want to replace fillings that are unattractive, you and your dentist can decide which ones should be replaced first and what replacement options would best suit you. There are many state-of-the-art dental filling materials and procedures available today that are quick, painless, and cost effective for replacing old, unattractive or defective fillings.

Options for replacing old, unattractive, or discolored fillings:

Composite (bonding) fillings - These are tooth-colored fillings that can be closely matched to the color of your existing teeth. They are particularly well suited for use in front teeth or visible parts of teeth and are one of the best ways to improve the health and beauty of your smile.

Crowns (Caps) - These types of restoration are used when a tooth is too damaged and cannot be repaired with a filling or other type of restoration. A crown is a covering that encases the entire tooth surface restoring it to its original shape and size. A crown protects and strengthens the remaining tooth structure and can be made of gold, porcelain, and other tooth-colored materials.

Inlays/Onlays - These restorations are custom made fillings. They can be made of composite resin, porcelain or gold and are made by a dental laboratory and placed by a dentist. Inlays/onlays are usually best for the posterior chewing surfaces of teeth and are utilized to conservatively repair teeth that have large defective/unattractive fillings or have been damaged by decay or trauma.

Porcelain veneers - Used primarily in the front teeth, veneers are very thin shells of tooth-shaped porcelain that are individually crafted and permanently cemented to the front surface of teeth. They are a great solution for fixing discolored, pitted, shipped, malformed, or slightly crooked teeth. Veneers are also used if you have unwanted spaces. Veneers are very durable, natural looking, and do not stain. This makes veneers a very popular solution for restoring a smile impaired by old, unattractive fillings.

As you can see, there are various options for replacing old, unattractive fillings. These treatments will provide strong, natural, and long-lasting replacement solutions to enhance the health and beauty of your smile.

What does heart disease and other medical conditions have to do with periodontal (gum) disease?

Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health.  Periodontal disease is one of the most common infections; often more prevalent than the common cold!  Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!

Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis.  It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth.  The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth.  When periodontal disease is not treated it can eventually lead to tooth loss!

There are numerous studies that have looked into the correlation between gum disease and major medical conditions.  These studies suggest people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections.  Research suggests that periodontal bacteria in the blood stream may:

  • Contribute to the development of heart disease
  • Increase the risk of stroke
  • Compromise the health of those that have diabetes or respiratory diseases
  • Increase a woman’s risk of having a preterm, low-birth weight baby

Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.

To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation.  Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.

Remember….the mouth body connection!  Taking care of your oral health may contribute to your overall medical health!

When are sealants recommended?

Although thorough brushing and flossing remove most food particles and bacteria from easy to reach tooth surfaces, they do not reach the deep grooves on chewing surfaces of teeth. More than 75 percent of dental decay begins in these deep grooves (called pits and fissures). Toothbrush bristles are too large to possibly fit and clean most of these areas. This is where sealants play an important role.

A sealant is a thin plastic coating that covers and protects the chewing surfaces of molars, premolars, and any deep grooves or pits on teeth. Sealant material forms a protective, smooth barrier covering natural depressions and grooves in the teeth, making it much easier to clean and help keep these areas free of decay.

Who may need sealants?

Children and teenagers - As soon as the six-year molars (the first permanent back teeth) appear or any time throughout the cavity prone years of 6-16.

Infants - Baby teeth are occasionally sealed if the teeth have deep grooves and the child is cavity prone.

Adults - Tooth surfaces without decay that have deep grooves or depressions that are difficult to clean.

Sealants are easily applied by your dentist or dental hygienist and the process only takes minutes per tooth. After the chewing surfaces are roughened with an acid solution that helps the sealant adhere to the tooth, the sealant material is “painted” onto the tooth surface, where it hardens and bonds to the teeth. Sometimes a special light will be used to help the sealant material harden.

After sealant treatment, it’s important to avoid chewing on ice cubes, hard candy, popcorn kernels, or any hard or sticky foods. Your sealants will be checked for wear and chipping at your regular dental check-up.

Combined with good home care, a proper diet, and regular dental check-ups, sealants are very effective in helping prevent tooth decay.

What should I do if a tooth is knocked out?

We’re all at risk for having a tooth knocked out.  More than 5 million teeth are knocked out every year!  If we know how to handle this emergency situation, we may be able to actually save the tooth.  Teeth that are knocked out may be possibly reimplanted if we act quickly, yet calmly, and follow these simple steps:

  1. Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
  2. DO NOT scrub or use soap or chemicals to clean the tooth.  If it has dirt or debris on it, rinse it gently with your own saliva or whole milk.  If that is not possible, rinse it very gently with water.
  3. Get to a dentist within 30 minutes. The longer you wait, the less chance there is for successful reimplantation.

Ways to transport the tooth

  • Try to replace the tooth back in its socket immediately.  Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place.  Apply a cold compress to the mouth for pain and swelling as needed.
  • If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk.  You can also place the tooth under your tongue or between your lower lip and gums.  Keep the tooth moist at all times.  Do not transport the tooth in a tissue or cloth.
  • Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit.  The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive and possibly last for many years.  So be prepared, and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

  • Wearing a mouthguard when playing sports
  • Always wearing your seatbelt
  • Avoiding fights
  • Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.

Why straighten teeth?

Straighter teeth perform chewing, biting and speaking functions more effectively than crooked teeth.  In addition, a straight smile boosts confidence, is aesthetically pleasing to look at, and can help stave off a wide variety of dental ailments.

There are several types of malocclusion including overbite, underbite, crossbite, and overcrowding.  Each of these alignment problems negatively impacts the functionality and cosmetic appearance of the teeth.

Here is a brief overview of some of the main disorders associated with crooked teeth:

Periodontitis – Periodontitis or gum disease begins with a bacterial infection.  The bacterial infection is caused by inadequate oral hygiene.  Crooked teeth are hard to clean effectively, which means that debris, plaque and bacteria can build up in hard-to-reach areas.  Straight teeth are much easier to clean and are at less risk of contracting gum disease.

Temporomandibular Disorder (TMJ) - Crooked teeth can lead to improper jaw alignment, which in turn causes a painful condition known as TMJ.  Severe headaches, jaw pain, lockjaw and the grinding of teeth characterize this debilitating disorder.

Tooth injury – Straight teeth creates a strong wall, which means injuries are less likely to occur.  Crooked teeth are weaker and often protrude, making them far more vulnerable to external injury.

Uneven wear – Crooked teeth cause some of the teeth to work harder than others when biting and chewing.  Straight teeth share the workload evenly, meaning less risk of injury and better aesthetics.

Teeth can be straightened using either orthodontic braces or customized aligning trays.  Orthodontic braces are usually affixed to the teeth for a set duration.  The brackets and archwires are tightened regularly by the orthodontist and removed when treatment is complete.  Fixed braces can be placed on the front side or back side of the teeth and are effective for most types of malocclusion.

Aligning trays are fully removable and are used where the malocclusion is less severe, and the teeth need to move a shorter distance.  These trays are replaced every few weeks for the duration of the treatment, and have proven to be equally effective for straightening teeth.

If you have questions about orthodontics and straightening teeth, please ask your orthodontist.

Dental Implants

Do dental implants hurt?

Once placed, dental implants are very comfortable and feel just like natural teeth. During the implant surgery, a local anesthetic will be used to numb the treatment area and you will receive sedation that you won't experience any pain. After the procedure, there will be some discomfort and swelling, which can typically be managed with over-the-counter or prescription medications. Most patient report feeling only minor discomfort after having an implant placed, and it generally passes within a few days.

What are dental implants made out of?

Dental implants are made from titanium, a biocompatible material that fuses directly with bone tissue in your jaw. This makes them incredibly strong and durable for years of use, providing a permanent anchor your for replacement teeth.

How long does it take to get an implant?

The full duration of the implant treatment process depends on many factors, such as the your unique condition and how complex your case may be. On average, it takes 3-6 months from start to finish before you have your new replacement tooth or teeth. The procedure itself typically takes two procedures -- one to place the implant post and one to attach the prosthetic tooth or bridge -- each taking roughly two hours.

What are the pros and cons of getting an implant?

The greatest benefits of getting a dental implant include improved aesthetics, better chewing ability, enhanced oral health due to fewer cavities and gum disease, and increased self-confidence from having beautiful new teeth that look natural! On the other hand, some downsides include higher cost than most other dental restorations (though many insurance companies provide coverage), and longer healing time compared to other restorations. Additional treatments such as bone grafts or sinus lifts might be needed, and individuals with certain medical conditions may not qualify for dental implants.

How long do implants last?

This type of restoration can last upwards of 10-15 years, and even longer in some cases depending upon how thoroughly they were cared for afterward by brushing twice daily with fluoride toothpaste and flossing once per day. Regular checkups should also be scheduled every six months to ensure maximum longevity so that your dentist can catch any signs of wear early on.

Are dental implants covered by insurance?

For many patients, insurance coverage is available depending on your plan’s specifics regarding oral care benefits as well as its deductible amount(s). It is best to check directly with your insurer first before any procedures are scheduled so you know what costs will fall upon yourself vs your insurer beforehand if there is any coverage provided at all.

Do dental implants require special care?

Dental implants don't require special care beyond good oral hygiene practices. Regular brushing, flossing, and dental check-ups are essential to maintain the health of the implant and surrounding teeth.

What if I don't have enough jawbone for implants?

If your jawbone isn't thick enough or is too soft, you may require a bone graft. This procedure involves adding bone or bone-like materials to the jaw to strengthen it for implants.

How do I know if I am eligible for dental implants?

Eligibility for dental implants generally requires good overall health, adequate jawbone density, and healthy gums. A thorough evaluation by your dentist will determine your suitability.

Are there any dietary restrictions after getting dental implants?

After implant surgery, it's recommended to stick to soft foods to protect the implant site during the initial healing period. Gradually, you can return to your normal diet as healing progresses.

Can dental implants be done in one day?

While some cases may allow for "immediate load" implants, most require a healing period before the final restoration. The feasibility of same-day implants depends on individual circumstances and jawbone condition.

How do I care for my dental implants?

Caring for implants involves the same good oral hygiene practices as natural teeth: regular brushing, flossing, and dental check-ups.

What is the success rate of dental implants?

Dental implants have a high success rate, typically above 95%, especially when placed by skilled professionals like Dr. Rosenberg.

Can anyone get dental implants?

Most adults in good general and oral health are candidates for implants. Certain health conditions may require additional considerations.

How long do dental implants last?

Dental implants are designed to be a long-term solution and can last many years, often a lifetime, with proper care.

Are dental implants painful?

With modern anesthesia and sedation options, most patients report minimal discomfort during and after the implant procedure.


How much does Invisalign cost?

The cost of Invisalign treatment depends on the complexity of your case and your treatment plan. Generally, Invisalign is comparable to the cost of traditional braces, though can be slightly higher when considering variables such as the number of aligners used and the length of treatment. We will does all of your payment and financing options make this treatment more affordable.

Is Invisalign covered by insurance?

Insurance coverage for Invisalign treatment varies among providers and policy holders. Some policies may provide full coverage or partially cover the costs associated with Invisalign treatment. It's best to check with your insurance provider prior to beginning any treatment plan so you know exactly what is covered under your policy.

Does Invisalign hurt?

Most patients do not experience pain while wearing their aligners. However, there may be a small amount of discomfort during the first few days as your teeth adjust to the new aligners. Your teeth may also be a bit tender after switching out each aligner due to the pressure placed on them during movement. This should subside after a few days and is normal during the course of treatment.

How long does Invisalign take to straighten my teeth?

The length of time it takes for Invisalign Treatment varies depending on the complexity or severity of each individual case. That said, most cases typically take anywhere from 6-18 months. Every 4-6 weeks, you will receive a new set of aligners that must be worn as directed in order to achieve optimal results within the projected timeline given by your dentist upon consultation.

Why should I choose Invisalign through my dentist instead of a take-home clear aligner company?

Choosing professional dental care over DIY solutions is always recommended when considering any type of orthodontic work. Consulting with an experienced dental professional allows you access to their expertise and knowledge when it comes to selecting the best possible solution for achieving desired results safely and effectively. With your dentist, you will never risk any unwanted side effects from improper alignment or usage instructions that are found with some at-home kits. Professional dentists will also closely monitor your smile throughout each step in treatment to ensure that all goals are achieved.

Can I see the results of Invisalign before I start?

Absolutely! With our 3D imaging technology, you can preview your future smile before beginning treatment.

Will Invisalign affect my speech?

There might be a short adjustment period, but most people adapt quickly without any long-term impact on speech.

How do I care for my Invisalign aligners?

Cleaning your aligners is easy! Brush them gently with toothpaste and rinse in lukewarm water.

Can I eat and drink with Invisalign aligners?

Yes, you can! Just remove your aligners while eating or drinking anything other than water.


Are veneers expensive?

The cost of veneers can vary depending on the type, number and complexity of treatment that is necessary. Generally speaking, composite or porcelain dental veneers are considered an elective cosmetic treatment and are not covered by insurance. Before undergoing any dental work, it is important to discuss your particular case with your dentist in order to understand all associated costs.

What are veneers made out of?

Veneers are typically made out of either porcelain or composite material. Porcelain veneers are made from thin sheets of medical-grade ceramic that is custom-made to fit each individual’s teeth perfectly. Composite veneers, on the other hand, are made out of a resin material that is applied directly onto the patient's teeth in layers. 

How long do veneers last?

If properly taken care of, porcelain veneers can last anywhere from 10 to 20 years before needing replacement. Composite veneers usually last 5 to 7 years before needing replacement. Regular dental checkups should be done every 6 months or so in order to maintain the longevity of your veneer treatment.

Do veneers hurt?

Generally speaking, applying dental veneers does not cause any pain or discomfort as most dentists use a local anesthetic beforehand. After the procedure is completed, you may experience some sensitivity for a few days since a thin enamel layer has been removed in order for the dentist to apply the new layers of material. However this should subside once you adjust to your veneers.

How long does it take to get veneers?

Getting veneer treatment typically takes two separate appointments: one for initial consultation and tooth preparation and another for placement and final adjustments. The preparation appointment usually lasts about an hour and involves reshaping your enamel and taking impressions of your teeth so that custom-made veneers can be fabricated. The placement appointment usually takes about 1-2 hours where the dentist will thoroughly clean your teeth before bonding the new veneer onto them with special cement and then polishing them off for a natural look and feel.

Dental Cleanings

How often should I see the dentist?

The American Dental Association recommends that adults visit their dentist at least twice a year for regular check-ups and professional teeth cleanings. However, depending on your individual oral health needs and risk factors, your dentist may recommend more frequent visits. For instance, if you are at an increased risk of cavities or gum disease or have other oral health issues, you may need to visit the dentist more regularly for evaluations and cleanings.

Are dental cleanings covered by insurance?

Most dental insurance plans will cover all or part of the cost of routine preventive care such as professional teeth cleanings and exams. Additionally, many plans also include coverage for additional treatments such as X-rays or fluoride treatments when necessary. Check with your insurance provider for specific coverage details related to your plan. 

How do dental cleanings work?

During a professional dental cleaning, your hygienist will typically use specialized tools to gently remove plaque and tartar build-up from your teeth and along your gum line. They may also floss between each tooth before polishing them with special instruments that help leave them feeling smooth and looking shiny. In some cases, they might also apply fluoride treatments to strengthen enamel and protect against tooth decay.

When should I take my child to the dentist for the first time?

It’s important to schedule an appointment with a family dentist after their first baby tooth erupts (usually between 6-12 months), so they can begin learning healthy habits that will help ensure lifelong oral health! At this appointment, your child’s dentist will review basic oral hygiene techniques with both you and your child. They will also provide basic preventive care such as examining their mouth for any potential problems like cavities or misalignment of their teeth.

Dental Emergencies

What counts as a dental emergency?

A dental emergency is any situation that requires immediate attention from a dentist. These can include severe toothaches, lost or knocked-out teeth, broken or cracked teeth, swollen gums, abscesses in the mouth, or other trauma to the mouth and jaw. If you are experiencing any of these issues, it’s best to seek emergency care right away.

Do I really need to see a dentist during a dental emergency?

Yes! During a dental emergency it’s imperative that you seek immediate care from a qualified and experienced dentist. While some people may attempt to alleviate their pain with over-the-counter medications (which is not recommended for most emergencies), only an experienced professional will be able to properly diagnose and treat your issue. Additionally, attempting to treat yourself can often lead to further complications, so it’s best to visit an expert immediately if possible.

Can I go to the emergency room if something is wrong with my tooth?

While visiting the ER can provide temporary relief from discomfort and pain associated with your condition, they typically do not have the resources necessary to fully diagnose and treat all types of dental emergencies. Your best bet is always going directly to our office, where we have the specialized training needed to treat these types of issues.

Are dental emergencies expensive?

The cost of treatment for a dental emergency will depend on several factors such as severity of the damage or infection, whether there is underlying health conditions that need addressing, type of materials and/or procedure required for treatment - among other things. Generally speaking however, emergency treatments tend to be more costly than regular services due simply due the expedited nature of appointments and treatments required for most cases. Additionally, some insurance companies may require prior authorization before covering certain treatments. It’s important you speak with our team during your visit. We can provide further information about your specific case prior seeking treatment so you can better understand what costs may be involved ahead of time.

Teeth Whitening

How much does teeth whitening at the dentist cost?

The cost of professional teeth whitening at the dentist will vary depending on the type of treatment you receive. Additionally, if you need additional dental work prior to whitening, such as filling cavities or replacing old crowns, that could increase the cost of treatment. It is best to speak to your dentist about the costs associated with specific types of teeth whitening treatments. Our team will provide you with a complete estimation of all treatment costs, as well as your payment and financing options.

Is teeth whitening safe?

Yes, professional teeth whitening is very safe when it is performed by a qualified and experienced dental professional. However, it is important to note that there are potential side effects that should be discussed with your dentist beforehand. These could include increased sensitivity in your gums and/or tooth enamel due to strong bleaching agents used during treatment; these effects are usually temporary and can often be minimized by using special toothpastes designed for sensitive teeth.

How long does teeth whitening at the dentist take?

The time required for professional teeth whitening at the dentist will depend on several factors including what type of treatment you have chosen and how severely stained your teeth are. LED treatments typically take between 30-45 minutes per session while tray-based treatments may require multiple appointments over a period of weeks or even months depending on your individual needs. Before undergoing any type of professional tooth whitening, it’s important to discuss all available options thoroughly with your dentist so they can provide an accurate timeline for completion.

Does teeth whitening hurt?

While most patients do not experience pain during professional tooth bleaching procedures, some people may notice an increase in sensitivity due to strong bleaching agents being used during treatment. If this occurs it is usually only temporary and can often be managed successfully by using special toothpastes designed for sensitive teeth. However, you should always discuss any concerns regarding pain or discomfort with your dentist before beginning treatment so they can address them accordingly and ensure you have a pleasant experience throughout the process.

How long does teeth whitening last?

The length of time that professional tooth bleaching results will remain visible will depend on several factors such as how often you consume staining foods and drinks (e.g., coffee and red wine), whether you smoke cigarettes, and how well you care for your newly brightened smile (proper brushing and flossing habits will help maintain results). That said, typical results from professionally administered tooth bleaching should last 6-12 months depending on these criteria. It’s always best to speak directly with your dental provider so we can advise you further based on their knowledge of your unique situation.

Can anyone get their teeth whitened?

Teeth whitening is suitable for most adults. However, it's not recommended for children under 16, pregnant women, and people with certain dental conditions.

Are there any side effects to teeth whitening?

Besides temporary sensitivity, some people may experience mild gum irritation. These side effects usually subside shortly after the treatment.

How can I maintain my teeth after whitening?

Maintain good oral hygiene, avoid staining foods and drinks, and consider using a whitening toothpaste. Regular dental check-ups are also important.

Is teeth whitening permanent?

No, teeth whitening is not permanent. To maintain results, you may need to repeat the whitening process periodically.

Can I whiten my teeth at home?

There are over-the-counter teeth whitening products, but for safety and effectiveness, it's recommended to opt for professional teeth whitening services provided by a dentist.

Does teeth whitening cause sensitivity?

Some people may experience temporary teeth sensitivity after whitening treatments. Your dentist can recommend ways to manage or reduce this sensitivity.

Will teeth whitening work on all types of teeth?

Whitening is not effective on all types of teeth. For example, it won't work on dental restorations like crowns or veneers, or on teeth with certain types of discoloration.

How long does the whitening effect last?

The effects of teeth whitening can last from a few months to up to three years, varying from person to person. The longevity is influenced by habits like smoking, and consumption of staining foods and drinks.

How does teeth whitening work?

Teeth whitening involves the application of bleaching agents, like hydrogen peroxide or carbamide peroxide, which break down stains into smaller pieces, making the color less concentrated and your teeth brighter.

Advanced Dental Care of Palm Beach Gardens is here to make you smile.