FAQ

Frequently Asked Questions

Important info

• Can migraines be caused by tooth problems?
• Is a cracked tooth an emergency?
• Is tooth bleaching harmful?

Oral health

• My family has soft teeth, what do I need to do to keep from getting cavities?
• Why are my gums receding?

Home care

• What type of toothpaste should I use?
• What type of toothpaste should my children use?
• How many times a day should I brush?
• What type of toothbrush should I use?

Office care

• At what age should my child start getting cleanings?

Can migraines be caused by tooth problems?

Yes! In fact many people who have migraines are unaware that their teeth are causing the problem. Migraines are a result of tense overworked muscles, and when teeth are positioned incorrectly, the muscles that control the lower jaw must compensate to protect these teeth from hitting together too hard.

A ground-breaking study was done in the 80s that found that as soon as the back teeth are no longer touching, the muscles that close the jaw (including the temporalis – commonly implicated in migraines) can only contract at 1/3 of their full force. This means that a dentist can create a guard that separates the back teeth and prevents tension in these muscles to prevent migraines from occurring.

Is a cracked tooth an emergency?

The answer is: it depends. If the tooth is painful, causing you to wake up in the night or to miss work or school, or hurts constantly, then we recommend coming in as soon as possible.

Other times, a piece of the tooth will break without damaging the nerve tissue inside the tooth. When this happens, often the tooth may be sensitive to cold or it may not be symptomatic at all. For these teeth, we can schedule at your convenience to evaluate for further treatment if necessary.

Is tooth bleaching harmful?

If properly administered, tooth bleaching is generally a safe procedure. Over-bleaching can result in several problems, however, including tooth sensitivity, and damage to the gums, which is usually reversible if the bleaching procedure is stopped. We would be happy to evaluate whether you would be a good candidate for professional tooth bleaching products.

My family has soft teeth, what do I need to do to keep from getting cavities?

The idea of “soft teeth” is somewhat of a myth. Several things contribute to how well a tooth can resist getting a cavity.

1. Having fluoride in the drinking water as a child
   When the fluoride ion is incorporated into the tooth as it develops, it becomes more resistant to acid damage (acid damage is the cause of all cavities, and it comes from several sources – plaque, stomach acid, acidic/citrous drinks and foods). Although you can’t change what happened as a child, you can start to protect your teeth now from the outside-in by making sure you use fluoride toothpaste twice a day, or we can give you a stronger prescription brand toothpaste if you feel you get cavities frequently.
2. Having good saliva flow
   Saliva is an important factor in having a healthy mouth, because saliva is antibacterial, it rinses teeth, helps to digest sugars, and also has minerals which help to strengthen weakened teeth. If your saliva is impaired due to medication or disease (in other words, you have dry-mouth), you will need to be very diligent with oral hygiene and staying away from sugary/sticky foods. Also you can consider using xylitol gum to stimulate more saliva, or use a saliva replacement like Biotene gel or spray.
3. Having a protective enamel layer on the teeth
   Most people have this protective layer of enamel on their teeth. If you lose this layer, the teeth wear away at a rate 7 times faster than before. Some things that can cause this protective layer to be lost include acid erosion (from acid reflux or acidic foods/drinks, etc). Also the enamel may be lost due to wear from improper toothbrushing (see the homecare section below for more information). Another common reason to lose the enamel is grinding the teeth together. Some genetic diseases can cause thin or absent enamel, but these conditions are rare.

Why are my gums receding?

There are several reasons your gums may be receding. We recommend that you come into the office so that we can properly evaluate your particular case.

One cause of gum recession is periodontitis. This is a serious disease caused by bacteria that is on the teeth. The body’s immune system fights the bacteria to keep the infection from spreading harmfully; however, in the process of fighting the bacteria, the bone that supports the teeth is damaged. When the bone is lost, the gums are lost as well, so the teeth appear longer in the mouth. Long term neglect can lead to tooth loss as the teeth completely lose their supporting bone.

Another cause of gum recession is mechanical damage. Mechanical damage often occurs from brushing incorrectly. Your hygienist will be happy to help you learn effective and safe brushing and flossing technique.

What type of toothpaste should I use?

We recommend a toothpaste with fluoride like Colgate or Crest. Fluoride helps remineralize teeth and strengthens them to protect against acid. Acid can come from sodas, tea, citrus fruits, and many other foods, but it also comes from bacteria that live in your mouth and turn the sugars that you eat into acid byproducts.

You can find out if a toothpaste has fluoride by looking on the box and making sure that it mentions “stannous fluoride,” “sodium fluoride,” or “amine fluoride.”

If your teeth are sensitive, look for a toothpaste that contains “strontium chloride” or “potassium nitrate.” Sensodyne is a good choice for sensitive teeth. Also brushing without toothpaste for a few days. If it still does not go away, it may be an indicator of a more severe problem, like a cavity, or a heavy bite.

There are also prescription brand toothpastes for people who are at a high risk for getting cavities. This is determined on a case-by-case basis.

What type of toothpaste should my children use?

For infants without teeth, you do not need to use a toothbrush or toothpaste. Simply wipe their gums with a warm moist cloth.

For young children, use normal toothpaste, but only a very, very small amount (about the size of a grain of rice). Ingesting too much toothpaste can lead to fluoridosis, which can cause chalky discoloration and weakening of their teeth.

How many times a day should I brush?

For most people, we recommend brushing twice a day, once in the morning, and, more importantly for the health of your teeth, right before going to bed. At night, the mouth gets dry, and this makes conditions perfect for cavities to develop. If the teeth are very clean before going to bed, there is less bacteria on the teeth to produce acid and cause tooth decay. Without as much saliva to neutralize the acid and wash away the bacterial colonies, the body has a harder time fighting decay on its own at night, so make sure your teeth are as clean as possible before going to bed. Brushing in the morning can help with bad breath.

Many foods and drinks (sodas, sports drinks, citrus drinks, tea) contain acid, which causes the teeth to become soft. It is best not to brush for at least thirty minutes after consuming acidic foods and drinks, because the outer layer of the teeth is still soft (demineralized) and susceptible to mechanical damage from brushing. Saliva contains minerals that seep back into the soft outer layer of the teeth, hardening them. This process takes about 30 minutes, and at that point it is again safe to brush gently.

What type of toothbrush should I use?

An extra soft bristle brush is the best for your teeth and gums. Electric toothbrushes have soft bristles, so this is also a good choice. Also, gentle brushing with good technique is more effective than vigorous brushing with bad technique. Gentle brushing protects the gums, and does not damage the teeth (yes, even teeth can be damaged by brushing over time!) Try to use less toothpaste and make sure your mouth is moist when brushing to prevent abrasive toothbrush damage.

Flossing is also important!

At what age should my child start getting cleanings?

We recommend bringing your child in for their first cleaning at age three. It is also helpful to bring younger children in so they can get used to the environment before they need treatment.